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2016| Nov-Dec | Volume 33 | Issue 6
Online since
October 27, 2016
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EDITORIAL
Interstitial lung disease (ILD) in India: Insights and lessons from the prospective, landmark ILD-India registry
Ganesh Raghu, Sanjeev Mehta
Nov-Dec 2016, 33(6):589-591
DOI
:10.4103/0970-2113.192874
PMID
:27890985
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ORIGINAL ARTICLES
Correlation of chest computed tomography findings with dyspnea and lung functions in post-tubercular sequelae
Ananya Panda, Ashu Seith Bhalla, Raju Sharma, Anant Mohan, Vishnu Sreenivas, Umasankar Kalaimannan, Ashish Dutt Upadhyay
Nov-Dec 2016, 33(6):592-599
DOI
:10.4103/0970-2113.192871
PMID
:27890986
Aims:
To study the correlation between dyspnea, radiological findings, and pulmonary function tests (PFTs) in patients with sequelae of pulmonary tuberculosis (TB).
Materials and Methods:
Clinical history, chest computed tomography (CT), and PFT of patients with post-TB sequelae were recorded. Dyspnea was graded according to the Modified Medical Research Council (mMRC) scale. CT scans were analyzed for fibrosis, cavitation, bronchiectasis, consolidation, nodules, and aspergilloma. Semi-quantitative analysis was done for these abnormalities. Scores were added to obtain a total morphological score (TMS). The lungs were also divided into three zones and scores added to obtain the total lung score (TLS). Spirometry was done for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV
1
), and FEV
1
/FVC.
Results:
Dyspnea was present in 58/101 patients. A total of 22/58 patients had mMRC Grade 1, and 17/58 patients had Grades 2 and 3 dyspnea each. There was a significant difference in median fibrosis, bronchiectasis, nodules (
P
< 0.01) scores, TMS, and TLS (
P
< 0.0001) between dyspnea and nondyspnea groups. Significant correlations were obtained between grades of dyspnea and fibrosis (
r
= 0.34,
P
= 0.006), bronchiectasis (
r
= 0.35,
P
= 0.004), nodule (
r
= 0.24,
P
= 0.016) scores, TMS (
r
= 0.398,
P
= 0.000), and TLS (
r
= 0.35,
P
= 0.0003). PFTs were impaired in 78/101 (77.2%) patients. Restrictive defect was most common in 39.6% followed by mixed in 34.7%. There was a negative but statistically insignificant trend between PFT and fibrosis, bronchiectasis, nodule scores, TMS, and TLS. However, there were significant differences in median fibrosis, cavitation, and bronchiectasis scores in patients with normal, mild to moderate, and severe respiratory defects. No difference was seen in TMS and TLS according to the severity of the respiratory defect.
Conclusion:
Both fibrosis and bronchiectasis correlated with dyspnea and with PFT. However, this correlation was not linear. The overall extent of radiological abnormalities correlated only with dyspnea but not with PFT.
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RADIOLOGY QUIZ
Abnormal central line position on a chest radiograph: Clue to an uncommon anomaly
Pooja Abbey, Harpreet Singh Kapoor, Rama Anand, Ranju Singh
Nov-Dec 2016, 33(6):680-681
DOI
:10.4103/0970-2113.192856
PMID
:27891004
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ORIGINAL ARTICLES
The burden of segregated respiratory diseases in India and the quality of care in these patients: Results from the Asia-Pacific Burden of Respiratory Diseases study
Aloke Gopal Ghoshal, GD Ravindran, Paras Gangwal, Girish Rajadhyaksha, Sang-Heon Cho, Abdul Razak Bin Abdul Muttalif, Horng-Chyuan Lin, Sanguansak Thanaviratananich, Shalini Bagga, Rab Faruqi, Shiva Sajjan, Pradeep Shetty, Raeesuddin Syed, Kim K Hamrosi, De Yun Wang
Nov-Dec 2016, 33(6):611-619
DOI
:10.4103/0970-2113.192878
PMID
:27890989
Background:
Chronic respiratory diseases such as asthma, allergic rhinitis (AR), chronic obstructive pulmonary disease (COPD), and rhinosinusitis are becoming increasingly prevalent in the Asia-Pacific region. The Asia-Pacific Burden of Respiratory Diseases study examined the disease and economic burden of AR, asthma, COPD, and rhinosinusitis across the Asia-Pacific and more specifically India.
Objectives:
To estimate the proportion of adults receiving care for asthma, AR, COPD, and rhinosinusitis and assess the economic burden, both direct and indirect of these chronic respiratory disease.
Subjects and Methods:
Consecutive participants aged ≥18 years with a primary diagnosis of asthma, AR, COPD, or rhinosinusitis were enrolled. Surveys comprising questions about respiratory disease symptoms, healthcare resource utilization, work productivity, and activity impairment were completed by treating physicians and participants during one study visit. Costs, indirect and direct, that contributed to treatment for each of the four respiratory diseases were calculated.
Results:
A total of 1000 patients were enrolled. Asthma was the most frequent primary diagnosis followed by AR, COPD, and rhinosinusitis. A total of 335 (33.5%) patients were diagnosed with combinations of the four respiratory diseases; the most frequently diagnosed combinations were asthma/AR and rhinosinusitis/AR. Cough or coughing up sputum was the primary reason for the current visit by patients diagnosed with asthma and COPD while AR patients reported a watery, runny nose, and sneezing; patients with rhinosinusitis primarily reported a colored nasal discharge. The mean annual cost per patient was US$637 (SD 806). The most significant driver of direct costs was medications. The biggest cost component was productivity loss.
Conclusions:
Given the ongoing rapid urbanization of India, the frequency of respiratory diseases and their economic burden will continue to rise. Efforts are required to better understand the impact and devise strategies to appropriately allocate resources.
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Lung malignancy: Diagnostic accuracies of bronchoalveolar lavage, bronchial brushing, and fine needle aspiration cytology
Rateesh Sareen, CL Pandey
Nov-Dec 2016, 33(6):635-641
DOI
:10.4103/0970-2113.192882
PMID
:27890992
Background
: Early diagnosis of lung cancer plays a pivotal role in reducing lung cancer death rate. Cytological techniques are safer, economical and provide quick results. Bronchoscopic washing, brushing and fine needle aspirations not only complement tissue biopsies in the diagnosis of lung cancer but also comparable.
Objectives:
(1) To find out diagnostic yields of bronchioalveolar lavage , bronchial brushings, FNAC in diagnosis of lung malignancy. (2) To compare relative accuracy of these three cytological techniques. (3) To correlate the cytologic diagnosis with clinical, bronchoscopic and CT findings. (4) Cytological and histopathological correlation of lung lesions.
Methods:
All the patients who came with clinical or radiological suspicion of lung malignancy in two and a half year period were included in study. Bronchoalveolar lavage was the most common type of cytological specimen (82.36%), followed by CT guided FNAC (9.45%) and bronchial brushings (8.19%). Sensitivity, specificity, positive and negative predictive value for all techniques and correlation with histopathology was done using standard formulas.
Results:
The most sensitive technique was CT FNAC – (87.25%) followed by brushings (77.78%) and BAL (72.69%). CT FNAC had highest diagnostic yield (90.38%), followed by brushings (86.67%) and BAL (83.67%). Specificity and positive predictive value were 100 % each of all techniques. Lowest false negatives were obtained in CT FNAC (12.5%) and highest in BAL (27.3%). Highest negative predictive value was of BAL 76.95 % followed by BB 75.59% and CT FNAC 70.59%.
Conclusion:
Before administering antitubercular treatment every effort should be made to rule out malignancy. CT FNAC had highest diagnostic yield among three cytological techniques. BAL is an important tool in screening central as well as in accessible lesions. It can be used at places where CT guided FNAC is not available or could not be done due to technical or financial limitations
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REVIEW ARTICLE
Quantitative computed tomography imaging in chronic obstructive pulmonary disease
Lalita Fernandes, Yasmin Fernandes, Anthony Menezes Mesquita
Nov-Dec 2016, 33(6):646-652
DOI
:10.4103/0970-2113.192880
PMID
:27890994
Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease having small airway inflammation, emphysema, and pulmonary hypertension. It is now clear that spirometry alone cannot differentiate each component. Quantitative computed tomography (QCT) is increasingly used to quantify the amount of emphysema and small airway involvement in COPD. Inspiratory CT guides in assessing emphysema while expiratory CT identifies areas of air trapping which is a surrogate of small airway inflammation. By constructing a three-dimensional model of airways, we can also measure the airway wall thickness of segmental and subsegmental airways. The aim of this review is to present the current knowledge and methodologies in QCT of the lung that aid in identifying discrete COPD phenotypes.
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CASE REPORTS
Endotracheobronchial lymphoma: Two unusual case reports and review of article
Trilok Chand, Avdhesh Bansal, Harsh Dua, Kapil Sharma
Nov-Dec 2016, 33(6):653-656
DOI
:10.4103/0970-2113.192873
PMID
:27890995
The tracheobronchial origin of non-Hodgkin's lymphoma (NHL) is a very rare presentation, and there are only a few case reports of primary tracheal or endobronchial NHL. We have two cases of primary tracheobronchial NHL; one case was incidentally diagnosed as anaplastic large cell lymphoma of endobronchial origin when a comprehensive workup and surgery were carried out for an endobronchial aspergilloma which was actually sitting on top of lymphoma. The second patient was a case of myelodysplastic syndrome who presented with acute respiratory distress; on thorough workup, he was found to have endotracheal B-cell lymphoma. Both cases were responding well with standard chemotherapy. The mortality in these kinds of patients is due to disease progression or airway compromise and treatment complications.
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Dry cough in a middle-aged man
Sheetu Singh, Nishtha Singh, Arpita Jindal
Nov-Dec 2016, 33(6):657-660
DOI
:10.4103/0970-2113.192870
PMID
:27890996
Cough is often a distressing feature and may be caused due to varied reasons. A 39-year-old man presented with complaints of cough and had significant pigeon exposure. His chest X-ray revealed mediastinal enlargement and computed tomography chest revealed air trapping and mediastinal lymphadenopathy. Both endobronchial and transbronchial biopsies revealed granulomas. Thus, the patient was diagnosed as a case of sarcoidosis and started on steroids. Hypersensitivity pneumonitis may often mimic sarcoidosis; however, the presence of endobronchial granulomas will diagnose the latter condition.
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ORIGINAL ARTICLES
Pulmonary alveolar proteinosis: Experience from a tertiary care center and systematic review of Indian literature
Vijay Hadda, Pawan Tiwari, Karan Madan, Anant Mohan, Nishkarsh Gupta, Sachidanand Jee Bharti, Vinod Kumar, Rakesh Garg, Anjan Trikha, Deepali Jain, Sudheer Arava, Gopi C Khilnani, Randeep Guleria
Nov-Dec 2016, 33(6):626-634
DOI
:10.4103/0970-2113.192876
PMID
:27890991
Background:
Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by deposition of lipoproteinaceous material within alveoli, with a variable clinical course. Here, we report an experience of management of PAP at our center. A systematic review of previously reported cases from India is also included in the article.
Materials and Methods:
This study included patients with primary PAP managed at our center from 2009 to 2015. Diagnosis of primary PAP was based on histopathologic diagnosis on bronchoalveolar lavage or transbronchial lung biopsy and absence of causes of secondary PAP. For systematic review of Indian publications, the literature search was performed using PubMed and EMBASE databases using the terms “pulmonary alveolar proteinosis'” or “alveolar proteinosis” and “India” or “Indian.”
Results:
During the above-specified period, five patients with diagnosis of PAP were admitted at our center. Median age of patients was 32 years (interquartile range [IQR] 30.5–59); 80% were female. Mean duration (± standard deviation) of symptoms was 6.2 (±1.79) months. Anti-granulocyte-macrophage colony stimulating factor (GM-CSF) antibodies were elevated in 4 out of 5 patients (80%). For management, whole lung lavage (WLL) was done for four patients with median volume of 32.5 (IQR 18–74) L per patient. All the patients showed significant symptomatic as well as improvement in physiological parameters. Subcutaneous GM-CSF and ambroxol were given to 3 patients and 1 patient, respectively. The median follow-up of all patients was 18 (IQR 5–44) months. A systematic review of all Indian studies of PAP revealed thirty publications.
Conclusions:
WLL is the most common, effective, and safe therapy in patients with PAP. GM-CSF administration is an efficacious treatment for patients with incomplete response after WLL.
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CASE REPORTS
Lophomonas blattarum
infection in immunocompetent patient
Rahul Tyagi, Kavita Bala Anand, Kishore Teple, Rajkumar Singh Negi
Nov-Dec 2016, 33(6):667-668
DOI
:10.4103/0970-2113.192867
PMID
:27890999
Lophomonas blattarum
(
L. blattarum
) is a protozoan parasite living in intestinal tracts of termites and cockroaches. Chen and Meng from China repoted first case of pulmonary
L. blattarum
infection in 1993. 137 cases have only been reported in literature between 1993 to 2013. Majority of these infections occur in immunocompromised patients and have been reported from China. We report a case of this rare entity in an immunocompetent young Indian male.
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ORIGINAL ARTICLES
A search for covert precipitating clinical parameters in frequent exacerbators of chronic obstructive pulmonary disease
Ankit Bhatia, Ved Prakash, Surya Kant, Ajay Kumar Verma
Nov-Dec 2016, 33(6):600-604
DOI
:10.4103/0970-2113.192877
PMID
:27890987
Introduction:
Acute exacerbations are a significant source of morbidity and mortality associated with chronic obstructive pulmonary disease (COPD). Some patients suffer an inordinate number of exacerbations while others remain relatively protected. The aim of this study was to evaluate the potentially modifiable precipitating parameters of frequent severe exacerbations requiring hospital admission in COPD.
Materials and Methods:
Consecutive patients admitted with acute exacerbation of COPD for a period of one year in a tertiary care hospital were evaluated prospectively. Data regarding the number of exacerbations in the previous year, current comorbidities, medications, and clinical and functional status of COPD patients were evaluated.
Results:
We included 98 COPD patients (81.63% men) admitted consecutively with exacerbations in our department. The mean number of severe exacerbations was (2.42 per patient/per year), and 65% of the patients had frequent severe exacerbations. Multivariate analysis indicated that serum uric acid, serum total IgE, depression and anxiety, gastroesophageal reflux disease symptoms, air pollution, poor adherence to inhaled therapy, and irregular outpatient followup visits were independent predictors of frequent severe exacerbations.
Conclusion:
COPD patients with frequent exacerbations should be carefully assessed for modifiable confounding risk factors regardless of poor lung function to decrease exacerbation frequency and related poor prognosis. Raised serum total IgE levels may point towards atopy as an additional comorbidity in COPD while uric acid can have a clinically useful role in risk stratification in a primary care setting.
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CASE REPORTS
Complete subglottic tracheal stenosis managed with rigid bronchoscopy and T-tube placement
Kuruswamy Thurai Prasad, Sahajal Dhooria, Inderpaul Singh Sehgal, Ashutosh Nath Aggarwal, Ritesh Agarwal
Nov-Dec 2016, 33(6):661-663
DOI
:10.4103/0970-2113.192879
PMID
:27890997
Surgery is the preferred treatment modality for benign tracheal stenosis. Interventional bronchoscopy is used as a bridge to surgery or in instances when surgery is not feasible or has failed. Stenosis in the subglottic trachea is particularly a treatment challenge, in view of its proximity to the vocal cords. Herein, we describe a patient with complete tracheal stenosis in the subglottic region, which developed after prolonged intubation and mechanical ventilation. The patient developed recurrent stenosis despite multiple surgical and endoscopic procedures. We were able to manage the patient successfully with rigid bronchoscopy and Montgomery T-tube placement.
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ORIGINAL ARTICLES
Percutaneous computed tomography-guided aspiration and biopsy of intrathoracic lesions: Results of 265 procedures
Zafar Neyaz, Hira Lal, Anuj Thakral, Alok Nath, Ram Naval Rao, Ritu Verma
Nov-Dec 2016, 33(6):620-625
DOI
:10.4103/0970-2113.192863
PMID
:27890990
Context:
Percutaneous computed tomography (CT)-guided needle aspiration and biopsy technique have developed over time as a method for obtaining tissue specimen. Although this is a minimally invasive procedure, complications do occasionally occur.
Aims:
The aim of the study was to evaluate the diagnostic yield and complications of 265 percutaneous CT-guided aspiration and biopsy procedures performed on various intrathoracic lesions.
Settings and Design:
Data of percutaneous CT-guided aspiration and biopsy procedures of intrathoracic lesions performed over a 4 year period were retrospectively analyzed.
Subjects and Methods:
Procedure details, radiological images, and pathological and microbiological reports were retrieved from radiology records and hospital information system. Technical success, diagnostic yield, and complication rates were calculated.
Results:
Total 265 procedures were performed for lung (
n
= 179), mediastinum (
n
= 73), and pleural lesions (
n
= 13). Diagnostic yield for lung, mediastinal, and pleural lesions was 80.7%, 74.2, and 75%, respectively, for core biopsy specimens. Major complication was noted in only one procedure (0.4%). Minor complications were noted in 13.6% procedures which could be managed conservatively.
Conclusions:
Percutaneous CT-guided aspiration and biopsy procedures for intrathoracic lesions are reasonably safe with good diagnostic yield. Complications are infrequent and conservatively managed in most of the cases.
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CASE REPORTS
Idiopathic dilatation of pulmonary artery
Rahul Kumar Sharma, Deepak Talwar, Sameer K Gupta, Shobhit Bansal
Nov-Dec 2016, 33(6):675-677
DOI
:10.4103/0970-2113.192869
PMID
:27891002
Idiopathic dilatation of pulmonary arteries (IDPA) is a rare abnormality of pulmonary arteries, the reported incidence in literature being as low as 0.007% in autopsy samples. With the improvement in diagnostic modalities, antemortem diagnosis of IDPA has been increasingly established by excluding diseases that induce pulmonary arterial enlargement. Here, we present a rare case of idiopathic dilatation of the pulmonary artery admitted with shortness of breath where IDPA was diagnosed as an incidental finding using computed tomography pulmonary angiography and cardiac catheterization.
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LETTERS TO EDITOR
Pleural nodules: A rare presentation of extrapulmonary tuberculosis
Urvinderpal Singh, Vinay Mohan, Navdeep Singh, Daksh Jhim, Muralidharan Ramaraj, Areekkara Poduvattil Prasanth, Hitesh Gour, Shailly
Nov-Dec 2016, 33(6):699-701
DOI
:10.4103/0970-2113.192855
PMID
:27891012
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2,013
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ORIGINAL ARTICLES
Ankylosing spondylitis and risk of venous thromboembolism: A systematic review and meta-analysis
Patompong Ungprasert, Narat Srivali, Wonngarm Kittanamongkolchai
Nov-Dec 2016, 33(6):642-645
DOI
:10.4103/0970-2113.192862
PMID
:27890993
Background:
Several immune-mediated inflammatory disorders, such as rheumatoid arthritis, psoriatic arthritis, and systemic lupus erythematosus have been linked to an increased risk of venous thromboembolism (VTE). However, the data on ankylosing spondylitis (AS) are limited.
Methods:
We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio comparing the risk of VTE and possible pulmonary embolism (PE) in patients with AS versus non-AS participants. Pooled risk ratio and 95% confidence intervals were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird.
Results:
Of 423 potentially relevant articles, three studies met our inclusion criteria and thus, were included in the data analysis. The pooled risk ratio of VTE in patients with AS was 1.60 (95% confidence interval: 1.05–2.44). The statistical heterogeneity of this study was high with an I
2
of 93%.
Conclusion:
Our study demonstrated a statistically significant increased VTE risk among patients with AS.
[ABSTRACT]
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1,904
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Variability in proteinase-antiproteinase balance, nutritional status, and quality of life in stable chronic obstructive pulmonary disease due to tobacco and nontobacco etiology
Anant Mohan, Mini Sharma, Arvind Uniyal, Rajlaxmi Borah, Kalpana Luthra, RM Pandey, Karan Madan, Vijay Hadda, Randeep Guleria
Nov-Dec 2016, 33(6):605-610
DOI
:10.4103/0970-2113.192859
PMID
:27890988
Context:
Although the role of proteinase/antiproteinase imbalance in chronic obstructive pulmonary disease (COPD) due to tobacco is well established, information in COPD due to nontobacco etiology is sparse.
Aims:
To assess the variability in metalloproteinase activity in COPD related to tobacco and nontobacco causes.
Settings and Design:
This is a hospital-based, prospective, observational study.
Subjects and Methods:
Serum matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinases-1 (TIMP-1) were estimated in 200 subjects divided equally into four groups, i.e. COPD in tobacco smokers, COPD in nonsmokers but with exposure to biomass-related indoor air pollution, smokers without COPD, and nonsmoking healthy controls. Anthropometric skinfold measurements, quality of life (QOL) using St. George Respiratory Questionnaire, and exercise capacity using the 6-min walk test (6-MWT) were carried out. Groups were compared using analysis of variance and Kruskal–Wallis plus Mann–Whitney U-test to assess differences between groups. The Chi-square and Fisher's exact tests were used to evaluate associations among categorical variables. Spearman's rank correlation was calculated to assess the correlation between data.
Results:
Patients with COPD due to either tobacco or nontobacco etiology were older, more malnourished, had worse QOL, and poorer exercise capacity compared to non-COPD subjects. Triceps, subscapular, and suprailiac skinfold thicknesses were less in smokers with COPD than biomass-related COPD. MMP-9 and TIMP-1 levels were similar across all groups. TIMP-1 significantly correlated with 6-MWT among all groups.
Conclusions:
The protease-antiprotease balance in COPD is similar irrespective of the presence or absence of tobacco exposure but is related to poor exercise capacity.
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CASE REPORTS
An unusual metastasis of lung adenocarcinoma: Biceps brachii muscle
Muzaffer Sariaydin, Ersin Gunay, Sevinc Sarinc Ulasli, Sibel Gunay, Betul Demirciler Yavas, Cigdem Tokyol, Mukremin Uysal, Mehmet Unlu
Nov-Dec 2016, 33(6):669-671
DOI
:10.4103/0970-2113.192857
PMID
:27891000
Skeletal muscle metastasis of nonsmall cell lung carcinoma (NSCLC) is a rare occurrence, and the most effective treatment modality is currently unknown. In this case presentation, we report a patient with NSCLC who underwent palliative radiotherapy for biceps muscle metastasis of NSLCS. Our case was a 49-year-old woman who had lung adenocarcinoma with biceps muscle metastasis. She had been followed up for 2 years due to Stage IV lung adenocarcinoma from whom a biopsy was taken from a painful mass in right arm that was found to be compatible with metastasis of lung adenocarcinoma. She had palliative radiotherapy for her painful mass and systemic chemotherapy was planned. After palliative radiotherapy, the pain originating from the metastatic mass in right biceps muscle alleviated. Palliative radiotherapy can be a valuable treatment option for cases with skeletal muscle metastasis.
[ABSTRACT]
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1,905
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NEWER TECHNIQUES
Endobronchial ultrasound-guided transbronchial needle aspiration of thyroid: Report of two cases and systematic review of literature
Karan Madan, Saurabh Mittal, Vijay Hadda, Deepali Jain, Anant Mohan, Randeep Guleria
Nov-Dec 2016, 33(6):682-687
DOI
:10.4103/0970-2113.192881
PMID
:27891005
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive and safe technique for a sampling of mediastinal lesions. Indications for EBUS-TBNA have gradually expanded since its introduction. The usual approach to cytological sampling of the thyroid gland is percutaneous ultrasound-guided fine needle aspiration (US-FNA) performed under local anesthesia. US-FNA may be risky or not feasible in intrathoracic/substernal thyroid location. Feasibility of aspirating thyroid lesions with EBUS-TBNA has been occasionally reported. We report two patients wherein EBUS-TBNA was utilized for thyroid lesion aspiration and definitive diagnosis. We highlight the utility and safety of EBUS-TBNA in the evaluation of intrathoracic thyroid lesions wherein image-guided percutaneous aspiration may be risky/sometimes impossible to perform. A systematic review of literature has also been performed summarizing and discussing the issues pertaining to EBUS-TBNA of the thyroid gland.
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1,894
216
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LETTERS TO EDITOR
Excessive dynamic airway collapse and wheeze: Reasons for contemplation
Animesh Ray
Nov-Dec 2016, 33(6):698-699
DOI
:10.4103/0970-2113.192865
PMID
:27891011
[FULL TEXT]
[PDF]
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[PubMed]
1,885
178
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CASE LETTERS
Pulmonary strongyloidiasis and hyperinfection in a renal transplant patient
Trilok Chand, Avdhesh Bansal, Sanjeev Jasuja, Gaurav Sagar
Nov-Dec 2016, 33(6):692-694
DOI
:10.4103/0970-2113.192860
PMID
:27891008
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1,797
167
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Multicentric Castleman's disease: “A rare entity that mimics malignancy”
Vishak K Acharya, Santosh Rai, Sachin Shirgavi, Radha R Pai, R Anand
Nov-Dec 2016, 33(6):689-691
DOI
:10.4103/0970-2113.192864
PMID
:27891007
[FULL TEXT]
[PDF]
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[EPub]
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1,639
179
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CASE REPORTS
Foreign body in the lung following dental procedure
Rajiv Goyal, Pratibha Gogia, Vaibhav Chachra, Kedar Hibare
Nov-Dec 2016, 33(6):664-666
DOI
:10.4103/0970-2113.192875
PMID
:27890998
This is an interesting case report of a foreign body (FB) aspiration in an adult patient. The FB in question was a dental drill, which accidentally went into the airways during a dental procedure. The extraction was technically difficult due to the peripheral location and thin and sharp tip of the FB. The extraction of this FB required a unique innovation through the rigid bronchoscope.
[ABSTRACT]
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1,583
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CASE LETTERS
Rare cause of spontaneous subcutaneous emphysema
Valliappan Muthu, Sahajal Dhooria, Ritesh Agarwal, Digambar Behera
Nov-Dec 2016, 33(6):688-689
DOI
:10.4103/0970-2113.192858
PMID
:27891006
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1,551
184
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COMMENTARY
Obese COPD is associated with higher systemic inflammation – A new COPD phenotype
PA Mahesh
Nov-Dec 2016, 33(6):678-679
DOI
:10.4103/0970-2113.192853
PMID
:27891003
[FULL TEXT]
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[PubMed]
1,493
218
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CASE REPORTS
Rigid bronchoscopic management of acute respiratory failure in a 30-year-old woman
Karan Madan, Ashesh Dhungana, Neha Kawatra Madan, Anant Mohan, Vijay Hadda, Rakesh Garg, Deepali Jain, Randeep Guleria
Nov-Dec 2016, 33(6):672-674
DOI
:10.4103/0970-2113.192868
PMID
:27891001
A 30-year-old woman presented with a history of progressive shortness of breath, cough, and hoarseness. Stridor was audible on examination. Chest X-ray showed normal lung fields and contrast-enhanced computed tomography thorax showed lower tracheal occlusion with endoluminal growth. Diagnostic flexible bronchoscopy demonstrated multiple whitish glistening nodules over both vocal cords and lower tracheal occlusion by whitish nodular growth. In view of critical central airway obstruction, rigid bronchoscopy and excision of the lower tracheal growth were performed. Histopathological examination of the excised specimen demonstrated features of squamous papillomas. A diagnosis of respiratory papillomatosis was established. On follow-up surveillance bronchoscopy, there was a gradual spontaneous regression of the residual lesions, and the patient remains currently asymptomatic 1 year since the procedure.
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1,453
171
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LETTERS TO EDITOR
Chronic granulomatous disease may be an underlying cause for invasive nocardiosis
Sujoy Khan, Parthasarathi Bhattacharya
Nov-Dec 2016, 33(6):703-704
DOI
:10.4103/0970-2113.192861
PMID
:27891014
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1,419
157
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Chronic obstructive pulmonary disease and cardiac comorbidities: A cross-sectional study
Varuna Jethani, Girish Sindhwani
Nov-Dec 2016, 33(6):697-697
DOI
:10.4103/0970-2113.192866
PMID
:27891010
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1,370
204
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CASE LETTERS
A forgotten foreign body in bronchus
Sanjivani J Keny, Uday C Kakodkar
Nov-Dec 2016, 33(6):694-696
DOI
:10.4103/0970-2113.192854
PMID
:27891009
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1,387
174
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ERRATUM
Erratum: Enhancing indoor air quality: The air filter advantage
Nov-Dec 2016, 33(6):705-705
DOI
:10.4103/0970-2113.192883
PMID
:27891015
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1,319
156
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LETTERS TO EDITOR
A rare cause of lung cavity
Yasir Peringattuthodiyil, Timothy Rajamanickam
Nov-Dec 2016, 33(6):702-703
DOI
:10.4103/0970-2113.192872
PMID
:27891013
[FULL TEXT]
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[PubMed]
1,224
152
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