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.

Kikuchi-Fujimoto Disease presenting with fever, lymphadenopathy and dysphagia.

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.