not availableFaridpur Med. Coll. J. Jan 2018;13(1): 1

Bronchial Asthma (BA) is a chronic airway disorder with significant morbidity and mortality but due to recent advances in the field of medicine most patients with BA can have complete symptom control and live a normal life. There are various routs of drug delivery for asthma control but among them aerosol inhalation is considered the optimal route. A number of pressured Metered Dose Inhalers (MDI) & Dry Powder Inhalers (DPI) are available for this purpose. However inhalation of therapeutic aerosols is not without difficulty, it requires precise instructions on the inhaler maneuvers, which is different from spontaneous normal breathing. Also, the characteristics of the inhaler device have to be suitable for the user. Available data indicate that, lack of knowledge demonstrated by health professionals & patients on the inhalation maneuvers & handling of inhalers resulting in a reduction of therapeutic benefit. The paper reviews the literature concerning the fundamental aspects of inhaler devices, inhalation maneuvers & device selection, in an attempt to increase the knowledge of and to optimize the clinical use of therapeutic inhalers. As a result of which Asthmatics can be kept under good control. Key words: Bronchial Asthma; MDI; DPI; Inhalation technique; Rotahaler; Cozyhaler. DOI: http://dx.doi.org/10.3329/fmcj.v6i2.9212 FMCJ 2011; 6(2): 104-106

:Asthma is one of the most common chronic medical conditions affecting the lungs during pregnancy. At any given time, up to 8% pregnant women have asthma. During pregnancy, asthma not only affects the woman, but it can also cut back on the oxygen to fetus. But this does not mean that having asthma will make pregnancy more difficult or dangerous to fetus. Pregnant women who have asthma that is properly controlled generally have normal pregnancies with little or no increased risk to pregnant women or their developing babies. Currently available national guidelines for the treatment of asthma during pregnancy emphasize the objective measurement of control, patient education, motivation, caution and medication adherence. The article reviews the available literature highlighting the appropriate selection of medications in the treatment of asthma during pregnancy, and to identify those factors which may influence the asthma care provider's ability to successfully manage this condition, and also illustrate that maintaining asthma control with long term medications in pregnancy is safer than the risk of uncontrolled asthma or untreated exacerbations for both the mother and the fetus. Women's drug treatment during pregnancy should be regularly assessed in the light of asthma control criteria.

Upper GI bleeding is a common medical emergency with a significant mortality, outcome of which depends upon the cause, appropriate and early intervention in a specialized center. This study was carried out to see the outcome of patient with Upper GI haemorrhage. Fifty cases with episode of upper gastrointestinal haemorrhage, admitted into medicine units of Faridpur Medical College Hospital from January 2011 to December 2011, were studied. Duodenal ulcer was the commonest cause of haematemesis and melaena followed by oesophageal varices, gastric ulcer and erosive gastritis. The peak incidence was among 35 to 45 years of age. Over all male female ratio was 4.55:1 but in case of duodenal ulcer it was 9:1. During hospital stay recurrent bleeding was noted in 10% of patients and during subsequent follow up it was 10% of the total and 50% in case of variceal bleeding group. Over all hospital mortality was 4% . DOI: http://dx.doi.org/10.3329/fmcj.v8i1.16891 Faridpur Med. Coll. J. 2013;8(1): 15-17

:Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory condition, the earliest manifestation of which is airway obstruction which is only partially reversible and the treatment rationales are provided accordingly. Research has shown that COPD-inflammation involves multiple inflammatory cells and mediators and the underlying pathology differs from asthma inflammation.For these reasons, therapeutic agents that are effective in asthma patients may not be optimal in COPD patients. COPD exacerbations are intensified inflammatory events compared with stable COPD. The clinical and systemic consequences believed to result from the chronic inflammation observed in COPD, suggest that inflammation intensity is a key factor in COPD and exacerbation severity and frequency. Although inhaled corticosteroids are commonly used and are essential in asthma management, their efficacy in COPD is limited, with only a modest effect at reducing exacerbations. The importance of inflammation in COPD needs to be better understood by clinicians, and the differences in inflammation in COPD versus asthma should be considered carefully to optimize the use of anti-inflammatory agents. Current COPD management focuses predominantly on symptom relief by optimizing bronchodilatation. The role of phosphodiesterase type 4 inhibitors (PDE4), statins, angiotensin converting enzyme inhibitors, theophylline and tumor necrosis factor inhibitors in COPD management will be reviewed. Targeting COPD inflammation with the goal of reducing exacerbations is a major focus of current clinical practice & outcome research.