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Background: Early diagnosis of lung cancer plays a vital role in reducing the lung cancer death rate. Different modalities can be applied e.g. radiology, bronchoscopy, bronchoalveolar lavage (BAL), and fine needle aspiration cytology. Cytological diagnostic techniques are safer, economical, and provide quick results. The aim of the study was to find out diagnostic yields of bronchoalveolar lavage in diagnosing lung cancer, and to determine the sensitivity, and specificity of BAL fluid cytology considering the bronchial biopsy as the gold standard.Methods: This cross-sectional study was carried out in the Department of Respiratory Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during the period from November 2018 to March 2020 with a total of 38 participants.Results: 33 (86.84%) patients were male, and 5 (13.16%) were female; the mean age was 58.29±13.11 years. In clinical presentations, cough was present in all 100% of the patients, and some more frequent presentations were shortness of breath in 26 (68.4%), hemoptysis in 24 (63.15%), and chest pain in 21 (55.26%). Majority of the patients (78.95%) were smokers. Considering histopathological findings, maximum patients had squamous cell carcinoma 13 (38.23%), then adenocarcinoma 11 (32.35%), small cell carcinoma 5 (14.70%), large cell carcinoma 3 (8.82%), and poorly differentiated non-small cell carcinoma 2 (5.88%). The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of BAL were 70.59%, 100%, 100%, 28.57%, and 73.68% respectively.Conclusions: BAL fluid cytology is a useful tool for the diagnosis of lung cancer. It has good sensitivity, and specificity, and shows nearly identical information as biopsy.

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.

Background: The most commonly performed surgical procedure in thoracic surgery is Tube thoracostomy. General surgeons, intensivists, emergency physicians, and respiratory physicians may at one time or the other be required to perform tube thoracostomy as a lifesaving procedure. Objective: To observe experience of tube thoracostomy under thoracic surgery unit of BSMMU, Dhaka, Bangladesh. Methodology: This was a prospective, descriptive study conducted at thoracic surgery unit of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Study duration was from 02.12.2018 to 01.10.2021, total 2 years and 10 months. All patients of all age group such as from 2 years of age to 93 years of age those who underwent Tube thoracostomy under thoracic surgery unit were included in the study. All the data were collected for age, sex, occupation, indications of tube thoracostomy, post procedural complications & hospital stay. Results: 250 patients of different pathologies related to chest underwent tube thoracostomy during this period. Mean age was 47.53 years SD± 2.15; minimum age was 2 years and maximum age was 93 years. Among them 173 (69.2%) were male and 77 (30.8%) were female. Male to female ratio was 2.24: 1. Pleural effusion was the most common indication of tube thoracostomy which was in 141 (56.4%) patients followed by pneumothorax 21 (11.6%) patients. Regarding the etiology for tube thoracostomy, it was found that Shows in (Figure 2) Routine 219 cases 87.6% and Emergency 31 cases 12.4% (Due to chest trauma following road traffic accident, during CV catheterization, during lung biopsy), which includes 141 (56.4%) patients of pleural effusion, 29 (11.6%) patients of hydro pneumothorax, and 27 (10.8%) patients of empyema thoracic. Postoperative complications were recognized in 8 patients in shows (Figure 6). It includes Surgical site infection in 5 (2.0%) patients and accidental withdrawal of chest tube by patient himself 3 (1.2%) had dislodged. In 56.0% cases chest drain tube was removed within 7 days (Table 3). Chest drain tube was always given in “Safety triangle”. All cases were done by local anesthesia (2% lignocaine injection). Mean hospital stay was 15.5 days with the range of 2 to 45 days. Conclusion: Chest tube insertion is the first line treatment for variety of life-threatening chest diseases. This is a safe & effective procedure with 3.2% post procedural complications which is comparable to international literature.

This study was carried out in the Respiratory wing, department of Medicine, Bangabandhu Sheikh Mujib Medical University to evaluate the efficacy of spirometric screening for the detection of chronic obstructive pulmonary disease (COPD) in Bangladeshi population. A total number of 400 participants were included in the study [60.50% male and 39.50% female, aged (M+/-SD) 48+/-7.54 years]. Free spirometry was offered to them. Among them 200 were smokers with a smoking duration of 17.07+/-7.50 pack-years and 200 non-smokers. Spirometric screening yielded diagnosis of COPD in 12.50% (50/400); of them 2.75% (11/400) was non-smoker compared to 9.75% (39/400) smoker (x2=17.92, p=0.001) as diagnosed by spirometry following Global Initiative for Chronic Obstructive Lung diseases (GOLD) criteria. Using operational severity criteria adopted from GOLD, mild obstruction was found in 36% (18/50), moderate obstruction in 50% (25/50) and severe obstruction was found in 14% (7/50) of all subjects. The hall mark symptom of COPD, exertional dyspnoea was seen in only 4.3% (17/400) of subjects, nonspecific symptoms like cough and sputum were found in 10% (40/400) and 9.3% (37/400) respectively. Physical signs like abnormal breath sound and rhonchi were found in 3.3% (13/400) and 2.3% (9/400) respectively. Our study observed that spirometry was an effective and easy method for detection of COPD in risk group population like smokers and thus promotes smoking cessation efforts to reduce the burden of COPD in the community.

Kikuchi Fujimoto Disease (KFD) can present with dysphasia, fever and lymphadenopathy. A young Bangladeshi girl presented with fever, cervical lymphadenopathy, dysphasia, weight loss and skin rash. Antitubercular drugs were given on clinical judgement, with no improvement after one month. Later, fine needle aspiration and histopathology of Lymph Node suggested KFD. Computerized Tomography (CT) scan of neck revealed enlarged retropharyngeal lymphnode (LN) causing pharyngeal narrowing. Oral Prednisolone was given showing improvement and no relapse was encountered. KFD may present with dysphasia uncommonly along with fever and lymphadenopathy. Awareness of this disorder by clinicians and pathologists will help prevent misdiagnosis and inappropriate treatment.