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2010| July-September | Volume 27 | Issue 3
Online since
August 10, 2010
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CASE REPORTS
Three cases of ARDS: An emerging complication of
Plasmodium vivax
malaria
Supriya Sarkar, Kaushik Saha, Chandra Sekhar Das
July-September 2010, 27(3):154-157
DOI
:10.4103/0970-2113.68323
PMID
:20931035
Plasmodium (P.) vivax
malaria is rarely associated with severe complications like acute respiratory distress syndrome (ARDS). We report three cases of ARDS, which occurred as a complication of vivax malaria, from the city of Kolkata. A middle aged man who developed ARDS along with hepatic and renal dysfunction on the day 7 after completion of antimalarial treatment; a 36-year-old man who developed ARDS on the day 5 after completion of antimalarial treatment and a 15-year-old boy who developed ARDS on day 2, before starting anti-malarial drug. In all cases, vivax malaria was diagnosed by peripheral blood film (PBF) examination. Associated
falciparum
infection was excluded by repeated PBF examination, and by negative
P. falciparum
malaria antigen tests. In all cases, ARDS was diagnosed by the presence of hypoxia with PaO
2
/ FiO
2
ratio < 200 and bilateral pulmonary infiltration, and by excluding cardiac disease by echocardiography. All cases typically had dramatic onset of ARDS, and required immediate (within hour of onset of dyspnea) institution of mechanical ventilation with high positive end expiratory pressure. All three cases recovered completely, and early ventilator support was life-saving.
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ORIGINAL ARTICLES
Lung cancer in the Kashmir valley
Parvaiz A Koul, Satish Kumar Kaul, Mohammad Mushtaq Sheikh, Reyaz A Tasleem, Azra Shah
July-September 2010, 27(3):131-137
DOI
:10.4103/0970-2113.68309
PMID
:20931030
Background:
Lung cancer has been found to be the second commonest cancer according to a hospital-based data from Kashmir, India. However, no incidence studies are available.
Objective:
To ascertain the incidence of lung cancer in Kashmir.
Materials and Methods:
All newly histologically diagnosed cases of lung cancer seen in various hospital and private laboratories of the Kashmir valley were registered over a period of two years (January 1, 2004 to December 31, 2005). Also included were patients attending the various oncological service areas of the institute and those diagnosed from any other laboratory outside the state. The incidence rate was calculated using the January 2005 population as the reference population estimated using the census-based projected populations.
Results:
Four hundred and sixty-two incident cases of lung cancer were seen during the study period. The crude incidence rate, age standardized (world) and truncated age adjusted (40-69 years, world) incidence rates for lung cancer per 100 000 population were 4.01, 6.48 and 15.28 respectively (males 6.55, 10.09 and 23.94 respectively and females 1.19, 2.14 and 4.65). The age adjusted rates for males in district Srinagar was 19.34 per 100 000. One hundred and fifty nine (69.8%) of the 221 had a history of Hukkah smoking.
Conclusions:
Even though Kashmir as a whole is a low incidence area for lung cancer (ASR of < 15), Srinagar district has the highest incidence of lung cancer among the males in Kashmir. The data presented is assumed to be the closest approximation to a population-based data registry and the geographical incidence maps of ICMR need appropriate updating
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CASE REPORTS
Primary adenoid cystic carcinoma of trachea presenting as midline neck swelling and mimicking thyroid tumor: A case report and review of literature
Paras Nuwal, Ramakant Dixit, Anand K Singhal
July-September 2010, 27(3):167-169
DOI
:10.4103/0970-2113.68330
PMID
:20931039
We report an extremely rare case of primary adenoid cystic carcinoma (ACC) trachea presenting as midline swelling neck and mimicking thyroid tumor. A 44-year-old female presented with painless midline swelling neck without any respiratory complaints, hoarseness of voice or dysphagia etc. Fine needle aspiration cytology (FNAC) from swelling reveal features of papillary carcinoma thyroid. Subsequently the operative findings, bronchoscopy and histological diagnosis of excised mass, along with review of FNAC, revealed features of ACC of trachea with exra tracheal extension anteriorly into the soft tissue neck, without actual invasion of the thyroid gland. The world literature on extension of an ACC arising in the laryngotracheal complex to thyroid or soft tissue neck and clinical manifestation as a thyroid nodule or mass is reviewed. The cytological differential diagnosis of ACC and CT findings are also briefly discussed.
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ORIGINAL ARTICLES
Non-invasive ventilation for acute exacerbation of COPD with very high PaCO
2
: A randomized controlled trial
Gopi C Khilnani, Nripen Saikia, Amit Banga, Surendra K Sharma
July-September 2010, 27(3):125-130
DOI
:10.4103/0970-2113.68308
PMID
:20931029
Objective:
To assess the role of non-invasive positive pressure ventilation (NIPPV) for management of Indian patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
Materials and Methods:
Forty patients (mean age 57.6 ± 10.8 years; M:F 31:9) with AECOPD with pH <7.35, admitted to the intensive care unit were included. Patients were randomized to receive NIPPV (N, n = 20) with conventional therapy or conventional therapy (C, n = 20) alone at admission. NIPPV was given through the nasal mask. Incidence of need of endotracheal intubation (ETI) was the primary efficacy variable. Hospital mortality, duration of hospital stay and change in clinical and blood gas parameters were the secondary outcome variables.
Results:
Mean pH at baseline for N and C groups were similar (7.23 ± 0.07) whereas PaCO
2
was 85.4 ± 14.8 and 81.1 ± 11.6 mm of Hg, respectively. At one hour, patients in N group had greater improvement in pH (
P
= 0.017) as well as PaCO
2
(P = 0.04) which corroborated with clinical improvement. Whereas need of ETI was reduced in patients who received NIPPV (3/20 vs 12/20,
P
= 0.003), in-hospital mortality was similar (3/20 and 2/20, P = NS). The mean duration of hospital stay was significantly shorter in N group (9.4 ± 4.3 days) as compared to C group (17.8 ± 2.6 days);
P
= 0.001.
Conclusions:
In patients with AECOPD, NIPPV leads to rapid improvement in blood gas parameters and reduces the need for ETI
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Evaluation of serum immunoglobulin E levels in bronchial asthma
Thirunavukkarasu Sandeep, Mysore Subrahmanyam Roopakala, Chickballapur Rayappa Wilma Delphine Silvia, Srikantaiah Chandrashekara, Mohan Rao
July-September 2010, 27(3):138-140
DOI
:10.4103/0970-2113.68312
PMID
:20931031
Background:
Immunoglobulin E and associated cellular responses are responsible for allergic airway diseases. A hypersensitivity reaction initiated by immunologic mechanisms, mediated by IgE antibodies occurs in allergic asthma
Aim:
To estimate and compare serum IgE levels in mild, moderate, and severe asthmatics and in normal subjects and to obtain a mathematical model describing the relationship between serum IgE levels and severity of asthma.
Materials and Methods:
A stratified sample of 60 patients within age group of 18-60 years and 31 male and 29 female asthmatic patients and 13 healthy controls within 18-60 years were included in this study and classified according to GINA classification. Serum IgE levels were estimated by using ELISA kit.
Results:
Mean IgE levels ranged from 151.95 IU/ml in normal subjects to 1045.32 IU/ml in severe asthmatics. The model developed was 27% efficient.
Conclusion:
Serum Immunoglobulin E levels were high in asthmatics as compared to normal subjects. On an average, the levels increased as the severity of asthma increased. However, there was no statistically significant correlation since the variability in each level of asthma was very large
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CASE REPORTS
Non-small cell lung carcinoma presenting as carcinomatous meningitis
AR Paramez, Ramakant Dixit, Neeraj Gupta, Rakesh Gupta, Manoj Arya
July-September 2010, 27(3):158-160
DOI
:10.4103/0970-2113.68324
PMID
:20931036
Meningeal carcinomatosis is a diffuse infiltration of leptomeninges and sub arachnoid space by malignant cells metastasizing from systemic cancer. Primary bronchogenic carcinoma presenting as carcinomatous meningitis is a very rare occurrence in clinical practice, often occurring during the treatment course of the underlying malignancy. We present this rare presentation in a young non-smoker male.
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ORIGINAL ARTICLES
Outcomes of category III and I in immunocompetent patients of tuberculous lymphadenopathy treated in revised national tuberculosis control programme
Nageen Kumar Jain, Ashok Bajpai, Shikha Jain
July-September 2010, 27(3):115-117
DOI
:10.4103/0970-2113.68305
PMID
:20931026
Background:
Retrospective observation analysis to evaluate the outcome of six month treatment regimen, CAT-III and CAT-I, for all patients diagnosed with tubercular lymphadenopathy at M.G.M. Medical College and M.Y. Hospital, Indore, India from January 2006 to December 2008.
Materials and Methods:
Out of 3158 cases of tuberculosis, there were 337 (10.67%) lymphnode cases; 31 (9.19%) HIV positive and 11(3.26 %) defaulters were excluded from the study. Of the remaining 295 cases of lymphadenopathy enrolled, 240 were on CAT-III and 55 cases of complicated lymphadenopathy were on CAT-I. All patients were followed for six months, to monitor response and complications. Patients with abscess formation or sinus formation underwent aspiration, AFB smear and culture sensitivity. In patients with persistent lymphadenopathy, repeat FNAC of the gland and in cases of hard lymphnode excision biopsy was done before receiving re-treatment regimen category -II or reserved drugs.
Result:
Out of 295 patients, 212 (71.86%) responded to treatment, however, 83 (28.14%) did not show response at the end of treatment. Of the 83 patients, 54 (65.06%) responded to re-treatment regimen CAT-II, while 29 (34.93%) were found to be drug resistant and were given second line anti tubercular drugs. In the follow-up at six months and later after the end of treatment, 11 (5.18%) relapse was seen.
Conclusion:
In our study, success rate of currently recommended regimens, category III and I under the revised national tuberculosis control programme in tubercular lymphadenopathy was 71.86%; with 28.34% of patients requiring re-treatment regimen. This requires a lager study involving more number of patients to prove adequacy of regimen.
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CASE REPORTS
Silicosis with bilateral spontaneous pneumothorax
Sanjay Fotedar, Dhruva Chaudhary, Vikas Singhla, Rajat Narang
July-September 2010, 27(3):173-175
DOI
:10.4103/0970-2113.68325
PMID
:20931041
Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax.The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.
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Cleidocranial dysplasia
Ramakant Dixit, Kalpana Dixit, AR Paramez
July-September 2010, 27(3):176-177
DOI
:10.4103/0970-2113.68322
PMID
:20931042
Cleidocranial dysplasia is a rare autosomal dominant condition with generalized dysplasia of bone, characterized by delayed closer of cranial sutures, hypoplastic or aplastic clavicles, short stature, dental abnormalities and a variety of other skeletal abnormalities. We present a seven-year-old female child presenting with classical features of cleidocranial dysplasia.
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6,250
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Erythema nodosum: Atypical presentation of common disease
Jagdeep Whig, Vineet Mahajan, Anil Kashyap, Sushil Gupta
July-September 2010, 27(3):181-182
DOI
:10.4103/0970-2113.68319
PMID
:20931044
Tuberculosis is a very common disease often presenting in an uncommon form. High level of suspicion is required to diagnose it, thereby preventing its morbidity and mortality. We present a case of young female with multiple tuberculo-protein hypersensitivity reactions without any evidence of active tuberculosis in the body.
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It's easy to miss complicated hydatid cyst of lung
Debabani Biswas, Atin Dey, Saurabh Biswas, Mukul Chakraborty
July-September 2010, 27(3):164-166
DOI
:10.4103/0970-2113.68328
PMID
:20931038
A 60-year-old female presented with pneumonitis of right lower zone. CT scan revealed mass like lesion with multiple air pockets. FNAC and ultrasound confirmed the diagnosis as isolated active pulmonary hydatid cyst, which is not common finding in adult population.
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LETTERS TO EDITOR
Chilaiditi sign
Vipul D Yagnik
July-September 2010, 27(3):190-190
DOI
:10.4103/0970-2113.68311
PMID
:20931048
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ORIGINAL ARTICLES
Pulmonary function test in healthy school children of 8 to 14 years age in south Gujarat region, India
Tahera H Doctor, Sangeeta S Trivedi, Rajesh K Chudasama
July-September 2010, 27(3):145-148
DOI
:10.4103/0970-2113.68317
PMID
:20931033
Objective:
To obtain reference values for FEV
1
, FVC, FEV
1
% and PEFR among children aged 8-14 years in south Gujarat region of India.
Materials and Methods:
This cross-sectional study was conducted among 655 normal healthy school children (408 boys and 247 girls) of Surat city aged 8 to 14 years studying in V to VII standard during November 2007 to April 2008. Height, weight, body surface area were measured. All included children were tested in a sitting position with the head straight after taking written consent from parents. Spirometry was done using the spirometer "Spirolab II" MIR 010. Spirometer used in the study facilitates the total valuation of lung function including forced vital capacity (FVC), forced expiratory volume in one second (FEV
1
), forced expiratory volume ratio in one second (FEV
1
%) and peak expiratory flow rate (PEFR).
Results:
FVC, FEV
1
and PEFR were found to be statistically significant in the study groups. For FVC and FEV
1
, highest correlation was found with age in girls and height in boys. For FEV
1
%, significant negative correlation was found with age and height in both sexes, but positive correlation was found with surface area. Similarly, PEFR showed highest correlation with surface area in boys and girls.
Conclusion:
Variables such as FVC, FEV
1
and PEFR show good positive correlation with height, age and body surface area in both sexes. There is a need to have regional values for the prediction of normal spirometric parameters in a country like India with considerable diversity.
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Why do tuberculosis suspects bypass local services to attend tuberculosis sanatorium?
Rajeswari Ramachandran, M Muniyandi, PG Gopi, Fraser Wares
July-September 2010, 27(3):111-114
DOI
:10.4103/0970-2113.68304
PMID
:20931025
Background:
The Government Hospital of Thoracic Medicine (GHTM), Tambaram, in Kanchipuram district (formerly known as tuberculosis [TB] sanatorium), Tamil Nadu, draws patients from all over India although RNTCP services have been in place country-wide for a number of years.
Objective:
To document the reasons for patients with chest symptoms attending GHTM, Tambaram.
Materials and Methods:
In a prospective observational study, on a simple random sample basis, TB suspects attending the out-patient department of GHTM during the period January-March, 2006, were interviewed using a semi-structured interview schedule. Information on demographic, socio-economic characteristics and reasons for attending GHTM for health care was collected.
Results:
A total of 2,023 respondents attended GHTM during the study period; 56% were males, 67% were aged <45 years, 63% were literates and the average annual family income was Rs 25,000. Multiple reasons for attending GHTM were given: popularity of the centre (82%), perceived availability of good treatment (52%), referral by earlier treated patients (36%), expectation of specialized care (22%), referred by treating physicians (13%), and came for inpatient care (11%).
Conclusion:
Despite the availability of local RNTCP health services, many patients with chest symptoms made use of GHTM services due to the reputation of the former "TB sanatorium" in the community. The findings suggest that there is a need to improve community awareness of the availability of free diagnostic and treatment facilities locally under RNTCP.
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394
Study of bronchoalveolar lavage in clinically and radiologically suspected cases of pulmonary tuberculosis
Usha Kalawat, Krishna K Sharma, Prakash N. R. Reddy, A Gururaj Kumar
July-September 2010, 27(3):122-124
DOI
:10.4103/0970-2113.68307
PMID
:20931028
Context:
About 30 to 50 % of pulmonary tuberculosis patients have sputum report negative for acid fast bacilli or present with no expectoration. A lot of research is going on to find methods to establish early and accurate diagnosis of pulmonary tuberculosis (PTB) as institutions of early treatment can have significant effects on morbidity and mortality of patients and also the development of MDR-TB. Samples other than sputum play an important role in the diagnosis of disease in such patients.
Aims:
To assess the significance of bronchoalveolar lavage samples and fiberoptic bronchoscopy (FOB) in the early diagnosis of occult sputum smear negative pulmonary tuberculosis.
Settings and Design:
Study was conducted in a tertiary care hospital. FOB was performed in patients with three consecutive sputum smear negative acid fast bacilli to obtain bronchoalveolar lavage (BAL) samples. Written informed consent was obtained from these patients.
Materials and Methods:
BAL samples were subjected to Z-N staining and culture on L-J slopes for acid fast bacilli. Sputum samples from the same patients were also cultured.
Results:
BAL samples were positive in 82.2% of sputum smear negative samples. Culture positivity of BAL samples was 90.9% as compared to sputum culture positivity which was 26.4%. Overall diagnosis could be established in 86.6% of patients with the help of fiber optic bronchoscopy.
Conclusions:
BAL samples are very useful in early sputum smear negative pulmonary tuberculosis and FOB can play an important role in diagnosis of lower respiratory tract infections with minimal complications in hands of an expert.
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REVIEW ARTICLE
Nosocomial pneumonia in critically ill patients
Girish L Dandagi
July-September 2010, 27(3):149-153
DOI
:10.4103/0970-2113.68321
PMID
:20931034
The care of critically ill patients in the intensive care unit (ICU) is a primary component of modern medicine. ICUs create potential for recovery in patients who otherwise may not have survived. However, they may suffer from problems associated with of nosocomial infections. Nosocomial infections are those which manifest in patients 48 hours after admission to hospital. Nosocomial infections are directly related to diagnostic, interventional or therapeutic procedures a patient undergoes in hospital, and are also influenced by the bacteriological flora prevailing within a particular unit or hospital. Urinary tract infections are the most frequent nosocomial infection, accounting for more than 40% of all nosocomial infections. Critical care units increasingly use high technology medicine for patient care, hemodynamic monitoring, ventilator support, hemodialysis, parenteral nutrition, and a large battery of powerful drugs, particularly antibiotics to counter infection. It is indeed a paradox that the use of high-tech medicine has brought in its wake the dangerous and all too frequent complication of nosocomial infections
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CASE REPORTS
Diagnostic role of magnetic resonance angiography in Swyer James syndrome: Case series of two cases
Umesh C Parashari, Ragini Singh, Anit Parihar, Pallavi Aga, Rajesh Yadav
July-September 2010, 27(3):161-163
DOI
:10.4103/0970-2113.68326
PMID
:20931037
Swyer James syndrome is a rare syndrome which occurs due to viral illness in early childhood. The post infective obliterative bronchiolitis results in arrest of lung growth and alveolarization with reduced vascularity resulting in classical radiological features. We describe two cases of patients fulfilling all the criteria of the syndrome - 1) Unilateral hyperlucent small lung in chest radiograph with air trapping on expiration, small ipsilateral hila and pulmonary artery. 2) Diffuse decrease in attenuation of lung parenchyma with bronchiectasis and reduction in vascularity. 3) Unilateral pruned tree appearance on angiography (MRA). The clinical presentation was recurrent chest infection in a child and infrequent bouts of hemoptysis in a middle aged female. The study demonstrates the role of magnetic resonance angiography in diagnosing the condition.
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Laser resection of endobronchial hamartoma via fiberoptic bronchoscopy
Satya Prakash Rai, Ashok Police Patil, Puneet Saxena, Amulyajit Kaur
July-September 2010, 27(3):170-172
DOI
:10.4103/0970-2113.68329
PMID
:20931040
Endobronchial hamartoma is a rare benign tumor of lung that may present with symptoms of airway obstruction with wheezing, stridor, recurrent pneumonia or atelectasis. We report a case of a patient with endobronchial hamartoma, recurrent pneumonia, who presented to us with sputum smear and culture positive pulmonary tuberculosis. He was treated with antitubercular treatment and endobronchial hamartoma was resected completely by diode laser through fiberoptic bronchoscope.
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Diagnosis of three cases of endobronchial tuberculosis presenting as unresolved pneumonia, following fiberoptic bronchoscopic biopsy
Partha Pratim Roy, Subir Kumar Dey, Anirban Sarkar, Amiya Kumar Dwari, Ankan Banerjee, Rik Banerjee
July-September 2010, 27(3):185-188
DOI
:10.4103/0970-2113.68316
PMID
:20931046
Nowadays, endobronchial tuberculosis is of rare occurrence. This article presents three such cases. All of them presented as unresolved pneumonia with collapse-consolidation in chest X-ray. All the three patients were sputum smear negative for acid fast bacilli. Diagnosis was possible only with fiberoptic bronchoscopy and bronchial biopsy.
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EDITORIALS
RNTCP and tuberculosis control - High time to act
Nirmal Kumar Jain
July-September 2010, 27(3):108-110
DOI
:10.4103/0970-2113.68303
PMID
:20931024
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4,557
662
LETTERS TO EDITOR
Periodontitis: A risk factor to respiratory diseases
Rajiv Saini, Santosh Saini, Sugandha Sharma
July-September 2010, 27(3):189-189
DOI
:10.4103/0970-2113.68313
PMID
:20931047
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2,404
424
ORIGINAL ARTICLES
Utility of fiberoptic bronchoscopy in diagnosis of various lung conditions: Our experience at rural medical college
Batau Bhadke, Radha Munje, Jaywant Mahadani, Amar Surjushe, Pradeep Jalgaonkar
July-September 2010, 27(3):118-121
DOI
:10.4103/0970-2113.68306
PMID
:20931027
Aim:
To evaluate the utility of fiberoptic bronchoscopy in order to find out the etiology in various lung conditions.
Materials and Methods:
Fiberoptic bronchoscopy was performed in 120 adult patients who had persistent opacities on chest radiography in the form of collapse, consolidation, hilar mass and cavity with proper antibiotic course of 1 to 3 months. Bronchoscopic aspirates, brushing and biopsy (as and when required) were taken. Patient with known lung cancer, sputum positive pulmonary TB, recent myocardial infarction, allergic diseases and blood dyscrasias were excluded.
Results:
Fiberoptic bronchoscopy was diagnostic in 90 (75%) patients. Bacterial pneumonias were found in 32 (26.66%), malignancy in 28(23.33%), pulmonary TB in 20 (16.66%), fungal pneumonia in 6(5%) and foreign bodies in 4(3.33%) patients. In 30(25%) patients no specific diagnosis was made.
Conclusion:
We conclude that fiberoptic bronchoscopy was found to be extremely useful in finding specific etiology of various lung diseases.
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BOOK REVIEW
Text Book of Pulmonary Medicine by Dr. D. Behera
AK Janmeja
July-September 2010, 27(3):191-191
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CASE REPORTS
Benign fibrous histiocytoma of larynx: A rare cause of acute airway obstruction
Shiv Sagar Gupta, Sanjay Singhal
July-September 2010, 27(3):183-184
DOI
:10.4103/0970-2113.68318
PMID
:20931045
Fibrous histiocytoma of larynx is a rare entity. We herein present a 35-year-old femaleof benign fibrous histiocytoma of larynx with severe airway obstruction that requiring urgent endotracheal intubation followed by tracheostomy. We also report the good long-term survival of this case after such a critical condition.
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Late recurrence of malignant melanoma presenting with hemoptysis
Karanam Gowrinath, Vasudevan Geetha
July-September 2010, 27(3):178-180
DOI
:10.4103/0970-2113.68320
PMID
:20931043
After a disease-free period of 10 years, a surgically treated case of cutaneous malignant melanoma is usually not followed up further and there is a tendency to assume that the disease is cured. Late recurrence (after 10 years) of cutaneous malignant melanoma, though infrequent, has been documented well in Western countries. In our country, the malignant melanoma is still considered uncommon and there is no data regarding its late recurrence. We report a case of pulmonary malignant melanoma as a late metastatic manifestation of primary plantar malignant melanoma in a 61-year-old man who presented with hemoptysis; metastatic malignant melanoma of the lung occurred 12 years after resection of primary malignant melanoma of sole of the right foot.
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EDITORIALS
From the Editor's desk
Virendra Singh
July-September 2010, 27(3):107-107
DOI
:10.4103/0970-2113.68302
PMID
:20931023
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ORIGINAL ARTICLES
Treatment of asthma: Identification of the practice behavior and the deviation from the guideline recommendations
Parthasarathi Bhattacharyya, Rantu Paul, Saikat Nag, Sujan Bardhan, Indranil Saha, Malabika Ghosh, Ratna Dey, Rana Dey, Sahidul Islam, Dipabali Acharyya (Ghosh)
July-September 2010, 27(3):141-144
DOI
:10.4103/0970-2113.68315
PMID
:20931032
Background:
Despite an exponential development of the understanding of the disease with availability of good therapy and feasibility of good control along with availability of globally accepted guidelines, there remains a significant gap between the guidelines and prevailing practice behavior for treating asthma all over the globe. This perhaps stands as the single most deterrent factor for good asthma care worldwide. The objective of the study is to analyze the asthma prescriptions to find out the available status of the practice behaviour and the deviations from the guideline in asthma practice.
Materials and Methods:
The asthma prescriptions of the referred patients presenting to the OPD services of the IPCR, Kolkata were photocopied and collected. They were further analyzed based on the available information upon a format being prepared on four major areas as qualifications, clinical recording habit, practice of evaluating patients, and treatment habit that stands apparent from the prescribed medications. The doctors were divided into three categories as a) MBBS, b) MD/DNB (medicine and respiratory medicine), and c) DM (non respiratory sub-specialities) and statistical analysis has been performed comparing the three groups as per the performance in the four pre-decided areas.
Results:
All the groups fall short of any guideline or text of asthma care in all the areas involved.
Conclusion:
The practice behaviour of our doctors for asthma care appears deficient in several areas and seems far from guideline recommendations. This needs further evaluation and adoption of appropriate interventions.
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