ABSTRACT
Background: Excessive daytime sleepiness is a key symptom in patients with sleep- breathing disorders (SBD) and represents a new major public health issue due to its repercussions. The ESS is a simple and validated method, which measures the probability of falling asleep in a variety of situations. Aims and objectives is to study the accuracy of the Epworth Sleepiness Scale (ESS) questionnaire in the identification of Obstructive Sleep Apnoea (OSA) in patients with symptoms of sleep disordered breathing in a tertiary care centre.Methods: This present study was conducted in the Department of Respiratory medicine, New Medical College, Kota on 70 adult patients who presented with symptoms of Sleep Disordered Breathing and underwent Type 2 Polysomnography after answering Epworth sleepiness score in Hindi Language.Results: Epworth sleepiness scale has predicted excessive day time sleepiness in 60% of study subjects with ESS score more than 10 taken as cut off. Mean value for ESS in the study was 10.78. 35.71% of the patients had severe OSA diagnosed by polysomnography and 30% patients had moderate OSA. Mild OSA was detected in 7.14% patients. Sensitivity of the ESS score >10 in diagnosing OSA was found to be 72.5%. Specificity of the scale was 73.6%.There was significant correlation between ESS score and diagnosis of OSA (p value <0.001).Conclusions: The study concludes that ESS has got good relevance in predicting OSA in patients with sleep disordered breathing.
ABSTRACT
Background: The treatment modality use in early pleural empyema mainly depends on the antimicrobial therapy along with thoracocentesis. In case of complicated empyema this modality does not work and lung not fully expand, until removal of adhesions. The main purpose of the current study is to analyze the experience of management of complicated parapneumonic effusion and empyema thoracic through rigid medical thoracoscopy under local anaesthesia. Aim and objective is to study the role of medical thoracoscopy in the management of empyema thoracic and parapneumonic effusion at tertiary health centre.Methods: This is a descriptive case series study in which 49 patients were recruited, who have clinically and radiologically show empyema thoracic, from department of Respiratory medicine, GMC, Kota, Rajasthan. All patients underwent medical thoracoscopy under local anesthesia. Written Informed consent was taken from the study participants. Ethical approval was obtained from Ethical Review Committee of the hospital. Patients who have HIV and Hbsag positive, those with multiple organ failure and bleeding disorders were excluded.Results: Total 49 patients, out of them 41(84%) were male and 8(16%) were female with mean age 45 years (range 18 to 70 years). Final evolution through chest x-ray revealed complete resolution or successful thoracoscopy done in 37 case of fibrinopurulent (92.50%) and 5 cases of organizing empyema (55.56%). overall success rate 85.71%. Total 7 cases (3 case of fibrinopurulent and 4 cases of organizing empyema) refer to higher center for decortications.Conclusions: Medical Thoracoscopy under local anaesthesia is a safe procedure, efficient and cost-effective intervention for early management of complicated empyema, particularly in early stage of empyema (fibro purulent).
ABSTRACT
Background: Lung cancer is most common cause of cancer related death in men and women world wise responsible for over 1 million death annually. Lung cancer is leading cause of cancer death in united states and worldwide. Lung cancer is the most common neoplasm contributing more frequent among males causing cancer related mortality in both sexes. Objective of this study was to radiological presentation in bronchogenic carcinoma along with prevalence of pulmonary TB in a tertiary center.Methods: Total of 100 patients with histologically proven lung cancer, from July 2018 to June 2019 at a tertiary center Kota Rajasthan. Data of participants regarding demographics, history of smoking habit, clinical presentation, histopathological type, radiographic findings on chest radiograph, ultrasonography, computed tomography (CT) scan, Statistical analysis was performed using descriptive statistics of the collected data.Results: Most common age group of bronchogenic carcinomas was seen between 60-69 years of age (37%) with male predominance (82%). smoking history present in about (80%) patients. Most common radiological presentation was a mass lesion present in 91% patients (n=91) followed by unilateral hilar prominence present in 44% of patients (n=44). Other common finding includes mediastinal widening (38%), collapse (26%). pleural effusion (22%), metastasis (22%), cavitation (13%), consolidation (12%), bony erosion (11%), pneumothorax (5%), and pancost tumor (4%). prevalence of pulmonary TB in bronchogenic carcinoma is 9% and this is due to high burden of pulmonary TB in India.Conclusions: In this study adenocarcinoma was found to be most common type of lung cancer. Smoking is most common risk factor. Pulmonary TB coexistence with bronchogenic carcinoma was more common. The local immunity is deteriorated in cancer cases.