A Case for Using Indian Prediction Equations for Pulmonary Function Tests in Indians
[Year:2019] [Month:April-June] [Volume:61] [Number:2] [Pages:2] [Pages No:61 - 62]
DOI: 10.5005/ijcdas-61-2-61 | Open Access | How to cite |
A Prospective Study on Patterns of Psychiatric Morbidity in Patients with Pulmonary Tuberculosis at a Tertiary Care Hospital in Northern India
[Year:2019] [Month:April-June] [Volume:61] [Number:2] [Pages:5] [Pages No:63 - 67]
Keywords: Anxiety disorders, Morbidity, Depression, Pulmonary tuberculosis
DOI: 10.5005/ijcdas-61-2-63 | Open Access | How to cite |
Background: An association has been described between tuberculosis (TB) and common mental disorders. We aimed to evaluate the patterns of psychiatric morbidities in patients with pulmonary TB. Methods: This was a prospective study which was conducted over a period of one-and-half year. A total of 198 patients were recruited for the study. Baseline psychiatric morbidity was assessed after two weeks of diagnosis and at the end of intensive phase. Psychiatric morbidity was assessed using Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM IV) based Mini-Plus. Results: In the present study 62.1% of patients with pulmonary TB had morbid baseline psychiatric disorders. Major depressive episode was the most common morbid psychiatric disorder (40.9%) followed by panic disorder (12.6%), agoraphobia (2.5%) and generalised anxiety disorder (2%). The psychiatric morbidity dropped to (11.6%); major depressive episode (10.1%) followed by panic disorder (1.5%) were the only diagnosis on follow-up. Conclusion: In view of high burden of psychiatric morbidity associated with pulmonary TB, there is a need for psychiatric services to be made available to these patients.
Comparison of Performance of APACHE II and SOFA Scoring Systems in Critically Ill Patients Admitted to Intensive Care Unit
[Year:2019] [Month:April-June] [Volume:61] [Number:2] [Pages:6] [Pages No:69 - 74]
Keywords: APACHE II, ICU, Mortality, SOFA, Mechanical ventilation, South India
DOI: 10.5005/ijcdas-61-2-69 | Open Access | How to cite |
Background: Several disease scoring systems have evolved for predicting the mortality in intensive care unit (ICU) patients. We evaluated the performance of Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scoring systems in providing mortality risk estimates in critically ill patients. Methods: During March 2015 to March 2016, 160 critically ill patients requiring mechanical ventilation (MV) at our tertiary care teaching hospital in south India were prospectively studied. Results: Compared to survivors, non-survivors were significantly older (median [interquartile range, IQR] age [years] 42.5 (28-54.3) versus 33 [22–49.3] [p=0.025]); had higher median (IQR) APACHE II score (23 [18-29] versus 15 [11.8-19]); and SOFA score (9 [6-12] versus 5 [4-7] [p<0.001]); required MV for a longer duration (9 [6–13] versus 6 [4–9] days [p=0.048]) and had lesser duration of ICU stay (7 [4–12] versus 13.5 [8-21.3] days [p<0.001]) and hospital stay (9 [7–17.3] versus 16 [11.8-28] days [p<0.001]). APACHE II score (cut-off > 17, sensitivity 67.8%, specificity 80%) and SOFA score (cut-off > 7, sensitivity 78.9% and specificity 67.1%) performed similarly in predicting mortality (difference between areas under the curve 0.0180; standard error 0.0316; 95% confidence interval, -0.0440 to 0.0800; z statistic 0.569; p=0.569). Conclusion: Both APACHE II and SOFA scores appear to be useful tools in predicting mortality in critically ill patients requiring MV in the setting of an ICU in south India.
Primary Mediastinal Cysts and Tumours: A 5-Year Single Centre Experience
[Year:2019] [Month:April-June] [Volume:61] [Number:2] [Pages:7] [Pages No:75 - 81]
Keywords: Primary mediastinal lesions, Lymphoma, Thymoma
DOI: 10.5005/ijcdas-61-2-75 | Open Access | How to cite |
Background: Primary mediastinal lesions pose a diagnostic and management challenge and the distribution of these lesions vary depending upon the population being studied and the type of the health-care facility. Methods: A prospective, observational study of consecutive patients presenting for the evaluation of widened mediastinum on the chest radiograph was conducted during the period of January 2012 to January 2016. Patients with primary oesophageal, cardiac, pulmonary masses extending into the mediastinum, metastatic disease, infection (tuberculosis, fungal infections) and sarcoidosis were excluded. Results: We studied 89 histopathological proven cases with primary mediastinal lesions; their mean age was 37.5±20.3 years; there were 50 (56.2%) males. There were 52 (58.4%) benign and 37 (41.6%) malignant lesions. In adults, 39/70 (55.7%) of masses were in the anterior, 11.4% (8/70) in the middle, 10% (7/70) in the posterior and 22.9% (16/70) were in multiple compartments of the mediastinum. In children, 36.8% (7/19) of the masses were in the middle, 31.6% (6/19) in anterior, 21.1% (4/19) in multiple compartment and 10.5% (2/19) in the posterior mediastinum. Lymphomas were the most common lesion 34.8% followed by thymic lesions 26.9%. Conclusion: Most of the primary mediastinal lesions could be diagnosed by image guided fiberoptic needle aspiration cytology/core biopsy
To Study Association Between Exhaled Carbon Monoxide Levels with Disease Severity in Various Stages of Obstructive Airway Disease
[Year:2019] [Month:April-June] [Volume:61] [Number:2] [Pages:4] [Pages No:83 - 86]
Keywords: Obstructive airway disease, Exhaled carbon monoxide, FEV1, Smoking
DOI: 10.5005/ijcdas-61-2-83 | Open Access | How to cite |
Background: Chronic obstructive pulmonary disease (COPD) is a general name for the chronic airflow obstruction that develops most commonly due to long term tobacco smoking and other noxious gases. The aim of the present study is to check whether exhaled carbon monoxide (CO) levels had any co-relations with disease severity in various stages of COPD. Methods: The clinical severity of asthma and COPD was determined using the criteria defined in the Global Initiative for Asthma (GINA) and Global Initiative for chronic obstructive pulmonary disease (GOLD) guidelines. Spirometry was used to confirm the presence of airway obstruction. Results: We observed that exhaled CO levels increased with increasing severity of airway obstruction. A statistically significant negative correlation was observed between forced expiratory volume in the first second and exhaled CO (p<0.05). Conclusions: We found that measuring the level of exhaled CO in patients with COPD along with spirometry forms a new approach for better understanding of the pathophysiology of COPD cases.
A Rare Case of Both Mediastinal and Pericardial Hydatid Cysts Presenting as Cardiomegaly
[Year:2019] [Month:April-June] [Volume:61] [Number:2] [Pages:3] [Pages No:87 - 89]
DOI: 10.5005/ijcdas-61-2-87 | Open Access | How to cite |
Elizabethkingia meningosepticum Isolated from Pleural Fluid: A Diagnostic Dilemma
[Year:2019] [Month:April-June] [Volume:61] [Number:2] [Pages:4] [Pages No:91 - 94]
Keywords: Elizabethkingia meningosepticum, Pleural effusion, Diagnosis, Tretament
DOI: 10.5005/ijcdas-61-2-91 | Open Access | How to cite |
Elizabethkingia meningosepticum has been reported in cases of pneumonia, endocarditis, wound infections, post-operative bacteraemia and meningitis. It usually affects patients with severe underlying illness/immunocompromised host. An 18-yearold female, presented with a history of fever, cough, expectoration, loss of appetite and breathlessness for two weeks. Diagnostic evaluation revealed right-sided pleural effusion with consolidation. In view of patient being an inmate at residential facility for homeless where prevalence of tuberculosis (TB) was high, anti-TB treatment was empirically initiated. Pleural fluid later grew a Gram-negative non-fermenter, identified as Elizabethkingia meningosepticum.
Pulmonary Paragonimiasis: A Great Masquerader
[Year:2019] [Month:April-June] [Volume:61] [Number:2] [Pages:3] [Pages No:95 - 97]
Keywords: Pulmonary eosinophilia, Paragonimus westermanii, Endemic haemoptysis
DOI: 10.5005/ijcdas-61-2-95 | Open Access | How to cite |
Pulmonary paragonimiasis is one of the rare causes of haemoptysis in humans. The clinical findings of paragonimiasis may mimic pleuro-pulmonary tuberculosis (TB), bronchitis, bronchiectasis, pneumonia, epilepsy or cerebral space-occupying lesion. It mimics pulmonary TB due to overlapping symptoms and it requires differentiation from the same in TB endemic areas. We carried out retrospective analysis of four cases of pleuro-pulmonary paragonimiasis who presented to our centre during the period from 2013 to 2017. All four cases had presented with streaky haemoptysis, chest pain and on evaluation were found to have pulmonary eosinophilia. One patient also had abdominal manifestations. Paragonimus eggs were demonstrated in respiratory secretions of three cases while one had eosinophilic pleuritis. Failure to suspect pulmonary paragonimiasis at initial evaluation results in wrong diagnosis as it masquerades many other diseases with common symptomatology.
Tracheal Tumour: An Unusual Cause of Severe Dyspnoea Treated as Severe Asthma
[Year:2019] [Month:April-June] [Volume:61] [Number:2] [Pages:2] [Pages No:99 - 100]
Keywords: Inflammatory myofibroblastic tumours, Benign, Pedunculated, Coblation
DOI: 10.5005/ijcdas-61-2-99 | Open Access | How to cite |
Inflammatory myofibroblastic tumours (IMTs) are rare neoplasms with benign clinical course. Although the aetiology is unclear, it is believed that IMTs are true neoplasms rather than a reactive or inflammatory lesion. We present the case of a 43-year-old female who presented to us with respiratory symptoms. She was being treated for bronchial asthma for the preceding nine months. Diagnostic testing revealed pedunculated tracheal tumour on computed tomography of the chest. Tracheostomy and tumour coblation was performed under general anaesthesia and histopathology revealed IMT.
[Year:2019] [Month:April-June] [Volume:61] [Number:2] [Pages:3] [Pages No:101 - 103]
DOI: 10.5005/ijcdas-61-2-101 | Open Access | How to cite |
[Year:2019] [Month:April-June] [Volume:61] [Number:2] [Pages:6] [Pages No:105 - 110]
DOI: 10.5005/ijcdas-61-2-105 | Open Access | How to cite |