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1.
Artículo en Inglés | IMSEAR | ID: sea-178036

RESUMEN

Primary malignant melanoma of the lung (PMML) is an extremely rare tumour with only sporadic case reports. We report the occurrence of PMML in a 58-year-old female. Although extremely rare, it must be considered in the differential diagnosis of bronchogenic carcinoma and a detailed systemic examination must be done to rule out any primary skin or eye involvement.

2.
Artículo en Inglés | IMSEAR | ID: sea-169357

RESUMEN

Obstructive sleep apnoea (OSA) and obstructive sleep apnoea syndrome (OSAS) are subsets of sleep-disordered breathing. Awareness about OSA and its consequences amongst the general public as well as the majority of primary care physcians across India is poor. This necessiated the development of the INdian initiative on Obstructive Sleep Apnoea (INOSA) guidelines under the auspices of Department of Health Research, Ministry of Health & Family Welfare, Government of India. OSA is the occurrence of an average five or more episodes of obstructive respiratory events per hour of sleep with either sleep related symptoms or comorbidities or >15 such episodes without any sleep related symptoms or comorbidities. OSAS is defined as OSA associated with daytime symptoms, most often excessive sleepiness. Patients undergoing routine health check-up with snoring, daytime sleepiness, obesity, hypertension, motor vehicular accidents and high risk cases should undergo a comprehensive sleep evaluation. Medical examiners evaluating drivers, air pilots, railway drivers and heavy machinery workers should be educated about OSA and should comprehensively evaluate applicants for OSA. Those suspected to have OSA on comprehensive sleep evaluation should be referred for a sleep study. Supervised overnight polysomnography (PSG) is the “gold standard” for evaluation of OSA. Positive airway pressure (PAP) therapy is the mainstay of treatment of OSA. Oral appliances are indicated for use in patients with mild to moderate OSA who prefer oral appliances to PAP, or who do not respond to PAP or who fail treatment attempts with PAP or behavioural measures. Surgical treatment is recommended in patients who have failed or are intolerant to PAP therapy.

5.
Indian J Chest Dis Allied Sci ; 2002 Jan-Mar; 44(1): 49-52
Artículo en Inglés | IMSEAR | ID: sea-30119

RESUMEN

Vocal cord dysfunction is a rare variety of upper airway obstruction characterized by typical laryngoscopic features and may mimic an acute asthma attack. The case presented in this report pertains to a 15-year-old girl who had repeated acute episodes of dyspnoea and wheezing and remained non-responsive to corticosteroids and inhaled bronchodilators requiring endotracheal intubations for adequate control. Laryngoscopic findings were consistent with vocal cord dysfunction. She was treated with a tracheostomy and psychological support.


Asunto(s)
Adolescente , Asma/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Enfermedades de la Laringe/patología , Pliegues Vocales/patología
6.
Indian J Pediatr ; 2001 Mar; 68(3): 239-42
Artículo en Inglés | IMSEAR | ID: sea-82569

RESUMEN

To study pulmonary function tests (PFT) in multiple transfusion recipient thalassemics, PFTs were done for 30 thalassemics and 20 matched controls. Confirmed cases of thalassemia on regular transfusion therapy were the subject of study. Apart from history and physical examination of the thalassemics, serum ferritin estimation and spirometry were done. Parameters studied included lung volumes--functional residual capacity (FRC), forced vital capacity (FVC), residual volume (RV) and total lung capacity (TLC); and flow rates--forced expiratory volume in one second (FEV1), forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC), peak expiratory flow 25-75 (PEF 25-75%) and peak expiratory flow rate (PEFR). Single breath carbon monoxide diffusing capacity (DLco) and arterial blood gas (ABG) were also analysed. The mean height and weight of thalassemics were below that of age matched controls. A restrictive abnormality in PFT was found in 86.6% cases. These patients were found to have a decrease in all the lung volumes namely FVC, FRC, RV and TLC with a proportional decrease in the flow rates, FEV1, PEF 25-75% and PEF with a normal (> 0.75) FEV1/FVC ratio. DLco was decreased in all the patients with restrictive lung disease and fall in DLco showed a good correlation (r = 0.7, P < .001) with the severity of restrictive disease suggesting that some intrapulmonary pathology is likely to be responsible for the restrictive pattern. None of the cases had an obstructive or mixed pattern of pulmonary dysfunction. No correlation was found between severity of restrictive disease and the serum ferritin levels. A negative correlation with degree of hepatosplenomegaly was found. No correlation was found between severity of the defect and age, number of blood transfusions received and hemoglobin at the time of doing the test. To conclude, restrictive lung disease is the predominant abnormality in multi-transfused thalassemics, which is probably due to pulmonary parenchymal pathology. The abnormality of PFTs is not directly related to iron overload.


Asunto(s)
Adolescente , Niño , Femenino , Ferritinas/sangre , Humanos , Masculino , Pruebas de Función Respiratoria , Talasemia beta/fisiopatología
7.
Indian J Chest Dis Allied Sci ; 2000 Jul-Sep; 42(3): 167-79
Artículo en Inglés | IMSEAR | ID: sea-29386

RESUMEN

Endoscopic therapy has been used extensively in every field of medicine. The bronchial tree is no exception. The rigid bronchoscope was mainly used for foreign body extraction and hemostasis from and in the bronchial tree. With the evolution of flexible fiberoptic bronchoscope, the scope of therapeutic bronchoscopy has widened. The principles of therapeutic bronchoscopy, the various indications and brief description of such procedures like laser-bronchoscopy, endo-bronchial brachytherapy, management of airway strictures, its role in management of hemoptysis and foreign body removal have been reviewed.


Asunto(s)
Obstrucción de las Vías Aéreas/terapia , Braquiterapia/métodos , Broncoscopía/métodos , Crioterapia/métodos , Cuerpos Extraños/terapia , Humanos
8.
Indian J Chest Dis Allied Sci ; 1999 Jul-Sep; 41(3): 159-62
Artículo en Inglés | IMSEAR | ID: sea-30142

RESUMEN

A six-week-old child with tracheal duplication presenting with congenital stridor is being reported. To the best of our knowledge, a tracheal web or tracheal duplication (as the present condition may be named) has not been described as a causative factor of infantile stridor.


Asunto(s)
Femenino , Humanos , Lactante , Ruidos Respiratorios/etiología , Tomografía Computarizada por Rayos X , Tráquea/anomalías
9.
Indian J Chest Dis Allied Sci ; 1999 Jul-Sep; 41(3): 169-73
Artículo en Inglés | IMSEAR | ID: sea-30064

RESUMEN

A case of a 63-year-old patient with motor neurone disease (amyotrophic lateral sclerosis) with central sleep apnoea syndrome is being reported. His sleep architecture was fragmented with a high apnea-hypopnea index of 65 per hour and maximum oxygen-desaturation of 78 percent. Total correction of sleep pattern with nasal non-invasive ventilation (BiPAP-ST) was demonstrated.


Asunto(s)
Esclerosis Amiotrófica Lateral/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Polisomnografía , Respiración con Presión Positiva , Apnea Central del Sueño/etiología
10.
Indian J Chest Dis Allied Sci ; 1999 Apr-Jun; 41(2): 115-9
Artículo en Inglés | IMSEAR | ID: sea-29227

RESUMEN

A patient of dengue hemorrhagic fever who progressed into acute respiratory distress syndrome (ARDS) is reported. The patient recovered after mechanical ventilation and supportive treatment.


Asunto(s)
Adulto , Antiinfecciosos/uso terapéutico , Dengue Grave/complicaciones , Diagnóstico Diferencial , Humanos , Pulmón/microbiología , Masculino , Respiración con Presión Positiva , Síndrome de Dificultad Respiratoria/microbiología , Pruebas de Función Respiratoria , Resultado del Tratamiento
11.
Indian J Chest Dis Allied Sci ; 1998 Apr-Jun; 40(2): 131-3
Artículo en Inglés | IMSEAR | ID: sea-29692

RESUMEN

A patient of tuberculous pyopneumothroax with broncho-pleural fistula in whom a mature roundworm Ascaris lumbricoides migrated from the intestine to lodge itself in the pleural cavity is being reported.


Asunto(s)
Animales , Ascariasis/complicaciones , Ascaris lumbricoides , Fístula Bronquial/parasitología , Empiema Pleural/parasitología , Humanos , Enfermedades Pulmonares Parasitarias/etiología , Masculino , Persona de Mediana Edad , Neumotórax/parasitología
13.
Indian J Chest Dis Allied Sci ; 1996 Apr-Jun; 38(2): 129-33
Artículo en Inglés | IMSEAR | ID: sea-29290

RESUMEN

Two patients with post-ventilatory tracheal stenosis were treated by repeated dilatation with oesophageal dilators under general anaesthesia, and direct vision of the fiberoptic bronchoscope. The results of dilatations were remarkable and the patients continue to be asymptomatic after a follow up of more than two years.


Asunto(s)
Adulto , Dilatación/métodos , Femenino , Humanos , Intubación Intratraqueal/efectos adversos , Masculino , Estenosis Traqueal/terapia , Traqueostomía
14.
J Indian Med Assoc ; 1995 Aug; 93(8): 307-9
Artículo en Inglés | IMSEAR | ID: sea-99073

RESUMEN

Pleural fluid cytology and pleural biopsy results were studied in 65 cases of pleural effusion. The efficacy of pleural biopsy in diagnosis of neoplastic and non-neoplastic pleural diseases was compared. Of the 24 cases with confirmatory evidence of cancer, 17(70.8%) has positive cytologic findings in pleural fluid, whereas pleural biopsy was diagnostic in only 13 cases (54.1%). For non-malignant pleural effusion in 41 cases 40(97.5%) has a definite diagnosis (tuberculous pleuritis, acute fibrinous pleuritis or hydatid cyst) which could be made by cytology while only 31(75.6%) out of 41 were diagnosed on pleural biopsy. The study indicates that cytologic evaluation of pleural fluid is more efficaceous in the diagnosis of malignant and non-malignant pleural disease than percutaneous pleural biopsy.


Asunto(s)
Biopsia con Aguja , Humanos , Derrame Pleural/patología , Derrame Pleural Maligno/patología , Valor Predictivo de las Pruebas
15.
Indian J Chest Dis Allied Sci ; 1992 Oct-Dec; 34(4): 167-73
Artículo en Inglés | IMSEAR | ID: sea-29410

RESUMEN

Baseline bronchial reactivity was studied in 36 patients with chronic obstructive lung disease (COLD) and 20 normal healthy controls using the inhalational histamine challenge test. Using a cut off PD20 dose of 0.195 mg of histamine, 83.3% patients of COLD demonstrated bronchial hyper-reactivity. Presence of bronchial reactivity correlated significantly with the baseline FEV1, FEF25-75 and the ratio FEV1/FVC (p = 0.0019, 0.00001 and 0.008) respectively. Thus, bronchial reactivity in subjects with COLD correlates most significantly with the maximum mid-expiratory flow rate (FEF25-75).


Asunto(s)
Hiperreactividad Bronquial/fisiopatología , Pruebas de Provocación Bronquial , Histamina/diagnóstico , Humanos , Enfermedades Pulmonares Obstructivas/diagnóstico , Masculino , Persona de Mediana Edad , Pruebas de Función Respiratoria , Fumar/fisiopatología
16.
Indian J Chest Dis Allied Sci ; 1992 Apr-Jun; 34(2): 57-64
Artículo en Inglés | IMSEAR | ID: sea-29218

RESUMEN

Sixty-five patients underwent unguided fiberoptic transbronchial biopsy on an out-patient basis. Satisfactory material for histopathological examination was obtained in 55 patients. A reasonably definite pathological diagnosis could be established in 51 patients. The commonest diagnosis arrived at was that of interstitial fibrosis. Complications were observed in 4 (6.2%) patients. Fiberoptic transbronchial biopsy is, therefore, a safe and efficacious out-patient technique for establishing a pathological diagnosis in patients with infiltrative, diffuse or localized pulmonary disease.


Asunto(s)
Atención Ambulatoria , Biopsia/instrumentación , Bronquios , Estudios de Evaluación como Asunto , Femenino , Tecnología de Fibra Óptica , Humanos , Pulmón/patología , Enfermedades Pulmonares/patología , Masculino
17.
Indian J Chest Dis Allied Sci ; 1992 Jan-Mar; 34(1): 11-7
Artículo en Inglés | IMSEAR | ID: sea-29509

RESUMEN

A double-blind crossover trial of prednisolone was conducted in 70 patients of chronic obstructive lung disease (COLD). Emphysema dominated the clinical picture in 38, rest being chronic bronchitis with varying degrees of air trapping. None of the patients had clinical asthma. All the patients had obtained maximal benefit from an optimal dose of bronchodilators prior to entering the study. Prednisolone in a dose of 0.8 mg/kg was prescribed in a double blind crossover manner with identical appearing placebo tablets. Patients were evaluated on a weekly basis for an objective as well as a subjective response and side effects of therapy. Thirty-four patients demonstrated a statistically significant improvement in pulmonary functions. In 20 others only subjective response was observed. A good objective response was predicted by a pre-study variability in FEV1, disease duration of less than 10 years and a history of smoking less than 50 pack years.


Asunto(s)
Bronquitis/tratamiento farmacológico , Método Doble Ciego , Femenino , Volumen Espiratorio Forzado , Humanos , Enfermedades Pulmonares Obstructivas/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Prednisolona/efectos adversos , Enfisema Pulmonar/tratamiento farmacológico , Pruebas de Función Respiratoria , Fumar , Factores de Tiempo
18.
Indian J Chest Dis Allied Sci ; 1991 Jul-Sep; 33(3): 129-32
Artículo en Inglés | IMSEAR | ID: sea-29291

RESUMEN

We studied the safety and efficacy of unguided transthoracic fine needle aspiration biopsy (FNAB) in peripheral lung lesions in an outpatient setting in 62 patients. The diagnostic yield of unguided aspiration was 67.7 per cent. Smaller lesions usually required guided FNAB. Specific tissue diagnosis was obtained in all cases aspirated successfully. Complications were seen in 7 patients (pneumothorax in 4 and haemoptysis in 3 patients). With careful patient selection, unguided FNAB can be an effective out-patient procedure for diagnosing lung lesion beyond the reach of the fiberoptic bronchoscope.


Asunto(s)
Atención Ambulatoria , Biopsia con Aguja/efectos adversos , Hemoptisis/etiología , Humanos , Pulmón/patología , Enfermedades Pulmonares/patología , Neumotórax/etiología
19.
Indian J Chest Dis Allied Sci ; 1991 Apr-Jun; 33(2): 63-7
Artículo en Inglés | IMSEAR | ID: sea-30489

RESUMEN

One hundred fifty-five cases of pleural effusion underwent a percutaneous pleural biopsy by the Cope needle. In the face of an inconclusive result in the first attempt, biopsy was repeated for upto three times. Diagnostic yields of biopsy in tuberculous and malignant effusion were 93.5 per cent and 66.7 per cent, respectively. When combined with pleural fluid cytology, a definite diagnosis of malignancy could be established in 80.95 per cent cases. Serial pleural biopsies significantly increased the diagnostic yield.


Asunto(s)
Biopsia con Aguja/métodos , Citodiagnóstico , Femenino , Humanos , Masculino , Pleura/patología , Derrame Pleural/patología , Derrame Pleural Maligno/patología
20.
Indian J Chest Dis Allied Sci ; 1990 Oct-Dec; 32(4): 205-8
Artículo en Inglés | IMSEAR | ID: sea-29902

RESUMEN

Adenosine deaminase (ADA) activity was studied in 53 patients with pleural effusions. Patients with tuberculous pleural effusion (36) had significantly higher ADA activity (77.68 IU/L; P less than 0.001) in comparison to malignant (14.47 IU/L) and parapneumonic (28.65 IU/L) effusions. When tested with a reference limit of over 50.75 IU/L, the specificity of ADA activity was found to be 94.1 per cent. With a sensitivity of 100 per cent, low cost and easy performance pleural fluid ADA activity is proposed as a routine investigation for etiological diagnosis in pleural effusion.


Asunto(s)
Adenosina Desaminasa/diagnóstico , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Derrame Pleural/diagnóstico , Sensibilidad y Especificidad , Tuberculosis/diagnóstico
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