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.Bangladesh Med Res Counc Bull 2014; 40 (2): 70-73

Background: Bangladesh is an endemic zone for re-emerging dengue viral infection since 2000. For the last few years, dengue viral outbreak occurs in the rainy season mostly in Dhaka city and seldom sporadic case finds beyond the Dhaka city of Bangladesh. But this outbreak expands also outside the Dhaka city of Bangladesh in 2019. Therefore, with scarcity of data regarding this field in the peripheral part of Bangladesh, we have designed this study among dengue infected patients in Jashore, Bangladesh. Objectives: This observational study aims to assess the clinical presentations, laboratory findings especially hematological changes and outcomes of patients with dengue viral infection at Jashore district in dengue outbreak-2019 in Bangladesh. Methodology: This was an observational study, carried out from 25thApril 2019 to 5thSeptember 2019 during dengue outbreak season in Jashore, Bangladesh. Patients were selected from outpatient department and indoor of a local private hospital in Jashore, Bangladesh who had given informed written consent to participate in our study. Result: Total eligible 77 patients were included in this study. Out of which 70 patients (90.9%) were dengue NS1 antigen Positive on Immunochromatography (ICT) and the rest were anti-dengue IgM antibody positive on ICT method. Around 74 (96.1%) patients had fever as the most common feature in dengue infection. Eighty-seven percentages (87%) of patients had history of headache. Other striking complaints were body ache (66.2%), back pain (51.9%), nausea (55.8%), vomiting (31.2%), anorexia (27.3%), arthralgia (29.9%) and retro-orbital pain (26.0%). Sore throat being a common feature in flu-like illness also found in 18.2% cases. Mean total count of whole blood count (WBC) falls on day 5 (5.76 X 109/L) and then gradually increased. Mean platelet count of study patient was normal throughout the course of the disease process. But, in some cases minimum platelets was found 21 X 109/L at the time of presentation and on day 5 and day 6 which was dropped down to 17 X 109/L. Mean Haematocrit (%) was more or less in a steady state throughout the acute phage of the disease. But, in some cases throughout the hospital stay minimum haematocrit was less than 30% and initially in some cases maximum haematocrit was more than 50% among some dengue infected patients. Total 67 (87%) subjects with dengue viral infection required hospital admission and mean hospital stay was 4 days with a standard deviation (SD) was ±2 days. Blood transfusion was required in only one patient. Around 95% patient was recovered and only 4 cases were referred to the higher centre further better management. Regarding complications, we had found diarrhoea in 9(11.7%) and bleeding disorder in 14.3% patients. Conclusion: In our study, the most common clinical presentations were fever, headache, body-ache, back pain, and gastrointestinal upset. The mean hematological started dropping down from 4th day and gradually improved after 7th day. Some patients developed diarrhea, bleeding disorders and hepatitis as complications during their disease process. We observed a good clinical outcome evident by without having severity and death toll among our study participants. There was very seldom requirement of blood and blood product transfusion in our study. J MEDICINE JAN 2021; 22 (1) : 33-40

Pulmonary fibrosis is becoming a recognized complication of coronavirus disease 2019 (COVID-19). Patients with pulmonary fibrosis may present with dry cough, shortness of breath, nail clubbing, low oxygen saturation. We report a case of a 40-year-old male patient with pulmonary fibrosis due to COVID- 19. Clinical examination showed that the patient was dyspneic with low oxygen saturation and there was bilateral inspiratory crepitation in the lower part of his chest. High resolution computed tomography showed bilateral multifocal patchy ground-glass opacities, consolidation with peripheral and basal distribution, sub-pleural fibrotic bands and vascular thickening (almost 40-45% of parenchymal involvement). We prescribed him an antifibrotic drug, nintedanib and there was a significant clinical and radiological improvement after 15 days of treatment. Nintedanib may have novel therapeutic role in preventing COVID-19 associated fibrosis. Birdem Med J 2021; 11(2): 148-152

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.

Atypical presentations may be presented with the common symptoms in Dengue. We, hereby, present a case of Dengue who was admitted in our hospital with the complaints of fever, upper abdominal pain, and vomiting, literally diagnosed as a case of acute pancreatitis.

This cross-sectional study was conducted to determine the serum lipid profiles in chronic obstructive pulmonary disease (COPD) patients and its correlation with the severity of COPD in the Department of Respiratory Medicine at Bangabandhu Sheikh Mujib Medical University. A total of 100 spirometric-confirmed cases of COPD were included. Fasting blood samples for lipid profiles were collected. To identify the association between severity of COPD with lipid profiles Pearson’s correlation was used. Further multiple linear regression was done to identify the relation. The mean (standard deviation) age of the patients was 59.0 (10.7)years. The ratio of males and females was 19:1. The mean forced expiratory volume (liters) in 1 second (FEV1) was 55.1 (18.1). Most of the patients had stage II (48%) and stage III (36%) airflow obstruction. Plasma level of total cholesterol and triglyceride tend to increase, statistically non-significant, with stages of COPD. However, the association of plasma lipids becomes statistically significant with FEV1 when the effects of age, BMI, pack-year smoking, duration of illness are accounted in multiple linear regression analysis. Bangabandhu Sheikh Mujib Medical University Journal 2022;15(4):37-41

Miliary tuberculosis (MTB) is a rare, disseminated, and active form of tuberculosis caused by Mycobacterium tuberculosis bacilli. It is mostly seen in immune-compromised patients but is sometimes reported in immune-competent hosts. We reported a 40-year-old immune-competent patient who presented with pyrexia of unknown origin.

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.