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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Management of coronary heart disease in Bangladesh- Part 1

Management of coronary heart disease in Bangladesh

 When the president prof. Yajuddin Ahmed was flown to Singapore in a ‘stable’ haemodynamic condition for treatment at the advice of a seven-member board comprised of the leading cardiologist of the country including National Professor Brigadier (retd) Dr. M A Malik known as the pioneer of heart treatment in Bangladesh, Prof Dr. Sufia Rahman, known as the cardiologist introducing interventional cardiology in the country, and Prof KMHS Sirajul Haque, and others-surely the board cold not depend on the quality of the cardiac treatment of the country. Or just they could not take risk, as far as the life of such a dignitary as our president was concerned. The president has been then undergoing treatment at the Combined Military Hospital (CMH), which is one of our few hospital richly equipped with the diagnostic technologies of the disease. In the mount Elizabeth Hospital of Singapore where the president was taken to, what did the doctors do? They followed the usual procedure, as is done in all such cases: they got an angiography of this heart, found one completely and two partially blocked arteries, and quickly overcome those blockages through an open-heart bypass surgery, the most invasive of cardiac interventions. The president come back after a few day, took test and after a prescribed period of time-about three weeks perhaps-joined his office. Now he is living a life with normal work output. The two ex-ministers BNP Secretary General Abdul Mannan and AL General Secretary Abdul Jalil are also heart patients: the farmer had an angioplasty, and the latter had a by-pass and an angioplasty. Abdul Jalil also has a pacemaker in his heart. Both of them went outside the country for their treatment because they could not depend on the standard of our cardiac treatment and also because they could afford to bear the expenditure, like all the rich people who are going to other countries for treatment, mostly to Singapore or Thailand.

What was the case, say, with an average businessman or a government official of a district town who developed heart blockages? The picture  one can imagine: For him reaching Dhaka was all, and for his relative who brought him to the capital, the matter was something to be talked about: we did not wait, we took him to Dhaka somehow we managed to collect the money, at the national Heart Foundation the ‘biggest surgeon’ of the country did the operation, the operation was successful, now he is OK, sitting in his shop, or going to his office. But there are many, unlucky the businessman or ................
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