Pacing in a Woman with Full Term Pregnancy: First Case Report in Bangladesh.

A 19-year-old primigravida was diagnosed to have complete heart block (CHB) during her antenatal checkup at 36 weeks. The patient had history of syncope a few years back. She was referred to the National Institute of Cardiovascular Diseases (NICVD). A temporary pacemaker was implanted at NICVD. She was then referred to Dhaka Medical College Hospital (DMCH), where a baby girl was delivered by cesarean section. A permanent pacemaker was implanted later at NICVD. To our knowledge this is the first case report of pace maker implantation in a pregnant woman from Bangladesh.

Anomalous Origin of Left Coronary Artery from Pulmonary Trunk in an Adult Patient –A Rare Occurrence.

Anomalous origin of coronary arteries is a rare cause of cardiac disease. One of the very rare coronary anomalies is origin of left main coronary artery from pulmonary trunk. Most of these patients die in the first year of life and only 10-15% survive in adulthood. We are reporting a rare case of anomalous origin of left coronary artery from pulmonary artery who survives into sixth decade of life.

Detection of Entamoeba histolytica DNA from liver abscess aspirate using polymerase chain reaction (PCR): a diagnostic tool for amoebic liver abscess.

Amoebic liver abscess is common in Bangladesh. It is usually diagnosed by suggestive clinical features, ultrasound findings and positive serology. However, none of these are definitive and the picture overlaps with pyogenic liver abscess. It is critical to differentiate amoebic liver abscess from pyogenic liver abscess as the treatment are different. This study was designed to evaluate the feasibility of using polymerase chain reaction (PCR) for detection of Entamoeba histolytica (E.histolytica) DNA in liver abscess pus for confirmatory diagnosis of amoebic liver abscess. This study was carried out in the department of Hepatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Thirty patients of amoebic liver abscess were included in this study. PCR was done to detect E.histolytica DNA in liver abscess aspirate of all patients by real time PCR method, using oligonucleotide primer containing small-subunit rRNA gene of E.histolytica. Real time PCR detected E.histolytica in liver abscess aspirate in 29 cases out of 30 cases and the sensitivity was 97% (p<0.001). This study also showed that antigen detection by ELISA in liver abscess aspirate was positive in 12 cases only and sensitivity was 40%. The study indicates that detection of E.histolytica by PCR is more sensitive than amoebic antigen detection and PCR assay can be successfully used to confirm the diagnosis of amoebic liver abscess.