RESUMO
Pulmonary capillary hemangiomatosis (PCH) is a rare disease usually associated with pulmonary hypertension which is classified in group I as per the World Health Organization (WHO) classification of pulmonary arterial hypertension (PAH). It is commonly presented as effort intolerance and hypoxia. Pulmonary capillary hemangiomatosis can present with ground-glass opacity on chest radiograph which can mimic interstitial lung disease. We need to consider PCH also in the differential diagnosis of interstitial shadows with these clinical presentations and should consider diagnostic evaluation for the same in case of unsatisfactory clinic-radiological response to treatment. We describe a case presented and treated as interstitial lung disease, which turned out to be PCH on lung biopsy. Interestingly, the case was not associated with any evidence of PAH.
RESUMO
Background: Lymph node tuberculosis (TB) is the most common form of extrapulmonary TB in India. Standards for TB care in India recommend microscopy/culture/CBNAAT/molecular test/histopathology examination and drug sensitivity testing on appropriate specimens from the presumed sites of involvement for all patients with presumptive extrapulmonary TB. Objectives: To analyze the utility of Xpert MTB/ Rif assay in lymph node TB. Methods: All patients who underwent lymph node sampling between July 2014 and June 2017 and for whom Xpert MTB/Rif assay was done were included. Demographic profile, Xpert MTB/Rif assay result, histopathology/cytology findings, smear acid-fast bacillus (AFB), and AFB culture results were noted. A composite reference score (CRS) was made. Results: Xpert MTB/Rif assay was positive in 63 of the 81 patients. Xpert had a sensitivity of 82.14% and specificity of 86.18%when compared against AFB culture and 75.61% and 98.97% when compared against CRS. Conclusion: Xpert MTB/Rif assay is a valuable test for rapid diagnosis of lymph node TB.
RESUMO
Background: The coexistence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) is termed “Overlap syndrome (OS).” Objectives: The present study aimed at estimating the prevalence of OS among patients diagnosed with OSA. Methods: It was a prospective observational study conducted on patients presenting to respiratory medicine outpatient department (sleep clinic) with symptoms of sleep-disordered breathing and was found to have OSA by overnight polysomnography. These patients were then subjected to spirometry to diagnose COPD. Results: The prevalence of OS in the study population was found to be 41.3%. Excessive daytime sleepiness was found to be higher in overlap group patients (P = 0.033), the difference was statistically significant. The mean age (59.9 ± 9.6 years) was found to be high in the OS group compared to those without the same. The mean forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC (pre? and postbronchodilator) spirometry parameters were found to be lower in patients with OS. Conclusion: The study showed that the prevalence of OS in the present study was 41.3%. Excessive daytime sleepiness and age >60 years were risk factors for OS in a patient with OSA. OS patients had lower pulmonary function values.
RESUMO
Background: It was observed that post?COVID patients reported persistent exertional dyspnea, cough, fatigue, or chest pain. About 10%–20% of patients may progress to pulmonary fibrosis. Pulmonary rehabilitation has been proven to be useful in improving effort tolerance and quality of life in chronic respiratory diseases. Objectives: The objective of this study was to assess the effectiveness of pulmonary rehabilitation in improving 6?min walk distance (6 MWD), peak flow, fatigue, anxiety, and depression in early postacute COVID disease. Materials and Methods: This quasi?experimental study was conducted during January 2021 to March 2021. The patients who recovered from COVID?19 and having persistent exertional dyspnea and fatigue after 3 weeks of recovery were included in the study. Baseline and postintervention assessment of 6 MWD, Visual Analog Scale for Fatigue (VAS?F), peak flow, and Hamilton rating scales (HAM) scales after 4 weeks were done. Compliance was ensured with weakly telemonitoring. Results: Significant improvement in peak flow, 6 MWD, Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), and VAS-F (P < 0.01) after 4 weeks of pulmonary rehabilitation. Conclusion: Early pulmonary rehabilitation in post?COVID syndrome can contribute to statistically significant improvement in functional and psychological parameters as well as post-COVID fatigue.