Acute Onset Dyspnea Due To Foreign Body (Pill) Aspiration In Left Main Bronchus.

Abstracts: Aspiration of tracheobronchial foreign commonly affects young children and it is uncommon in adults. Bronchoscopy both flexible and rigid is recommended to reveal the aetiology and therapeutic removal of foreign body aspiration. Here we report a case of pill aspiration presenting with acute onset breathlessness in emergency. Investigation of a case revealed left lung atelectasis on chest X-ray. Further workup by bronchoscopy showed an endobronchial mass lesion in left main bronchus causing left lung atelectasis. The obstruction was removed and patient improved promptly.

Diagnosis of interstitial pulmonary fibrosis-an update.

The most common and most lethal type of idiopathic interstitial pneumonia (IIP) is idiopathic pulmonary fibrosis (IPF), which accounts for 55% of lung diseases classified as IIPs. Diagnosis of IPF requires precision and a multidisciplinary approach .Indeed, an early and accurate diagnosis of IPF is critical for a better outcome, especially with the advent of new specific treatments for this disease. The previous guidelines using major and minor criteria for the clinical (i.e. non-pathological) diagnosis of IPF have been discarded, as it is now clear that, in an appropriate clinical setting, the presence of a classical UIP pattern on the HRCT scan is sufficient for a diagnosis of IPF to be made. In the presence of the four classical features, that together accurately identify a Usual interstitial pneumonia (UIP) pattern, a definitive diagnosis of IPF can be made. Guidelines emphasizes the importance of multidisciplinary discussion between clinicians, radiologists and pathologists to improve diagnostic confidence. The course of disease in IPF is unpredictable, but the importance of an early diagnosis is clear, as individuals with less severe lung function abnormalities have a better prognosis.

Role of flexible fiberoptic bronchoscopy in suspected sputum smear negative pulmonary tuberculosis cases at microscopy centre under RNTCP.

Background: Microbiological diagnosis is the main stay for the effective treatment of pulmonary tuberculosis. About 31%of the new cases may be smear-negative for AFB. Difficulties arise when a patient who is suspected of active tuberculosis, both clinically and radiologically, does not produce sputum or when it is available AFB may be negative. Fiberoptic bronchoscopy offers a mean of investigation whereby bronchial secretion and washing can be collected from the most likely abnormal site under direct vision. Aims & Objective: To study the role of flexible fiberoptic bronchoscopy in suspected sputum smear negative pulmonary tuberculosis cases at microscopy centre under RNTCP. Material and Methods: Thirty three patients aged Above 18 years old who were suspected of having pulmonary tuberculosis based on clinical and radiological appearances were prospectively studied. All subjects had at least 2 sputum smear examination which were negative for acid fast bacilli according to the revised national tuberculosis control program (RNTCP). The bronchoscopy was performed transnasally using fujinon bronchoscope by 2 bronchoscopists under local anaesthesia. A thorough examination of bronchial tree was carried out and bronchial aspirate (BA) bronchoalveolar lavage (BAL) bronchial brushing, transbronchial lung biopsy (TBLB) and post bronchoscopy sputum (PBS) were collected. The specimen obtained was placed on slides for Ziehl-Nielsen stain. Bronchial biopsy was performed on abnormal looking mucosa and stained with Eiosin-hematoxylin and Ziehl- Nielsen stains. Results: In total 33 sputum smear negative suspected pulmonary tuberculosis cases, at microscopy centre under RNTCP, early diagnosis of pulmonary tuberculosis was established in 10 (30.30%) cases and in 3 (9.09%) cases diagnosis of malignancy was established. Conclusion: Fiberoptic Bronchoscopy is a useful procedure to establish the diagnosis of pulmonary tuberculosis when sputum smear examination does not show acid fast bacilli. This allows appropriate treatment to be started with confidence.

Impact of Behaviour Change Communication among Pregnant Women Regarding Knowledge of Low Birth Weight Infants’ Susceptibility to Certain Morbidities.

Objective: To assess the impact of Behaviour Change Communication (BCC) Package among pregnant women regarding correct knowledge of susceptibility of the low birth weight neonate to certain morbidities. Study Design: A community based intervention study. Place and Duration of Study: Field practices areas of Urban Health Training Center Department of Community Medicine, JNMCH, AMU Aligarh (UP) India, between September 2008 to August 2009. Participants: 200 pregnant women (100 pregnant women from each intervention and nonintervention groups) were enrolled. Sampling: Purposive sampling method. Statistical Analyses: Data analysed with Epi Info version 3.5.1. Significant difference was determined using Chi- square test. The impact of Behaviour Change Communication was assessed using relative risk and difference was accepted significant at more than 95% (p value <0.05). Intervention and non-intervention were also compared after 7th and 28th of delivery days. Results: Before BCC package intervention, there was no significant difference (pvalue> 0.05) between two groups regarding correct knowledge about susceptibility of low birth weight infants to different conditions. Due to impact of BCC Intervention, knowledge regarding susceptibility of LBW baby to infection was increased to two times. Knowledge regarding susceptibility of LBW baby to yellow palm and sole was increased to four and half times. Knowledge regarding susceptibility of LBW baby to feeding difficulty was increased to seven times and knowledge regarding susceptibility of LBW baby to hypoglycemia was increased to 4.75 times. Knowledge of mother regarding susceptibility of LBW baby to infection, yellow palm and sole, feeding difficulty and hypoglycemia were increased significantly (p-value <0.05) in the intervention group due to impact of the BCC package on 7th day of follow up and was maintained on the 28th day after delivery. Conclusion: There was significant improvement in pregnant women regarding correct knowledge about susceptibility of the low birth weight neonate to different conditions.

Good and harmful neonatal practices among pregnant women in peri-urban area of Aligarh.

Background: Neonatal mortality in developing countries is one of the most important problems that need immediate attention in order to achieve Millennium Development Goals. Aims & Objective: To assess the knowledge and practices of pregnant women regarding good and harmful neonatal practices. Material and Methods: Study Design: A community based study. Setting: Field practice areas of Urban Health Training Center Department of Community Medicine, JNMCH, AMU Aligarh. Participants: 200 pregnant women. Sampling: Purposive sampling. Study Period: one year. Statistical Analysis: Data analysed with Epi Info version 3.5.1. Percentages, and Chi Square Test used. Results: Initiation of breastfeeding within 1 hour was done only in 16% of babies. Colostrum was given by 41% mothers. 20% babies were exclusively breastfed. Witch craft in neonatal illness was noticed in 70% babies. Majority of babies (97%) were applied kajal in the eyes. Prelacteal feeds were given in 80% and pacifiers in 72.5% babies. All the home deliveries except one were conducted by untrained dais. Untrained Dai did not wash their hands with soap and water in 64.5% of home deliveries. Dark and ill-ventilated room for conducting the delivery was used in 82% deliveries. The cord was cut with a used blade, or any unsterile scissors, knife, or sickle, broken cup in 68.8% of deliveries. Application of ghee/ cow dung on the cord was done in 93.5% deliveries. 100% newborns were given bath soon after birth. Delivery room was not warm in 54.6% of deliveries. Conclusion: It was concluded that harmful newborn care practices were common. This can be attributed largely to dais because most of deliveries were conducted at home. Some good practices were prevalent in the community like new blade, delivery in a warm room, practice of rooming-in.

Impact of behaviour change communication among pregnant women regarding good and harmful traditional practices.

Background: Neonatal survival is influenced much by care provided by the family before, during and after delivery, which in turn is influenced by mother’s beliefs, and perceptions of her immediate family. Objective: To assess the behaviour of pregnant women regarding good and harmful neonatal care practices. 2. Implementation and assessing impact of Behaviour Change Communication (BCC) Package among pregnant women regarding good and harmful neonatal care practices. Methods: A community based intervention study was conducted in the field practice area of the Urban Health Training Centre, Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India. 200 pregnant women were enrolled purposively. Data were analyzed with Epi Info version 3.5.1. Percentages, and Chi Square Test used. Results: Due to implementation of BCC Package in intervention, good practices like giving colostrum were increased two times. Initiation of breastfeeding within 1 hour was increased 4.7 times, exclusive breastfeeding was gone up 3.8 times and induction of burping was increased 6 times. There was significant difference (P–value <0.05) between the two groups on 7th and 28th days of delivery. Harmful practices like not washing hand were decreased 3.83 times, use of dark and ill-ventilated room was decreased 2.54 times, and practice of cutting the cord with a used blade, or any unsterile scissors, knife, or sickle, broken cup was decreased 3 folds. Application of ghee/ cow dung on the cord was decrease significantly. Practices of prelacteals and use of pacifier, application of kajal, and witch craft for neonatal illnesses were reduced significantly. Conclusion: There was significant improvement in pregnant women regarding traditional neonatal practices. Some practices had not changed due to some strong cultural beliefs and influence of mother in-law and elderly females of the family.