Lung India最新文献

{"title":"STOPBANG vs. STOPBWANG: Comparative predictive performance for obstructive sleep apnoea severity and oxygen desaturation in an Indian cohort.","authors":"Arup Haldar, Raja Dhar, Somnath Maity, Beauty Biswas, Shyam Krishnan, Amrita Bhattacharya","doi":"10.4103/lungindia.lungindia_449_25","DOIUrl":"https://doi.org/10.4103/lungindia.lungindia_449_25","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnoea (OSA) is underdiagnosed in India, necessitating context-specific screening tools. While STOPBANG (incorporating neck circumference) is widely used, waist circumference (reflecting visceral adiposity) may better predict OSA severity and oxygen desaturation in populations with the high abdominal obesity. This study compared STOPBANG, STOPBAWG (waist-modified STOPBANG), and STOPBWANG (STOPBANG + waist) for predicting OSA severity and hypoxemia in an Indian cohort.</p><p><strong>Methods: </strong>Retrospective analysis of 662 Indian adults undergoing polysomnography (PSG) for suspected OSA. Anthropometrics (neck/waist circumference, Body Mass Index [BMI]), Epworth Sleepiness Scale (ESS), and desaturation indices (DI, T90) were analysed. Predictive performance of STOPBANG, STOPBAWG, and STOPBWANG for OSA severity (Apnoea-Hypopnea Index [AHI-based]) was evaluated using logistic regression (Area Under the Curve [AUC] and Akaike Information Criterion [AIC]). Linear regression assessed associations between anthropometrics and oxygen desaturation.</p><p><strong>Results: </strong>Waist circumference >36 inches showed the strongest association with severe OSA (93.5% of severe OSA patients, P < 0.001) and oxygen desaturation ( R² =0.093 for T90). STOPBANG outperformed STOPBAWG (AUC: 0.849 vs. 0.819; AIC: 164.2 vs. 167.66). STOPBWANG (STOPBANG + waist) achieved the highest predictive accuracy (AUC: 0.88, AIC: 148.94). ESS correlated moderately with both tools (STOPBANG: r = 0.343; STOPBAWG: r = 0.316), but did not enhance model performance.</p><p><strong>Conclusion: </strong>STOPBANG remains superior to waist-modified STOPBAWG for OSA screening in Indians. However, integrating waist circumference into STOPBANG (STOPBWANG) significantly improves risk stratification, reflecting visceral adiposity's role in hypoxemia. Clinically, waist circumference should complement-not replace-neck circumference in OSA screening tools for abdominal obesity-predominant populations.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 3","pages":"253-257"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844592","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":"Beyond the protocol: Making pulmonary rehabilitation stick in complex COPD care.","authors":"Yating Pan, Tao Yu","doi":"10.4103/lungindia.lungindia_37_26","DOIUrl":"https://doi.org/10.4103/lungindia.lungindia_37_26","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 3","pages":"351-352"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844399","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":"Fragile immunity, fatal foe: A cluster of Pneumocystis jirovecii pneumonia cases in children with haematological malignancies on chemotherapy.","authors":"Masoom Nathani, Ravinder Kaur, R Kevin Joseph, Piali Mandal, Jagdish Chandra, Sonal Saxena","doi":"10.4103/lungindia.lungindia_481_25","DOIUrl":"https://doi.org/10.4103/lungindia.lungindia_481_25","url":null,"abstract":"<p><strong>Background: </strong>Pneumocystis jirovecii causes a potentially fatal interstitial pneumonia, especially in immunosuppressed hosts. It was the most common cause of death in children with leukaemia, before the introduction of prophylaxis.</p><p><strong>Aims: </strong>In this study, we evaluated the clinical and demographic characteristics of proven PJP cases in children with haematological malignancy on chemotherapy. The study also determined the association of PJP characteristics with various phases of chemotherapy.</p><p><strong>Methods: </strong>This was a retrospective study conducted at a tertiary care teaching hospital in Delhi. Cases included 13 children less than 12 years of age with leukaemia on chemotherapy with proven PJP diagnosis, according to the EORTC/MSGERC guidelines. For microbiological diagnosis, direct immunofluorescence was performed using the Merifluor® Pneumocystis kit manufactured by Meridian Bioscience Inc.</p><p><strong>Results: </strong>B-cell acute lymphoblastic leukaemia was the most common haematological malignancy seen in these cases. Most of the PJP cases were seen in the maintenance phase of chemotherapy. The clinical profile of the PJP cases includes fever, cough, cytopenia, hypoxaemia, coryza, dyspnoea, and hepatitis. The radiological findings of the PJP cases include bilateral diffuse ground-glass opacification, perihilar infiltrates, and unilateral infiltrates. The mortality rate of the PJP cases was 15.4%.</p><p><strong>Conclusions: </strong>Pneumocystis jirovecii causes a potentially life-threatening pneumonia, especially in immunocompromised individuals such as children with leukaemia on chemotherapy. PJP presents more severely with rapid progression and higher mortality rate in children with leukaemia than in HIV-positive cases. Therefore, early diagnosis and prompt treatment initiation is paramount in reducing morbidity and mortality in these cases.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 3","pages":"304-308"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844497","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":"Microdebrider - Assisted management of central airway obstruction via rigid bronchoscopy: A preliminary study on safety and efficacy.","authors":"Shyam Krishnan, Avirup Maiti, Arun Pankajakshan, Amrita Bhattacharyya, Aditya Satpati, Mohammed Munavvar, Raja Dhar","doi":"10.4103/lungindia.lungindia_524_25","DOIUrl":"https://doi.org/10.4103/lungindia.lungindia_524_25","url":null,"abstract":"<p><strong>Background: </strong>Central Airway Obstruction (CAO) presents a significant challenge in both malignant and benign conditions, requiring urgent intervention. Traditional debulking methods have limitations, prompting the exploration of alternative techniques like the microdebrider, initially used in otolaryngology. Our study, assesses the safety and efficacy of the microdebrider in managing CAO.</p><p><strong>Methods: </strong>This prospective, non-randomized interventional study included patients with CAO treated using the microdebrider during therapeutic bronchoscopy between February 2023 and January 2024. Data collected included patient demographics, obstruction characteristics, procedural time, and adverse events. The microdebrider was introduced via a rigid bronchoscope, and additional techniques like APC and electrocautery were employed as needed. Five historical control cases were analyzed for comparison.</p><p><strong>Results: </strong>Among 21 cases, 71% were malignant, primarily non-small-cell lung cancer (52.4%). Severe obstructions (>70%) were present in 81% of cases. Post-debulking, the mean obstruction reduced to less than 10%, with 76% categorized as insignificant. The mean procedure time was 28 minutes, with no adverse events observed. Compared to historical controls, microdebrider procedures were faster (28 vs. 51.2 minutes), with lower residual obstruction (10% vs. 20%).</p><p><strong>Conclusions: </strong>The microdebrider is an effective and economical tool for rapidly re-canalizing severely obstructed airways, particularly in broad-based tumors. It offers advantages over traditional methods, including shorter procedural times and fewer complications. Our study supports the microdebrider's relevance in managing CAO, especially in resource-limited settings.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 3","pages":"277-282"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844511","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":"Role of serum biomarkers KL-6, SP-D and CCL-18 in assessing interstitial lung disease in systemic sclerosis: A prospective observational study from India.","authors":"Shalini Dubey, Aashish O Agrawal, Girish Kakade, Zena Patel, C Balakrishnan, Rohini Samant","doi":"10.4103/lungindia.lungindia_508_25","DOIUrl":"https://doi.org/10.4103/lungindia.lungindia_508_25","url":null,"abstract":"<p><strong>Background: </strong>Systemic sclerosis (SSc) is a connective tissue disorder characterized by fibrosis of the skin and internal organs, with interstitial lung disease (ILD) affecting over 50% of patients. Early detection and monitoring of SSc-ILD are essential for timely intervention.</p><p><strong>Objectives: </strong>To evaluate the utility of serum biomarkers Krebs von den Lungen 6 (KL-6), C-C motif chemokine ligand 18 (CCL-18) and surfactant protein D (SP-D) in assessing ILD in Indian patients with SSc.</p><p><strong>Methods: </strong>In this prospective observational study, 76 patients with SSc were evaluated for ILD using high-resolution computed tomography (HRCT), pulmonary function tests (PFTs) and serum biomarker levels. Correlations between biomarker levels and clinical, radiological and functional parameters were assessed.</p><p><strong>Results: </strong>Serum KL-6 levels showed a significant negative correlation with forced vital capacity (FVC) ( r = -0.58, P = 0.01) and were significantly elevated in patients with progressive ILD ( P < 0.0001). SP-D levels correlated significantly with HRCT scores ( r = 0.42, P = 0.04), diffusing capacity of carbon monoxide ( r = -0.528, P = 0.017) and modified Rodnan Skin Score (mRSS) ( r = 0.42, P = 0.02). CCL-18 levels demonstrated a strong positive correlation with mRSS ( r = 0.72, P = 0.016). KL-6 and CCL-18 levels were higher in patients with diffuse cutaneous SSc. SP-D levels were significantly elevated in SSc patients with ILD compared to those without ( P = 0.04).</p><p><strong>Conclusion: </strong>KL-6 and SP-D are promising tools for monitoring disease progression and guiding treatment in SSc-ILD, with KL-6 reflecting early alveolar inflammation and SP-D indicating the extent of alveolar injury.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 3","pages":"271-276"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844456","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":"Affordable use of indwelling pleural catheters for malignant pleural effusion.","authors":"Aarushi Chokhani, V Dhyana, Manish K Aggarwal, Ketan Kumar, Amit Jain, Sankar N Raman, Ramsubramaniam Kottasiamy, Eshita Shah, Avinash Murugan, Pankul Mangla, K V Arul, Rajiv Goyal","doi":"10.4103/lungindia.lungindia_585_25","DOIUrl":"https://doi.org/10.4103/lungindia.lungindia_585_25","url":null,"abstract":"<p><strong>Background and objective: </strong>Indwelling pleural catheters (IPC) relieve symptoms in malignant pleural effusion (MPE), while maintaining a reasonable quality of life. However, the high cost of the catheter and the drainage bottles limits their use in low- and middle-income countries. The objective of this study was to determine the time to pleurodesis, feasibility and safety while reusing a low-cost adaptor kit for IPC drainage in a retrospective cohort of patients with MPE.</p><p><strong>Methods: </strong>Consecutive patients undergoing IPC insertion over 5 years at a tertiary cancer center were included. IPCs were preferably inserted on outpatient basis, and drained at home using an adaptor kit and syringe. Talc pleurodesis was offered on lung re-expansion and reduction in drainage. IPC was removed if pleurodesis was achieved, after which follow up was done till 1 year.</p><p><strong>Results: </strong>The study included 69 patients. Twenty-five (36.2%) patients achieved pleurodesis during follow up after 40 (IQR 30-62) days. Thirteen patients who had undergone talc instillation achieved pleurodesis after 34 (IQR 21-40) days as compared to 46.5 (IQR 40-73.5) days in the 12 patients with spontaneous pleurodesis ( P = 0.06). We recorded 12 (17.4%) severe adverse events. Pleurodesis failure was noted in 2 (11.1%) patients after IPC removal.</p><p><strong>Conclusion: </strong>IPC was an effective treatment in adults with MPE with an acceptable incidence of adverse events when aspirated using adaptor kit. Studies comparing IPC and intercostal drainage tubes in our setting are needed.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 3","pages":"291-296"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844352","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 precision bronchodilator therapy in airflow limitation with asthma defining reversibility: An appraisal through pharmaco-responsiveness-based real-world observation.","authors":"Parthasarathi Bhattacharyya, Srijita Sen, Shuvam Ghosh, Avishek Kar","doi":"10.4103/lungindia.lungindia_398_25","DOIUrl":"https://doi.org/10.4103/lungindia.lungindia_398_25","url":null,"abstract":"<p><strong>Background: </strong>The advent of glycopyrronium responsiveness (GPR) has opened an avenue for precision bronchodilator therapy in asthmatics.</p><p><strong>Methods: </strong>We noted 2-Chair test (2CT) and spirometry with salbutamol bronchodilator-responsiveness (BDR) followed immediately by GPR in a cohort of asthmatics in an open, randomised observation. We treated (GINA stage-2 and 3) asthmatics with long-acting β2-agonist plus inhaled-corticosteroid (LABA-ICS) for salbutamol-BDR and with inhaled triple therapy (LABA-LAMA-ICS) for those having BDR and GPR. We compared the spirometry and 2-chair tests statistically between the initial and the follow-up status.</p><p><strong>Results: </strong>The two groups (30 each) were similar in demographic (age, body mass index), spirometric, and 2CT parameters. Post treatment (346.2 ± 242.3 and 390.2 ± 212.6 days for BDR and BDR+GPR-positive cases), both the groups improved universally. The GPR-positive triple drug treated group had similar change (215.7 ± 346.1 vs. 161.3 ± 318.7, P = 0.1578) in trough FEV1 but had a significantly higher value for post-salbutamol (449.0 ± 209.0 vs. 348.7 ± 282.2; P = 0.0201) and post-GP (531.7 ± 248.7 vs. 348.7 ± 282.2; P = 0.0015) FEV1 values on follow-up. The patients accepted the triple therapy universally without any serious adverse events. The two groups had similar number of mild exacerbations.</p><p><strong>Conclusions: </strong>The pharmaco-responsiveness based add-on LAMA is seen to improve lung function of asthma in early GINA stages with parallel, though not significant, changes in the post-exercise recovery response (Desat-max in 2CT). The observation demands attention to consider upfront prescription of LAMA based on universal performance of GP responsiveness in asthma.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 3","pages":"258-265"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844634","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":"Tracing the track: From chronic cough to cervical fistula.","authors":"Teresa Belo, M Argel, S Figueiredo, S Guerra, J Elvas Henrique, P Silva João","doi":"10.4103/lungindia.lungindia_153_26","DOIUrl":"https://doi.org/10.4103/lungindia.lungindia_153_26","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 3","pages":"343-344"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844589","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":"Bluish-green pleural effusion.","authors":"Ramakant Dixit, Siddharth Mathur","doi":"10.4103/lungindia.lungindia_512_25","DOIUrl":"https://doi.org/10.4103/lungindia.lungindia_512_25","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 3","pages":"340-341"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844444","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 and safety of daily drug regimens containing high-dose versus standard-dose rifampicin for treating pulmonary tuberculosis: Systematic review and meta-analysis.","authors":"Ashutosh N Aggarwal, Ritesh Agarwal, Sahajal Dhooria, Perumal K Bhavani, Kuruswamy T Prasad, Inderpaul S Sehgal, Valliappan Muthu","doi":"10.4103/lungindia.lungindia_532_25","DOIUrl":"https://doi.org/10.4103/lungindia.lungindia_532_25","url":null,"abstract":"<p><p>Standard rifampicin doses used to treat pulmonary tuberculosis lie at the lower end of drug exposure-response curve. We evaluated if higher daily rifampicin doses result in greater efficacy or harm. We searched literature databases for randomized controlled trials comparing efficacy and/or safety of standard and high rifampicin doses (>=15 mg/kg/day) for treating pulmonary tuberculosis. Our co-primary efficacy endpoints were proportion of patients with positive mycobacterial culture at end of intensive phase and end of treatment. The primary safety endpoint was incidence of severe hepatotoxicity. Secondary efficacy endpoints were proportion of patients with culture positivity at 1, 3, and 4 months, death, treatment failure, recurrence after treatment, and loss to follow-up. Secondary safety endpoints were incidence of adverse event (any, serious, and drug-related serious), hepatotoxicity, and treatment interruption/discontinuation. We generated summary risk ratios (RR) using random effects models. We identified 5668 publications and selected 12 studies with 3230 participants. Nine studies had low risk of bias. Those on high-dose rifampicin had significantly lower culture positivity at end of intensive phase (summary RR 0.74, 95%CI 0.62-0.89), but not at end of treatment (summary RR 0.52, 95%CI 0.23-1.15), as well as significantly higher incidence of severe hepatotoxicity (summary RR 2.06, 95% CI 1.15-3.68) and treatment interruption/discontinuation (summary RR 1.89, 95%CI 1.09-3.28). Other secondary efficacy and safety outcomes were similar between the two treatment strategies. We conclude that higher daily rifampicin doses accelerate sputum conversion by the end of intensive phase of ATT, but severe hepatotoxicity remains a potential concern.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 3","pages":"309-322"},"PeriodicalIF":1.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844513","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}