Incidence, Risk Factors and Short Term Outcome of Acute Kidney Injury among Patients with Acute Coronary Syndrome

Background: Cardio-renal syndrome is the leading cause of death globally. Acute kidney injury (AKI) is a major complication among patients admitted in Coronary Care Unit (CCU) with acute coronary syndrome (ACS). AKI in ACS patients is associated with higher morbidity, mortality and prolong hospital stay. Objective: To determine the incidence, risk factors and short term outcome of acute kidney injury (AKI) among the patients admitted in CCU with ACS. Methods: This cross sectional study was conducted at Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2013 to December 2013. Following selection criteria a total of two hundred (200) patients with ACS were studied. AKI was defined according to the KDIGO guideline and further categorized by RIFLE criteria. Data of patients with AKI and those without AKI were analyzed and compared by statistical tests. Results: Majority of the study patients were male (79.5%). AKI was developed in 40 of the 200 study patients (20.0%). The mean (±SD) age of the study patients was 60.1 ± 11.1 years in patients with AKI and 55.9 ± 10.1 years in patients without AKI. Our data analysis showed that older age (>65 years), diabetes mellitus, dyslipidemia and smoking were significantly correlated to the development of AKI. Mortality was significantly high in AKI group (7.15%) compared to no AKI group (1.25%). Out of 27 patients who achieved renal recovery most (80.8%) belonged to risk class. Severity of AKI showed significant effect on renal recovery and final outcome. Conclusion: This study demonstrated that, incidence of AKI among patients with ACS was 20%. Elderly patients, diabetes mellitus, dyslipidemia, and exposure to smoking were significantly associated with development of AKI in ACS.

Thyroid Disorders in Women with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is one of the common endocrinopathies of women in the reproductive age group. Thyroid hormones have various effects on the reproductive system of female. PCOS and thyroid dysfunction are linked to each other since several years. Objective: To evaluate and detect the thyroid dysfunction in patients with PCOS attending in a tertiary care hospital in Bangladesh. Methodology: This was a prospective cross sectional study conducted from November 2018 to October 2019 at Department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh on one hundred and fifty (150) PCOS women of reproductive age (15 - 45 years). All data of the study subjects regarding socio-demographic, anthropometric and clinical manifestations were recorded accordingly. Their thyroid function tests (serum level of FT3, FT4, TSH) were done at the hospital laboratory and results were recorded. Result: Mean (±SD) age of the study subjects was 24.57 ± 4.27 years. The maximum numbers [108 (72.0%)] of PCOS women were between 18 - 25 years age group. Among total (150) study population, 51 (34.0%) were overweight, 36 (24.0%) were obese and 63 (42.0%) were within normal weight level. Hirsutism was found in 87 (58%) study subjects while 24 (16%) subjects had acne in their face, 54 (36%) subjects had oligomenorrhea and 45 (30%) subjects had irregular periods. Among 150 PCOS women, 120 (80%) were married and 30 (20%) were single;of them primary infertility was detected in 58 (48.33%) women followed by the normal fertility status [51 (42.5%)] and 11 (9.17%) had secondary infertility. Among total (150) study subjects, 105 (70%) were in euthyroid state, hypothyroidism was found in 33 (22.0%) subjects and hyperthyroidism was detected in 12 (8%) subjects. Conclusions: Present study demonstrated that, thyroid disorders are prevalent in 30.0% of PCOS patients. Hypothyroidism is almost three-fold more prevalent than hyperthyroidism.