{"title":"Prevalence of frailty among chronic respiratory disease patients.","authors":"Rm Pl Ramanathan, Sivaguru Muthusamy, Krishna J Kumar, Anusuya Krishnan","doi":"10.4103/lungindia.lungindia_464_23","DOIUrl":"10.4103/lungindia.lungindia_464_23","url":null,"abstract":"<p><strong>Background: </strong>Although frailty is one of the aging syndromes, it can occur at a younger age and in individuals with organ diseases. Identifying frailty and pre-frailty in patients with chronic respiratory diseases (CRDs) is an emerging assessment in the field of pulmonary medicine and rehabilitation. The aim of this study was to find out the prevalence of frailty among chronic respiratory disease patients.</p><p><strong>Methods: </strong>A single centre cross-sectional survey study with a total population of 381 patients, adults aged 18-90 years presenting to the pulmonology OPD was included based on the inclusion and exclusion criteria. Primary data collected were demographics, medical history, including comorbidities, use of long-term oxygen therapy (LTOT), BiPAP (Bilevel Positive Airway Pressure), previous hospital admissions, medication history and frailty assessment were done using the Fried frailty index.</p><p><strong>Results: </strong>Univariate analysis showed that sex, ECHO abnormality, patients using LTOT, BiPAP, home nebulizers and patients who did not attend the pulmonary rehabilitation programme had a significant association with frailty. Multivariate analysis showed that female sex, LTOT use and older age were significantly associated with frailty.</p><p><strong>Conclusion: </strong>Frailty is frequent in CRD patients regardless of age. The prevalence of frailty has an association with female sex, patients using LTOT, and home BiPAP.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"41 3","pages":"181-184"},"PeriodicalIF":1.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11093132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858299","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}
Lung IndiaPub Date : 2024-05-01Epub Date: 2023-08-01DOI: 10.4103/lungindia.lungindia_64_23
Thisarana Wijayaratne, James Owen, Ahmed Fahim
{"title":"Clinical behaviour and mortality in idiopathic vs secondary nonspecific interstitial pneumonia.","authors":"Thisarana Wijayaratne, James Owen, Ahmed Fahim","doi":"10.4103/lungindia.lungindia_64_23","DOIUrl":"10.4103/lungindia.lungindia_64_23","url":null,"abstract":"<p><strong>Rationale: </strong>Nonspecific interstitial pneumonia (NSIP) is a subtype of interstitial lung disease which can either be idiopathic or secondary to other conditions. Idiopathic NSIP is a relatively rare entity and diagnosis should be considered carefully as it is mainly a diagnosis of exclusion. The aim of this retrospective study was to evaluate a cohort of NSIP patients with a view to identifying any clinical and mortality differences between idiopathic and secondary varieties.</p><p><strong>Methods: </strong>We screened 700 patients from our interstitial lung disease database and identified 44 cases of NSIP retrospectively. Statistical analysis was conducted to evaluate if there was a difference in demographics such as gender and ethnicity, physiological parameters including forced vital capacity, diffusing capacity, average oxygen saturations, and immunology profile between two groups. Furthermore, a difference in mortality was evaluated between idiopathic and secondary NSIP.</p><p><strong>Results: </strong>The data analysis showed that 63.6% (28 of 44) of patients had idiopathic NSIP versus 36.4% (16 of 44) of patients had secondary NSIP. Majority of the secondary NSIP patients had an underlying connective tissue disease. In the idiopathic variety, there was a male preponderance (64.2%, P = .02) which was statistically different compared to relatively equal gender divide in secondary NSIP which was statistically insignificant (male vs. female: 43.8% vs. 56.3%, respectively, P = .42). The mean age of the idiopathic group was 74 years compared to 64 years in the secondary group which was statistically different (P = .01). In both groups (idiopathic and secondary NSIP), more than two-thirds (68%) were of White British ethnicity. Immunology profile was similar across both groups with no statistical difference in IgM, IgG, or IgA levels. At the time of analysis, there were 17.9% deaths (5 of 28) in the idiopathic NSIP group versus 6.3% (1 of 16) in the secondary NSIP group but this was not statistically significant (P = .14). Similarly, there was no statistically significant difference in the forced vital capacity (P = .59), diffusing capacity (P = .88), and resting oxygen saturations (P = .28) between idiopathic and secondary NSIP varieties.</p><p><strong>Conclusion: </strong>Our analysis showed that there was a statistically significant difference in gender (male preponderance in idiopathic NSIP only) and mean age difference among both varieties. There were no statistically significant differences in the clinical features and outcomes including mortality, physiological, and immunological parameters between idiopathic and secondary NSIP. Idiopathic NSIP was more common than secondary NSIP and secondary NSIP is mostly due to underlying connective tissue disease.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"41 3","pages":"172-175"},"PeriodicalIF":1.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11093133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868571","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}
Lung IndiaPub Date : 2024-03-01Epub Date: 2024-02-27DOI: 10.4103/lungindia.lungindia_449_23
Eshita Shah, N Sankara Raman, Manish K Aggarwal, Amit Jain, Arushi Chokhani, Avinash Murugan, Rajiv Goyal, Laengmawia Darlong, Ullas Batra
{"title":"Accuracy of endobronchial ultrasound (EBUS) in the staging of lung cancer - A comparison of staging EBUS with postoperative pathological nodal staging.","authors":"Eshita Shah, N Sankara Raman, Manish K Aggarwal, Amit Jain, Arushi Chokhani, Avinash Murugan, Rajiv Goyal, Laengmawia Darlong, Ullas Batra","doi":"10.4103/lungindia.lungindia_449_23","DOIUrl":"10.4103/lungindia.lungindia_449_23","url":null,"abstract":"<p><strong>Background: </strong>Endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-TBNA) has replaced mediastinoscopy as the preferred investigation for evaluating mediastinum in staging lung cancer. There is little evidence of mediastinal staging by EBUS-TBNA from India.</p><p><strong>Objectives: </strong>To study endobronchial ultrasound's diagnostic accuracy in staging lung cancer.</p><p><strong>Methodology: </strong>We retrospectively analysed patients operated on for lung cancer where EBUS was performed preoperatively for mediastinal staging. We compared the histological findings obtained from different mediastinal lymph nodes (LNs) by EBUS-TBNA with the pathology of the same LNs obtained after surgical dissection as the reference standard.</p><p><strong>Results: </strong>Seventy-six patients underwent curative surgery for lung cancer. The diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of EBUS-TBNA in predicting mediastinal metastasis were 93.9%, 40%, 99%, 80% and 94.6%, respectively. Of the 115 LNs sampled, EBUS-TBNA was false negative in six nodes, resulting in an up-staging of six patients.</p><p><strong>Conclusions: </strong>EBUS-TBNA has a high diagnostic accuracy for lung cancer staging.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"41 2","pages":"93-97"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10959321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874928","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":"A rare case of isoniazid mono-resistant tuberculosis presenting as cardiac tamponade along with an anterior mediastinal mass in a 15-year-old immunocompetent patient.","authors":"Richa Mishra, Ashima Jamwal, Bishal Gupta, Sudeep Kumar, Abhijeet Bharali, Parijat Das, Alok Nath, Manoj Jain, Zafar Neyaz","doi":"10.4103/lungindia.lungindia_221_23","DOIUrl":"10.4103/lungindia.lungindia_221_23","url":null,"abstract":"<p><strong>Abstract: </strong>A 15-year-old boy presented with a sudden onset of breathlessness for 7 days, gradual loss of weight of 17.6 lbs over the last month and progressive hoarseness of voice for 7 months. The contrast-enhanced computed tomography (CECT) scan revealed a heterogeneously enhancing lesion in the anterior mediastinum with multiple discrete lymph nodes in the cervical and mediastinal locations. The GeneXpert MTB/RIF assay performed on the CT-guided biopsy of the mass was negative, but the culture for Mycobacterium tuberculosis was positive at 7 weeks of incubation. There was a suboptimal radiological response after 6 months of treatment. First-line drug susceptibility testing (DST) performed by line probe assay (LPA) on the positive culture detected high-level resistance to isoniazid. The treatment was modified as per DST results to which the patient responded well.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"41 2","pages":"130-134"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10959313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861011","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":"Burden of Tuberculosis among tribal populations of India: A systematic review and meta-analysis.","authors":"Aninda Debnath, Nidhi Singh, Sunanda Gupta, Jugal Kishore","doi":"10.4103/lungindia.lungindia_412_23","DOIUrl":"10.4103/lungindia.lungindia_412_23","url":null,"abstract":"<p><strong>Abstract: </strong>Tuberculosis (TB) continues to impose a significant burden on tribal populations in India, a high-risk group for the disease. Despite its preventable and curable nature, TB remains a formidable health challenge for these communities. However, a critical knowledge gap exists regarding the population-based prevalence of TB among tribal populations in India. The current systematic review and meta-analysis were carried out to provide a single, population-based estimate. A comprehensive search was conducted on PubMed, Embase, Scopus, and Web of Science databases using the keywords 'tuberculosis', 'TB', and 'tribal' or 'tribes'. This search encompassed articles published between 1 January 2000 and 1 March 2023. The included articles underwent a quality assessment screening to ensure their reliability and relevance. Subsequently, a pooled estimate of TB prevalence among tribal populations was quantified using a random-effects model. To investigate potential sources of heterogeneity in the prevalence estimates, subgroup analyses were performed. We identified 14 studies that encompassed a substantial population of 267,377 individuals from various regions in India belonging to tribal communities. The application of a random-effects model yielded a pooled prevalence estimate of 894.4 per 100,000 population, with a 95% confidence interval ranging from 523.5 to 1361.9. The assessment of heterogeneity using the Cochrane Q test indicated significant variability among the included studies (I2 = 99.17%; P < 0.001). Notably, the prevalence of TB among tribal populations was found to be higher than the national prevalence. The scientific evidence available for the prevalence of TB among tribal populations is restricted to a few tribes only. Conducting further research to estimate the prevalence among other tribes all over the country is the need of the hour and should be addressed accordingly.</p>","PeriodicalId":47462,"journal":{"name":"Lung India","volume":"41 2","pages":"121-129"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10959318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867731","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}
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