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Official publication of Indian Chest Society
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2006| October-December | Volume 23 | Issue 4
Online since
January 30, 2009
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REVIEW
Breathing exercises as adjuvant in the management of COPD : An overview
S Kant, GV Singh
October-December 2006, 23(4):165-169
DOI
:10.4103/0970-2113.44394
COPD is the most common chronic lung disease. It is a major cause of chronic morbidity, mortality and health care used throughout the world and resulting in an economic and social burden that is both substantial and increasing also in our country. Pharmacotherapy alone does not optimize and have limited role in improving dyspnea,
exercise
limitation and quality of life which are characteristic and troublesome features of COPD. Breathing exercises are popular among patients, physician and physiotherapist and has been shown to improve efficiency of ventilation and exercise performance. But the efficacy of breathing exercises in relieving dyspnea varies greatly among patients. True values of these techniques have not yet been formally established, though they would seem to have intrinsic merit.
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837
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CASE REPORTS
Massive pleural effusion due to asymptomatic pancreatic disease
RS Bedi
October-December 2006, 23(4):163-164
DOI
:10.4103/0970-2113.44393
A Case of massive haemorrhagic pleural effusion with high amylase levels secondary to asymptomatic pancreatic disease is reported. It is suggested that pleural fluid amylase content should be measured in any case of exudative pleural effusion of unknown aetiology.
[ABSTRACT]
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6,084
418
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ORIGINAL ARTICLES
Role of bronchoalviolar lavage in pulmonary infections
GC Bhatia, N Hemvani, DS Chitnis
October-December 2006, 23(4):147-150
DOI
:10.4103/0970-2113.44388
It was aimed to evaluate the diagnostic utility of bronchoalve Veolar lavage (BAL) from cases of infiltrative diseases of lung admitted at Choithram Hospital & Research Centre, Indore (M.P.) during 2003 to 2004. The analysis included gram's staining, semi quantitative bacterial culture, AFB smear and culture, WBC and differential count and cytology. The gram's staining was found to have 83.6% sensitivity as compared to semi quantitative culture. Colony count >10,000 / ml was considered as significant and 142 specimens yielded single organism while 56 had poly-microbial infections. Gramnegative bacilli like E.coli, Klebsiella spp. and Pseudomonas aeruginosa formed pyogenic infections. The analysis revealed pyogenic infections in 51%, tuberculosis in 21%, fungal infections in 12% and malignancy in 2% cases. Thus, the analysis of BAL specimen is valuable in the diagnosis of infiltrative disorders of lung.
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5,452
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CASE REPORTS
Lung abscess due to pulmonary candidiasis
Prem Prakash Gupta, Dipti Agarwal, R Yadav
October-December 2006, 23(4):160-162
DOI
:10.4103/0970-2113.44392
Here we describe a patient who developed lung abscess caused by Candida albicans. There was no evidence of disseminated/ extrapulmonary candidiasis or any immunodeficiency. However, he was taking high doses of inhaled corticosteroid for chronic airflow obstruction. CT guided percutaneous needle aspiration provided the specimen which confirmed the diagnosis of pulmonary candidiasis. His sputum culture was also positive for Candida albicans. The patient achieved favourable outcome with a 4 weeks treatment with fluconazole. The case is presented here due to unique possible association of pulmonary candidiasis with intake of high doses of inhaled corticosteroids.
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4,417
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EDITORIAL
Asthma - Impact on pregnancy outcome
M Sabir, AK Raghuram
October-December 2006, 23(4):135-137
DOI
:10.4103/0970-2113.44385
[FULL TEXT]
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ORIGINAL ARTICLES
Comparison of the bronchodilatation produced by inhalation of ipratropium bromide and salbutamol sequentially and in fixed dose combination in stable bronchial asthma patients
A Mohan, R Guleria, C Mohan, M Rathi, C Das
October-December 2006, 23(4):138-142
DOI
:10.4103/0970-2113.44386
Objectives
: The combination of a 43-2 agonist and an anticholinergic agent is often used to manage bronchial asthma. However, it is unclear whether these drugs should be given separately in sequence or in a fixed dose combination for maximum effect.
Methods
: 27 patients with stable bronchial asthma were given the above two drugs in two separate sessions one week apart. In one session they were given the above two drugs as a fixed dose combination and in the other session, they were given sequentially with salbutamol following ipratropium after 30 minutes. Spirometry was performed at baseline and 15, 30 and 60 minutes after inhaling the second drug.
Results
: Both groups showed significant improvement in forced vital capacity (FVC), forced expiratory time in one second (FEV
1
), peak expiratory flow rate (PEFR) and forced expiratory flow (FEF
25-75
) from baseline upto one hour. FVC increased initially and then stabilized; however, the increase was more sustained in the group getting combination treatment. This group also showed a higher rise in FEV
1
(p=0.02). Both FEV
1
and FEF
25-75
decreased after 30 minutes in the group that received sequential therapy. PEFR increased continuously till 60 minutes in both groups and there was no significant difference between them (p=0.98).
Interpretation and Conclusion:
Both methods of drug dosing produce equivalent bronchodilation. Fixed dose combinations produced a more sustained rise in FVC and higher increase in FEV
1
. Hence fixed dose combinations are more effective short-term bronchodilators and give an added advantage of reducing the number of inhalers required, thus improving compliance.
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CASE REPORTS
Pneumomediastinum, simultaneous bilateral spontaneous pneumothorax and subcutaneous emphysema following burn
Ramakant Dixit, Hetal Shah, Kalpana Dixit, NJ Shah
October-December 2006, 23(4):154-157
DOI
:10.4103/0970-2113.44390
Simultaneous bilateral spontaneous pneumothorax and pneumomediastinum with subcutaneous emphysema following burn is unreported in the literature. We describe such case in an 18-year-old male patient with possible mechanism of such presentation.
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ORIGINAL ARTICLES
Nutritional status predicts outcome in patients hospitalised with exacerbation of COPD
Jayant Thomas Mathew, GV Veena, Anura V Kurpad, George A D'Souza
October-December 2006, 23(4):143-146
DOI
:10.4103/0970-2113.44387
Nutritional status affects outcome in acute illnesses. Weight loss is associated with poor lung functions and outcome in chronic obstructive pulmonary diseases (COPD). There is not much data on the effects of nutritional status on hospital outcome in patients with acute exacerbation of COPD. This study was conducted to address this issue. Twenty five patients with COPD admitted with acute exacerbation in a tertiary care teaching hospital in Southern India were studied. Lung functions were assessed by spirometry. Nutritional status was assessed using anthropometric measures {body mass index (BMI), mid-arm circumference (MAC), triceps skin-fold thickness (TSF) and fat free mass (FFM)}. Resting energy expenditure (REE) was measured using indirect calorimetry. Hospital outcome was determined by mortality, number of days to improve subjectively and number of days to discharge. Patients with a lower BMI, MAC and TSF took a longer time to recover. REE was found to be lower in patients with weight loss unlike the Western patients. On multivariate analysis, only a lower BMI was associated with a longer time to recovery. Thus, nutritional status is an important predictor of hospital outcome in patients with COPD.
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2,758
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CASE REPORTS
Pericardial hydatid cyst
AB Parihar, BR Maldhure
October-December 2006, 23(4):158-159
DOI
:10.4103/0970-2113.44391
Pericardial cyst are rare anomaly. Hydatid cyst in Pericardium represent only 0.52% of cases of systemic echinococal infection. They are usually unilocular and filled with clear liquid giving rise to term "Spring water cyst," usually do not cause symptoms only noticed because of external compression or rupture into heart. Pericardial cysts are differentiated from other benign development abnormality like benign intrapericardial branching cyst which identified on 2 dimensional echocardiography and computed tomography.
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VIEWPOINT
Operational problems and suggestions for improvement in functioning of DOTS at medical college hospitals in India (Experience of a medical college teacher)
PR Gupta
October-December 2006, 23(4):172-174
DOI
:10.4103/0970-2113.44396
[FULL TEXT]
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1,773
256
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CASE REPORTS
A rare case of primary mediastinal non-seminomatous germ cell carcinoma in a 18 year old boy
S Kundu, S Mandal, A Sengupta, A Dey
October-December 2006, 23(4):151-153
DOI
:10.4103/0970-2113.44389
A 18 year old Hindu boy presented with left sided chest pain, shortness of breath, high fever and swelling of left side of chest and left arm. He was anaemic with features of Superior Venacaval (SVC) Obstruction. CT Scan of Thorax revealed huge heterogeneous anterior mediastinal mass. He had very high level of serum alpha fetoprotein. CT guided Fine Needle Aspiration Cytology (FNAC) gives the diagnosis of Yolk sac tumour . As USG of abdomen and testes were normal, it is a case of primary mediastinal Yolk sac ( Endodermal sinus ) tumour. Although nonseminomatous germ cell tumour is 30-40% more common in Klinefelter's syndrome
[1]
, Karyotyping of this patient was normal.
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CME
Weight loss and skeletal muscle dysfunction in chronic obstructive pulmonary disease
PS Shankar
October-December 2006, 23(4):175-177
DOI
:10.4103/0970-2113.44397
[FULL TEXT]
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1,380
273
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VIEWPOINT
Chemoprophylaxis in sexually transmitted HIV/AIDS lung diseases
K Venu
October-December 2006, 23(4):170-171
DOI
:10.4103/0970-2113.44395
[FULL TEXT]
[PDF]
1,356
205
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