Lung India最新文献

{"title":"Clinical and molecular insights into primary ciliary dyskinesia: Genotype-phenotype correlation and protein interaction networks in an Indian retrospective cohort.","authors":"Janani Balaji, Anitha M Barney, Madhan Kumar, Devasahayam J Christopher, Barney Isaac, Mohan S Kamath, Richa Gupta, Sumita Danda","doi":"10.4103/lungindia.lungindia_346_26","DOIUrl":"https://doi.org/10.4103/lungindia.lungindia_346_26","url":null,"abstract":"<p><strong>Background and objective: </strong>Primary ciliary dyskinesia (PCD) is a rare genetic disorder causing defective ciliary motility, leading to chronic respiratory disease, neonatal distress, subfertility, and laterality defects. This study examines the clinical and genetic spectrum of PCD in a South Asian cohort, focusing on genotype-phenotype correlations, protein interaction effects of pathogenic variants, and the role of bioinformatics in improving molecular diagnosis.</p><p><strong>Methods: </strong>We conducted a retrospective study of suspected PCD cases at a tertiary referral centre in India from 2017 to 2025, reviewing clinical, laboratory, imaging, and exome sequencing data. Protein-protein interaction (PPI) and Gene Ontology (GO) enrichment analyses were performed to assess functional convergence.</p><p><strong>Results: </strong>Out of 41 individuals suspected of having PCD, 31 were molecularly confirmed. Most cases presented in childhood, while a subset presented in adulthood, often primarily with infertility. Pathogenic or likely pathogenic variants were identified in 18 genes associated with PCD, with the most common being DNAH11, DNAH9, DNAH5, and CCDC40; homozygous variants were predominant. Structural modelling indicated the preservation of global protein folds, with localised conformational deviations noted particularly in DNAH5 and DNAH11 . PPI network analysis revealed significant interaction enrichment ( P < 1 × 10 -16 ). GO analysis showed strong enrichment of cilia-related biological processes, including microtubule-based processes (-log 10 FDR = 22.96) and microtubule bundle formation (-log 10 FDR = 27.54).</p><p><strong>Conclusions: </strong>This study enhances understanding of PCD variants in the Indian population and highlights the value of combining clinical evaluations with genomic and structural analyses. PPI and GO analyses reveal disrupted ciliary pathways linked to PCD.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138832","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":"An innovative \"Grading System for Lung Adhesions\" - The Indian Way.","authors":"Mohan Venkatesh Pulle, Arvind Kumar","doi":"10.4103/lungindia.lungindia_93_25","DOIUrl":"10.4103/lungindia.lungindia_93_25","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 5","pages":"609-610"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overfitting and subgroup P -value inconsistencies in mortality prediction analysis of a VV-ECMO cohort.","authors":"Sai Karthik Guniganti, Balamoni Vinay Kumar Goud","doi":"10.4103/lungindia.lungindia_357_26","DOIUrl":"10.4103/lungindia.lungindia_357_26","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 5","pages":"614-615"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing adult pneumococcal vaccination in India: Evidence from serotype surveillance.","authors":"Tj Barney Isaac, M Gurumoorthy, Parvaiz A Koul, Vijai K Ratnavelu, Balaji Veeraraghavan","doi":"10.4103/lungindia.lungindia_415_25","DOIUrl":"10.4103/lungindia.lungindia_415_25","url":null,"abstract":"<p><strong>Introduction: </strong>Pneumococcal disease, caused by Streptococcus pneumoniae , is a major public health burden with high morbidity and mortality across all age groups in India. Limited adult pneumococcal vaccination policies, evolving serotype patterns, and delayed herd protection from paediatric immunization continue to challenge effective prevention of pneumococcal disease in adults.</p><p><strong>Methods: </strong>This retrospective laboratory surveillance study includes Streptococcus pneumoniae isolates from adults (>18 years) collected between January 2018 and May 2025 at Christian Medical College, Vellore and were serotyped using the Quellung and co-agglutination method. Percentage of serotype coverage for PCV20, PCV21, and PPSV23 was analysed.</p><p><strong>Results: </strong>Among 1,065 adult pneumococcal isolates, PCV20 covers 66.5% of invasive pneumococcal disease (IPD) serotypes, including emerging serotypes such as 15B and 11A, while PCV21 aligns poorly with the local epidemiology, covering only 46.5% of adult IPD serotypes. PPSV23 offers limited additional relevant serotype coverage beyond PCV20 and is limited by lower immunogenicity and hyporesponsiveness to multiple doses.</p><p><strong>Discussion: </strong>Our findings highlight significant gaps between the circulating serotypes in adults in India and those covered by current vaccines. PCV20 shows promise for broader adult protection; however, further multi-centre studies, cost-effectiveness analyses, and enhanced surveillance are needed to inform policy and optimize immunization strategies in resource-limited settings.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 5","pages":"556-560"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unicentric Castleman disease presenting as hyperenhancing mediastinal mass: A case series diagnosed by linear endobronchial ultrasound guided mediastinal nodal biopsy.","authors":"Rinoosha Rachel, Makkena Avinash Rao, Kavumkal R Balasubramoniam, Venkata Nagarjuna Maturu","doi":"10.4103/lungindia.lungindia_140_26","DOIUrl":"10.4103/lungindia.lungindia_140_26","url":null,"abstract":"<p><p>Unicentric Castleman disease (UCD) is an uncommon benign lymphoproliferative disorder that typically presents as solitary mediastinal or hilar nodal enlargement and may mimic malignant or hyper vascular lesions on imaging. We describe a case series of three women presenting with solitary, well-circumscribed mediastinal or hilar masses-two presented with chronic dry cough (one associated with anaemia) and one identified incidentally during routine screening. Contrast-enhanced computed tomography (CECT) demonstrated intensely enhancing hyper vascular nodal lesions, while positron emission tomography-computed tomography (PET-CT) revealed mild fluorodeoxyglucose uptake without additional nodal or extra nodal involvement, supporting an unicentric process. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was performed that was nondiagnostic in all cases, yielding reactive cytology without architectural detail. In contrast, EBUS-guided intranodal forceps or cryo biopsy was performed that resulted adequate tissue with preserved nodal architecture, helping definitive histopathological and immunohistochemical diagnosis of hyaline vascular UCD. Two patients subsequently underwent complete surgical excision followed by symptomatic resolution and favourable outcomes, while one declined surgery. This series highlights the characteristic clinic-radiologic pattern of solitary hyper enhancing thoracic nodal disease and underscores the limitations of needle aspiration cytology. Minimally invasive mediastinal nodal biopsy can establish definitive diagnosis preoperatively and facilitate timely curative management in patients with UCD.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 5","pages":"590-594"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the Baveno classification system in patients with obstructive sleep apnoea.","authors":"Ahmad A Bamagoos, Siraj O Wali","doi":"10.4103/lungindia.lungindia_796_25","DOIUrl":"10.4103/lungindia.lungindia_796_25","url":null,"abstract":"<p><strong>Introduction: </strong>The Baveno classification system has been proposed as a simple method for screening obstructive sleep apnoea (OSA) severity in clinical settings. The current study aimed to determine the prevalence of the Baveno groups among participants from Saudi Arabia. It also aimed to compare OSA patient characteristics between groups of the Baveno classification.</p><p><strong>Methods: </strong>A retrospective chart review of polysomnography-diagnosed adult OSA patients' records has been performed. According to the Baveno classification system, participants were assigned to 2 × 2 Groups A-D based on their typical OSA symptoms and end-organ complications. The four groups were compared in terms of prevalence, routine clinical measurements, polysomnography measurements and prescription of continuous positive airway pressure (CPAP) therapy.</p><p><strong>Results: </strong>Among the 817 participants of the current study (57% males, age = 52 [±15] years, Body Mass Index = 37 [±10] kg/m 2 ), the proportion of participants included in the Baveno groups from A to D was: 16%, 51%, 6% and 27%, respectively. All demographics and polysomnography variables were significantly different between the four Baveno groups (one-way analysis of variance or Chi-square test, P < 0.01). Variables moved toward unfavourable values (e.g. more age) when moving from Group A through to Group D. However, mixed results are evident between Groups B and C. Prescription of CPAP (proportion of patients offered CPAP and optimal pressure requirement) was not different between the Baveno classification groups.</p><p><strong>Conclusion: </strong>Although the Baveno classification is successful in identifying the two main ends of the OSA spectrum, it requires refinement to enable accurate detection of the heterogeneous nature of the disease.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 5","pages":"507-513"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT manifestations of pulmonary mucormycosis: Influence of risk factor, symptom duration, and glycemic control.","authors":"Nidhi Prabhakar, Mandeep Garg, Ritesh Agarwal, Uma Debi, Inderpaul S Sehgal, Shivaprakash M Rudramurthy, Nalini Gupta, Amanjit Bal, Harkant Singh, Raja Ramachandran, Shiv Patil, Soham Mukherjee, Arunaloke Chakrabarti, Valliappan Muthu","doi":"10.4103/lungindia.lungindia_46_26","DOIUrl":"10.4103/lungindia.lungindia_46_26","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary mucormycosis (PM) imaging has been characterised primarily in patients with hematologic malignancies. Imaging patterns may differ in diabetes mellitus-associated PM (DAPM), the most common risk factor globally, due to different immunologic profiles and disease progression. The impact of glycemic control on CT findings in DAPM is unknown.</p><p><strong>Methods: </strong>We retrospectively analysed chest CT scans of patients with PM, compared DAPM with PM in other risk factors (PMOR), and evaluated imaging features across glycated haemoglobin (HbA1c) categories. The secondary objective was to determine associations between imaging features and mortality in DAPM. Imaging patterns recorded by two radiologists were compared between study groups, and multivariable logistic regression analysis of mortality was performed.</p><p><strong>Results: </strong>Among 193 patients (161 DAPM, 32 PMOR), consolidation (97%) and cavitation (84%) were the most frequent. DAPM presented significantly later (median 30 vs. 7 days; P < 0.001) and showed distinct features: smaller nodules (62%, <10 mm) with centrilobular distribution (37.4%), while PMOR had larger nodules (10-30 mm, 55.0%) with random distribution (75.0%). Lymphadenopathy was more common in DAPM (26.0% vs. 9.4%, P = 0.043). Among DAPM, Bird's nest sign increased with HbA1c severity: 7.7% (HbA1c ≤7%), 33.3% (HbA1c 7-9%), and 43.3% (HbA1c>9%), P = 0.030. Overall, 12-week mortality was 47.9%. Although the reversed halo sign and bird's nest sign were associated with mortality on univariable analysis, neither was significant after adjusting for clinical factors.</p><p><strong>Conclusion: </strong>DAPM presents later and exhibits distinct imaging features compared to PMOR. Bird's nest sign is more frequent with HbA1c >9%. No imaging features were independently associated with mortality.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 5","pages":"545-555"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Day-time split study for management of obstructive sleep apnoea: Proof of concept study.","authors":"Abhishek Goyal, Arwa Bohra, Khushboo Saxena, Asha Undrajavarapu, Avishek Kar","doi":"10.4103/lungindia.lungindia_787_25","DOIUrl":"10.4103/lungindia.lungindia_787_25","url":null,"abstract":"<p><strong>Objective: </strong>Waiting time for diagnosis and treatment of obstructive sleep apnoea (OSA) is increasing due to a lack of adequate amount of sleep labs. This study was done to find out the feasibility of daytime split Polysomnography (PSG) in patients with excessive daytime sleepiness (EDS) so as to reduce waiting time in sleep labs.</p><p><strong>Methods: </strong>Thirty patients with EDS (defined by Epworth Sleepiness scale ≥14) underwent both dPSG (daytime) and nPSG (nighttime). Diagnostic sleep parameters, titration pressures were compared. A questionnaire consisting of 12 questions for the experience of patients, technicians, and physicians was filled out after each dPSG and nPSG.</p><p><strong>Results: </strong>Thirty patients (11 females and 19 males) underwent both dPSG and NPSG. The mean age and BMI were 55.23 ± 8.1 years and 36.11 ± 7.70 kg/m², respectively. PSG parameters (sleep efficiency, total sleep time, time in bed) were not different in the two groups. During dPSG titration, optimal, good and adequate titration was achieved in 22%, 19% and 52% respectively, compared to 33%, 15% and 44% during nPSG. In the Likert scale questionnaire, patients had comparable sleep quality in both PSGs. Technicians felt more sleepy during nPSG, and most technicians preferred dPSG over nPSG. Physicians' agreement with titration done by technicians was equal in both dPSG and nPSG.</p><p><strong>Conclusions: </strong>Daytime split PSG may be a viable alternative to night PSG in patients with OSA with excessive sleepiness. This can ensure early treatment of patients with OSA.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 5","pages":"561-565"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SWORD survey: Seasonal trends in hospitalisation and mortality among patients with respiratory illnesses in India.","authors":"Sheetu Singh, Bharat B Sharma, Arvind K Sharma, Nishtha Singh, Krishna K Sharma, Tejraj Singh, Nirmal K Jain, Parvaiz A Koul, Sundeep Salvi, Virendra Singh","doi":"10.4103/lungindia.lungindia_812_25","DOIUrl":"10.4103/lungindia.lungindia_812_25","url":null,"abstract":"<p><strong>Objective: </strong>The SWORD study examined seasonal variations in respiratory disease related hospitalisations and mortality across India. It also assessed risk factors and comorbidities influencing these outcomes.</p><p><strong>Methods: </strong>This multicentre, questionnaire-based, point prevalence study was conducted across four seasonal weeks in 2017-2018. Data on respiratory admissions on the first day and deaths over the following week were collected.</p><p><strong>Results: </strong>At 245 centres, 2,886 patients were hospitalised, and 394 deaths occurred. COPD was the leading cause of both hospitalisations and deaths, followed by tuberculosis (TB), respiratory tract infections (RTI), asthma, pleural effusion, lung cancer, bronchiectasis, and interstitial lung disease (ILD). Respiratory admissions and deaths peaked in winter (28.7% and 32.7%) and were lowest in summer (21.1% and 18.0%). COPD hospitalisations were significantly higher in winter than summer (OR: 1.39; 95% CI: 1.1-1.8), with mortality showing a similar pattern. Key risk factors for hospitalisation and death varied by disease.</p><p><strong>Conclusion: </strong>Respiratory hospitalisations and deaths in India follow a clear seasonal trend, with winter posing the highest risk and summer the lowest. COPD, TB, RTI, asthma, pleural effusion, lung cancer, bronchiectasis, and ILD were the most frequent causes. These findings underscore the need for targeted, season-specific strategies to manage respiratory diseases effectively.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 5","pages":"496-506"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of multiplex PCR panels for optimum management of lower respiratory Infections Employing FilmArray Pneumonia Plus Testing-results of the UPLIFT study.","authors":"Rajesh Venkitakrishnan, Bismil Aisha Basheer, Melcy Cleetus, Divya Ramachandran, Anand Vijay, Hasha Thankam Somson, Sonya Joy, Neethu Susan Philip, Susan John","doi":"10.4103/lungindia.lungindia_30_26","DOIUrl":"10.4103/lungindia.lungindia_30_26","url":null,"abstract":"<p><strong>Background and objective: </strong>The objectives of this study were to assess the yield of multiplex PCR testing in LRTI and its utility in antimicrobial streamlining. Establishing the microbial aetiology is of paramount importance for tailored antimicrobial therapy in lower respiratory tract infections (LRTI). Multiplex PCR panels (FilmArray Pneumonia Plus Panel [FAPP]) have been shown to provide better diagnostic yield in LRTI.</p><p><strong>Methods: </strong>A total of 103 patients hospitalized with LRTI were enrolled. The culture isolates, their sensitivity pattern, and antimicrobial resistance were noted. Time taken for availability of FAPP results as well as culture positivity was documented. Antibiotic modification made based on identification of the pathogens along with their resistant gene patterns from appropriate samples and time taken to reach that decision was noted and compared between conventional culture and FAPP.</p><p><strong>Results: </strong>FAPP detected at least one pathogen in (92/103) of tested specimens. Conventional culture detected at least one pathogen in 36 (34.9%) cases only. The mean duration of antibiotic therapy in FAPP-positive cases was 4.89 ± 1.84 days versus 7.2 ± 3.83 days in cases where FAPP was negative ( P value of 0.019). Similarly, the duration of hospital stay in FAPP-positive cases versus -negative cases was 5.136 ± 1.73 days versus 7.6 ± 3.36 days, respectively ( P value 0.007). Mean turnaround time (TAT) for the FAPP was strikingly low with FAPP. Antimicrobial modification guided by FAPP was achieved in 83 out of 103 patients (80.6%), substantially higher than with conventional culture.</p><p><strong>Conclusion: </strong>In hospitalized patients with LRTI, FAPP provided better diagnostic sensitivity, better detection of resistance, faster TAT, higher potential for antimicrobial modification, lesser days of antibiotic use, and shorter hospital stay compared to culture.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 5","pages":"536-544"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13568555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}