The Journal of Association of Chest Physicians最新文献

{"title":"Safety and efficacy of bronchoscopy with transbronchial lung biopsy in interstitial lung diseases: our experience","authors":"Neenu N, Kanmani Mk, K. Utpat, U. Desai","doi":"10.4103/jacp.jacp_1_23","DOIUrl":"https://doi.org/10.4103/jacp.jacp_1_23","url":null,"abstract":"Background Interstitial lung diseases (ILDs) are a heterogeneous group of disorders with wide spectrum whose accurate diagnosis and proper treatment pose a great challenge. Our study is focused on safety and efficacy of bronchoscopy with transbronchial lung biopsy (TBLB) in patients with ILD. Methodology A prospective observational study of 68 patients was conducted in our tertiary care center. Diagnostic role, yield, and safety of TBLB in ILD were studied by comparing with high-resolution computed tomography (HRCT) patterns and histopathology. Results A total of 136 cases of ILD were referred to us in the said period. Of these, 75 patients underwent bronchoscopy and 68 underwent bronchoscopy with TBLB. Among them, the most common HRCT pattern was chronic hypersensitivity pneumonitis (HP) 47.06%. ILDs were subdivided as, with known cause (13.24%), 64.71% granulomatous ILDs (17.65% sarcoidosis and 47.06% chronic HP) and 22.06% idiopathic interstitial pneumonitis IIP). Pathological diagnosis of ILD was obtained in 54.41%. Based on etiological classification, pathological diagnosis was obtained in 46.67% IIP, 11.11% ILD with known cause, and 65.9% granulomatous ILD. A total of 16.2% patients had complications with no mortality. Complications associated with TBLB in IIP with non-IIP cases as well as usual interstitial pneumonia (UIP) with non-UIP cases were statistically significant. Conclusion Bronchoscopy was safe and well tolerated. Most important limiting factor was awareness about bronchoscopy and unwillingness for the procedure on understanding the risks of the same in ILD. TBLB is a useful diagnostic procedure for our ILDs as a part of multidisciplinary approach with total yield of 54.41% and more yield in chronic HP and sarcoidosis. We experienced a low rate of complications.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"51 1","pages":"129 - 136"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent administration of COVID-19 vaccine and seasonal influenza vaccine: safe according to a small observation","authors":"S. Yasri, A. Kleebayoon, V. Wiwanitkit","doi":"10.4103/jacp.jacp_20_23","DOIUrl":"https://doi.org/10.4103/jacp.jacp_20_23","url":null,"abstract":"","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"287 1","pages":"187 - 187"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis preventive therapy – Clinical practice issues","authors":"A. Ghoshal, Supriya Sarkar, Arup Halder, Aparup Dhua, Chandra Das, Parthajit Das, Abhra Chowdhury, Sanjay Kumar Thakur, Anindya Majumder","doi":"10.4103/jacp.jacp_48_23","DOIUrl":"https://doi.org/10.4103/jacp.jacp_48_23","url":null,"abstract":"Latent tuberculosis (LTB) is now termed as tuberculosis infection (TBI). Prevention of active TB disease by treatment of tuberculosis infection is a critical component of the National Strategic Plan 2017-25 for TB Elimination in India by 2025. Programmatic Management of Tuberculosis Preventive Therapy (PMTPT) is a public health document while treatment of tuberculosis infection is essentially a clinical approach. Here we have attempted to address the gray areas answering from clinical viewpoint.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"427 1","pages":"115 - 123"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic role of fibreoptic bronchoscopy in the etiological diagnosis of various bronchopulmonary diseases: A prospective study in a tertiary care hospital in South India","authors":"Badusha Mohammed, Sampath Yerramsetti, Anil Kumar, Sravani Penumetcha, Niharika Ikkurthy, S. Prakash","doi":"10.4103/jacp.jacp_24_22","DOIUrl":"https://doi.org/10.4103/jacp.jacp_24_22","url":null,"abstract":"Aims: To know the diagnostic yield of FOB in various bronchopulmonary diseases and to compare the pre- and postbronchoscopy diagnosis. Settings and Design: The present prospective study was carried out in 130 patients from September 1, 2020 to September 30, 2021 in a tertiary care hospital of South India. Materials and Methods: The demographic data, chest radiographic findings, prebronchoscopy suspected clinical diagnosis, bronchoscopic findings, microbiological results, pathological data, and postbronchoscopy confirmed clinical diagnosis were recorded as per a predesigned proforma and analyzed. Results: The mean age of the patients was 52.5 years (SD ± 15.4, range: 18–85) with 73.8% males and 26.2% females. The most common prebronchoscopy suspected clinical diagnosis was lung malignancy (n = 59, 45.3%) followed by lung infections (n = 34, 26%) and pulmonary tuberculosis (n = 20, 15.3%). The distribution of the clinical diagnosis postbronchoscopy was as follows: lung malignancy (n = 44, 33.8%), lung infections (n = 31, 23.8%), and pulmonary tuberculosis (n = 16, 12.3%). FOB diagnostic yield of lung malignancy, lung infections, and pulmonary tuberculosis was 59.3%, 50%, and 40%, respectively. Thirty-five (79.5%) cases of confirmed lung malignancy, 17 (54.8%) of lung infections, and 8 (50%) cases of confirmed pulmonary tuberculosis were accurately suspected by the clinician before bronchoscopy. Overall, the diagnostic yield of FOB was established in 92 cases (70.7%). Conclusion: Bronchoscopy could establish a diagnosis in more than two-thirds of the cases. The most suspected prebronchoscopy diagnosis and the confirmed postbronchoscopy diagnosis was lung malignancy. Pulmonary infections had the best correlation between prebronchoscopy and postbronchoscopy diagnosis.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"11 1","pages":"19 - 27"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42403079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and outcome of pneumothorax, pneumomediastinum, and subcutaneous emphysema in COVID-19 patients","authors":"Priyadarshini Raykar, Anup Banur, Gururaj Mahanthappa, Eti Ajith, Kushal Bondade, S. Angadi, Jisna Jith","doi":"10.4103/jacp.jacp_25_22","DOIUrl":"https://doi.org/10.4103/jacp.jacp_25_22","url":null,"abstract":"Background: Pneumothorax, pneumomediastinum, and subcutaneous emphysema are few of fatal complications noted in patients with COVID-19 pneumonia. Various studies have shown prevalence of pneumothorax ranging between 1% and 2% in COVID-19 pneumonia. Materials and methods: A total of 10 inpatients admitted with COVID-19 disease confirmed by RT-PCR test who developed pneumothorax, pneumomediastinum, and subcutaneous emphysema during hospital stay by sequential sampling method were included in the study. Demographic data, duration of hospital stay, underlying comorbidities, predisposing factors, radiographic characteristics, and mode of oxygen delivery were collected and analyzed. Results: In our study, mean age group of patient who developed pneumothorax, pneumomediastinum, and subcutaneous emphysema was 39.8 years. Male to female ratio was 9:1. Mean time duration of onset of pneumothorax, pneumomediastinum, and subcutaneous emphysema from the day of hospitalization was 17.3 (8–30) days. Nine patients were on NIV (non-invasive ventilation) while one patient was on NRBM. Right sided involvement was noted in five patients, three had left sided involvement, and two patients had bilateral pneumothorax. Five patients had pneumomediastinum and subcutaneous emphysema along with pneumothorax. All patients received antivirals (Inj. Remdesivir), systemic steroids along with other supportive treatment. Except for one patient, all patients who developed pneumothorax, pneumomediastinum, and subcutaneous emphysema succumbed. All patients’ chest radiograph was consistent with COVID-19 pneumonia. One patient had pulmonary cyst on Computerized Tomography (CT) thorax which was done post intercostal drainage of pneumothorax. Mean time of death after development of pneumothorax, pneumomediastinum, subcutaneous emphysema was 4.3 days. Comorbidities observed were bronchial asthma, obesity, and status post Caesarian section. Conclusion: Development of pulmonary barotrauma in COVID-19 patients is associated with high mortality. Presence of pulmonary cyst, prexisting bronchial asthma, obesity, systemic steroids are possible poor determinants.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"11 1","pages":"28 - 35"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70780151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asthma: Cells involved in the pathophysiology of asthma","authors":"Vivek Shinde, Pavankumar Wankhede, N. Vyawahare","doi":"10.4103/jacp.jacp_41_22","DOIUrl":"https://doi.org/10.4103/jacp.jacp_41_22","url":null,"abstract":"Asthma is a complex chronic inflammatory disease of the bronchioles characterized by airway hyperresponsiveness, bronchial hyperresponsiveness, and airway obstruction. Asthma is classified into various types. The epidemiological studies say that there are approximately 310 million people affected. The asthma prevalence is increasing considerably among developing and developed nations. Many of the patients remain undiagnosed because of the lack of healthcare facilities. Asthma is a complex disease that involves several cells (T-lymphocytes, B-lymphocytes, mast cells, eosinophils, dendritic cells, macrophages, chemokines, cytokines, histamines) that when activated can trigger the pathogenesis of asthma. The pathogenesis of each cell varies from the other. It also varies with age, gender, and exposure type.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"11 1","pages":"10 - 18"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42485996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare cause of unilateral hemopneumothorax","authors":"Sumit Jain, Krishnapriya Kumar","doi":"10.4103/jacp.jacp_32_22","DOIUrl":"https://doi.org/10.4103/jacp.jacp_32_22","url":null,"abstract":"A 46-year-old male patient presented with high-grade fever, chills, hemoptysis, myalgia, acute onset of dyspnea, and right-sided chest pain. Emergency chest radiograph revealed right hydropneumothorax. On insertion of intercostal drain, there was a sudden gush of hemorrhagic fluid suggestive of hemothorax. There was no history of trauma or bleeding tendencies. Laboratory investigations revealed thrombocytopenia and positive dengue immunoglobulin M (IgM). The patient improved on aggressive supportive therapy. Subsequently, he underwent video-assisted thoracoscopic surgery (VATS) for non–re-expansion of lung. We report here a rare case of dengue hemorrhagic fever presenting as unilateral hemopneumothorax. Nontraumatic hemopneumothorax as an initial presentation of dengue is being reported for the first time in literature.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"11 1","pages":"40 - 42"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45512169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of opaque hemithorax","authors":"Prof Vikas Kumar, AmitKiran Rath, Avishek Kar, S. De","doi":"10.4103/jacp.jacp_28_22","DOIUrl":"https://doi.org/10.4103/jacp.jacp_28_22","url":null,"abstract":"Opaque hemithorax itself presents a plethora of causes. The physicians often mistook opaque hemithorax as massive pleural effusion. But rare causes of opaque hemithorax should also be explored. Hydatidosis is one of the rare causes of opaque hemithorax. Hydatidosis remains the endemic disease in some regions of the world. The liver and the lungs are the most affected sites in adults. Very few cases have been described in literature regarding hydatid cysts presenting as opaque hemithorax. A 20-year-old nonsmoker male admitted in our hospital with complaints of shortness of breath and cough for the last 1 year. Chest x-ray was suggestive of left opaque hemithorax with contralateral mediastinal shift. Ultrasonography of the chest revealed multiple anechoic cystic lesions of varying size. Computed tomography chest suggested the presence of multiple multiloculated cystic lesions in the entire left hemithorax. Transthoracic needle aspiration fluid cytology gave the suspicion of parasitic cyst. On further workup, the hydatid serology was found to be positive. Our patient presented with opaque hemithorax, and further workup leads us to the diagnosis of pulmonary hydatidosis.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"7 4","pages":"50 - 52"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41275491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral pneumothorax in COVID recovery: Tale of two cases","authors":"Sharad Joshi, Ankit Bhatia, Nitesh Tayal","doi":"10.4103/jacp.jacp_29_22","DOIUrl":"https://doi.org/10.4103/jacp.jacp_29_22","url":null,"abstract":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leading to coronavirus disease 2019 (COVID-19) mainly affects the lungs leading to complications of acute lung injury. Pneumothorax has been observed as a complication in COVID-19 cases requiring urgent intervention and may indicate poor prognosis in view of severe underlying lung damage. Bilateral pneumothorax is an even dreaded and rare complication requiring immediate recognition and management. We present two similar cases of bilateral pneumothorax with COVID-19 pneumonia with none requiring positive pressure ventilation and no preexisting lung disease. Our cases are a reminder about the severity of lung damage in COVID-19 and that a good vigilance is required in the event of an acute deterioration.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"11 1","pages":"53 - 57"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48121713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare adverse effects of anti tuberculous therapy − a case series","authors":"N. Sharma, Kunal Kumar, Sarvinder Singh, P. Saxena, Nalin Singh, Akhil Kollammarukudy Ravi","doi":"10.4103/jacp.jacp_11_22","DOIUrl":"https://doi.org/10.4103/jacp.jacp_11_22","url":null,"abstract":"Tuberculosis is prevalent throughout the world and is a major public health problem in most developing countries. Standardized and directly observed treatment under NTEP (National Tuberculosis Elimination Programme) is currently recommended for drug-sensitive pulmonary tuberculosis in India. It is generally well tolerated, with few minor side effects. Severe side effects necessitating discontinuation of therapy are rare with standard TB treatment regimens. Drug-resistant tuberculosis (DR-TB) has become more common in recent years, posing a challenge to global efforts to control the disease. Therapy for DR-TB has been associated with many adverse effects. Therefore, close monitoring of patients on DR-TB therapy is necessary to ensure that adverse effects of drugs are recognized early by healthcare personnel and treated accordingly. This will improve drug compliance and, hence, treatment goals. Here we report three cases of tuberculosis who had unusual adverse effects while receiving anti-tuberculous medication, prompting drug discontinuation.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"11 1","pages":"43 - 49"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49401853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}