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Official publication of Indian Chest Society
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2009| October-December | Volume 26 | Issue 4
Online since
October 9, 2009
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CASE REPORTS
Intralobar sequestration of lung
R Prasad, Rajiv Garg, Sanjay Kumar Verma
October-December 2009, 26(4):159-161
DOI
:10.4103/0970-2113.56357
PMID
:20532005
Intralobar pulmonary sequestration is characterized by the presence of nonfunctional parenchymal lung tissue, receiving systemic arterial blood supply. It lacks normal communication with tracheobronchial tree. Failure to diagnose and treat this condition can lead to recurrent pneumonia and fatal hemoptysis. The aim of this case report is to increase awareness about the condition and to review criteria of its definitive diagnosis and subsequent treatment.
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Acute pulmonary alveolar proteinosis due to exposure to cotton dust
Gurcharan Singh Thind
October-December 2009, 26(4):152-154
DOI
:10.4103/0970-2113.56355
PMID
:20532003
Secondary pulmonary alveolar proteinosis (PAP) is rare but may occur in association with malignancy, certain infections, and exposure to inorganic or organic dust and some toxic fumes. This case report describes the second recorded case of PAP due to exposure to cotton dust. A 24-year-old man developed PAP after working as a spinner for eight years without respiratory protection. He was admitted as an emergency patient with very severe dyspnea for four months and cough for several years. Chest X-ray showed bilateral diffuse alveolar consolidation. He died 16 days later, and a diagnosis of acute pulmonary alveolar proteinosis was made at autopsy. The histopathology demonstrated alveoli and respiratory bronchioles filled with characteristic periodic acid Schiff-positive material, which also revealed birefringent bodies of cotton dust under polarized light. Secondary PAP can be fatal and present with acute respiratory failure. The occupational history and characteristic pathology can alert clinicians to the diagnosis.
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Primary endobronchial
Hodgkin's disease
Prakash R Malur, Gajanan S Gaude, Hema B Bannur, Shivappa B Anurshetru, Vijayalaxmi V Suranagi, Ranjit P Kangle, Annasaheb J Dhumale, Pradeep H Patil, Reshma Davanagere
October-December 2009, 26(4):136-138
DOI
:10.4103/0970-2113.56350
PMID
:20531998
We report a case of primary pulmonary Hodgkin's disease presenting as an endobronchial mass. Tissue diagnosis was made by microscopic examination following open thoracotomy and excision biopsy of the mass. The patient responded well to the chemotherapy regimen.
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ORIGINAL ARTICLES
Five-year trend of acquired antitubercular drug resistance in patients attending a tertiary care hospital at Dehradun (Uttarakhand)
Jagdish Rawat, G Sindhwani, Ruchi Juyal Dua
October-December 2009, 26(4):106-108
DOI
:10.4103/0970-2113.56342
PMID
:20531990
Background/Aim:
To study the prevalence and trend of acquired drug resistance to the first line antitubercular drugs
. Materials and Methods:
Sputum of 215 previously treated adult pulmonary tuberculosis (TB) patients over a period of 2002-2006 were subjected to culture and sensitivity testing against common antitubercular drugs.
Result:
Growth of
Mycobacterium tuberculosis
was obtained from sputum specimen of 184 (85.58%) of the 215 patients who were studied; Overall, 113 (62.77%) of these were resistant to at least one antitubercular drug. Resistance to isoniazid was most common (62.22%) followed by rifampicin (57.22%). Multidrug resistance (MDR) was observed in 103 (57.22%) cases. During the five-year study period, an increasing trend in drug resistance including MDR-TB was observed.
Conclusion:
This study showed increasing trend in drug resistance including MDR-TB in five years.
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CASE REPORTS
Primary carcinoma of the lung in von Recklinghausen neurofibromatosis
KB Gupta, Vipul Kumar, Sanjeev Tandon, Meenu Gill
October-December 2009, 26(4):130-132
DOI
:10.4103/0970-2113.56348
PMID
:20531996
von Recklinghausen neurofibromatosis (NF-1) is the most common inherited syndrome predisposing to neoplasia, particularly neural crest-derived tumors. However, lung malignancies reported in association with neurofibromatosis are sparse. We present a case of a 48-year-old man with NF-1 that manifested as carcinoma of lung, in order to discuss the linkage between these two entities.
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Tracheal metastasis of small cell lung cancer
Sajal De
October-December 2009, 26(4):162-164
DOI
:10.4103/0970-2113.56358
PMID
:20532006
Endotracheal metastases of primary lung cancer are rare. Only one case of tracheal metastasis from small cell lung cancer has been reported in literature. Here, we report a rare case of a 45-year-old woman who was admitted for sudden-onset breathlessness with respiratory failure and required ventilatory support. Endotracheal growth was identified during bronchoscopy, and biopsy revealed endotracheal metastasis of small cell lung cancer.
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EDITORIALS
Asthma and gastroesophageal reflux: End of the blame game
Sachin Kumar, Dheeraj Gupta
October-December 2009, 26(4):100-101
DOI
:10.4103/0970-2113.56340
PMID
:20531988
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ORIGINAL ARTICLES
Five-years experiences of the revised national tuberculosis control programme in northern part of Kolkata, India
Sudipta Pandit, Atin Dey, Arunabha Datta Chaudhuri, Mita Saha, Amitava Sengupta, Sushmita Kundu, Sourin Bhuniya, Shib Singh
October-December 2009, 26(4):109-113
DOI
:10.4103/0970-2113.56343
PMID
:20531991
Background:
The Revised National Tuberculosis Control programme (RNTCP), India.
Aim:
To assess the impact of the expansion of the RNTCP in the case detection and treatment outcome.
Materials and
Methods:
Reports of patients with tuberculosis (TB) diagnosed and treated under RNTCP from 2001 to 2005 under Bagbazar TB unit (TU), Kolkata, reviewed retrospectively.
Results:
Of 2814 cases registered between 2001 and 2005, 1268 were new smear-positive pulmonary TB (PTB), 308 were new smear-negative PTB and 536 were new extrapulmonary TB (EPTB). During that period, the new smear-positive case detection rate increased from 41 to 61 per lakh population, the annual total case detection rate increased from 87 to 142 per lakh and the treatment success rate reduced from 90% to 76%. The default and failure rates increased from 7% to 10% and from 3% to 10%, respectively.
Conclusion:
A steady increase was observed in the annual total case detection rate and annual new smear-positive case detection rate from 2001 to 2005, but the 3-month conversion rate and cure rate of new smear-positive patients were progressively decreased. Default rate and treatment failure rate of new smear-positive patients were also increased. So it needs extra attention and evaluation of this disappointing treatment outcome.
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CASE REPORTS
A case of pulmonary carcinoid tumor with concomitant tuberculosis
Ramakant Dixit, Rakesh Gupta, Ajay Yadav, AR Paramez, Gautam Sen, Sidharth Sharma
October-December 2009, 26(4):133-135
DOI
:10.4103/0970-2113.56349
PMID
:20531997
The simultaneous occurrence of pulmonary carcinoid tumor and tuberculosis is very rare. A case of pulmonary carcinoid tumor is described in a 35-year-old male patient who had concomitant ipsilateral pulmonary tuberculosis. The importance of dual pathological diagnosis in clinical practice is also emphasized.
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An unusual presentation of immotile-cilia syndrome with azoospermia: Case report and literature review
Ramakant Dixit, Kalpana Dixit, Savita Jindal, KV Shah
October-December 2009, 26(4):142-145
DOI
:10.4103/0970-2113.56352
PMID
:20532000
Immotile-cilia syndrome is a rare disorder characterized by chronic recurrent sino-pulmonary infection, impaired tracheobronchial clearance, situs inversus in about 50% of cases, and living but immotile spermatozoa of normal morphology in semen analysis. In this report, we describe an unusual presentation of immotile-cilia syndrome with azoospermia in a 32-year-old male patient. The diagnosis was based on history of recurrent respiratory tract infection, bronchiectasis, maxillary sinusitis, hypoplasia of frontal sinuses, dextrocardia with situs inversus, impaired nasal mucociliary clearance, etc. Semen analysis revealed azoospermia without any evidence of obstruction in epididymides or vas deference. Normal spermatogenesis was seen on testicular biopsy.
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ORIGINAL ARTICLES
Role of fine-needle aspiration cytology in evaluating mediastinal masses
DK Pandey, Zuber Ahmad, I Masood, SK Singh, Z Jairajpuri
October-December 2009, 26(4):114-116
DOI
:10.4103/0970-2113.56344
PMID
:20531992
Background:
Fine-needle aspiration cytology is an important and useful investigation and is considered next to imaging in the diagnosis of mediastinal lesions. We carried out this study in the Department of TB and respiratory diseases JNMC Aligarh from March 2000 to March 2002 with the following aims.
Objectives:
To make etiological diagnosis of mediastinal lesions, determine the pathological type of the tumor in cases of malignancy and evaluate the role of fine-needle aspiration cytology in staging of bronchogenic carcinoma.
Materials and m0 ethods:
A total of 56 patients were included in this study who had mediastinal mass with or without lung lesions on chest X-ray or computed tomography scan. Of these patients, 36 had mediastinal mass only and 20 had mediastinal mass with parenchymal lesion.
Results:
In the present study, of 56 patients, 36 had mediastinal masses and 20 had pulmonary mass.
Conclusion:
Percutaneous fine-needle aspiration is an easy and reliable method for reaching a quick tissue diagnosis in pulmonary and mediastinal masses.
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CASE FOR DIAGNOSIS
A young nonsmoker male patient with breathlessness
Ramakant Dixit, Sidharth Sharma, Manoj Arya
October-December 2009, 26(4):123-126
DOI
:10.4103/0970-2113.56346
PMID
:20531994
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CASE REPORTS
Aspergilloma in sarcoidosis
Jagruti Hede, Rahul Bahot, JR Shah
October-December 2009, 26(4):127-129
DOI
:10.4103/0970-2113.56347
PMID
:20531995
This is a case report of a 48-year-old man, followed up for nearly 30 years who initially developed sarcoidosis at the age of 18 that went into remission after 8 years of treatment. Ten years later, he developed sputum-positive tuberculosis and was cured with anti-tubercular treatment. Following this, there was progression of sarcoidosis to stage IV fibrocystic disease. Ten years later, he had massive hemoptysis during which time, aspergilloma was detected in a sarcoid cystic cavity.
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Marfan syndrome with multiseptate pneumothorax and mandibular fibrous dysplasia
A Kate, D Gothi, JM Joshi
October-December 2009, 26(4):146-148
DOI
:10.4103/0970-2113.56353
PMID
:20532001
We describe a rare case of pneumothorax due to Marfan syndrome associated with fibrous dysplasia of the mandible. Marfan syndrome and fibrous dysplasia were possibly due to a common etiological factor. The association between the two and other tumors described in literature related to Marfan syndrome is discussed.
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Acute lung injury following exposure to nitric acid
TK Jayalakshmi, Samir Shah, Ivona Lobo, Abhay Uppe, Ankur Mehta
October-December 2009, 26(4):149-151
DOI
:10.4103/0970-2113.56354
PMID
:20532002
We present a series of three cases of survival following inhalation of nitric acid fumes, which resulted in acute respiratory distress. Inhalation of nitric acid fumes and its decomposition gases such as nitrogen dioxide results in delayed onset of acute respiratory distress syndrome. Intensive respiratory management, ventilatory support, and steroids can help in survival.
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Diphenylhydantoin (phenytoin)-induced chronic pulmonary disease
Ramakant Dixit, Kalpana Dixit, Paras Nuwal, Arunima Banerjee, Sidharth Sharma, Lokendra Dave
October-December 2009, 26(4):155-158
DOI
:10.4103/0970-2113.56356
PMID
:20532004
Drug-induced respiratory diseases are difficult to diagnose and therefore usually not identified, probably underestimated and under-reported. We report a case of diphenylhydantoin/phenytoin-induced chronic pulmonary disease in a 62-year-old male patient presenting with progressive dyspnea, eosinophilia, and pulmonary abnormalities. The importance of drug history in clinical history-taking and early diagnosis of drug-induced respiratory diseases is emphasized so as to prevent permanent pulmonary damage.
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Nonseminomatous germ cell tumor with seizure disorder and mental retardation
Vinaya Karkhanis, JM Joshi
October-December 2009, 26(4):139-141
DOI
:10.4103/0970-2113.56351
PMID
:20531999
We report a case of a patient who presented with anterior mediastinal mass, seizure disorder, and mental retardation. Computerized tomography-guided fine-needle aspiration biopsy of the mass showed nonseminomatous germ cell tumor. Chromosomal analysis showed XXY karyotype. A diagnosis of Klinefelter syndrome and mediastinal germ cell tumor was made.
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EDITORIALS
From the Editor's desk
SK Jindal
October-December 2009, 26(4):99-99
DOI
:10.4103/0970-2113.56339
PMID
:20531987
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1,094
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ORIGINAL ARTICLES
The impact of "World Health Organization - Government of India guidelines on chronic obstructive pulmonary diseases-2003" on quality of life
Ashok K Janmeja, Prasanta R Mohapatra, Mandeep Kumar
October-December 2009, 26(4):102-105
DOI
:10.4103/0970-2113.56341
PMID
:20531989
Background:
The World Health Organization-Government of India (WHO-GOI) Guidelines - 2003 for management of chronic obstructive pulmonary diseases (COPD) is a consensus statement. However, the outcome and impact of its implementation on quality of life (QOL) among COPD patients has not been studied so far.
Materials and
Methods:
The patients were randomized to intervention group (n = 50) and control group (n = 40). All were treated and followed up for 6 months. A pulmonary physician reviewed patients of both the groups, at least 3 times in 6 months period. St. George's Respiratory Questionnaire was measured at baseline and at 6 months. Patients in control group visited the center on a "need to" basis and were prescribed conventional treatment by the doctor on duty.
Results:
Forty-two patients in the intervention group and 32 in the control group completed 3 visits over the period of 6 months and were included in analysis. The severity as per the guidelines was moderate in 74% and severe in 26% in intervention group while it was moderate in 64% and severe in 36% cases in control group. Follow-up QOL scores were significantly better as compared with baseline values (
P
< 0.001).The QOL of the patients treated according to the guidelines were significantly better (
P
< 0.001) than those in the control group with conventional treatment.
Conclusion:
The consensus derived recommendations of WHO-GOI Guidelines for COPD-2003 are beneficial for management of COPD patients over conventional management.
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REVIEW ARTICLE
Sleep effects on breathing and respiratory diseases
Sumer S Choudhary, Sanjiw R Choudhary
October-December 2009, 26(4):117-122
DOI
:10.4103/0970-2113.56345
PMID
:20531993
To understand normal sleep pattern and physiological changes during sleep, sleep and breathing interaction, nomenclature and scales used in sleep study, discuss the effect of rapid eye movements and non-rapid eye movements while sleep and to review the effects of obstructive and restrictive lung disease on gas exchange during sleep and sleep architecture.
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2,109
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