Diagnostic and therapeutic utility of indigenous technique of pleuroscopy in undiagnosed cases of exudative pleural effusions

Background and aims: In developing countries, there is a shortage of resources and skilled manpower and a large num-ber of patients. To overcome these problems, an indigenous technique of pleuroscopy has been developed in our institute. In this technique, medical thoracoscopy is done by using a set of patented conduits and a fibre-optic bronchoscope. In this study, we describe our experience with this technique of pleu-roscopy in undiagnosed cases of exudative pleural effusion. Methods: 156 undiagnosed cases of exudative pleural effu-sion were conducted over a period of two and half years. Indigenous technique of pleuroscopy, permitted thorough exploration of the pleural space, permitting multiple biopsies to clinch the diagnosis. Results: The appearance of pleura showed as inflamed/red-dened pleura in 29 (18.6%) cases, thin transparent adhesions in 31 (19.9%), thin transparent loculations in 26 (16.7%) , thick loculations in 12 (7.7%) , hard pleural surface in 11 (7%), large nodules/masses in 13 (8.4%), small milliary seedlings or sago grain appearance in 18 (11.5%), scattered masses or nodules in 13 (8.4%) and broncho-pleural fistula in 3 (1.9%) cases. Histopathological analysis showed chronic inflammation in 40.8% (58), Tubercular lesions in 25.4 % (36) of patients. There were three cases each of Primary Aspergillosis and malig-nant mesothelioma, and the rest 26.9% (42) were malignant metastasis in the pleura. The diagnostic yield of pleuroscopy pleural biopsy was 91% (142). Follow-up chest x-rays after six months showed significant reduction in residual pleural thickening (RPT).Conclusion: TheIndigenous Pleuroscopy technique is an efficient procedure and has good diagnostic and therapeutic yield for undiagnosed exudative pleural effusions. It also reduces morbidity, complications, disease progression, and has a significant role in reduction of RPT

Effects Of Air Pollutants On Lung Functions Of Traffic Policemen Of Ujjain, Madhya Pradesh, India

Background- Maximum Air pollution is at road side. It can cause acute and chronic respiratory diseases. Traffic policemen are continuously exposed to pollutants. Study was done for lung function assessment of traffic policemen of Ujjain city. Methodology- Detailed history and clinical examination were done. Spirometry was done before and after duty with Spirolab III machine. Results-100 traffic policemen 98% were male and 2% female. Duty place- roadside-90% and office -10%.Daily exposure- 63% were 6 hours or less and 37% were more than 6 hours. Service length- 79% had 10 years or more period. Spirometry results were pre duty 60% normal , 33% restrictive, 4% obstructive and 3% mixed . Air quality index of Ujjain was good and satisfactory. Conclusion-Spirometry is a good tool for lung function assessment and diseases (asthma, COPD) detection. Regular health check-ups, spirometry, facemask use and quit smoking are essential for healthy lungs.