The Journal of Association of Chest Physicians最新文献

{"title":"COVID-19 and rhino-orbital mucormycosis – A case report","authors":"Dilbagh Singh","doi":"10.19080/ijoprs.2021.05.555654","DOIUrl":"https://doi.org/10.19080/ijoprs.2021.05.555654","url":null,"abstract":"There is a constant rise in cases of rhino-orbital mucormycosis in people with coronavirus disease 2019 (COVID-19). Generally, mucormycosis develops in immunosuppression or debilitating diseases. In cases having head and neck involvement, the mold enters the respiratory tract with further involvement of nose and sinuses and there is consecutive progression into orbital and intracranial structures. Diabetes mellitus (DM) is an independent risk factor for both severe COVID-19 and mucormycosis. The clinical examination and direct smears are helpful for early diagnosis of the disease and timely intervention. For the better prevention and management of such opportunistic infections in COVID-19 patients, it is prudent to establish prophylactic treatment protocols along with rational use of corticosteroids. We here report a case of rhino-orbital mucormycosis infection caused by Rhizopus oryzae in a COVID-19 patient with DM.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"11 1","pages":"100 - 103"},"PeriodicalIF":0.0,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46475079","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":"Prevalence of different sleep problems in patients with respiratory diseases presented to a respiratory outdoor clinic: A descriptive analysis","authors":"A. K. Haldar, A. Chatterjee","doi":"10.1101/2021.06.17.21258633","DOIUrl":"https://doi.org/10.1101/2021.06.17.21258633","url":null,"abstract":"Introduction: A patient with compromised respiratory system due to some diseases, may have disturbed sleep to a great extent. It has been proved in various community based epidemiologic studies. Though most of such studies available had concentrated on single respiratory disease like Chronic Obstructive Pulmonary Disease (COPD) or Asthma in the community. But such studies are hardly available for patients attending a respiratory clinic, where all respiratory ailments were evaluated with concurrent sleep problems. The present study is one such. Methods: Total 163 patients were screened and among them 100 were selected as the study group. The patients were enquired with a standard questionnaire provided to them. In addition, they were given separate questionnaire as STOP BANG, Insomnia Severity Index Score, RLS questionnaire. Those persons with STOP BANG > 5, were also advised for a polysomnography (PSG), if not already done. Descriptive statistical analysis has been carried out in the present study. Results: The present study is a cross-sectional depiction of relationships between various respiratory diseases and sleep problems. As per this study, most patients were asthmatic and commonest sleep problem was OSA. A subgroup analysis was done to determine the significance of difference of various parameters between the three groups of asthmatic patients, patients having COPD and the “Other” group. Discussion: Subjective sleep problems were significantly more in Asthma group than COPD group (P < 0.0362). The mean STOP BANG was more in COPD group than the Asthma group (P < 0.0301). Though OSA was the commonest sleep problem between the three groups, but the prevalence was not statistically significant between them. More patients in the COPD group had insomnia, but it was not statistically significantly more than in Asthma group. Sleeping pill use was significantly more in COPD group than the Asthma group (P < 0.0039). Conclusion: Sleep problems are common in patients with respiratory diseases and OSA is the most common problem according to the present study. Asthma patients had more subjective sleep problems. Sleeping pill use was more common in COPD patients instead of having less subjective sleep complaints than asthma patients.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"11 1","pages":"36 - 39"},"PeriodicalIF":0.0,"publicationDate":"2021-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44389210","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":"Organizing pneumonia as preliminary presentation of rheumatoid arthritis: A case report and review of literature","authors":"Vikrant Ranga, Amitesh Gupta, P. Mrigpuri, S. Spalgais","doi":"10.4103/jacp.jacp_35_20","DOIUrl":"https://doi.org/10.4103/jacp.jacp_35_20","url":null,"abstract":"Rheumatoid arthritis (RA) is a systemic disease frequently involving the respiratory system. Organizing pneumonia (OP) is a defined pulmonary manifestation seen in patients with RA-associated interstitial lung disease. Even though OP following articular involvement is common, rarely it could be the first manifestation of RA. We herein report a case of 45-year-old female, who presented with OP as the first manifestation of RA with negative serology at presentation.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"9 1","pages":"45 - 48"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42374366","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":"COVID-19 versus H1N1: pandemic to pandemic − a comparative analysis of clinical presentation, lab parameters, disease severity and outcome","authors":"Manoj Saluja, D. Pillai","doi":"10.4103/jacp.jacp_46_20","DOIUrl":"https://doi.org/10.4103/jacp.jacp_46_20","url":null,"abstract":"Background: Since December 2019, we have been facing the coronavirus disease 2019 (COVID-19) pandemic. January 30, 2020 marked India’s first case. A similar entity H1N1 was responsible for the last pandemic our civilization saw. Comparing the clinical and radiological characteristics, severity and prognosis of the two is the objective. Methods :Cross-sectional, observational, and comparative study of patients diagnosed with COVID-19 (April–May 2020) and H1N1 (January 2017–December 2019). Results :We observed raised male to female (M:F) ratio in both, average age higher in H1N1, moderate to severe symptoms with worse clinical status in H1N1, and COVID more often being associated with mild symptoms. Thrombocytopenia, lymphocytosis, and raised lactate dehydrogenase (LDH) were seen in both the diseases but were worse in H1N1; multiorgan involvement was seen in H1N1 (P < 0.001). COVID-19 patients who did report complications were refractory to routine critical care management. Radiographic abnormality was present in both. Poor prognosis was noted in elderly, especially those with comorbidities. This association was less evident in COVID-19. Discussion: Though Severe Acute Respiratory Syndrome- Corona Virus 2 has a milder course, sudden deterioration can be fatal. Serial monitoring of history and vitals is the key. Swine flu patients with a comparatively aggressive course need to be managed accordingly, but Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation Score-II, and similar scoring can help in triage and predicting prognosis. Clinical and laboratory findings are similar − swine flu has more complications but increased risk of cardiac involvement is seen in COVID. Chest X-ray proves sufficient for imaging, reducing the requirement of computed tomography (CT) scans. Studies involving larger sample size and interventional trials are need of the hour.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"9 1","pages":"7 - 15"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46145022","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":"Unusual presentation of adenocarcinoma of lung with metastasis in a young female","authors":"H. Pandya, H. Pandya","doi":"10.4103/jacp.jacp_33_20","DOIUrl":"https://doi.org/10.4103/jacp.jacp_33_20","url":null,"abstract":"Adenocarcinoma of lung remains the commonest subtype of lung cancer. Despite of recent advances, the presentation of carcinoma of lung is delayed many of the times until later stages. Here is a case of a young pregnant female with adenocarcinoma of lung with brain metastasis with unusual presentation.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"9 1","pages":"37 - 40"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48326867","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":"Feasibility of testing bronchodilator responsiveness with glycopyrronium in obstructive airway diseases: the initial appraisal of the pilot experience","authors":"P. Bhattacharyya, D. Saha, S. Sengupta, Debkanya De","doi":"10.4103/jacp.jacp_34_20","DOIUrl":"https://doi.org/10.4103/jacp.jacp_34_20","url":null,"abstract":"Background: The short onset of action of glycopyrronium bromide, makes it a suitable antimuscarinic agent to test bronchodilator-responsiveness in airway diseases. The objective of the study was to explore the feasibility of the testing so. Methods: Subjects with features of airflow obstruction (FEV1/FVC < 0.07) were given to inhale a 50-μg single dose of dry powder of glycopyrronium bromide immediately following standard salbutamol-induced bronchodilator reversibility. A repeat spirometry was done after 30 minutes and the changes noted. The impact of both the drugs on spirometric variables suggesting airflow obstruction (FEV1. FEV1/FVC, and FEF25-75) were assessed statistically. A salbutamol-reversibility of ≥12% and >200ml was noted to differentiate asthmatics from chronic obstructive pulmonary disease (COPD) patients. Result: In a total of 35 subjects (asthma-10, COPD-25) with moderate baseline airflow obstruction [FEV1/FVC: 0.57 ± 0.12 and FEV1 (%predicted) as 46.17 ± 15.21], there was global improvement across the spirometric variables to serial inhalation of salbutamol and glycopyrronium. The post salbutamol changes in FEV1 (absolute value) were significant (P = 0.0001) overall and also for both asthma and COPD. Following inhalation of glycopyrronium, the changes were again significant for overall (P = 0.0001), asthma (P = 0.0065), and COPD (P = 0.0001). The parallel change in FEF25-75 was, however, showing better reversibility in asthma (P = 0.0008) with salbutamol compared to COPD (P = 0.1846) and the reverse to glycopyrronium inhalation that results in better reversibility in COPD (P = 0.0085) compared to asthma (P = 0.0949). Conclusion: Testing the reversibility with glycopyrronium appears feasible and safe in obstructive airway disease. It induced add-on reversibility once used after standard salbutamol reversibility. The observation demands further evaluations.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"9 1","pages":"16 - 21"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48438406","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":"Utilizing flexible bronchoscopy for the diagnosis of endobronchial tuberculosis with negative sputum acid-fast bacillus","authors":"N. Huan, Nurul Izzati Mohd Yusof, H. Ramarmuty, T. Khoo, Yean-Chen Lai, S. Lo, K. S. Sivaraman Kannan","doi":"10.4103/jacp.jacp_20_20","DOIUrl":"https://doi.org/10.4103/jacp.jacp_20_20","url":null,"abstract":"Background: Endobronchial tuberculosis (EBTB) should be viewed as a distinct subset of tuberculosis due to various pitfalls: (a) often diagnosed late, (b) mimicking other conditions, for example, lung carcinoma, and (c) risks of bronchostenosis if treated late. Flexible bronchoscopy (FB) offers a reliable and safe modality to increase the diagnostic yield of EBTB when sputum acid-fast bacillus (AFB) is negative. In this study, we aim to determine the clinical presentation, bronchoscopic characteristics, and safety of FB for the diagnosis of EBTB at our centers. Methods: From September 2018 to December 2019, 25 patients with EBTB from Queen Elizabeth Hospital and Labuan Hospital, Malaysia were enrolled in this study. Histopathology and/or microbiology were diagnostic in all patients. All patients underwent FB only after sputum smears for AFB were negative. Results: The most common presenting complaint was cough (68%), followed by loss of weight (52%), loss of appetite (36%), fever (32%), hemoptysis (28%), and dyspnea (24%). Lung mass/nodule was seen on imaging in 56% of patients, followed by consolidation (36%), cavity (36%), tree-in-bud appearance (32%), and collapse (24%). The most common Chung’s classification of EBTB appearance was edematous-hyperemic (60%); other appearances in order of descending frequencies were: fibro-stenotic (24%), caseating (24%), tumorous (16%), and granular (16%). Bronchial lavage cultures and/or histopathology cultures were positive for tuberculosis in 72% of patients. No procedure-related mortality or major complications were reported. Conclusion: Even in tuberculosis endemic settings, empirical pharmacological treatment of all suspected EBTB cases will inadvertently lead to delay in attaining competing differential diagnoses in some. FB in selected patients is safe and effective as it enhances treatment confidence by providing histological and/or microbiological evidence thereby ruling out other differentials when initial sputum results were inconclusive.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"9 1","pages":"1 - 6"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48649520","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":"Pulmonary cryptococcosis presenting as miliary tuberculosis in an immunocompetent patient","authors":"Sharad Joshi, Nitesh Tayal, Rajesh Gupta, Ankit Bhatia, N. Kapoor","doi":"10.4103/jacp.jacp_5_20","DOIUrl":"https://doi.org/10.4103/jacp.jacp_5_20","url":null,"abstract":"Pulmonary Cryptococcosis is a rare and difficult to diagnose entity. It has been found to be associated with immunocompromised patients. Pulmonary Cryptococcosis in an immunocompetent patient is extremely rare condition. A high degree of suspicion is required to diagnose the condition. We hereby present a case of pulmonary cryptococcosis in an immunocompetent young male which is a rare clinical entity.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"9 1","pages":"29 - 31"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46230941","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":"Double hit: Synchronous gastrointestinal stromal tumour (GIST) & lung neuroendocrine tumour − a rare case of multiple primary malignancies","authors":"K. Kumar, D. Prajapat, Arjun Prakash, C. Dabral, D. Talwar","doi":"10.4103/jacp.jacp_16_20","DOIUrl":"https://doi.org/10.4103/jacp.jacp_16_20","url":null,"abstract":"Gastrointestinal Stromal Tumours (GISTs) are rare but remain the most common mesenchymal tumour of the Gastrointestinal tract (GIT). The asynchronous occurrence of other malignancies in patients with GIST during the clinical course is relatively common. However, the synchronous coexistence of GIST and lung cancer has only rarely been reported. We report the case of a 65-year-old male, a former smoker, who was diagnosed with synchronous occurrence of mesenteric GIST and Primary Large Cell Neuroendocrine Cancer (LCNEC) of the lung. There are few case reports on synchronous occurrence of GIST with primary lung cancer but till date no case report exists on GIST with primary LCNEC of lung.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"9 1","pages":"32 - 36"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47138804","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":"Swyer-James-Macleod Syndrome: A Rare Finding in a Case of Haemoptysis","authors":"N. Sharma, Preeti Gupta, A. Yadav","doi":"10.4103/jacp.jacp_18_20","DOIUrl":"https://doi.org/10.4103/jacp.jacp_18_20","url":null,"abstract":"Swyer-James-MacLeod Syndrome (SJMS) is a rare cause of a hyperlucent unilateral hemithorax. It is usually found in childhood and is a long-term sequalae of postinfectious bronchiolitis obliterans. It can be an incidental finding in adults. Most patients are asymptomatic. However, some patients can present with recurrent pulmonary infections, haemoptysis or dyspnoea. The diagnosis of SJMS is made radiographically by chest x-ray and CT scan. Majority of symptomatic patients will require conservative management. It is also important to rule out other diseases which have similar radiological picture as inaccurate diagnoses can lead to inappropriate therapy. Here we report a case of 63-year-old woman who presented with haemoptysis and progressive dyspnoea and was subsequently diagnosed as a case of SJMS.","PeriodicalId":30411,"journal":{"name":"The Journal of Association of Chest Physicians","volume":"9 1","pages":"41 - 44"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47858135","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}