RESUMEN
Unguided FNAC may be the only option left for accurate diagnosis of malignant lesions in the lung in resource poor settings. The present study was done with the aim of assessing the accuracy and utility of unguided transthoracic fine needle aspiration cytology in the diagnosis of lung cancer. Methods: An interventional study was taken up in the Department of Respiratory Medicine, JN Institute of Medical Sciences, Imphal. All patients admitted in the IPD with suspected malignant lung lesions during the period July 2017-Dec 2018 was included. After obtaining prior informed written consent fine needle aspiration was done from the dullest area on chest wall by using a lumbar puncture needle under local anaesthesia. The slides prepared thereafter were alcohol-fixed and sent to the Department of Pathology, JNIMS for cytological examination. The patients were observed closely after the intervention to detect any complications. Results: Completed data sets could be obtained from 20 study subjects. Unguided fine needle aspiration cytology had a diagnostic yield of 75% for detecting malignant lesions in the lung. Only minor post-procedure complications were encountered in 10% of the patients. Conclusion: The unguided trans-thoracic fine needle aspiration cytology has many merits. It is rapid, safe, accurate and cost-effective for the diagnosis of intra-thoracic peripheral lesions. It can also be used as an outdoor procedure even in peripheral health centres in properly selected cases.
RESUMEN
Studies regarding clinical profile of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) is extremely rare from the north-eastern part of India. This necessitates the present study. Aim: The present study aimed to describe the clinical profile of Acute Exacerbation of COPD (AECOPD) patients admitted in the Department of Respiratory Medicine, JNIMS, Imphal. Methods: The hospital records of all Acute Exacerbations of COPD patients admitted during the period Sept 2015 to Aug 2016 in the IPD of the Department of Respiratory Medicine, JNIMS were recorded retrospectively and analyzed by using descriptive statistics. Results: A total of 100 patients were admitted during the study period of one year. The mean age (SD) of the patients was found to be 71.3 (10.567) years. Female patients outnumbered male patients (M:F=1:1.08). The last quarter of the year (Sept-Dec) showed the least number of patients admitted while remaining months of the year had variable but relatively higher number of patients admitted with a peak in August. Dyspnoea was the commonest symptom which was found in almost all the patients (99%). Co-amoxiclav, Cephalosporin, Macrolide and Fluoroquinolone were the antibiotics most frequently used. In addition to the antibiotics mentioned above, steroids were needed and administered in 74 cases (74%). Methylprednisolone and Hydrocortisone were the main steroidal preparations used. Ventilation support was needed by two (2%) patients. And altogether three patients died during the study period (3%). The period of stay in IPD by all the patients ranged from 2-35 days with a mean (SD) of 8.51 (6.268) days. Conclusion: COPD exacerbation was seen in ageing population of both sexes. Dyspnoea was commonest symptom and mean hospital stay was 8.51 days. Antibiotics and steroid commonly prescribed were Coamoxiclav and methylprednisolone respectively. 3% of study population expired.