prevalence of allergic rhinitis and atopic markers in obstructive sleep apnea

Allergic rhinitis [AR] related inflammation might worsen the severity of obstructive sleep apnea [OSA], however, the relationship between the two disorders remains controversial. Our aim was to determine the prevalence of AR and atopic markers in OSA. This cross-sectional study recruited participants with sleeprelated complaints referred to a sleep center from February 2013 to June 2014. The diagnosis of OSA was based on the Berlin questionnaire [BQ] followed by confirmatory polysomnography [PSG]. The diagnosis of AR was made via focused history and clinical examination and was confirmed by measuring atopic markers. OSA was diagnosed in 97 out of 157 adults attending the sleep clinic [61.8%]. There was a high prevalence of AR [52.6%] among OSA individuals. This was not significantly different from the frequency in the non-OSA individuals [p = 0.5]. Elevated total immunoglobulin E [IgE; >100 K/micro L], eosinophil count, and positive Phadiatop tests were found in individuals with OSA to be 37.1%, 11.3%, and 41.2%, respectively. Individuals without OSA have shown similar percentages. In our cohort, there was no significant difference in frequency of AR and atopy among participants with OSA compared to those without OSA

Clinical pattern of tuberculosis among Saudi nationals in the western region of Saudi Arabia

Tuberculosis is a major health problem in Saudi Arabia and developing countries. Understanding the epidemiology of the disease helps in its early identification and prevention. This study was conducted to evaluate the pattern and clinical presentation of Mycobacterium tuberculosis [MTB] among Saudi nationals. We reviewed the clinical and laboratory records of 147 patients with proven cultural diagnosis of MTB attending King Khalid National Guard Hospital [KKNGH], Jeddah, Saudi Arabia between June 1993 and June 1999 and also studied the symptoms and clinical pattern of the disease. Our study demonstrated that MTB affected mainly young adults in their second and third decades. There was no significant difference in the prevalence of the disease between the genders, though slightly more males [75/147, 51%] were affected compared to females [72/147, 49%]. There was a high incidence of extra-pulmonary TB [36.6%], with lymph node involvement being the most common extra-pulmonary site [27%]. Although the most common symptoms were chronic cough [51.7%], fever [46.3%] and weight loss [41.5%], these symptoms seem to occur less frequently in patients with TB than previously reported. There was an alarming high prevalence of drug resistant MTB [15% for isoniazid, 9.5% for rifampicin, 8.2% for pyrazinamide, 15.6% for ethambutol, and 9.5% for multi-drug resistant]. The presence of classical symptoms of MTB [cough, fever, weight loss] was less frequent than expected suggesting atypical presentation of the disease may be more common than what was previously held. There was a high incidence of extra pulmonary TB in our study, lymph node involvement being the most common. Physicians working in Saudi Arabia should be aware of the unusual presentation of the disease. The high prevalence of drug resistant MTB emphasizes the importance of performing culture and sensitivity tests for MTB in all new cases