Management of coronary heart disease in Bangladesh- part 2

the government official, who could not hope to get there necessary treatment available even in Dhaka.

The picture is that a group of people cannot depend on the heart treatment quality of the country, and they can afford to go elsewhere, and for another getting treatment available in Dhaka is all. And the third one has nothing but to frustrate over their fate. Treatment in a foreign hospital at a cost of huge amount of money cannot assure anyone of recovery and health, especially when the disease is severe.

Going to Bamrungrad Hospital in Bangkok and staying for months there and spending huge amount of money, could not bring back to normalcy the life of former Dhaka city Mayor Shimul, who had suffered a massive heart attact, and he died. The similar is the case is severe. But the expert surgeons of the country are doing bypass surgeries with a few terminal incidents, achieving the international standard in terms of treatment quality of the neighbouring countries. In the last year about 10,000 bypass surgeries were performed in Bangladesh. Beside the traditional bypass Bangladesh surgeons are also successfully doing off-pump beating heart surgery. The bypass attempt in their hands something is also slipping away only when the patient is very old and, as earlier pointed out, the case is severe. But this picture is so everywhere in the world. But it is alleged that sometimes ‘stable’ patients are dying in the hand of our surgeons. If it is true, it is, by the present-day treatment standard of the less-invasive intervention angioplasty-placing of a stent by  squishing the blocked artery with a ballon, thereby increasing blood flow in the heart-is equally some in the country.

Nowadays the cardiologists of the country are successfully placing more than one stent in the heart and their patients are living normal life. Along with the drug treatment ,bypass surgery and angioplasty ,our doctors are also helping  the heart responsible for the coronary heart disease .some cardiac scientists have even convincingly called the heart disease  as the disease of  lifestyle modification that includes a comprehensive diet plan ,exercise ,meditation ,giving up smoking ,etc bypass surgersty are mere  palliative measures in the treatment of the disease .after a few years ,it is seen, the bypasses

And the opened again .thinking over the importance of the lifestyle   modification in preventing and managing the heart disease, all  the heart hospitals of the country should necessarily establish cardiac rehabilitation cells and give life-saving preventing advice to the patients and those who are likely to develop the disease because of there risk factors.

But bypass surgery or angioplasty treatment in the country is centred in Dhaka. The divisional and district towns are yet to provide support of an 

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Pregnancy Initial Screening History-,Pregnancy

Pregnancy Initial Screening History

# Maternal age: Pregnancybelow the age of 17 or above the age of 35 years. Primingravidea above the age of 30 years. Pregnancy is safest between the ages of 2o-29 years. Pregnancy following a long period of infertility and after induction of ovulation.

#Reproductive history: Second and third pregnancies after a normal first delivery carry the low risk.

The high risk factors, in reproductive history are:

# Two or more previous abortions or previous induced abortion. These cases run the risk of further abortion or preterm delivery.

# Previous stillbirth, neonatal death or birth of babies with congenital abnormality.

# previous preterm labour or birth of a small for date baby or, weight of baby 3.5 kg or more.

# Grand multiparty

# Previous Cesarean section or hysterectomy.

# pre-eclampsia, eclampsia

# third stage abnormalities this has a particular tendency to recur.

# previous infant with Rh-isoimmu nisation or ABO incompatibility.

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