Prevalence of Carotid Artery Stenosis in Patients Undergoing Coronary Artery Bypass Grafting: A Single-Centre Study in Bangladesh

Coronary artery disease (CAD) is one of the important causes of mortality worldwide. South Asians, notably Indians are unduly prone to develop CAD with its incidence being doubled in the last three decades among both rural and urban settlers. CAD prevalence of in Bangladesh is not known. There are merely a limited number of small-scale epidemiological studies are existing. Recent data indicates CAD prevalence in our country to lie between 1.85-3.4% in rural and 19.6% in an urban sample of working professionals. Despite marked disparity in values, the disease seems to be in rising trend. Patients with concomitant CAD and carotid artery disease are at increased risk of developing peri-operative neurological events including stroke. By far, the prevalence of carotid artery disease in candidates of CABG has not yet been determined in our country. There is a lack of pre-operative guidelines as well for the necessary vascular investigations that should be performed on CABG candidates before they go to the operation table. Pre-operative non-invasive carotid Doppler ultrasonography is a useful screening tool for carotid artery disease in all patients undergoing CABG. This was a cross-sectional observational study, was conducted in the Radiology & Imaging department of Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from January 2017 to June 2017. The present cross-sectional study was intended to determine the prevalence of concurrent occurrence of carotid and coronary artery disease in elderly patients undergoing CABG. Total 210 elderly (from 60 & above) patients scheduled for CABG taken as study population. There was bilateral carotid atherosclerotic plaque in 15(12.2%) patients. Right carotid plaque was in 69(56.0%) patients, left carotid plaque in 54(43.9%) patients. Carotid stenosis grading was done in percentage (%). There was significant (>50.0%) stenosis of right carotid system in 12 patients (17.4%) and significant stenosis of left carotid system in 18 patients (33.3%). Right carotid system & bulb was the most common site of plaque formation. We can conclude from this study that a substantial proportion of patients after a particular age possess carotid artery disease simultaneously with coronary artery disease, routine evaluation of carotid arteries of the elderly patients scheduled for CABG is strongly suggested.

Insulinotrophic drugs. Effect on intestinal abosorption of sugar

The effect of some insulinotrophic drugs on the transport of sugar was investigated in fasted, narcotized rats by continuous perfusion of cannulated long intestinal loops with galactose solution (18 mM.) circulated by air lift. Three consecutive perfusions (fifty minutes each) were performed in each rat, the drug being given in the second perfusion only. The rate of galactose disappearance was expressed as per cent of that in the first perfusion in the same rat.

Tolbutamide (50 mg./l kg. weight), glycodiazine (50 mg./l kg. weight), glisoxepid (BAY 4231, 2 mg./l kg. weight) and glibenclamide (0.25 mg./l kg. weight) were found to increase the rate of galactose disappearance in the second perfusion by 21 per cent, 5 per cent, 12 per cent and 25 per cent, respectively, and in the third perfusion by 21 per cent, 26 per cent, 32 per cent and 21 per cent, respectively, as compared to the rate in the corresponding perfusion of a control group. This increase was significant (P values < 0.05) with all drugs in the second and third perfusions with the exception of glisoxepid in the second perfusion. These results are discussed in relation to the action of insulin and the effect of diabetes on intestinal absorption of sugars.