A case of Lymphocytic Interstitial Pneumonia in a defaulter HIV-positive patient

Background:Chronic Renal Failure (CRF) is characterized by gradual, progressive and permanent decrease in the renal functions. Moreover, CRF adversely effects the functioning of the various other organs. Dyslipidemia is the characteristic of the CRF, moreover lipid profile disorder appear from the onset of the CRF. However, severity of disturbance depends on the stage of CRF. MDA one of the important marker of oxidative stress is the product of lipid peroxidation, which is produced by oxidation of poly unsaturated fatty acid. Increased oxidative stress leads to distruction of bio-molecules, protein, DNA and RNA of the cells. Methods: This was a cross sectional type of study conducted in the TMMC & RC, Moradabad (U.P.). Total sixty patients of CRF patients > 20 years were included in the study. Lipid profile which included serum concentration of total cholesterol (TC), triglycerides (TG) and high density lipoprotein (HDL) were calculated enzymatic method CHOD-POD method, GPO-PAP method, CHOD-POD/ Phosphotungstate method respectively Results:There was a significant difference between the mean values of TC (< 0.001), TG (< 0.001), LDL (< 0.001), VLDL (< 0.001) of CRF patients and Control group III. MDA level was significantly high in group I and group II compare to group III. Further, the levels of MDA were significantly high in group I CRF patients on dialysis when compared to group II conservatively managed patients (p < 0.001). Conclusion: Findings of the present study showed that there is increased oxidative stress level as well elevated risk of CVD in CRF patients on dialysis. More of altered level of lipids induces atherosclerosis in CRF patients. Therefore, the present study suggest that management lipids and oxidative stress should be included during the treatment of CRF patients.

Chronic Dry Cough in Allergic Respiratory Diseases: Diagnostic and Management Approach.

Cough is considered as a single most common complaint for which patients globally seek medical attention. A multitude of allergic etiologies contribute to the development of chronic cough in adults, which makes the diagnosis and treatment quite challenging. Allergic cough is a distinct entity where there is no respiratory obstruction and there is presence of a family history, past history and/or concomitant allergic conditions. Sensitivity to allergens is readily demonstrable by skin testing. It is also characterized by a therapeutic response to epinephrine and a periodic nature. The intention of this article is to highlight the common causes of chronic dry cough associated with allergic diseases, to differentiate allergic cough from various other causes of chronic cough associated with asthma syndromes (which include related airway disorders like ‘classic’ asthma [cough-variant asthma], nonasthmatic eosinophilic bronchitis and atopic cough) and to discuss its management strategies.

An unusual case of invasive aspergillus ulcerative tracheobronchitis without involvement of lung parenchyma in a post-renal transplant patient.

We present the case of a 54-year-old male, who presented with respiratory complaints four months after he underwent renal transplantation. Bronchoscopy showed ulcerated mucosa of the left main bronchus and computed tomography (CT) of the thorax showed foci of air within the bronchial wall. A biopsy from the lesion showed septate fungal hyphae, dichotomously branching at acute angles. A locally invasive Aspergillus ulcerative tracheobronchitis with no parenchymal involvement is an important cause of tracheobronchitis in post-renal transplant patients. An early diagnosis and institution of appropriate treatment can improve the outcome. A combination treatment of caspofungin and voriconazole can be considered if patient is not responding to voriconazole alone.