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Background : 20-30% of the Indian population suffers from at least one allergic disease that can have an adverse impact on the quality of life of the patients. Aim : To develop expert opinion-related guidance for the diagnosis and management of allergic disorders. Methodology : An advisory board meeting (hybrid mode) was conducted with 11panel members of the Indian Medical Association (IMA). The panel members discussed issues related to the management of allergic disorders based on the Delphi method. Result : Spirometry is helpful in selected patients of allergic rhinitis where the coexistence of asthma is suspected. In patients with urticaria second-generation antihistamines are preferred for both adults and children due to their low side effects, less drug-drug interaction, anticholinergic effects, longer duration of action, and higher safety. Diagnosis of allergic contact dermatitis can be made based on occupational and exposure history. In atopic dermatitis, patient education about lifestyle changes can prevent flare-ups. In patients with asthma, patients must be educated about the use of the peak flow meter. The diagnosis of food allergy can be made by correlating the food intake timing withthe patient history and the results of allergy testing. Allergic drug reactions can be treated with oral antihistaminic drugs, emollients, and if needed topical corticosteroids. Conclusion : The diagnosis of allergic disorders requires the clinician to consider the clinical presentation, patient history, presence of triggers, and comorbid conditions. Patient education and the new generation of antihistaminic drugs can improve the quality of life of patients with allergic disorders
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Background: Tetracycline, talc, and bleomycin have been proved to be effective in recurrent spontaneous pneumothorax andmalignant pleural effusion. Recent studies have shown the efficacy of 2% betadine in pleurodesis.Objective: The objective of this study was to find out the success rate of 2% betadine in pleurodesis in patients with recurrentspontaneous pneumothorax and malignant pleural effusions.Materials and Methods: The study was conducted in SVS Medical College, Mahabubnagar Dist., Telangana, during the periodof May 2016 - Feb 2019. Patients with malignant pleural effusion and recurrent spontaneous pneumothorax were taken intoconsideration. About 2% betadine with xylocaine was used in this study.Results: A total of 26 patients underwent pleurodesis. Eighteen patients had malignant pleural effusion and eight patients hadrecurrent spontaneous pneumothorax. Of 26 patients, 23 (88.5%) patients had successful pleurodesis. Among 23 patients whohad underwent successful pleurodesis, 16 had malignant pleural effusion and seven had recurrent spontaneous pneumothorax.Conclusion: In our observation, we have seen that pleurodesis with 2% betadine is very effective and inexpensive in pleurodesiswithout many complications
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Introduction: Definition of undiagnosed pleural effusion was considered as the failure to achieve an etiologic diagnosis byinitial pleural fluid microbiological, biochemical analysis, and at least three pleural fluid cytologies negative for malignant cells orother definite causes. Medical thoracoscopy also referred to as pleuroscopy is an endoscopic evaluation of the pleural space.Thoracoscopy was mainly used in the etiological diagnosis of pleural effusions and therapeutic procedures such as pleurodesisand adhesiolysis. In around 20%–30% of cases, etiology remains unclear and in this context, thoracoscopy becomes animportant investigation modality.Materials and Methods: It is a prospective, interventional study taken up as a pilot project by the Department of PulmonaryMedicine of SVS Medical College and Hospital, Mahabubnagar, Telangana, India. A total of 30 patients were satisfyingthe inclusion criteria and were further studied for their thoracoscopic and histopathological findings from January 2018 toNovember 2018.Results: A total of 30 patients out of whom 19 patients were male (63.3%) and 11 patients (36.6%) were female. The mostcommon respiratory symptom was shortness of breath in 18 patients (60%) and cough in 12 patients (40%). Out of the total30 cases, 23 (76.66%) were malignant and 7 (23.33%) were diagnosed to be having tuberculosis (benign). According to thehistopathological diagnosis, 20 (66.6%) had metastatic adenocarcinoma, 7 (23.3%) had tuberculosis and malignant lymphoma,and metastatic squamous cell carcinoma and sarcoma were detected in 1 (3.3%) patient. According to thoracoscopic findings,13 (43.3%) patients had mass lesion, 12 (40%) patients had nodule, 3 (6.6%) patients had adhesions, and 2 (10%) patientshad plaques. Majority of the mass lesions 11 (36.66%) were metastatic adenocarcinomas and majority of nodules 5 (16.66%)were diagnosed as tuberculous lesions.
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Introduction: Non-resolving or slowly resolving pneumonia is not uncommon, affecting 10–20% of patients admitted withcommunity-acquired pneumonia (CAP). Non-resolving pneumonia is a challenging clinical problem. Incidence of non-resolvingpneumonia was found to be 10–15% among hospitalized patients with CAP and of them 6% developed progressive pneumonia.This study aims to evaluate the patients of non-resolving or slowly resolving pneumonias to establish the cause of it.Methodology: It is a prospective, observational study taken up by the Department of Pulmonary Medicine of SVS MedicalCollege and Hospital, Mahabubnagar, Telangana. All the enrolled cases of non-resolving or slowly resolving pneumonia whichsatisfy the inclusive criteria were taken into the study from June 2017 to December 2018. A total of 28 patients were satisfyingthe inclusion criteria and were further studied for evaluating the causative factors. The study was started after taking the approvalof the Institutional Ethics Committee, SVS Medical College and Hospital, Mahabubnagar, Telangana.Observation and Results: The mean age of the patients was 48.2 years. Of 28 patients, 18 (64.2%) were male and 10 (35.7%)were female with a male:female ratio – 1.8:1. Fever (81%) and cough (86%) were the most common symptoms. Smoking wasthe most common comorbidity noted (60.7%) followed by alcoholism (46.6%), diabetes (39.28%), hypertension (25%), andchronic obstructive pulmonary disease (21.4%). The most common cause of non-resolution of pneumonia in this study wastuberculosis 11 (39.28%) followed by bacterial pneumonias 9 (32.1%) which were caused by drug-resistant organisms. Othercauses were malignancy 6 (21.4%), foreign body 1 (3.57%), and fungal pneumonia 1 (3.57%).
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Background and objectives: The objective of the present study is to evaluate the yield of AFB by direct sputum smear examination with Bronchial Washings and Post Bronchoscopy sputum smear examination. Materials and methods: This prospective study was conducted on 100 patients with suspected pulmonary TB October 2015 – September 2017 at S.V.S Medical College, Mahabubnagar. Results: Out of 100 clinically suspected, sputum smear negative cases, 38 cases were diagnosed as active pulmonary tuberculosis. Bronchial washings for AFB smear was positive in 32/100 (32%) of cases and post bronchoscopic sputum smear was positive in 16/100 (16%) of cases. Both bronchial washings and post bronchoscopic sputum smear for AFB was positive in 10 (10%) of cases. 4/16 additional cases are diagnosed by post bronchoscopic sputum smear over the bronchial washings. Total yield of bronchoscopy in the diagnosis of sputum negative Pulmonary Tuberculosis was A.N.V. Koteshwar Rao, L. Bhaskar, K. Vamshi, Pradyut Waghray. Yield of AFB by direct sputum smear examination with bronchial washings and post bronchoscopy sputum smear examination. IAIM, 2017; 4(11): 113-116. Page 114 38.00% of which bronchial washing smear samples are superior in the diagnosis and is contributed to 32% . Conclusion: It has shown that additional yield of 38% more than direct sputum smear examination, which helps to initiate early treatment of tuberculosis.
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Background and objectives: The objective of the present study was to study the the clinicopathological profile of the lung cancer in Mahabubnagar. Materials and methods: We performed a retrospective analysis of histopathologically proven cases of bronchogenic carcinoma admitted in our hospital from January 2011 to May 2016. Results: Our study included 67 patients with confirmed cases of lung cancer. Male to female ratio was 1.7:1. The common age group was 40-60 years (52.2%). The most common histopathological type was Adenocarcinoma (38.8%) followed by Squamous cell carcinoma (31.4%). Endobronchial biopsy has more yields in squamous cell carcinoma 8 cases (38.1%), CT Guided biopsy has more yields in Adenocarcinoma 14 cases (53.8%), Small cell carcinoma 4 cases (66.7%), and in carcinoma in situ 6 cases (55.4%), pleural biopsy has highest yield in the diagnosis of malignant mesothelioma 1 case (100%). Among all the procedures CT Guided biopsy has the highest diagnostic yield 29 cases (43.2%). Conclusion: CT guided biopsy has the highest yield for the diagnosis of lung malignancies especially if the tumour is peripherally located.
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Impaired mucus clearance or mucus hypersecretion are important feature of many pathological respiratory conditions and in ICU patients. Mesna is a potent mucolytic available as 200 mg/ml solution for neublization and endotracheopulmonary instillation. As effective “mucus clearance” is critical in managing post-operative and other ICU conditions to prevent complications like atelectasis and hypoxia, there is a need to review the clinical results of mucolytic agent Mesna, and its role in mucociliary clearance in critical care patients and in other respiratory conditions.