The Indian journal of chest diseases & allied sciences最新文献

{"title":"Pattern of drug-resistance and treatment outcome in multidrug-resistant pulmonary tuberculosis.","authors":"C. Nagaraja, B. Shashibhushan, M. Asif, P. H. Manjunath, C. Sagar","doi":"10.5005/ijcdas-54-1-23","DOIUrl":"https://doi.org/10.5005/ijcdas-54-1-23","url":null,"abstract":"AIMS AND OBJECTIVES\u0000To study the pattern of drug-resistance and treatment outcomes among patients with confirmed multidrug-resistant pulmonary tuberculosis (MDR-PTB).\u0000\u0000\u0000METHODS\u0000A prospective study was conducted at Rajiv Gandhi Institute of Chest Diseases, Bengaluru, Karnataka, India. Between January 2005 and December 2008, 224 confirmed MDR-PTB cases were studied for various drug-resistance patterns, and their treatment outcomes were analysed until November 2010. Sputum culture and drug sensitivity tests (DST) were carried out at National Tuberculosis Institute, Bengaluru; DST was done for all first-line drugs except pyrazinamide.\u0000\u0000\u0000RESULTS\u0000Of the 224 MDR-PTB patients, 146 (65.2%) were resistant to all first-line drugs, 39 (17.4%) to isoniazid, rifampicin and streptomycin; 19 (8.5%) to isoniazid, rifampicin and ethambutol; and 20 (8.9%) to isoniazid and rifampicin. Among them, 145 (64.7%) patients were cured, 5 (2.2%) had treatment-failure, 10 (4.4%) died, and 64 (28.5%) defaulted. Among 145 cured cases, 100 (69%) were resistant to all first-line drugs, 23 (16%) to isoniazid, rifampicin and streptomycin, 11(8%) to isoniazid, rifampicin and ethambutol, and 11(8%) to isoniazid and rifampicin.\u0000\u0000\u0000CONCLUSIONS\u0000The most common pattern observed in this study was resistance to all four first-line drugs followed by resistance to isoniazid, rifampicin and streptomycin. Patients resistant to all first-line drugs had early sputum culture conversion and better cure rate as compared to other resistance patterns.","PeriodicalId":76635,"journal":{"name":"The Indian journal of chest diseases & allied sciences","volume":"351 1","pages":"23-6"},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80026448","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":"Adenocarcinoma (somatic-type malignancy) in mature teratoma of anterior mediastinum.","authors":"Nidhi Paliwal, K. Gupta, R. Dewan, S. Mullick","doi":"10.5005/ijcdas-55-1-39","DOIUrl":"https://doi.org/10.5005/ijcdas-55-1-39","url":null,"abstract":"Mature teratoma is a common anterior mediastinal tumour. However, occurrence of transformed malignant component within it is very rare. We report a case of a 32-year-old female presenting with dry cough and chest pain. Contrast-enhanced computed tomography (CT) showed a large thin-walled cystic lesion measuring 11.4 cm x 10.6 cm x 10.0 cm in the anterior mediastinum. Right postero-lateral thoracotomy was performed and the tumour was completely excised. Histopathological examination of the excised specimen was suggestive of mature teratoma with transformed malignant component, adenocarcinoma (somatic-type malignancy).","PeriodicalId":76635,"journal":{"name":"The Indian journal of chest diseases & allied sciences","volume":"422 1","pages":"39-41"},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78155434","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":"Treatment practices in pulmonary tuberculosis by private sector physicians of Meerut, Uttar Pradesh.","authors":"K. Gowrinath","doi":"10.5005/ijcdas-55-1-55","DOIUrl":"https://doi.org/10.5005/ijcdas-55-1-55","url":null,"abstract":"To the Editor: Dr Ashish Yadav et al1 showed that majority of qualified private physicians in Meerut were not following the Revised National Tuberculosis Control Programme (RNTCP) regimens to treat pulmonary tuberculosis. Without proper knowledge of principles of intermittent therapy or multidrug resistant tuberculosis treatment, no private medical practitioner can offer correct treatment regimen. The information about treatment regimens under RNTCP is available in the internet.2 If internet facility is not used, books, medical journals, medical conferences or continuous medical education (CME) programmes are other sources of information on RNTCP. An average private medical practitioner in rural or semi-urban area usually does not make use of above sources. This is the main reason for prescription errors and misconceptions about intermittent treatment regimens of TB. Different effective daily treatment regimens were developed in the past to treat tuberculosis (TB) and have been included in standard medical books. When same drugs are given, therapeutically RNTCP regimen can only be as effective as daily short course regimen. The article did not mention the percentage of qualified private physicians who started practicing medicine before implementation of RNTCP in our country. I learnt only daily treatment regimens of TB during my postgraduate course in 1991 as there was no RNTCP. Before directly observed treatment, short-course (DOTS)plus was introduced, we followed World Health Organization (WHO) guidelines for management of multidrug-resistant (MDR) TB and presented our experience in national conference.3 Even today DOTS-plus facility is created in selected cities that too for treatment failure cases treated under category II regimen of RNTCP. Therefore, DOTSplus programme is meant for patients treated in government sector hospitals only. Authors have not documented whether the qualified private physicians were following WHO regimens for MDR-TB or not. In our place, DOTS-plus committee is for government doctors only and none of the private sector doctors with better qualification and experience in the management of MDR-TB is included that committee. When private sector doctors are not adequately represented in government committees/meetings or scientific programmes or TB conferences, majority of medical practitioners of our country particularly those who secured medical degrees Treatment Practices in Pulmonary Tuberculosis by Private Sector Physicians of Meerut, Uttar Pradesh","PeriodicalId":76635,"journal":{"name":"The Indian journal of chest diseases & allied sciences","volume":"37 1","pages":"55"},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79895128","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":"Challenges of training in pulmonary medicine in India.","authors":"S. Jindal","doi":"10.5005/ijcdas-55-2-73","DOIUrl":"https://doi.org/10.5005/ijcdas-55-2-73","url":null,"abstract":"challenges in its growth than its sister specialities of medicine. The confusion is reflected in the very use of an array of terms used for its nomenclature (Table 1), while several of these terms are not commonly used in India.1 Consensus has somehow eluded in spite of the felt-need for an universally acceptable terminology. There is further compounding of confusion because of the lack of standardisation of requirements of attributes for training. There is an unfinished debate on the issue of treating pulmonology as a sub-(or super-) speciality of medicine. Pulmonary Medicine as a Super-speciality","PeriodicalId":76635,"journal":{"name":"The Indian journal of chest diseases & allied sciences","volume":"51 1","pages":"73-4"},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74380090","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":"Decoding population genetics: impact on tuberculosis control and treatment.","authors":"M. Bose","doi":"10.5005/ijcdas-54-1-5","DOIUrl":"https://doi.org/10.5005/ijcdas-54-1-5","url":null,"abstract":"","PeriodicalId":76635,"journal":{"name":"The Indian journal of chest diseases & allied sciences","volume":"18 1","pages":"5-7"},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78242113","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":"Haemoptysis after four years of lobectomy for aspergilloma.","authors":"G. Sindhwani, J. Rawat, Vikas Kesarwani","doi":"10.5005/ijcdas-55-1-43","DOIUrl":"https://doi.org/10.5005/ijcdas-55-1-43","url":null,"abstract":"We present a case of a 26-year-old male who underwent lobectomy for life-threatening haemoptysis due to aspergilloma in an old tuberculosis left upper lobe cavity who presented with recurrence of haemoptysis four years after the surgery. Fibreoptic bronchoscopy revealed Aspergillus colonisation in the ectatic residual bronchus which is an uncommon complication of lobectomy. The patient was successfully managed with antifungal agents.","PeriodicalId":76635,"journal":{"name":"The Indian journal of chest diseases & allied sciences","volume":"13 1","pages":"43-4"},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89362856","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":"Pulmonary renal syndrome in a case of Wegener's granulomatosis.","authors":"S. Kundu, Swapnendu Misra, R. Halder, A. Roychowdhury","doi":"10.5005/ijcdas-55-1-49","DOIUrl":"https://doi.org/10.5005/ijcdas-55-1-49","url":null,"abstract":"We report a case of a 42-year-old patient who presented with Wegener's granulomatosis complicated by pulmonary renal syndrome, i.e., diffuse alveolar haemorrhage and rapidly progressive crescentic glomerulonephritis. The patient was treated with plasmapheresis and immunosuppressive drugs--intravenous cyclophosphamide and methyl prednisolone. The clinical, haematological and biochemical parameters improved substantially and remission is achieved.","PeriodicalId":76635,"journal":{"name":"The Indian journal of chest diseases & allied sciences","volume":"31 1","pages":"49-52"},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76216686","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":"Cardiopulmonary exercise testing in evaluation of patients of chronic obstructive pulmonary disease.","authors":"A. Ganju, A. Fuladi, B. Tayade, N. Ganju","doi":"10.5005/ijcdas-53-2-87","DOIUrl":"https://doi.org/10.5005/ijcdas-53-2-87","url":null,"abstract":"BACKGROUND\u0000Objective assessment of severity in patients with chronic obstructive pulmonary disease (COPD) is mainly limited to pulmonary function testing performed at rest. But, accurate assessment of exercise capacity in patients with COPD may be possible with cardiopulmonary exercise testing (CPET).\u0000\u0000\u0000METHODS\u0000Forty-three patients with stable COPD were included and were divided into three groups based upon the spirometry data as per the Global Initiative for Obstructive Lung Disease (GOLD) guidelines as follows: Group A: mild COPD, Group B: moderately severe COPD and Group C: severe COPD. Symptom-limited CPET was performed using treadmill on incremental continuous ramp protocol in all of them.\u0000\u0000\u0000RESULTS\u0000Five patients (11.6%) had mild COPD; 16 (37.2%) had moderately severe COPD and the remaining 22 (51.6%) patients had severe COPD. Anaerobic threshold was attained in all the 43 patients. The dominant symptom at peak exercise were dyspnoea (n = 19) and both dyspnoea and leg fatigue (n = 7). The other causes of exercise limitation included dyspnoea with significant oxygen desaturation (n = 6); and dyspnoea with severe oxygen desaturation (n = 2). Six patients complained only of leg fatigue at peak exercise. A significant correlation between forced expiratory volume in the first second (FEV1) percent predicted and the predicted maximum oxygen uptake (VO2 max % predicted) was observed in all the three groups (r = 0.39, p = 0.011) but with marked variability of peak VO2 for a given degree of airflow obstruction. Twenty-three (53.5%) patients with low anaerobic threshold (< 30%) were identified as potential group likely to benefit from exercise training for pulmonary rehabilitation.\u0000\u0000\u0000CONCLUSIONS\u0000Cardiopulmonary exercise testing is useful to determine the causes of exercise limitation and to assess the maximal exercise capacity of patients with COPD.","PeriodicalId":76635,"journal":{"name":"The Indian journal of chest diseases & allied sciences","volume":"33 1","pages":"87-91"},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76631925","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":"Transthoracic decompression of emphysematous bulla: a novel experience.","authors":"P. Bhattacharyya, S. Bardhan, S. Nag, S. Mukherjee, A. Verma","doi":"10.5005/ijcdas-53-1-51","DOIUrl":"https://doi.org/10.5005/ijcdas-53-1-51","url":null,"abstract":"Emphysematous bullae are closed air containing spaces in lung parenchyma that may severely compromise lung function in patients of chronic obstructive pulmonary disease (COPD). We describe a simple and minimally invasive procedure to decompress a large emphysematous bullae in a patient with advanced COPD and high surgical risk. Transthoracic decompression of the bulla was accomplished under short-acting anaesthesia and muscle relaxation resulting in significant symptomatic, radiological and functional improvement.","PeriodicalId":76635,"journal":{"name":"The Indian journal of chest diseases & allied sciences","volume":"21 1","pages":"51-3"},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82594291","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":"How to plan for methane mitigation and utilisation strategies?","authors":"J. Pandey, A. Mishra, U. Sur, M. Tembhare, R. Kumar, S. Wate","doi":"10.5005/ijcdas-52-1-60","DOIUrl":"https://doi.org/10.5005/ijcdas-52-1-60","url":null,"abstract":"","PeriodicalId":76635,"journal":{"name":"The Indian journal of chest diseases & allied sciences","volume":"25 1","pages":"60-1"},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77893998","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}