Tracheobronchomalacia as a rare cause of chronic dyspnea in adults

Objective: To emphasize the importance of a careful clinical evaluation to prevent unnecessary interventions and treatments

Clinical Presentation and Intervention: A 76-year-old female patient had been diagnosed with asthma during previous admissions to different hospitals. She had also undergone fiberoptic bronchoscopy [FOB] on 2 occasions for evaluation of right middle lobe atelectasis observed on computed tomography. A repeated FOB revealed tracheobronchomalacia and nodular bronchial amyloidosis. A silicone Y stent was inserted, but the dyspnea increased. Excessive granulation tissue developed, and the patient died despite ventilatory support

Conclusion: The stenting technique used did not prevent the development of respiratory failure and death in this patient. Hence, a surgical procedure could be considered as an alternative to stenting in such cases

randomized trial of smoking cessation. medication versus motivation

A prospective randomized study was undertaken to assess the effectiveness and side effect profiles of nicotine patch and bupropion therapies for smoking cessation. Three hundred and fifty patients were referred to our smoking cessation program in the Department of Pulmonary Diseases, Gaziantep University between September 2002 and July 2003. Of these, only 131patients fulfilled the trial criteria. We randomized the patients into nicotine patch [n=50], bupropion [n=50] and control groups [n=31]. Cases were followed up for 24 weeks. Questionnaires including the Fagerstrom test for nicotine dependence and Beck Depression Inventory were carried out at initial evaluation. Declaration of quitting and exhaled carbon monoxide level less than 10 ppm was accepted as success criteria. Success rates were 26% for nicotine patch group, 26% for bupropion and 16% for control group at the end of the 24th week [p=0.56]. Beck depression inventory scores did not differ significantly between the groups, however none of the cases with scores greater than 13 succeeded regardless of the group. Mean body weight at baseline and change at 6 months did not differ significantly between the groups. Sleep disturbance was significantly more common in nicotine patch and bupropion groups than the control group [p=0.008]. The present study reinforces the role of medical doctors and importance of close follow up in smoking cessation, and directed counseling is quite as effective as pharmacologic therapy and is the sole approach without any adverse effects

Pulmonary function tests of lentil mill workers in Gaziantep in turkey

Symplocos racemosa Roxb. is a medicinal plant widely used by the traditional practitioners in various disease conditions as single or in compounds, known as Lodh tree or Lodh Pathani. Effect of the aqueous extract of the stem-bark of Symplocos racemosa Roxb. [SRR] on food and water intake was studied using Swiss Webster mice. On a 24-hour metabolic studies SRR reduced the food and water intake and also the urination and the defaecation. For the toxicological study the alcoholic extract of the bark was used and Sprague-Dawley rats were used as experimental animal. In a 21-day long growth study no effect on the body weight gain was revealed. The administration of the alcoholic extract of SRR significantly reduces the weight of the male liver and increases the weight of the heart of both the male and the female rats significantly. It slightly increases the weight of the ovary and significantly increases the weight of the caput epididymidis but did not have any notable effect on other male sex organ weights. There were no other notable changes in the weight of other organs. A total of 28 tissues were subjected to histological evaluation. Of these, a gross histological change was observed in the kidneys. In the liver and thymus there were slight histological changes. No histological abnormalities were found in the rest of the tissues