National Institute of Diseases of the Chest and Hospital (NIDCH) is a state supported research institute and hospital in Bangladesh. It was established in 1955 as TB Hospital. In 1962 it was upgraded as National Chest Diseases Institute.
BACKGROUND:Oral and ocular medications are frequently used in the treatment of allergic rhinitis (AR). As part of the update of the Allergic Rhinitis and its Impact on Asthma (ARIA)-EAACI guidelines, this manuscript presents the ARIA-EAACI 2024-2025 recommendations for oral and ocular treatments. METHODS:The ARIA-EAACI 2024-2025 guideline panel issued recommendations following the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) evidence-to-decision framework. Several sources of evidence were used to inform panel judgements and recommendations, including systematic reviews, mHealth and pharmacovigilance data as well as a survey on costs. RESULTS:Eight guideline questions concerning oral treatments for AR and three questions concerning ocular treatments were addressed. These questions led to the recommendations. Overall, these questions concern the choice between different classes of medication. They also discuss the role of oral antihistamines (OAH), leukotriene receptor antagonists (LTRA), ocular antihistamines (OcAH) and ocular mast cell stabilisers. Four questions had not been previously evaluated in ARIA guidelines, while, for the other four, there was a change in the strength or directionality of the recommendations. Overall, these guidelines recommend using intranasal corticosteroids over OAH and using OAH over LTRA. Moreover, they suggest using OAH over OcAH and suggest being against adding LTRA to OAH. Finally, considerations for choosing between different individual OAHs are presented. CONCLUSION:This ARIA-EAACI 2024-2025 article supports patients, their caregivers and healthcare professionals in choosing oral and ocular treatments for AR. Decisions on treatment should consider the clinical variability of the disease, patients' values and the affordability of medications.
Giant cell tumor of bone (GCTB) is an uncommon, ,usually benign tumor ,which can be locally aggressive. It mostly affects long bone, rib involvement is rare & having multiple rib lesions is very unusual. We report the case of a 47 years old man who presented with chest pain & fever. Initial chest imaging showed opacities along both side of the chest wall. Further tests revealed multifocal GCTB affecting several ribs. Chest Heart J. 2024; 48(2) : 120-123
Background: Flail chest is a severe thoracic injury associated with significant morbidity and mortality. Understanding the clinical profile, outcomes, and risk factors is crucial for effective management. This study aimed to evaluate the clinical conditions, outcomes, and predictors of mortality in patients with flail chest injuries at a tertiary care center. Method: This cross-sectional study was conducted in the Department of Thoracic Surgery, National Institute of Diseases of Chest & Hospital (NIDCH), Dhaka, Bangladesh, from January 2010 to December 2010. This study included 60 patients with flail chest injuries who were admitted at this study institution. Results: The mean age of patients was 39.85 ± 16.3 years, with a majority over 40 years (45%). Males predominated (72%), with a male-to-female ratio of 2.5:1. Central flail chest was the most common type (63.3%), and road traffic accidents were the leading cause of injury (80%). All patients presented with chest pain, while 63.3% had respiratory distress and 25% exhibited cyanosis. The mean number of fractured ribs was 7 ± 1.5. Pneumonia developed in 31.7% of patients, and adult respiratory distress syndrome occurred in 8.3%. The mean hospital stay was 12.2 ± 1.25 days, and the overall mortality rate was 10%. Significant predictors of mortality included age e”60 years (83.3% of non-survivors vs. 7.4% of survivors, p < 0.0001), pneumonia (66.7% vs. 11.1%, p = 0.0006), and requirement for mechanical ventilation (83.3% vs. 5.6%, p < 0.0001). Conclusion: Flail chest is associated with substantial morbidity and mortality. Older age, pneumonia, and mechanical ventilation are significant predictors of mortality, highlighting the need for early recognition and intensive management of high-risk patients. Chest Heart J. 2025; 49(1) : 22-28
Superior vena cava obstruction (SVCO) can cause significant mortality and morbidity. When complicated by stridor it becomes a medical emergency. Among the Non-small cell lung cancer (NSCLC), squamous cell cancer presents most commonly due to its central location, while adenocarcinoma stays as a rare cause of SVCO. We present this case of a 38 years old Bangladeshi male smoker patient who has been diagnosed as a case of adenocarcinoma lung following a history of pain in right chest, arm, hand with swelling of face and neck for 1 month. Following admission, meticulous regular physical examination revealed a right supraclavicular lymph node measuring 2*2 cm that played a vital role in reaching the diagnosis. His CECT scan of chest showed a mass in right upper lobe merging with mediastinum compressing SVC. FNAC from the supraclavicular lymph node revealed metastatic adenocarcinoma. Chest Heart J. 2025; 49(1) : 44-46
Allergic Rhinitis and its Impact on Asthma (ARIA) was, up until 2017, a guideline using the best evidence (Grading of Recommendations, Assessment, Development and Evaluation, GRADE) and developed as a change management strategy. A second change management strategy-in collaboration with the European Academy of Allergy and Clinical Immunology (ARIA-EAACI)-was developed as a person-centred, digitally enabled, artificial intelligence-assisted care (person-centred care) with strong political involvement. The digital tools of ARIA are mainly based on MASK-air, an Organisation for Economic Co-operation and Development (OECD) Best Practice for integrated care for chronic diseases. Artificial intelligence was used, in particular, to approach the patients' views and expectations. The current paper describes the steps to build and achieve a new change management strategy. The future of the Change Management strategy is (i) a collaboration between ARIA and EAACI, (ii) the development of ARIA 2024-2025 guidelines, (iii) the new ARIA-MeDALL classification of multimorbid airway diseases and (iv) embedding MASK-air in a registry for severe allergic diseases. The ultimate goals of the ARIA-EAACI change management strategy will be (i) the transformation of health and care in rhinitis and asthma multimorbidity and (ii) the development of novel guidelines and policies in a cost-effective manner, improving shared-decision-making.
