Trapped in Statelessness: Rohingya Refugees in Bangladesh.

The Rohingya people are one of the most ill-treated and persecuted refugee groups in the world, having lived in a realm of statelessness for over six generations, and who are still doing so. In recent years, more than 500,000 Rohingyas fled from Myanmar (Burma) to neighboring countries. This article addresses the Rohingya refugee crisis in Bangladesh, with special emphasis on the living conditions of this vulnerable population. We reviewed several documents on Rohingya refugees, visited a registered refugee camp (Teknaf), collected case reports, and conducted a series of meetings with stakeholders in the Cox's Bazar district of Bangladesh. A total of 33,131 registered Rohingya refugees are living in two registered camps in Cox's Bazar, and up to 80,000 additional refugees are housed in nearby makeshift camps. Overall, the living conditions of Rohingya refugees inside the overcrowded camps remain dismal. Mental health is poor, proper hygiene conditions are lacking, malnutrition is endemic, and physical/sexual abuse is high. A concerted diplomatic effort involving Bangladesh and Myanmar, and international mediators such as the Organization of Islamic Countries and the United Nations, is urgently required to effectively address this complex situation.

Combined pleural fluid cholesterol and total protein in differentiation of exudates and transudates.

BACKGROUND: The management strategy to be adopted in pleural effusion depends on whether an effusion is a transudate or exudate. OBJECTIVE: To evaluate the usefulness of pleural fluid cholesterol and/or total protein measurements for differentiating between exudates and transudates, and to compare it with Light's criteria. METHODS: In this prospective study 60 patients with pleural effusion were included. Pleural fluid total protein, lactate dehydrogenase (LDH) and cholesterol as well as serum total protein and LDH levels along with other investigations were studied. Clinical classification of transudate or exudate was done on the basis of aetiology. RESULTS: Based on clinical signs and symptoms, chest radiograph, other investigations and response to treatment, 49 of these effusions were classified as exudates and 11 as transudates. Using pleural fluid cholesterol levels at a cut-off point of greater than 60 mg/dL and/or total protein at a cut-off point of greater than 3 g/dL for distinguishing transudates and exudates, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), were 100 percent. Using Light's criteria for discriminating transudates and exudates, sensitivity, specificity, PPV and NPV were found to be 98%; 100%; 100% and 92%, respectively. The differences resulted from a mis-classification of one expected exudate as transudate by Light's criteria. CONCLUSION: Pleural fluid cholesterol and total protein are simple, cost-effective, and useful parameters in distinguishing pleural transudates from exudates, with the advantage of requiring only two laboratory determinations and no simultaneous blood sample, compared to the use of Light's criteria.

Pleural tuberculosis presented as multiple pleural masses: An atypical presentation.

Tuberculous involvement of the pleura usually presents as pleural effusion, empyema or pleural thickening. Pleural tuberculosis presenting with multiple masses without parenchymal involvement or lymphadenopathy has been reported rarely in the English literature. We report a case of a 68-year-old male with unilateral pleural tuberculosis presenting as multiple different sized nodular masses evident on computed tomography (CT) of the chest with a large hemorrhagic pleural effusion, which initially raised a possibility of mesothelioma. Pleuroscopy also revealed multiple pleural masses. Pathological examination of the biopsy specimen showed multiple epitheloid cell granulomas confirming the diagnosis.

Partial duplication of the trachea in an adult: an accidental finding on bronchoscopy.

Partial duplication of the trachea is a very rare congenital tracheal anomaly that is detected during infancy. To our knowledge, there are only 3 reported cases of partial duplication of the trachea in the literature, which were all detected during infancy. We are reporting the first case of partial duplication of the trachea in an adult, which was detected accidentally during routine diagnostic bronchoscopy. Partial duplication of the trachea can easily be misdiagnosed as an accessory bronchus or congenital tracheal diverticulum, if it is not carefully evaluated. It is possible that similar cases in the past may have been misdiagnosed as tracheal bronchus or congenital tracheal diverticulum on bronchoscopy.