The Indian Journal of Chest Diseases and Allied Sciences

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2013 | January-March | Volume 55 | Issue 1

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EDITORIAL

Raj Kumar

Allergy Situation in India: What is Being Done?

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:2] [Pages No:7 - 8]

   DOI: 10.5005/ijcdas-55-1-7  |  Open Access |  How to cite  | 

275

EDITORIAL

Tamilarasu Kadhiravan

Adherence and Acquired Drug-Resistance in Tuberculosis: Wisdom Stood on its Head

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:2] [Pages No:9 - 10]

   DOI: 10.5005/ijcdas-55-1-9  |  Open Access |  How to cite  | 

176

Original Article

M.O. Al-Ghobain, M.S. Al-Moamary, M.S. Al-Hajjaj, A.I. Al-Fayez, S.I. Basha

Prevalence of Rhinitis Symptoms Among 16 to 18 Years Old Adolescents in Saudi Arabia

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:4] [Pages No:11 - 14]

Keywords: Rhinitis, Prevalence, ISAAC, Saudi Arabia

   DOI: 10.5005/ijcdas-55-1-11  |  Open Access |  How to cite  | 

Abstract

Objective. The present study was designed to estimate the prevalence of rhinitis symptoms among secondary school students in Saudi Arabia Methods. A cross-sectional study was conducted among children from secondary schools in the city of Riyadh. The study utilised the International Study of Asthma and Allergies in Children (ISAAC) questionnaire. Results. Among the 3073 students (1504 boys and 1569 girls), the prevalence of life-time rhinitis, rhinitis in the past 12 months, and hay fever were 43.8%, 38.6% and 21.3%, respectively. There was a significant difference between boys and girls in the prevalence of life-time rhinitis (41% versus 46.5%, p=0.02) and the prevalence of rhinitis in the past 12 months (35.1% versus 41.9%, p=0.001). There was no significant difference between boys and girls in the prevalence of hay fever (22.5% versus 20.2%, p=0.144). The prevalence of asthma symptoms among students with life-time rhinitis and hay fever were 35.4% and 39.9%, respectively. Asthma symptoms were strongly linked with life-time rhinitis (Odds Ratio [OR]=2.5, p<0.001) and hay fever (OR=2.4, p value<0.001). Conclusions. The prevalence of rhinitis symptoms is high among 16 to 18 years old adolescents in Saudi Arabia, and symptoms are more common in girls compared to boys. Rhinitis symptoms are also associated with a high frequency of asthma symptoms. [Indian J Chest Dis Allied Sci 2013;55:11-14]

199

Original Article

Dibya Ranjan Pati, Madhu Khanna, Binod Kumar, Prashant Kumar, Roopali Rajput, Latika Saxena, Sharvani , S.N. Gaur

Clinical Presentation of Patients with Seasonal Influenza and Pandemic Influenza A (H1N1-2009) Requiring Hospitalisation

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:5] [Pages No:15 - 19]

Keywords: Pandemic influenza H1N1, Comorbidity, ARDS, Intensive care

   DOI: 10.5005/ijcdas-55-1-15  |  Open Access |  How to cite  | 

Abstract

Background. A sudden increase in the number of novel influenza A virus (pH1N1-2009) infection prompted us to compare the clinical presentation and outcomes of patients infected with pH1N1-2009 and seasonal influenza A virus during the postpandemic phase. Methods. During the period August 13 to September 27, 2010, case records of 106 patients with severe influenza like illness (ILI) and respiratory complications who underwent diagnostic testing by real-time polymerase chain reaction (RT-PCR) for confirmation of pH1N1-2009 were retrospectively studied. Results. Nineteen (17.9%) patients were tested positive for pH1N1-2009 and 78 (73.6%) were tested positive for seasonal influenza A virus. The mean age of patients infected with pH1N1-2009 was 45.2±15.3 years (range of 22 to 80 years). Common presenting symptoms included fever in 17 (89.4%), cough in 16 (84.2%), myalgia in 15 (78.9%) and breathlessness in 10 (52.6%) patients. The most common comorbidities included bronchial asthma/bronchitis/chronic obstructive pulmonary disease (COPD) in 4 (21%); followed by hypertension in 3 (15.8%) and diabetes in 3 (15.8%) patients. Overall, of the 97 influenza infected patients, 9 (9.3%) needed hospitalisation to the intensive care unit (ICU); one patient with COPD died due to multi-organ failure. Conclusions. Both the pandemic and seasonal strains were found to be co-circulating in the community. Patients with severe hypoxia, hypertension, acute respiratory distress syndrome and shock required ICU care.

232

Original Article

Sushmita Choudhury

Combined Pleural Fluid Cholesterol and Total Protein in Differentiation of Exudates and Transudates

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:3] [Pages No:21 - 23]

Keywords: Pleural fluid total protein, Cholesterol, Light's criteria, Transudates, Exudates

   DOI: 10.5005/ijcdas-55-1-21  |  Open Access |  How to cite  | 

Abstract

Background. The management strategy to be adopted in pleural effusion depends on whether an effusion is a transudate or exudate. Objective. To evaluate the usefulness of pleural fluid cholesterol and/or total protein measurements for differentiating between exudates and transudates, and to compare it with Light's criteria. Methods. In this prospective study 60 patients with pleural effusion were included. Pleural fluid total protein, lactate dehydrogenase (LDH) and cholesterol as well as serum total protein and LDH levels along with other investigations were studied. Clinical classification of transudate or exudate was done on the basis of aetiology. Results. Based on clinical signs and symptoms, chest radiograph, other investigations and response to treatment, 49 of these effusions were classified as exudates and 11 as transudates. Using pleural fluid cholesterol levels at a cut-off point of greater than 60 mg/dL and/or total protein at a cut-off point of greater than 3 g/dL for distinguishing transudates and exudates, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), were 100 percent. Using Light's criteria for discriminating transudates and exudates, sensitivity, specificity, PPV and NPV were found to be 98%; 100%; 100% and 92%, respectively. The differences resulted from a mis-classification of one expected exudate as transudate by Light's criteria. Conclusion. Pleural fluid cholesterol and total protein are simple, cost-effective, and useful parameters in distinguishing pleural transudates from exudates, with the advantage of requiring only two laboratory determinations and no simultaneous blood sample, compared to the use of Light's criteria.

208

REVIEW ARTICLE

Vinaya S. Karkhanis, J.M. Joshi

Pneumoconioses

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:10] [Pages No:25 - 34]

Keywords: Pneumoconiosis, Occupation, Fibrosis

   DOI: 10.5005/ijcdas-55-1-25  |  Open Access |  How to cite  | 

Abstract

Occupational lung diseases are caused or made worse by exposure to harmful substances in the work-place. “Pneumoconiosis” is the term used for the diseases associated with inhalation of mineral dusts. While many of these broadspectrum substances may be encountered in the general environment, many occur in the work-place for greater amounts as a result of industrial processes; therefore, a range of lung reactions may occur as a result of work-place exposure. Physicians in metropolitan cities are likely to encounter pneumoconiosis for two reasons: (i) patients coming to seek medical help from geographic areas where pneumoconiosis is common, and (ii) pneumoconiosis caused by unregulated small-scale industries that are housed in poorly ventilated sheds within the city. A sound knowledge about the various pneumoconioses and a high index of suspicion are necessary in order to make a diagnosis. Identifying the disease is important not only for treatment of the individual case but also to recognise and prevent similar disease in co-workers.

487

Radiology Forum

Julpikar Sarkavas, Vinaya S. Karkhanis, Jyotsna M. Joshi

Primary Achalasia with Pneumoesophagus and Bronchopleural Fistula Causing Right Lung Collapse and Bronchiectasis

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:3] [Pages No:35 - 37]

   DOI: 10.5005/ijcdas-55-1-35  |  Open Access |  How to cite  | 

208

CASE REPORT

Nidhi Paliwal, Kumud Gupta, R.K. Dewan, Shalini Mullick

Adenocarcinoma (Somatic-Type Malignancy) in Mature Teratoma of Anterior Mediastinum

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:3] [Pages No:39 - 41]

Keywords: Adenocarcinoma, Mature teratoma, Mediastinum

   DOI: 10.5005/ijcdas-55-1-39  |  Open Access |  How to cite  | 

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 11.4cmx10.6cmx10.0cm 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).

178

CASE REPORT

Girish Sindhwani, Jagdish Rawat, Vikas Kesarwani

Haemoptysis after Four Years of Lobectomy for Aspergilloma

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:2] [Pages No:43 - 44]

Keywords: Aspergilloma, Lobectomy, Haemoptysis

   DOI: 10.5005/ijcdas-55-1-43  |  Open Access |  How to cite  | 

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.

157

CASE REPORT

Shafali Nandwani, Apurva Pande, Mahip Saluja

A Case of Staphylococcus Toxic Shock Syndrome Presenting with Multiple Pneumatocoeles in the Chest

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:3] [Pages No:45 - 47]

Keywords: Acute respiratory distress syndrome, Staphylococcus aureus, Pneumatoceles, Toxic shock syndrome, Pyelonephritis, Septic emboli

   DOI: 10.5005/ijcdas-55-1-45  |  Open Access |  How to cite  | 

Abstract

Staphylococcus toxic shock syndrome is a severe illness caused by infection with toxin producing Staphylococcus aureus and is associated with a poor outcome. We report a case of Staphylococcus TSS presenting with cough and expectoration along with multiple pneumatoceles visible on the chest radiograph that progressed to acute respiratory distress syndrome with eventual foci in brain. The patient was aggressively managed and recovered completely.

182

CASE REPORT

Susmita Kundu, Swapnendu Misra, Ranjit Kumar Halder, Arpita Roychowdhury

Pulmonary Renal Syndrome in a Case of Wegener's Granulomatosis

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:4] [Pages No:49 - 52]

Keywords: Pulmonary renal syndrome, Wegener's granulomatosis, Plasmapheresis

   DOI: 10.5005/ijcdas-55-1-49  |  Open Access |  How to cite  | 

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.

218

Book Review

S.K. Sharma

Pulmonary Vascular Disorders

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:2] [Pages No:53 - 54]

   DOI: 10.5005/ijcdas-55-1-53  |  Open Access |  How to cite  | 

173

Correspondence

K. Gowrinath, A. Yadav

Treatment Practices in Pulmonary Tuberculosis by Private Sector Physicians of Meerut, Uttar Pradesh

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:2] [Pages No:55 - 56]

   DOI: 10.5005/ijcdas-55-1-55  |  Open Access |  How to cite  | 

201

Abstracts' Service

Abstracts' Service

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:3] [Pages No:57 - 59]

   DOI: 10.5005/ijcdas-55-1-57  |  Open Access |  How to cite  | 

174

Panel of Reviewers—2012

Panel of Reviewers—2012

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:1] [Pages No:60 - 60]

   DOI: 10.5005/ijcdas-55-1-60  |  Open Access |  How to cite  | 

198

Guidelines to Authors

Guidelines to Authors

[Year:2013] [Month:January-March] [Volume:55] [Number:1] [Pages:6] [Pages No:61 - 66]

   DOI: 10.5005/ijcdas-55-1-61  |  Open Access |  How to cite  | 

166

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