Journal of Advanced Lung Health最新文献

{"title":"Unveiling Thrombocytopenia in Drug-resistant Extrapulmonary Tuberculosis: A Comprehensive Review","authors":"Sanchit Mohan, Nupoor Vaghasia, Vishwanath Pujari, P. Meshram","doi":"10.4103/jalh.jalh_13_24","DOIUrl":"https://doi.org/10.4103/jalh.jalh_13_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 Immune thrombocytopenia (ITP) is caused because of antibodies to platelets. ITP can be primary or secondary; secondary ITP is usually caused by infections. Tuberculosis (TB) is a rare cause of secondary ITP. Linezolid, despite being the backbone of a drug-resistant TB regimen, is the most common drug to cause thrombocytopenia in this subset of patients. Treatment of ITP requires immunosuppression with pulse steroids and intravenous immunoglobulin which can lead to dissemination of TB and can be catastrophic in patients of drug-resistant TB. Here, we present a case of drug-resistant extrapulmonary TB with ITP, which was managed with low-dose corticosteroids. This case highlights the importance of complete evaluation for the cause of thrombocytopenia and considering ITP as a differential before discontinuing any essential drug in these patients.","PeriodicalId":402083,"journal":{"name":"Journal of Advanced Lung Health","volume":"30 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141344131","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":"The Papanicolaou Society of Cytopathology System for Reporting Respiratory Cytology: To Establish Efficacy and Ease to Use in Routine Cytology Practice","authors":"Neha Sharma, Sonam Sharma, Mukul Singh","doi":"10.4103/jalh.jalh_17_24","DOIUrl":"https://doi.org/10.4103/jalh.jalh_17_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Various pulmonary cytology techniques have been established, representing morphological diversity and ranging from non-invasive to minimally invasive. However, there is currently no widely accepted classification system for respiratory cytology. In 2016, the Papanicolaou Society of Cytopathology (PSC) proposed a six-tiered category system for the cytological sample obtained from the respiratory tract. The diagnostic efficacy of such a category system can help in the early diagnosis of lung cancer patients, thereby reducing mortality and morbidity.\u0000 \u0000 \u0000 \u0000 The aim of this study was to determine the diagnostic accuracy and utility of PSC guidelines for reporting respiratory cytology specimens in comparison to histopathology.\u0000 \u0000 \u0000 \u0000 This study was conducted over 6 months, from September 2023 to February 2024, on a prospective basis. Out of a total of 165 samples analyzed, 147 (89%) were bronchoalveolar lavage samples, 09 (05%) were bronchial brushings, 03 (02%) were bronchial washings, and 06 (04%) were endobronchial ultrasound-guided transbronchial fine-needle aspiration. These cytological specimens were processed and categorized according to the PSC reporting system for respiratory cytology, as non-diagnostic, benign, atypical, neoplastic (benign/undetermined malignant potential), suspicious of malignancy, and malignant. In all cases, the histopathological correlation with corresponding transbronchial or endobronchial lung biopsy was done.\u0000 \u0000 \u0000 \u0000 Our study found that 4% of the cases were non-diagnostic, 80% were benign, 13% were atypical, 2% were suspicious for malignancy, and 1% were malignant. When compared with the histological diagnosis, the sensitivity was 53.13%, the specificity was 93.23%, and the overall accuracy was 85.45%.\u0000 \u0000 \u0000 \u0000 The PSC reporting system for respiratory cytology can easily standardize reporting patterns to enhance communication between cytopathologists and clinicians, ultimately improving patient care.\u0000","PeriodicalId":402083,"journal":{"name":"Journal of Advanced Lung Health","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141344490","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":"Metastatic Poorly Differentiated Lung Cancer Shrouded in Pulmonary Tuberculosis – Lessons to Learn!","authors":"Yash Jagdhari, Mansi Gupta, Neha Nigam, Manish Ora","doi":"10.4103/jalh.jalh_10_24","DOIUrl":"https://doi.org/10.4103/jalh.jalh_10_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 Tuberculosis (TB) remains an important cause of morbidity and mortality in many countries including India. It is a major public health concern particularly for India, as it has the highest burden of TB cases with two deaths occurring due to TB every 3 min. The incidence of lung cancer is reportedly higher in patients with pulmonary TB than in the general population. However, a diagnosis of bronchogenic carcinoma superimposed on pulmonary TB is difficult to establish due to masking of the signs, symptoms, and radiologic findings by the preexisting disease. On the other hand, the presence of underlying lung malignancy has been correlated with an increased risk of developing TB and even associated with poorer outcomes. Here, we share an interesting case where metastatic lung carcinoma was suspected and diagnosed, due to a good and careful follow-up in a young patient with active pulmonary TB infection.","PeriodicalId":402083,"journal":{"name":"Journal of Advanced Lung Health","volume":"19 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141340714","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":"Accidental Finding of Tracheal Diverticulum in a Case with Intractable Cough","authors":"Tamizhan Sekar, Anand Agrawal, Kamaljeet Singh, Sunaina Kharb","doi":"10.4103/jalh.jalh_11_24","DOIUrl":"https://doi.org/10.4103/jalh.jalh_11_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 A 43-year-old female presented with complaints of an intractable cough with sputum and fullness in the neck region, which led to irritation and shortness of breath for the last 10 months. The computed tomography (CT) neck was suggestive of small tracheal diverticula seen along the right posterolateral aspect of the trachea, caudal to the level of the thyroid gland, bulging on the posterolateral wall of the trachea on coughing, as visualized through a fibro-optic video bronchoscope. Knowledge about the diagnosis of tracheal diverticulum is essential to avoid overtreatment of an uncontrolled cough and the management of other associated complications in the future.","PeriodicalId":402083,"journal":{"name":"Journal of Advanced Lung Health","volume":"4 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141341074","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":"Clinical Utility of Pulmonary Rehabilitation in Diffuse Parenchymal Lung Diseases","authors":"Ambarish Joshi, Gorle Sujatha, Nitesh Gupta, Rohit Kumar, Manas Kamal Sen, P. Ish, Vidushi Rathi, H. Popalwar","doi":"10.4103/jalh.jalh_5_24","DOIUrl":"https://doi.org/10.4103/jalh.jalh_5_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Pulmonary rehabilitation (PR) can help in improving the exercise capacity and quality of life (QoL) in diffuse parenchymal lung diseases (DPLDs), even in end-stage lung diseases listed for lung transplant. With the paucity of literature from the Indian population, the current study assessed PR’s benefits on the respiratory functions and exercise capacity in DPLD.\u0000 \u0000 \u0000 \u0000 This prospective interventional study was conducted over 18 months in patients with diagnosed stable DPLD who were previously not involved in any PR program. All the enrolled patients underwent 12-week in-hospital, supervised PR program, which included exercise training with increasing load, endurance training, resistance training, flexibility training, and stretching. The patients were evaluated for the measures at baseline and after 12 weeks of a rehabilitation program.\u0000 \u0000 \u0000 \u0000 There was a significant improvement in respiratory capacity forced expiratory volume in 1 s (FEV1), 6-min walk distance (6MWD), Modified Medical Research Council (MMRC), and total St. George’s Respiratory Questionnaire scores (P < 0.05) after the completion of the PR program. Among the outcome parameters, there were no significant differences in the PO2 and FEV1/forced vital capacity ratio (P > 0.05) etiologically; the improvement was significant for all outcome parameters except MMRC and symptom score in the idiopathic pulmonary fibrosis (IPF) group (P = 0.165). In the non-IPF group, the improvement was significant for all outcome parameters except PO2 (P = 0.9). On multivariate linear regression, age was the only independent factor for 6MWD (P = 0.0002; 95% confidence interval [CI]: −5.019–−1.665) and MMRC (P = 0.005; 95% CI: 0.007–0.037).\u0000 \u0000 \u0000 \u0000 This study reveals that PR is effective for people with DPLD in decreasing the symptoms and improving the exercise capacity and QoL. Clinical improvement is greater in those with non-IPF compared to IPF, but both groups as a whole achieved clinically significant improvements. An adaptation of the PR regimen as per age may be necessary for optimizing the clinical benefits.\u0000","PeriodicalId":402083,"journal":{"name":"Journal of Advanced Lung Health","volume":"30 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141355499","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 Case Report On Unusual Mediastinal Mass","authors":"E. V. Krishnakumar, Sandhra Satish, Joy Augustine, K. K. Ajaykumar, C. D. Paul, N. A. Arun, P. Unnikrishnan","doi":"10.4103/jalh.jalh_53_23","DOIUrl":"https://doi.org/10.4103/jalh.jalh_53_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 A 28-year-old female, a known case of neurofibromatosis 1, presented to the respiratory medicine department with complaints of breathlessness and cough for 2 weeks’ duration. Clinical examination revealed right-sided moderate pleural effusion. Computed tomography (CT) chest revealed a large anterior mediastinal mass with chest wall infiltration. Histopathology showed neoplasm with epithelioid cells, arranged as sheets and interlacing spindle cells with a moderate amount of eosinophilic cytoplasm and inconspicuous nucleoli. Histopathological examination of excised specimen showed a malignant peripheral nerve sheath tumor with rhabdomyoblastic differentiation also known as malignant triton tumor. After palliative chemotherapy, later on follow-up, CT-guided biopsy from right side chest wall lesion also showed the same. Because of this rare presentation, we are reporting this case.","PeriodicalId":402083,"journal":{"name":"Journal of Advanced Lung Health","volume":"33 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141356867","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":"Fat Embolism Syndrome in a Preoperative Patient","authors":"Sunny George, K. Anithakumari., Parvathi Rajendran, Sophia Philip, Renjana Anirudhan, A. A. F. Ali., S. Ganashree","doi":"10.4103/jalh.jalh_57_23","DOIUrl":"https://doi.org/10.4103/jalh.jalh_57_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 Dyspnea following a long bone fracture brings in the possibility of fat embolism, especially if the symptoms start around 48–72 h after the trauma. Although long bone fractures are associated with fat embolism in more than 90% of cases, the florid syndrome related to fat embolism occurs only in <5% of cases. Here, we report a young male who was admitted to the surgery intensive care unit following a road traffic accident was evaluated for dyspnea before an elective long proximal femoral nailing and internal fixation procedure.","PeriodicalId":402083,"journal":{"name":"Journal of Advanced Lung Health","volume":"76 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141359818","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":"Efficacy of Inhaled Corticosteroids in Patients with Bronchiectasis without Airway Hyperresponsiveness: A Pilot Study","authors":"Safia Ahmed, S. Sutravey","doi":"10.4103/jalh.jalh_9_24","DOIUrl":"https://doi.org/10.4103/jalh.jalh_9_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 The effect of inhaled corticosteroids (ICS) in stable cases of bronchiectasis without hyperresponsiveness has not been studied. The objective of the study was to assess the effect of inhaled fluticasone 500 μg twice daily on health-related quality of life (HRQoL), pulmonary function, and frequency of exacerbations in stable patients of bronchiectasis without bronchial hyperresponsiveness (BHR) diagnosed by indirect bronchoprovocation test.\u0000 \u0000 \u0000 \u0000 It was a pilot study with an open-label randomized control design conducted in a Tertiary Care Chest Hospital, with 40 patients in each arm. Bronchiectasis was diagnosed by high-resolution computed tomography chest. Patients with BHR were excluded by performing an indirect bronchoprovocation test using inhaled adenosine monophosphate. Eighty patients meeting the inclusion criteria were randomized into intervention group (IG) receiving 500 μg fluticasone propionate twice a day and control group (CG) receiving standard care without ICS. Both groups were assessed monthly till 6 months. Clinical data (mainly forced expiratory volume in 1st s [FEV1], number of exacerbations, HRQoL by St. George respiratory questionnaire (SGRQ) was collected at baseline and end of 6 months.\u0000 \u0000 \u0000 \u0000 Eighty (IG - 40, CG - 40) patients of stable state noncystic fibrosis bronchiectasis completed the study. The mean age in our study was IG 49.7 ± 17.6 vs. CG 49.9 ± 16.6, males IG 62.5% vs. CG 60%, most common etiology was tuberculosis IG 40% (16/40) vs CG 37.5% (15/40). Difference in SGRQ score (baseline end of treatment) IG 5.47 vs. CG 1.65 (p = 0.00). Difference in FEV1 IG 0.054L vs. CG 0.004L (P = 0.00), mean number of exacerbations at end of treatment IG – 1 ± 0.9 vs. CG 1.2 ± 1.1.\u0000 \u0000 \u0000 \u0000 Patients with stable bronchiectasis without BHR, treated with inhaled fluticasone 500 μg twice daily for 6 months showed a clinically significant improvement in HRQoL. No statistically significant difference was seen in pulmonary function and frequency of exacerbations.\u0000","PeriodicalId":402083,"journal":{"name":"Journal of Advanced Lung Health","volume":"74 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141357903","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":"Intracranial Hypertension in a Person Infected with Influenza A: An Accidental Diagnosis","authors":"Jolsana Augustine, Caroline Theresa Paulson, Khadiga Abdalla, Ahmed Ahmed Ebied, Mohammed Harriss","doi":"10.4103/jalh.jalh_55_23","DOIUrl":"https://doi.org/10.4103/jalh.jalh_55_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 Idiopathic intracranial hypertension (ICH) is a neurological syndrome determined by a rise in intracranial pressure without a specific cause. The exact pathophysiology of this disease is unknown. Intake of retinoids, steroid hormones, high body mass index, release of cytokines, and adipokine levels could be possible causal or associated factors. The association of influenza with ICH has been observed rarely in adults. The clinical symptoms can be headache, disturbance of vision, diplopia, and tinnitus, which can be very well missed during an acute flu attack as the symptoms overlap. Even though papilledema is considered the most specific sign, it is rarely found. Neuroradiological signs on magnetic resonance imaging may suggest the diagnosis of idiopathic ICH. Ophthalmological evaluation is mandatory to find out complications and sequelae in the form of visual loss. Lumbar puncture and cerebrospinal fluid opening pressure measurement are helpful in establishing a diagnosis as well as relieving pressures as part of the management. Influenza is a preventable disease with the administration of a yearly vaccine against specific strains of the virus for the year and region, as released by the Center for Disease Control.","PeriodicalId":402083,"journal":{"name":"Journal of Advanced Lung Health","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141359599","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":"Relationship between the ABO/Rh Blood Group Factors with Coronavirus Disease 2019 Severity and Mortality among Hospitalized Patients in Algeria: A Single-center Study","authors":"A. Ketfi, Karima Zouai, Yacine Djagheri, K. Djenouhat, Rama Touahri","doi":"10.4103/jalh.jalh_6_24","DOIUrl":"https://doi.org/10.4103/jalh.jalh_6_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 The novel coronavirus causes the deadly disease, severe acute respiratory syndrome (SARS). Therefore, it is necessary to identify prognostic factors for patients hospitalized with SARS-coronavirus-2 infection to identify patients with increased mortality risk. Several studies have shown that polymorphisms within the ABO gene are associated with different traits, including risk factors for coronavirus disease 2019 (COVID-19) mortality.\u0000 \u0000 \u0000 \u0000 We conducted a prospective, single-center study at the Pulmonologist Department of Rouiba Hospital, Algiers. The medical records of 498 COVID-19 patients enrolled in this cohort study were hospitalized between March 2020 and March 2022. The patient reported the blood group (grouping card) or was carried out on site. The patients were divided into 10 groups: A+, A−, B+, B−, O+, O−, AB+, AB−, (Rhesus+ABO/Rh blood groups), and Rhesus-groups, according to the distribution of ABO blood group. The different ABO blood group of the 498 patients was analyzed and compared according to their prognosis, death, or transfer to an intensive care unit.\u0000 \u0000 \u0000 \u0000 Four hundred and ninety-eight patients were evaluated, 213 (42.8%) were male, and the mean age was 55.2 years (standard deviation: 15.3). A total of 473 (94.98%) patients were discharged, and 25 (5.02%) died during hospitalization. The number of patients with ARh negative was significantly higher in the dead patients 30% among 10 patients (P = 0.0002) versus 5.6% for A+, compared to improved individuals and more computed tomography scan lesion extension 40% (P = 0.021) between 50% and 75% vs. 13.2% ± 34.0% (P = 0.034) for the A(+) group, and hypernatremia 141.2 ± 2.7 (P = 0.056) versus 137.4 ± 4.36 for A(+) group. The distribution of ABO blood groups was statistically different between the two groups. The dead patients had the blood groups A(−), (30%), A+ (5.6%), B− (0%), B+ (1.5%), AB− (0%), AB+ (0%), O− (20%), and O+ (4.3%), respectively.\u0000 \u0000 \u0000 \u0000 The protective nature of all blood groups (AB, B, and O+) was observed in patients presenting with COVID-19 symptoms of varying severities. Blood grouping A and especially A− and O− are marked by a high risk of COVID-19 infection, serious form, and mortality and therefore deserve particular attention in their management.\u0000","PeriodicalId":402083,"journal":{"name":"Journal of Advanced Lung Health","volume":"36 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141355756","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}