Intra-Cavitary Masses: Rare Presentation of a Common Illness in SAARC Nation.

Cardiovascular tuberculosis (TB) is a relatively uncommon manifestation of Mycobacterium tuberculosis infection. TB can affect all three layers of the heart; endocardial tuberculoma is the rarest form. Endocardial tuberculoma, when it occurs, can easily be confused with other common causes of intracardiac mass lesions, especially in echocardiography. Timely diagnosis and appropriate treatment is essential, as only this can lessen the associated morbidity and mortality. Here, a case of cardiovascular TB has been described in a middle-aged woman from the SAARC nation; the woman presented with simultaneous pericardial constriction and multichamber endocardial tuberculoma. Combined pharmacological and surgical approach was successful.

Hypertension in Bangladesh: a review.

Hypertension (HTN) is an increasingly important medical and public health problem. In Bangladesh, approximately 20% of adult and 40-65% of elderly people suffer from HTN. High incidence of metabolic syndrome, and lifestyle-related factors like obesity, high salt intake, and less physical activity may play important role in the pathophysiology of HTN. The association of angiotensin-converting enzyme (ACE) gene polymorphism and low birth weight with blood pressure has been studied inadequately. Studies have found relationship between mass arsenic poisoning and HTN. Hypovitaminosis D presumably plays role in the aetiopathogenesis of HTN in Bangladeshi population. South Asians appear to respond to antihypertensive therapy in a similar manner to the Whites. The latest National Institute for Health and Clinical Excellence guideline advocates a calcium-channel blocker as step 1 antihypertensive treatment to people aged > 55 years and an ACE inhibitor or a low-cost angiotensin-II receptor blocker for the younger people. Calcium-channel blockers and beta-blockers have been found to be the most commonly prescribed antihypertensive drugs in Bangladesh. Non-adherence to the standard guidelines and irrational drug prescribing are likely to be important. On the other hand, non-adherence to antihypertensive treatment is quite high. At the advent of the new millennium, we are really unaware of our real situation. Large-scale, preferably, nation-wide survey and clinical research are needed to explore the different aspects of HTN in Bangladesh.