Cutaneous Tuberculosis: An Update.

Among extra pulmonary tuberculosis cutaneous tuberculosis occurs rarely, despite a high and increasing prevalence of tuberculosis worldwide particularly in developing countries. Cutaneous tuberculosis can be acquired exogenously or endogenously and present as a diverse of differing clinical morphologies. Diagnosis of these lesions can be difficult, as they resemble many other dermatological conditions that are often primarily considered. Moreover, microbiological confirmation is poor, despite scientific advances, such as the more frequent use of polymerase chain reaction. Furthermore, treatment of cutaneous tuberculosis is also challenging in many cases.

A Community study of obstructive sleep apnea hypopnea syndrome (OSAHS) in middle-aged Bangladeshi population.

Obstructive sleep apnea hypopnea syndrome (OSAHS) is the occurrence of repetitive episodes of complete or partial upper airway obstruction during sleep in association with loud snoring and daytime sleepiness and is a risk factor for hypertension, cardiovascular and cerebrovascular diseases and more. The present study was performed to assess the prevalence as well as the clinical and anthropometric predictors of OSAHS in an urban community of middle aged Bangladeshi population. The study was a cross-sectional, community-based prevalence study which was performed in an urban community in Dhanmondi Thana Pourashava of Dhaka city from July 2007 to June 2008. About 2500 citizens, aged 30-60 years were included in the study. In stage one of the study, they were informed about the polysomnography (PSG) study (stage two of the study) and 2250 of them gave consent. Subjects were then divided into habitual (495) and non-habitual snorers (1755). Among 2250 subjects, the prevalence of obstructive sleep apnea hypopnea (OSAH) in habitual snorers was 48.33% (239/495), and that in non-habitual snorers was 1.66% (29/1755). So, the overall prevalence of OSAH in the screened population was 11.91%, and that of OSAHS was 3.29%. Likewise, the prevalence of OSAH and OSAHS in men were 17.37% and 4.49%, respectively and 6.25% and 2.14% in women. Multivariate analysis revealed that male gender, age, obesity (defined by a high body mass index), waist/hip ratio were significant risk factors for OSAHS. These findings can help us in identifying the prevalence of OSAHS in the community and further planning in the management of obesity and cardiovascular diseases.

Reference values of 6 minutes walk test (6 MWT) in Bangladeshi healthy subjects aged 25-55 years.

INTRODUCTION: The six minute walk test (6MWT) is increasingly accepted worldwide to assess functional exercise capacity of cardiac and pulmonary diseases for its simplicity. AIMS AND OBJECTIVES: The aim of the present study was to provide reference values for 6 Minute Walk Distance (6MWD) and other primary variables such as oxygen saturation (SaO2), pulse rate (PR) and breathlessness perception done in 6MWT. METHODS: We studied a sample of 190 healthy subjects (53 females) of age between 25-55 years (37.9 ± 8.5 years). Baseline lung functions including forced expiratory volume in 1st second (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio were measured by a flow sensing spirometer. All subjects performed 6MWT according to standard protocol provided by the American Thoracic Society (ATS) guidelines. The fatigue and dyspnoea was measured before and after 6MWT by modified Borg scale. The SaO2 and PR were measured also by a light weight pulse oxymeter. RESULTS: The mean 6MWD was 466.7 ± 69.4 meter, ranging from 213 to 659 meter and the mean Distance Work (DW) was 28732 ± 7024 kg-m. Dyspnoea status and oxygen saturation remained unaltered throughout the walk. Mean resting and walking SaO2 values were, respectively, 97.1 ± 1.3% and 96.8 ± 1.5%: The mean change in SaO2 was 3 ± 1.5%. PR was significantly affected by the walk. Mean resting and maximum PR after walking were respectively, 80 ± 7 and 103 ± 12 bpm (p < .01). Gender significantly affected the 6MWD (p < .01). In all subjects, the 6MWD was inversely and directly related, respectively, to age (r = -.15; P < .05) and height (r = .41; P < .01). CONCLUSION: This study showed reference values for the 6MWT variables of subjects in Bangladeshi population.