Lung India最新文献

{"title":"Asthma, COPD, and asthma-COPD overlap: A comparative study of inflammatory biomarkers and quality of life.","authors":"M Ahmed Safwan, Nitin Goel, Raj Kumar","doi":"10.4103/lungindia.lungindia_605_25","DOIUrl":"10.4103/lungindia.lungindia_605_25","url":null,"abstract":"<p><strong>Background: </strong>Asthma, COPD, and ACO are chronic airway disorders with distinct and overlapping features. This study aimed to compare clinical profiles, inflammatory biomarkers, and quality of life among these groups.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 168 patients (56 each with asthma, COPD, and ACO). All participants underwent clinical assessment, spirometry, St George's Respiratory Questionnaire (SGRQ), skin prick testing, and measurement of inflammatory markers, including FeNO, eosinophil count, total IgE, vitamin D, hs-CRP, and interleukins (IL-4, 5, 6, 8, 13, 17, 33).</p><p><strong>Results: </strong>ACO patients were younger than COPD patients but older than asthma patients. Asthma patients had the highest prevalence of allergic rhinitis and skin prick positivity. FEV 1 and FEV 1 /FVC were significantly lower in COPD and ACO compared to asthma, but not different between COPD and ACO. Bronchodilator response was higher in asthma and ACO than in COPD. Asthma patients had significantly higher FeNO, eosinophil counts, and IgE levels compared to COPD, with ACO showing intermediate values. IL-4 and IL-5 were highest in asthma, IL-6 and IL-8 in COPD, with ACO again showing intermediate levels. ACO patients had the highest SGRQ scores, indicating the worst quality of life. Correlation analysis showed group-specific associations between interleukins and clinical parameters.</p><p><strong>Conclusion: </strong>ACO exhibits intermediate clinical and inflammatory profiles between asthma and COPD. While individual biomarkers assist in characterizing these diseases, a combination of clinical, functional, and inflammatory parameters offers better differentiation. ACO patients experience a significant symptom burden, necessitating tailored diagnostic and therapeutic approaches.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 4","pages":"364-370"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354369","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":"Successful treatment of chronic retained bronchial foreign bodies and secondary bronchial stenosis with balloon bronchoplasty in young patients: A case series with review of literature.","authors":"Deependra K Rai, Dhruv Talwar, Niraj K Singh, Jisha G Panicker, Parul Sharma, Sreyashi Pal","doi":"10.4103/lungindia.lungindia_666_25","DOIUrl":"10.4103/lungindia.lungindia_666_25","url":null,"abstract":"<p><strong>Abstract: </strong>Foreign body aspiration, though uncommon, remains a potentially fatal condition associated with significant morbidity and mortality. While children constitute majority of cases, a few occur in adults-particularly in the elderly. However, chronic retained foreign bodies in the young adult population are exceedingly rare, and when encountered, pose unique challenges due to chronic inflammatory changes, excessive granulation tissue, and resultant bronchial stenosis. These factors often complicate retrieval and may necessitate surgical intervention, including lobectomy. In this case series, we present two young patients with chronic retained bronchial foreign bodies (retained for 13 years and 15 years respectively) and associated bronchial stenosis, both of whom were successfully removed with balloon bronchoplasty to dilate the stenotic segment, enabling removal of the foreign body. Notably, both patients were spared lobectomy and its associated morbidity. Both the patients showed clinical and radiological improvement post procedure and are doing well on follow-up. Foreign bodies aspirated during childhood might present in the adulthood after being undetected for years due to neglected symptoms with associated chronic changes making foreign body removal complex. This case series highlights the importance of a complete trial of bronchoscopy guided foreign body removal strategy, including balloon bronchoplasty, in patients with chronic retained foreign bodies and associated bronchial stenosis before proceeding to surgical resection especially in young patients.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 4","pages":"442-448"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354515","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":"Advances and challenges in the management of haemoptysis in the emergency department: A narrative review.","authors":"Prakash Ranjan Mishra, Khushboo Choudhury, Bharath Gopinath","doi":"10.4103/lungindia.lungindia_612_25","DOIUrl":"10.4103/lungindia.lungindia_612_25","url":null,"abstract":"<p><strong>Abstract: </strong>Haemoptysis, defined as the expectoration of blood from the lower respiratory tract, can present to the emergency department (ED) with symptoms ranging from mild, self-limiting to massive haemorrhage. Severe presentations account for approximately 5% of cases, with mortality primarily because airway flooding with blood leading to hypoxia. This underscores the importance of early airway protection and structured resuscitation in emergency settings. This narrative review summarizes the current evidence to guide emergency physicians in the management of haemoptysis. Aetiologies vary geographically: pulmonary tuberculosis accounts for up to 40% of cases in low- and middle-income countries, whereas malignancy, cardiovascular disease, and bronchiectasis predominate in high-income regions. Management begins with differentiating haemoptysis from pseudohaemoptysis and gastrointestinal bleeding, followed by risk stratification and initial stabilization of the patient. CT angiography helps in localization of bleeding and underlying pathology, while flexible bronchoscopy is the gold standard for both diagnosis and therapeutic interventions. Nebulized tranexamic acid is emerging as a rapid, localized, and safe adjunct in emergency settings, reducing the need for invasive procedures. Haemostasis can be achieved by bronchial artery embolization in over 90% of cases, while surgery is reserved for refractory or localized disease. Despite these advances, challenges remain in optimizing the timing and integration of imaging, pharmacological adjuncts, and invasive procedures. A multidisciplinary approach involving emergency physicians, pulmonologists, interventional radiologists, and thoracic surgeons is crucial to improving outcomes in this complex, potentially life-threatening condition. Further studies are needed to standardize protocols and priorities for emergency management of massive haemoptysis.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 4","pages":"423-430"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354335","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":"Chronicity and comorbidities: Is estimated longer duration of obstructive sleep apnoea linked to higher cardiometabolic risk?","authors":"Krishnapriya S Kumar, Kritarth Rawat, Lokesh Kumar Saini, Barun Kumar, Kalyani Sridharan, Ravi Gupta, Saikat Banerjee, Mayank Mishra, Ruchi Dua, Prakhar Sharma, Girish Sindhwani","doi":"10.4103/lungindia.lungindia_888_25","DOIUrl":"10.4103/lungindia.lungindia_888_25","url":null,"abstract":"<p><strong>Background and objectives: </strong>Obstructive sleep apnea (OSA) is associated with an increased risk of cardiometabolic disorders. Still, the role of OSA duration in the development and severity of these conditions remains unclear. This study aimed to evaluate the association between estimated OSA duration and cardio-metabolic comorbidities.</p><p><strong>Materials and methods: </strong>In this cross-sectional study, 279 adults (≥35 years; body mass index ≥20 kg/m 2 ) with moderate-severe OSA diagnosed by level-1 polysomnography were included. Diagnosis of cardiometabolic disorders was based on examination, medical records, and laboratory investigations. Duration of OSA was estimated using the OSA-Onset algorithm, and comorbidity prevalence was compared across tertiles of estimated duration.</p><p><strong>Results: </strong>In this cross-sectional exploratory analysis, the median estimated OSA duration was 18.7 years, and the median estimated age of onset was 32.3 years. Systemic hypertension was the most prevalent comorbidity (79.6%) and showed a higher prevalence across tertiles of estimated OSA duration (68.8%, 83.9%, and 86%, respectively; P = 0.007). In multivariable models, estimated OSA duration was statistically associated with hypertension (odds ratio [OR] 1.039, 95% confidence interval [CI] 1.012-1.068; P = 0.005). Sensitivity analysis excluding participants with implausible negative onset estimates yielded similar results (OR 1.036, 95% CI 1.006-1.066; P = 0.017). No statistically significant associations were observed for other cardiometabolic conditions. Given multiple comparisons and correlated outcomes, findings should be interpreted as exploratory.</p><p><strong>Conclusion: </strong>In this cross-sectional exploratory study, longer algorithm-estimated OSA duration was statistically associated with hypertension but not with other cardiometabolic comorbidities. These findings are hypothesis-generating and require confirmation in longitudinal studies.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 4","pages":"390-398"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354425","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":"Methodological considerations on 'an international collaborative initiative to screen primary ciliary dyskinesia with high-speed video microscopy and nasal nitric oxide at a tertiary referral centre in South India'.","authors":"Etika Rana, Sanam Maurya","doi":"10.4103/lungindia.lungindia_173_26","DOIUrl":"10.4103/lungindia.lungindia_173_26","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 4","pages":"477-478"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354554","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":"Contarini syndrome due to tuberculous pleuritis and hepatic hydrothorax in a low-resource setting.","authors":"Gerardo Marrero-Ortega, Alejandro Hernández Gutiérrez, Ricardo Cesar Solis, Homero Nañez-Terreros, Erick Joel Rendón-Ramírez, Alejandra De Las Fuentes-Cepeda","doi":"10.4103/lungindia.lungindia_78_26","DOIUrl":"10.4103/lungindia.lungindia_78_26","url":null,"abstract":"","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 4","pages":"461-462"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354434","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 characteristics and comorbidities of sleep apnea in the older and oldest-old inpatients.","authors":"Chunli Wang, Qi Xu, Songbai Zhao, Keke Yang, Xusheng Shao, Genqiang Fang, Ling Yang","doi":"10.4103/lungindia.lungindia_677_25","DOIUrl":"10.4103/lungindia.lungindia_677_25","url":null,"abstract":"<p><strong>Background and objective: </strong>Obstructive sleep apnea (OSA) was one common disorder associated with cardiovascular morbidity and mortality. It's incidence increased with age. The purpose of this study was to investigate the geriatric characteristics, morbidities, and heart structural changes associated with OSA.</p><p><strong>Materials and methods: </strong>This study included 311 inpatients aged ≥60 years old between January 2018 and December 2020, who had undergone PSG testing. Demographic, clinical, and polysomnographic data of patients were compared between OSA and non-OSA, moderate-severe OSA and mild OSA, oldest-old OSA and young-old OSA.</p><p><strong>Results: </strong>Of 311 inpatients, 128(41.2%) had OSA and 183 (58.8%) did not; the mean age was 83.647.15 years, and 10% was female. There was no difference in comorbidities or cardiac structure and function between the OSA and non-OSA groups, However, oldest-old OSA patients had lower oxygen saturation and higher rates of some comorbidities than young-old OSA group, and the moderate-severe OSA had also lower oxygen saturation.</p><p><strong>Conclusions: </strong>The study found a higher prevalence of OSA-related morbidity in oldest-old patients over 85 years of age. The young-old patients with OSA were probably self-modulated and more tolerant. The severity of OSA also affected the patient's clinical presentation.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 4","pages":"384-389"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354412","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":"Concordance between different tools monitoring progression in interstitial lung diseases at 6 months-A prospective observational study.","authors":"Singh Itishree, Saxena Puneet, Kumar Abhishek, Kartik Sivasami, Malik Virender, J Sankar, K Ravi Akhil, Tiwari Saurabh, Kumar Prashant, Jain Harsh","doi":"10.4103/lungindia.lungindia_594_25","DOIUrl":"10.4103/lungindia.lungindia_594_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Interstitial lung disease (ILD) encompasses a wide variety of disorders with variable progression patterns. Monitoring typically involves assessing dyspnoea scores, spirometry parameters, 6-minute walk test (6MWT) parameters, and high-resolution CT (HRCT) scans. The agreement between the relative changes in these parameters over time is not known. To evaluate the concordance between changes in clinical, functional, physiological, and radiological parameters over 6 months in a diverse ILD cohort.</p><p><strong>Settings and design: </strong>Prospective observational study conducted from 01 July 2022 to 31 January 2024 at a tertiary care teaching hospital.</p><p><strong>Methods and patients: </strong>Ninety-nine ILD patients underwent baseline and 6-month assessments of dyspnoea (mMRC), forced vital capacity (FVC), six-minute walk distance (6MWD), distance-saturation product (DSP), and HRCT. Patients were categorised as having lung-restricted or systemic disease-associated ILD. Changes were classified using established minimal clinically important differences. Concordance was analysed using weighted kappa; correlations were evaluated with Spearman's test.</p><p><strong>Results: </strong>Of 99 patients, 67.7% had ILD secondary to a systemic condition. Correlations between FVC, DSP, and 6MWD were moderate to strong both at baseline and at 6 months. Concordance among changes in clinical scores, FVC, 6MWD, and HRCT at the 6-month follow-up was low, with weighted-kappa values ranging from 0.023 to 0.158 for the overall study group. The strongest agreement was observed between clinical scores and FVC. The concordance was similarly poor in both subgroups.</p><p><strong>Conclusions: </strong>Despite moderate baseline correlations, changes in different ILD monitoring parameters showed poor agreement, underscoring the multidimensional nature of disease progression. Comprehensive, multimodal follow-up remains essential, and multicentre validation is warranted.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 4","pages":"412-417"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354405","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":"Normal spirometry with high and asthma-defining bronchodilator responsiveness: An appraisal from real-life data.","authors":"Shuvam Ghosh, Mintu Paul, Srijita Sen, Pallav Bhattacharyya, Dipanjan Saha, Avishek Kar, Saikat Banerjee, Parthasarathi Bhattacharyya","doi":"10.4103/lungindia.lungindia_847_25","DOIUrl":"10.4103/lungindia.lungindia_847_25","url":null,"abstract":"<p><strong>Background: </strong>Spirometric exercise in symptomatic patients (with/without suspicion of airflow obstruction) often ends with results showing normal pre-bronchodilator values.</p><p><strong>Methods: </strong>We screened two different populations with prospectively archived spirometry, consisting of a) clinical suspicion of OAD (obstructive airway disease) and b) all other indications without any suspicion of OAD. Both populations underwent BDR (bronchodilator responsiveness) with salbutamol. We screened out the patients that displayed 'normal spirometry' [pre-bronchodilator (FEV1/FVC > 0.7 with FEV1 and FVC > 80%] and further looked for the presence of high (≥200 mL alone) or asthma-defining (>200 mL and 12%) BDR in them.</p><p><strong>Results: </strong>The two sets included 1019 and 3060 subjects in patients with or without suspected OAD. They showed the presence of 11.87% (121/1019) and 27.71% (848/3060) of normal spirometry. In the first set, 24.7% ( n = 30) and 17.35% ( n = 21), and in the second set, 12.26% ( n = 104) and 4.7% ( n = 40) patients had high (>200 mL) or asthma-defining (200 mL plus 12%) BDR. Thus, the asthma-defining BDR is present in 2.06% (21/1019) and 1.30% (40/3060) of patients with or without suspected OAD with normal pre-bronchodilator spirometry. The prevalence of isolated high BDR (200 mL) was present in 0.88% [9 (30-21) out of 1019] and 2.09% [ n = 64 (135-54)/3060] of them.</p><p><strong>Conclusion: </strong>Some patients with respiratory symptoms with or without suspicion of airflow obstruction display pre-bronchodilator normal spirometry, and some of them demonstrate high or asthma-defining bronchodilator responsiveness. Performing BDR should be a routine in respiratory practice.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 4","pages":"399-403"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354504","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":"Pulmonary tuberculosis and the surgeon.","authors":"Sabyasachi Bal","doi":"10.4103/lungindia.lungindia_65_25","DOIUrl":"10.4103/lungindia.lungindia_65_25","url":null,"abstract":"<p><strong>Abstract: </strong>Though medical management is the cornerstone of management of pleuropulmonary tuberculosis today, surgery may play a significant collaborative role, both in its diagnosis and in its treatment in well defined clinical scenarios. In drug resistant tuberculosis, empyemas and bronchial stenosis, surgery may play a very important role and may also successfully resolve symptoms produced by TB sequelae such as symptomatic bronchiectasis and aspergillomas. Recent advances in thoracic surgery and the use of minimally invasive surgical techniques has made surgical options safer and with a significant decrease in morbidity and mortality, thereby enabling surgical solutions for a bigger number of tuberculosis related problems. It is important for all clinicians treating tuberculosis to understand the indications for surgery and to work together with surgeons so that the most appropriate treatment can be offered to the patient at the correct time. Perhaps the time has also come to explore the role of multidisciplinary teams to enable this to happen. This review attempts to define the role and timing of surgery in the management of pleuropulmonary tuberculosis.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"43 4","pages":"431-437"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354542","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}