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Aim: To detect the right ventricular status by echocardiography of COPD patients. Background: Chronic obstructive pulmonary disease is an increasing cause of chronic morbidity and mortality worldwide. Smoking is the major cause and the patients consult with physicians very much late when become complicated. Echocardiography is the main determinant of outcome of COPD patient. We can assess the level of pulmonary hypertension which leads to right heart failure. Methods : This is a cross sectional study. Study place was Department of Medicine, Rangpur Medical College from 1 st July to 30 September 2014.Clinically and post bronchodilator Spiro metrically diagnosed cases were taken. Patients were graded into Mild, Moderate, severe and very severe categories according to GOLD criteria. Statistical analysis was done with echo findings of RV dilatation and hypertrophy by using Chi-square test and statistical significance was taken as p < 0.05 Results : Mean age was 61.50 (sd±9.76) years with male predominance. Mean duration of disease was 6.80 ( sd ± 4.71) years. Patients had a mean duration of smoking of 23.2 ±3.6 pack years. ECG and Echo findings such as RV dilatation, RV hypertrophy and pulmonary hypertension were showed significant correlation with severity and duration of disease. Diagnosis of cor-pulmonale was clinically 20%, ECG 50% and echocardiographically 92%.Conclusion : COPD is more common in males in 5 th to 7 th decade with the smoking history of more than 20 pack years. Most patients have moderate to severe disease at presentation. Echocardiography can detect the RV dysfunction in COPD patient earlier. ECG and Echo findings increase as the severity and duration of the disease increases and echocardiography is better than ECG or clinical methods in detecting RV dysfunction.

Background: Clarithromycin resistance globally has challenged the success of conventional Clarithromycin based triple therapy for Helicobacter Pylori eradication. Levofloxacin has primarily been considered as a second-line treatment but may also be used as primary therapy. Recently, some studies have evaluated its efficacy as a valid alternative to standard antibiotics as first-line therapy for H. pylori infection. This study was intended to assess the eradication success of Levofloxacin based first-line triple therapy and also to see it’s compliance & adverse effect profile. Materials and methods: This non-randomized single-arm clinical trial was carried out in the Department of Gastroenterology, BSMMU from March 2016 to March 2017 involving 123 H. pylori-positive patients with endoscopically proven peptic ulcer disease to assess the eradication success of levofloxacin based first-line triple therapy and also to see its compliance and adverse effect profile. H. pylori status were detected by urea breath test. Patients were treated with amoxycillin 1 gm 12 hourly, levofloxacin 500 mg 12 hourly and omeprazole 20 mg 12 hourly for 14 days and were followed-up at 2 months after completion of therapy for repeat urea breath test. Results: A total of 97 patients returned for followup.  Male proportion was 63.41% and female was 36.58% with the median age of 57 years. On intention-to-treat analysis, the eradication rate of H. pylori was 65.85% and on per-protocol analysis, it was 83.50%. Total 15.44% patients developed adverse effects, all were mild to moderate in nature. One patient discontinued treatment because of epigastric pain and vomiting. Conclusion: Levofloxacin-based therapy was effective, well-tolerated and compliance was excellent; but the eradication rate was not satisfactory.  JCMCTA 2020 ; 31 (1) : 102-107

Congenital myasthenic syndromes (CMS) comprise a heterogeneous group of rare inherited diseases in which the neuromuscular transmission in the motor plate is compromised by one or more genetic pathophysiological specific mechanisms are characterized by fatigable weakness of skeletal muscle (e.g., ocular, bulbar, limb muscles) with onset at or shortly after birth or in early childhood; rarely, symptoms may not manifest until later in childhood. The diagnosis of CMS is based on clinical findings, a decremental EMG response of the compound muscle action potential (CMAP) on low-frequency (2- 3 Hz) stimulation, absence of anti-acetylcholine receptor (AChR) and anti-MuSK antibodies in the serum, a positive response to acetylcholinesterase (AchE) inhibitors and lack of improvement of clinical symptoms with immunosuppressive therapy. Pathogenic variants in one of multiple genes encoding proteins expressed at the neuromuscular junction are currently known to be associated with subtypes of CMS. The most commonly associated genes include: CHAT, CHRNE, COLQ, DOK7, GFPT1 and RAPSN. We studied on a sibling presented with progressive fatigability and fluctuating ptosis with frequent exacerbations of muscle weakness during infections since infancy. On both cases CT scan of chest were negative for thymoma, antibodies against the acetylcholine receptor (AChR) and the muscle specific kinase (MuSK) were negative and decremental response on electrophysiological study of Repetitive nerve stimulation (RNS) and EMG were consistent with disease of neuromuscular junction (post synaptic) and they were only on pyridostigmine for long time with marked improvement of symptoms and signs. Considering all scenario both of our cases mostly fits with the autosomal recessive, post synaptic CMS associated with Rapsyn deficiency. Objective : As in Bangladesh, there is inadequate data on the epidemiological profile of CMS, our aim is to describe these cases for their rarity and the difficulty encountered in diagnosis as they are easily confused with Juvenile Myasthenia Gravis (JMG) and familial myopathies. As both the cases are very rare, it should be an original article. Bangladesh Journal of Neuroscience 2019; Vol. 35 (2): 95-103

PAM is a rare parenchymal Lung disease. Very few case report are available about PAM in Bangladesh. It is diagnosed incidentally during chest radiograph. It is a autosomal recessive disease and is associated with sporadic or familial mutation of SLC 34A2 gene. Many patients are asymptomatic and have either normal or restrictive pulmonary function. Some patients remain static and others progress into pulmonary dysfunction, respiratory failure and corpulmonale. The disease is usually discovered up to 40 years and there is no definitive treatment of this disease. Chest radiograph, HRCT used lung biopsy (transbronchial or open) are the main investigations. This patient come with chest pain and dyspnoea on exertion and nonproductive cough and diagnosed as PAM incidentally during chest radiograph. On the basis of clinical features and laboratory finding, we diagnosed him a case of PAM a very rare condition. As there is no definitive treatment, we treat himsymptomatically.Medicine Today 2015 Vol.27(2): 40-43