The Indian Journal of Chest Diseases and Allied Sciences

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2014 | July-September | Volume 56 | Issue 3

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EDITORIAL

S. Kashyap, Anjali Solanki

Lung Cancer Screening in India: A Long Way To Go

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:2] [Pages No:145 - 146]

   DOI: 10.5005/ijcdas-56-3-145  |  Open Access |  How to cite  | 

367

EDITORIAL

Vishal Bansal

Pulmonary Rehabilitation in Chronic Respiratory Diseases

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:2] [Pages No:147 - 148]

   DOI: 10.5005/ijcdas-56-3-147  |  Open Access |  How to cite  | 

315

Original Article

Navneet Singh, Gella Vishwanath, Ashutosh N. Aggarwal

Clinical Experience on Use of Oral EGFR-TKIs as First-line Treatment of Advanced NSCLC from a Tertiary Care Centre in North India and Implications of Skin Rash

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:4] [Pages No:149 - 152]

Keywords: Lung cancer, Epidermal growth factor receptor, Tyrosine kinase inhibitor, Skin rash, Overall survival

   DOI: 10.5005/ijcdas-56-3-149  |  Open Access |  How to cite  | 

Abstract

Background. Limited data are available from India on treatment outcomes with oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in newly diagnosed non-small cell lung cancer (NSCLC). We studied the demographic profile and treatment outcomes of patients with NSCLC, receiving first-line treatment with oral EGFR-TKIs. Methods. Retrospective study of newly diagnosed NSCLC patients treated with oral EGFR-TKIs over a 4-year period at a tertiary care institute in North India. Results. Of 76 patients studied, females and non-smokers constituted 32.9% and 48.7%, respectively. Majority of patients had adenocarcinoma (59.2%), stage IV (64.5%) disease and Karnofsky performance status <70 (74.5%). Gefitinib was the most frequently used EGFR-TKI (92.1%). Most common indication for the use of EGFR-TKIs was poor performance status (65.8%). Among assessable patients, disease control and progressive disease were evident in 66% and 34%, respectively. Most common side effects were skin rash (17%) and diarrhoea (10.6%). Patients with and without skin rash differed significantly in relation to objective response to treatment (100% versus 23.1%) and overall survival (median not reached versus 178 days). On multivariate logistic regression analysis, malignant pleural effusion was associated with occurrence of rash (odds ratio=0.19; 95% confidence interval = 0.04-0.95; p=0.04). Conclusions. Oral EGFR-TKIs appear to be useful for the treatment of clinically selected patients with advanced NSCLC. Occurrence of skin rash was independently associated with treatment response and better survival in the current study.

293

Original Article

Tiyas Sen Dutt, Syed Zulkharnain Tousheed, B.V. Murali Mohan

Community Acquired Pneumonia and Cardiac Diseases: A Fatal Association

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:4] [Pages No:153 - 156]

Keywords: Community acquired pneumonia, Acute coronary events

   DOI: 10.5005/ijcdas-56-3-153  |  Open Access |  How to cite  | 

Abstract

Background. Community acquired pneumonia (CAP) remains a common disease condition attributing to a significant mortality and morbidity worldwide. Acute cardiac events (ACEs) are one of the most life-threatening complications in patients with severe pneumonia. Methods. Retrospective study of burden of ACE in 105 patients admitted with CAP. Results. Twenty-five patients with (CURB-65) score ranging between 0 – 2 did not require intensive care unit (ICU) admission and were admitted in the ward and high dependency unit. Of these, 12 developed ACE and 4 required to be shifted to the ICU for further management. Eighty patients with a CURB—65 score of greater than 3 were admitted to the ICU. Of the patients admitted to the ICU, 10 with ACE died; 2 patients without ACE also died. Conclusions. Our observations suggest that ACE constitute an important cause of morbidity and mortality in patients with CAP requiring hospitalisation.

434

Original Article

N.L.N. Moorthy, P. Navaneeth Sagar Reddy, T. Aruna, D. Mahesh Chander

Role of Magnetic Resonance Imaging Cephalometry in Obstructive Sleep Apnoea

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:3] [Pages No:157 - 159]

Keywords: Obstructive sleep apnoea, Magnetic resonance imaging cephalometry

   DOI: 10.5005/ijcdas-56-3-157  |  Open Access |  How to cite  | 

Abstract

Background. Obstructive sleep apnoea (OSA) is one of the most common public health problems in adults. Patients with OSA are prone for excessive adipose tissue deposition in the neck, which in turn, increases the upper airway narrowing. Of the imaging modalities available for assessing the upper airway, magnetic resonance imaging (MRI) is found to be useful technique for defining soft tissue abnormalities. Methods. We prospectively studied 50 patients presenting with OSA and 50 normal controls to evaluate the role of MRI cephalometry in the diagnosis of OSA and compared the cross-sectional area and antero-posterior diameter of the upper airway in the retro-palatal airway and retro-glossal areas by MRI cephalometry. Results. In comparison with controls, cases had a significantly lower cross-sectional area and antero-posterior diameter of the upper airway in the retro-palatal airway and retro-glossal areas. Conclusions. Our observations suggest that MRI cephalometry is a sensitive technique for the diagnosis of OSA.

298

REVIEW ARTICLE

Raj Kumar

Smoking Cessation: An Update

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:9] [Pages No:161 - 169]

Keywords: Tobacco, Smoking, Respiratory diseases, Smoking cessation

   DOI: 10.5005/ijcdas-56-3-161  |  Open Access |  How to cite  | 

Abstract

Intervention for smoking cessation has become on urgent need because of increasing tobacco use and health hazards, especially in developing countries. Smoking cessation will be at different states of readiness. The states may be: (i) not ready (pre-contemplation), (ii) unsure (contemplation), (iii) ready (preparation), (iv) action, and (v) maintenance. Counselling and behavioural management is important. The '5 A's-based intervention in the form of Ask, Advise, Assess, Assist and Arrange is implemented. Pharmacologic management is based on first-line treatment in the form of nicotine replacement therapy, bupropion and varinicline and second-line treatment as clonidine and nortriptalin. Every health professional has obligation to help their patients to quit and the intervention should be diagnostic and therapeutic. The best results are obtained by behavioural and social support combined with pharmacotherapy whenever needed. The paper highlights the important component of intervention in smoking cessation.

511

Radiology Forum

Shobitha Rao, P.S. Srilatha, A.K. Mohapatra

Congenital Cystic Adenomatoid Malformation of the Left Lung Presenting in an Adult

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:2] [Pages No:171 - 172]

Keywords: Congenital abnormalities, Lung, Adult

   DOI: 10.5005/ijcdas-56-3-171  |  Open Access |  How to cite  | 

249

Radiology Forum

Nishtha Singh

Spontaneous Oesophago-Pleural Fistula

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:2] [Pages No:173 - 174]

   DOI: 10.5005/ijcdas-56-3-173  |  Open Access |  How to cite  | 

273

CASE REPORT

S. Mukherjee, A. Dattachaudhuri, P. Bhanja, J. Deb, S. Begum, S. Bhuniya, S. Nandi

A Rare Case of Primary Adenoid Cystic Carcinoma of Lung

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:3] [Pages No:175 - 177]

Keywords: Adenoid cystic carcinoma, Salivary gland type cancer, Lung cancer, Bronchogenic carcinoma

   DOI: 10.5005/ijcdas-56-3-175  |  Open Access |  How to cite  | 

Abstract

A 33-year-old male presented with repeated episodes of blood-streaked sputum for last one-and half-year. Chest radiograph showed consolidation in the right lower zone. Fibreoptic bronchoscopy revealed an endoluminal growth in the right lower lobe bronchus. Histopathological examination of bronchoscopic biopsy specimen confirmed adenoid cystic carcinoma.

252

CASE REPORT

Damyanti Agrawal, T.K. Lahiri, S. Lakhotia

Giant Mediastinal Haemangiopericytoma: An Uncommon Case

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:4] [Pages No:179 - 182]

Keywords: Haemangiopericytoma, Thoraco-mediastinal tumours

   DOI: 10.5005/ijcdas-56-3-179  |  Open Access |  How to cite  | 

Abstract

Haemangiopericytoma is a rare soft tissue tumour characterised by tightly packed tumour cells situated around thin walled endothelial lined vascular channels, ranging from capillary sized vessels to large gaping sinusoidal spaces. The tumour cells are surrounded by reticulin and are negative for muscle, nerve and epithelial markers. The diagnosis of extra-pulmonary intra-thoracic, extra-pleural mediastinal mass is difficult. It constitutes only 6% of all primary tumours and cysts of the mediastinum. We report the rare occurrence of primary intra-thoracic, extra-pulmonary mediastinal haemangiopericytoma of mesenchymal origin with perivascular localisation. The patient underwent right postero-lateral thoracotomy and postoperatively received chemotherapy with adriamycin (60 mg/m2) on day 1 and ifosfamide (1.5 g/m2) on day 1 to 3. Thirtyseven months after the operation, the patient has been well with evidence of a single recurrence in the left lower lobe.

231

CASE REPORT

Susmita Kundu, Debabani Biswas, Swapnendu Misra, Shantanu Dutta, Annoy Sen

Ancient Schwannoma of Vagus Nerve Mimicking Hamartoma

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:3] [Pages No:183 - 185]

Keywords: Schwannoma, Popcorn calcification

   DOI: 10.5005/ijcdas-56-3-183  |  Open Access |  How to cite  | 

Abstract

Schwannomas arising from vagus nerve sheath are rare mediastinal neurogenic tumours. Schwannomas usually arise from left hemithorax. Unlike a hamartoma, radiologically, calcification is rarely seen in schwannomas. We present the rare case of an ancient schwannoma arising from vagus nerve sheath from the right hemithorax presenting with gross calcification.

288

CASE REPORT

Karan Madan, Loganathan Nattusamy, Sudheer Arava, Randeep Guleria

Tracheobronchopathia Osteochondroplastica: A Rare Cause of Difficult Intubation

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:3] [Pages No:187 - 189]

Keywords: Tracheobronchopathia osteochondroplastica, Ossification, Airway obstruction

   DOI: 10.5005/ijcdas-56-3-187  |  Open Access |  How to cite  | 

Abstract

Tracheobronchopathia osteochondroplastica is a rare benign airway disorder which is characterised by submucosal nodules projecting into the tracheo-bronchial lumen usually involving the cartilaginous portions of the tracheo-bronchial tree or larynx. The condition is usually asymptomatic but can rarely present with difficulty during endotracheal intubation or rarely with obstructive airway complications. Bronchoscopic appearance is usually sufficient to make the diagnosis, and tissue biopsies are seldom required. No specific treatment is required in asymptomatic patients. However, interventional bronchoscopy procedures or surgery may be helpful in symptomatic cases

248

CASE REPORT

G.K. Yadav, Shyam Lal, N. Dange, K.G. Marwah, J.P. Singh

Poland's Syndrome with Unusual Hand and Chest Anomalies: A Rare Case Report

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:4] [Pages No:191 - 194]

Keywords: Poland's syndrome, Bifid ribs, Congenital anomalies, Symbrachydactyly

   DOI: 10.5005/ijcdas-56-3-191  |  Open Access |  How to cite  | 

Abstract

Poland's syndrome is a rare congenital anomaly consisting of a unilateral absence of the pectoralis major, ipsilateral muscle, hand anomaly and occasionally associated other malformations of the chest wall and breast. Many structural and functional abnormalities have been described in association with this syndrome. We report an incidentally diagnosed case in a 27-year-old male patient who presented to us with symbrachydactyly. In addition to this, anterior depression of 2nd, 3rd and 4th ribs and bifid (forked) 5th rib was present on radiological investigations. The body of sternum was short and deformed on the right side with absence of xiphoid process. All middle phalanges were absent on right hand. It is a rare variant of Poland's syndrome.

311

Correspondence

Viroj Wiwanitkit

Clinical Profile of Pneumonia and Its Association with Rain Wetting in Patients Admitted at a Tertiary Care Institute During Pandemic of Influenza A (H1N1) pdm09 Virus Infection

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:1] [Pages No:195 - 195]

   DOI: 10.5005/ijcdas-56-3-195  |  Open Access |  How to cite  | 

312

Book Review

D. Behera

Atlas of Fiberoptic Bronchoscopy

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:1] [Pages No:197 - 197]

   DOI: 10.5005/ijcdas-56-3-197  |  Open Access |  How to cite  | 

267

Abstracts’ Service

Abstracts’ Service

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:3] [Pages No:199 - 201]

   DOI: 10.5005/ijcdas-56-3-199  |  Open Access |  How to cite  | 

299

Guidelines to Authors

Guidelines to Authors

[Year:2014] [Month:July-September] [Volume:56] [Number:3] [Pages:6] [Pages No:203 - 208]

   DOI: 10.5005/ijcdas-56-3-203  |  Open Access |  How to cite  | 

214

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