Breast tuberculosis in a postmenopausal woman with an insidious manner: a case report

Mammary tissue, skeletal muscle, and spleen are less frequently affected by mycobacterium tuberculosis [TB]. The most common age for breast TB is between 50 and 70. On this article, we are reporting a 72-year-old woman who presented with chronic cough, lobar consolidation in right middle lobe [RML] on the CXR, and a mass in her right breast revealed on the physical examination. Biopsy from the breast lesion showed granulomatous changes and acid fast bacilli were detected by bronchoalveolar lavage. Treatment for TB was begun and the patient showed significant improvement. Based on the patient's age, breast carcinoma was suspected first. Sinus formation was found on her breast ultrasound. This is a common finding and not diagnostic for TB. Our report is a reminder that although breast masses in older women tend to be more malignant, tuberculosis should be considered in differential diagnosis, especially in postmenopausal women. Moreover, breast TB can present with insidious growth without any symptoms

Comparison of the osteoporosis between male smokers with and without chronic obstructive pulmonary disease

Background: Osteoporosis is the most common metabolic bone disease that represents an increasingly serious problem, particularly as the population ages. It occurs because loss of bone mineral content. Osteoporosis, thus, causes significant morbidity, especially in elderly, due to recurrent pathologic fractures. It has been suggested that Chronic Obstructive Pulmonary Disease [COPD] is a risk factor for osteoporosis. We intended to investigate the relationship between COPD and osteoporosis in our patient population

Materials and Methods: Setting: Pulmonary diseases division of Hazrate Rasool-e-Akram hospital. Design: It is a case- control study

Target: One hundred volunteer men with history of at least 20 pack year cigarette smoking were sequentially assigned into two groups: 50 patients with COPD [according to the result of spirometry] and a control group of 50 individuals of matching age

Interventions: All individuals were underwent Bone Mass Densitometry [BMD] by Dual-Energy X-Ray Absorptiometry [DEXA], and Pulmonary Function Testing [PFT]

Statistical Analysis: The data was processed using descriptive statistical analysis and t-test and chi[2] test

Results: The frequency of osteoporosis in our patient and control groups were 52% [26 patients] and 8% [4 persons], respectively. The mean T-score value of spinal bone density in patient and control groups were -1.15 and +0.62 respectively [p <0.0001]. The mean T-score value of femoral bone density was -2.58 in patient group and -0.49 in controls [p <0.0001]. There was a statistically significant correlation between the presence of osteoporosis with both the severity and duration of COPD [p <0.0001]. However, BMD was not correlated with the body mass index [BMI], age or the amount of cigarette smoking. Patients with COPD are 12.5 times more likely than their controls to develop osteoporosis [OR: 12.46, CI 95% = 3.9 - 39.85]

Conclusion: Our study confirms that COPD is a risk factor for osteoporosis. There may be many contributing factors such as immobility, chronic respiratory acidosis and the use of gluccocorticoids. Therefore, prevention of osteoporosis should be a part of medical care for COPD patients