ABSTRACT
Background:Arterialhypoxaemiaisthecommonestcomplication,sincerespiratory depressantdrugsareusedforpremedication,andtheairwayisalsopartially occludedbythebronchoscope.Thestudyisthereforedesignedtofindoutthechangesinarterialoxygen tensionduring (FOB)alongwitheffectoncentral hemodynamics, pre andpost procedure ECGand PFT.Objectives were tofind out thechanges in arterial oxygentension during FOB, to study the effects of FOBon central hemodynamics, electrocardiographicallyand pulmonaryfunction tests.Methods:One hundred patients aged above 20 years undergoing FOB were evaluated for the arterial oxygen tension and cardiac rhythm changes at KNCH, Jodhpur during 12 months study period from 2019 to 2020.Results:All patients developed a fall in PaO2following FOB but hypoxaemia was noted only in 18 cases. Bronchial washing, punch biopsy and brush biopsy did contribute to hypoxaemia significantly. There was a uniform rise in heart rate in all the patients after FOB which was statistically significant. There was slight sinus tachycardia inmostofthecases although ECG indicated no major arrhythmias.ThepulmonaryfunctionswhichincludechangeinVC,FVC, FEV1andPEFR after FOB, on statisticallycomparisonnostatistical difference could be observed. Therewasnosignificantchangein PaCO2level and pH level.MeanofSBP andmeanofDBPwasstatistically significant.Conclusions:All patients showed a decline in arterial PaO2after FOB which was highly significant. There was slight sinus tachycardia in most of cases. FOB itself does not endanger the patients with any significant or serious complications.
ABSTRACT
Introduction: Microbiologically confirmed pulmonarytuberculosis patients under Revised National TuberculosisControl Programme (RNTCP) are treated with a 6-monthshort-course chemotherapy (SCC) regimen irrespectiveof co-morbid conditions. The aim of present study was todetermine the time taken for SSC conversion with standardcurrent treatment with anti-tubercular drugs and analysis ofrisk factors if any delaying it. We undertook this prospectivestudy to compare sputum conversion rates (smear) at the endof intensive phase (IP) of Category regimen.Material and methods: was a prospective study which wasconducted for a period of eleven months from August 2018 toJune 2019 at Department of Respiratory Medicine, K.N ChestHospital, S.N Medical College, Jodhpur Rajasthan India.Patients visiting Department of Respiratory medicine and whowere diagnosed as pulmonary tuberculosis by sputum smearexamination were included in study.Result: Sputum smear-positive patients are infectious to closecontacts as well as to community as they continue to expelbacilli for a variable period of time after initiation of DOTSregimen. Most patients undergo sputum conversion by theend of 3rd month. Patients who have predominant cavitatorydisease in radiology, high smear grading before treatment, aprior history of DS/DR tuberculosis are more likely to havedelayed sputum smear conversion.Conclusion: There need to mandate DST at the starting ofDOTS in line with latest RNTCP guidelines to prevent thedevelopment of MDR strains and failures. Also there is astrong need to constitute strong infection control measures tillpatients are labelled as noninfectious.
ABSTRACT
Saber sheath trachea is defined as an anteroposterior (sagittal) diameter of intrathoracic trachea exceeding to lateral (coronal) by a ratio of 2:1 as measured at the site 1 cm above the aortic arch and the extra thoracic trachea being normal. It is most commonly seen in males and is considered to be a diagnostic sign of Chronic obstructive pulmonary disease.