Lung India最新文献

{"title":"Serum periostin and carcinoembryonic antigen for diagnosing and assessing response in allergic bronchopulmonary aspergillosis.","authors":"Renu Sah, Valliappan Muthu, Parul Kamboj, Arnab Pal, Shivaprakash M Rudramurthy, Sahajal Dhooria, Inderpaul Singh Sehgal, Kuruswamy Thurai Prasad, Mandeep Garg, Ashutosh N Aggarwal, Ritesh Agarwal","doi":"10.4103/lungindia.lungindia_32_25","DOIUrl":"10.4103/lungindia.lungindia_32_25","url":null,"abstract":"<p><strong>Background and objective: </strong>Serum periostin and carcinoembryonic antigen (CEA) are markers of type 2 inflammation. However, their role in diagnosing and monitoring treatment responses in allergic bronchopulmonary aspergillosis (ABPA) remains uncertain. The objective of the study was to assess the diagnostic performance of serum CEA and periostin in distinguishing ABPA from asthma. We also evaluate their usefulness in monitoring treatment responses.</p><p><strong>Methods: </strong>We enrolled consecutive subjects with ABPA (cases) and asthmatic patients without ABPA (controls). Serum periostin and CEA levels were measured at baseline and again 2 months after oral prednisolone. We constructed receiver operating characteristic (ROC) curves and determined sensitivity and specificity using the optimal cut-off derived from Youden's index.</p><p><strong>Results: </strong>We enrolled 112 and 108 subjects with ABPA and asthma (median age: 34 years) respectively. At baseline, the median serum periostin (22.03 vs 16.36 ng/mL; P < 0.001) and CEA levels (4.80 vs 2.35 ng/mL; P < 0.001) were significantly higher in the ABPA group than in the controls. CEA (AUROC = 0.77) showed better diagnostic accuracy than serum periostin (AUROC = 0.64) in differentiating asthma from ABPA. After 2 months of treatment, median serum CEA (4.8 ng/mL vs 3.7 ng/mL) and periostin levels (22.03 vs 17.74 ng/mL) declined significantly. However, 34% and 30% of subjects exhibited increased periostin and CEA levels following treatment.</p><p><strong>Conclusion: </strong>While serum CEA and periostin exhibit modest diagnostic performance in differentiating ABPA from asthma, they are suboptimal for monitoring treatment responses. Further studies are required to validate our findings.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 4","pages":"309-314"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498302","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":"Pancreaticopleural fistula causing amylase-rich pleural effusion: Case series from a rural tertiary care hospital.","authors":"Rashni Belandor Janardhanachar, Veena Bhaskar S Gowda, Sapna Purushotham, Aishwarya S Durgad","doi":"10.4103/lungindia.lungindia_515_24","DOIUrl":"10.4103/lungindia.lungindia_515_24","url":null,"abstract":"<p><p>Pancreaticopleural fistula (PPF) is a rare (<1%) complication of acute and/or chronic pancreatitis which causes recurrent massive pleural effusions. Patient presents with respiratory symptoms rather than abdominal symptoms, which makes the diagnosis challenging and delayed. Amylase-rich pleural effusions have been reported in pancreatic diseases, oesophageal rupture, and malignant pleural effusions. Pancreatitis-related effusion including PPF should be kept in mind when a patient with chronic alcohol consumption presents with an effusion and PF amylase may aid with diagnosis. We present a case series of four young males with a history of recurrent massive pleural effusions and their varied clinical presentations, diagnostic work-up, approach and management in a rural tertiary care hospital in south India, thus contributing to literature as well emphasizing the importance of such easily available biomarkers in day-to-day practice.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 4","pages":"371-375"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601933","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":"Eosinophil count and treatment response in COPD patients.","authors":"C R Kiran, K Anitha Kumari, Sanjeev Nair, A Fathahudeen","doi":"10.4103/lungindia.lungindia_630_24","DOIUrl":"10.4103/lungindia.lungindia_630_24","url":null,"abstract":"<p><strong>Background and objective: </strong>Eosinophils are an integral part of lung defence against microbes. It is also responsible for untoward hyper immune responses responsible for lung diseases including Chronic Obstructive Pulmonary Disease (COPD). To compare COPD patients with high and low Absolute Eosinophil Count (AEC) regarding their frequency of exacerbations, and response to treatment.</p><p><strong>Materials and methods: </strong>Prospective observational study. Patients were divided into 2 groups above and below the mean AEC and followed up for 6 months, during when their frequencies of exacerbations were followed up. At the end of 6 months, symptomatology and lung function were reassessed.</p><p><strong>Results: </strong>Those with high AEC had a shorter time to first exacerbation. These patients also needed significantly greater number of inpatient admissions during the study period. Fall in FEV1 was also significantly higher in this group. There was no significant difference in changes in BMI, CAT or MMRC scores, between these groups.</p><p><strong>Conclusion: </strong>Patients with high AEC are at higher risk of exacerbations, as well as loss of lung function.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 4","pages":"337-342"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498295","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":"Bridging the gap: Early detection of pulmonary tuberculosis among PLHIV in Western Rajasthan, India.","authors":"Aditi Gupta, Ravisekhar Gadepalli, Vidhi Jain, Kumar S Abhishek, Nishant Kumar Chauhan, Deepak Kumar","doi":"10.4103/lungindia.lungindia_639_24","DOIUrl":"10.4103/lungindia.lungindia_639_24","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains a leading cause of mortality among people living with HIV (PLHIV), with delayed diagnosis contributing significantly to poor outcomes. Early detection through systematic screening and diagnostic tools is essential to reduce morbidity and mortality in this high-risk population. This study aimed to evaluate the utility of the World Health Organization (WHO) four-symptom screen (fever, cough, weight loss, and night sweats), using Xpert MTB/RIF (Cepheid, Sunnyvale, California) as the gold standard for early detection of pulmonary TB in HIV-positive patients.</p><p><strong>Methods: </strong>A total of 249 HIV-positive patients attending a tertiary care centre in Western India were screened using the WHO four-symptom tool. All patients, regardless of symptoms, underwent testing with Xpert MTB/RIF. Sensitivity, specificity, and predictive values were calculated for the symptom screen and individual symptoms. Univariate and multivariate analysis was performed to determine significance (P < 0.05).</p><p><strong>Results: </strong>The WHO four-symptom screen identified 40.2% of participants (n = 100) as screen-positive. Xpert MTB/RIF confirmed pulmonary TB in 5.6% (n = 14) of the total population. The combined sensitivity and specificity of the WHO symptom screen were 85.7% and 62.6%, respectively, with a high negative predictive value of 98.7%. Fever and cough were the most significant predictors (P < 0.05) in multivariate analysis.</p><p><strong>Conclusion: </strong>The study highlights the importance of systematic TB screening among PLHIV using the WHO symptom tool in conjunction with molecular diagnostics. This approach facilitates early diagnosis and treatment, contributing to better health outcomes and aligns with global TB elimination strategies.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 4","pages":"347-351"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498378","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":"Rigid bronchoscopic extraction of a 23 cms long \"twig\": Possibly the longest aspirated airway foreign body ever extracted?","authors":"Karan Madan, Saurabh Mittal, Sachidanand Jee Bharti, Vijay Hadda, Anant Mohan, Randeep Guleria","doi":"10.4103/lungindia.lungindia_459_24","DOIUrl":"10.4103/lungindia.lungindia_459_24","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 4","pages":"378-379"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601937","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":"An uncommon solitary pulmonary cavity in a post renal transplant patient.","authors":"Avdhesh Bansal, Priya Sharma, Sanjiv Jasuja","doi":"10.4103/lungindia.lungindia_548_24","DOIUrl":"10.4103/lungindia.lungindia_548_24","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 4","pages":"376-377"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601929","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":"Clinical spectrum of lung cancer across hospitals under the National Cancer Registry Programme in India: Challenges and opportunities.","authors":"Sunil Kumar, Anita Nath, Kondalli Lakshminarayana Sudarshan, Thilagavathi Ramamoorthy, Jyoutishman Sakia, Naveen Kumar, Suryanarayana Vs Deo, Deepali Jain, Prabhat S Malik, Prashant Mathur","doi":"10.4103/lungindia.lungindia_569_24","DOIUrl":"10.4103/lungindia.lungindia_569_24","url":null,"abstract":"<p><strong>Background and objective: </strong>Lung cancer is one among the top five cancers in India, both in incidence and mortality and is thus, a significant public health challenge. The economic disparities among nations significantly contribute to differences observed in the management of lung cancer.</p><p><strong>Methods: </strong>This study analysed the clinical spectrum of lung cancer from several hospitals using data from the National Cancer Registry Programme concerning demographic characteristics of patients, histological variants, and diagnostic and management practices between 2012 and 2019. For this descriptive study, data was drawn from 96 Hospital-Based Cancer Registries. Altogether, all cases classified under ICD-10, C34.90 were included in this study.</p><p><strong>Results: </strong>The study findings revealed that most lung cancer cases occurred in males aged 50-74 years and females aged 45-69 years. Adenocarcinoma were the most common (39.7%) variety, almost twice higher than squamous cell carcinoma subtypes. The majority (50.7%) of the patients with lung cancer were detected with distant metastases. Low rates of surgery were observed among the patients who had localised/locoregional spread, while one third of the patients diagnosed at another facility reported to the treating hospital between 7 to 30 days after diagnosis.</p><p><strong>Conclusion: </strong>This study highlights that delay in referral and subsequent treatment initiation are critical challenges in lung cancer care, including delayed diagnosis, limited treatment options, and a lack of streamlined referral processes. The study findings will be crucial for identifying the gaps in care and guiding strategies to improve early diagnosis and treatment of lung cancer.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 4","pages":"283-290"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498380","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":"Effect of exposure to ambient particulate matter on risk of developing pulmonary tuberculosis: A systematic review and meta-analysis.","authors":"Nisha Kumari, Shashi Bhushan Singh, Dewesh Kumar, Geetu Singh, Pravin Yannawar, Lakhan Majhee, Anjani Kumar, Nitika Keshri, Sandip Kumar, Sunil Kumar Mahto","doi":"10.4103/lungindia.lungindia_552_24","DOIUrl":"10.4103/lungindia.lungindia_552_24","url":null,"abstract":"<p><p>Tuberculosis (TB) is a major global health challenge, particularly in polluted areas. The relationship between ambient particulate matter and TB risk remains unclear, making this systematic review and meta-analysis (SRMA) vital for assessing this link. This SRMA aimed to estimate the association between exposure to ambient particulate matter (PM10 and PM2.5) and the risk of pulmonary tuberculosis (PTB) infection. A literature search was conducted in PubMed, Web of Science, and Cochrane (English-language studies) on January 29, 2024. The review followed PRISMA Guidelines (2020) for comprehensive literature searches, data extraction, and quality assessment of included studies. A random-effects model was used for meta-analysis to estimate pooled effect sizes and assess heterogeneity. Study quality and publication bias were also evaluated. Of the 507 articles identified, 25 met the inclusion criteria. Long-term PM2.5 exposure was linked to a 26% increase in PTB risk (RR =1.26, 95% CI: 1.07-1.48), while short-term exposure raised the risk by 10% (RR =1.10, 95% CI: 0.98-1.25). Long-term PM10 exposure increased PTB risk by 7% (RR =1.07, 95% CI: 1.02-1.12), with short-term exposure showing a similar increase (RR =1.07, 95% CI: 0.95-1.17). Subgroup analysis revealed PTB risk increased by 15% in males and 29% in females for PM2.5, and by 10% in males and 7% in females for PM10. A 10 µg/m³ increase in Particulate matter is associated with a higher risk of pulmonary tuberculosis, highlighting the need for targeted public health measures to reduce particulate exposure, especially in high-risk urban and industrial areas.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 4","pages":"359-366"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498294","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":"Risk factors for asthma across India: Results from global asthma network (GAN) phase I study.","authors":"Sheetu Singh, Sundeep Salvi, Sushil K Kabra, Meenu Singh, Shally Awasthi, Padukuduru Anand Mahesh, Arvind K Sharma, Sabir Mohammed, Thevaruparambil U Sukumaran, Aloke G Ghoshal, Nishtha Singh, Daya K Mangal, Monica Barne, Sanjeev Sinha, Sanjay K Kochar, Udaiveer Singh, Akash Mishra, Virendra Singh","doi":"10.4103/lungindia.lungindia_626_24","DOIUrl":"10.4103/lungindia.lungindia_626_24","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess the risk factors and triggers predisposing to asthma in Indian children and adults.</p><p><strong>Methods: </strong>The Global Asthma Network Phase I study was a multicentre, international, school, and questionnaire-based cross-sectional study conducted across the world with nine centers in India from 2017-18, the current study being analysis of the Indian data.</p><p><strong>Results: </strong>There were 20084 children, 25887 adolescents, and 81296 adults from 9 sites across India. The adjusted odds ratio (AOR) and 95% confidence interval (CI) for atopic factors were as follows: parental history of asthma in adults (AOR 2.88, CI 2.21-3.75), hay fever in children (AOR 2.05, CI 1.62-2.58), and hay fever in adolescents (AOR 1.65, CI 1.40-1.94). Environmental triggers such as exposure to damp spots in the home (AOR1.28, CI 1.05-1.55), antibiotics consumption (AOR 1.80, CI 1.30-2.51), paracetamol taken during pregnancy (AOR 1.23, CI1.02-1.49), and laying on a woollen blanket in the first year of life (AOR 1.67, CI1.34-2.03) were the risk factors predisposing to current wheeze in the children. Risk factors for current wheeze in the adolescents included passage of trucks in front of the house (AOR 1.20, CI 1.04-1.39), and pet animal exposure (AOR 1.32, CI 1.14-1.53); and in the adults included damp spots in houses (AOR 1.61, CI 1.47-1.77), and the use of coal or kerosene or cow dung as a cooking fuel (AOR 1.48, CI 1.28-1.71). Personal factors such as the history of pneumonia in the children (AOR 1.71, CI 1.36-2.15); wheezing after exercise (AOR 1.45, CI 1.23-1.69), hospitalization in the past year (AOR 2.85, CI 2.61-3.59) and caesarean birth (AOR 1.28, CI 1.07-1.53) in the adolescents were associated with current wheeze. India-specific triggers included consumption of bananas (AOR 1.34, CI 1.10-1.63), curd (AOR 1.49, CI 1.23-1.82), packed crunchies (AOR 1.23, CI 1.03-1.48), ice-creams (AOR 1.31, CI1.12-1.53) in adolescents and use of mosquito repellents in adults (AOR 1.11, CI 1.01-1.22).</p><p><strong>Conclusion: </strong>The study identifies genetic, environmental, personal health, and dietary risk factors for asthma in India, underscoring the need for public health measures to improve air quality, promote dietary awareness, and reduce indoor hazards.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 4","pages":"291-298"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498300","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":"Sensitivity and specificity of Gene Xpert Ultra in extrapulmonary tuberculosis (EPTB).","authors":"A Keerthi Prakash, Gayathri Devi Anur Ramakrishnan","doi":"10.4103/lungindia.lungindia_144_25","DOIUrl":"10.4103/lungindia.lungindia_144_25","url":null,"abstract":"<p><strong>Introduction: </strong>Gene Xpert sensitivity is low in paucibacillary conditions like extrapulmonary tuberculosis (EPTB); to overcome that, Gene Xpert Ultra was introduced. This study aims to assess Gene Xpert Ultra's diagnostic accuracy in EPTB.</p><p><strong>Methods: </strong>This prospective observational study was conducted at Apollo Hospital, Greams Road, Chennai, Tamil Nadu, India, from May 2022 to April 2023. A total of 200 patients, 39 (19.5%) abdominal, 61 (30.5%) musculoskeletal, one (0.5%) bone marrow, 50 (25%) lymph nodes, 11 (5.5%) CNS, two (1%) upper airway, one (0.5%) cardiovascular, and 35 (17.5%) pleural cases were enrolled. Samples were analyzed for Gene Xpert Ultra, MGIT culture, cytology, and histopathology wherever feasible with tuberculosis. Tissue sampling was performed rather than bodily fluid in all cases except in CNS and abscess, where CSF and pus were analyzed, respectively. Gene Xpert Ultra was then compared with MGIT culture and Composite reference standard (CRS).</p><p><strong>Results: </strong>The pooled sensitivity and specificity of Gene Xpert Ultra were 96.18% and 18.84% against MGIT and 94.30% and 100% against CRS. The lowest sensitivity (90%) was in CSF, and the highest (100%) was in pleura against CRS.</p><p><strong>Conclusion: </strong>Gene Xpert Ultra has high sensitivity and specificity in tissue samples in various system involvements. This study recommends employing Gene Xpert Ultra in EPTB and further encourages tissue sample testing.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"42 4","pages":"304-308"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498301","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}