Diagnostic yield of broncho-alveolar lavage fluid and postbronchoscopic sputum cytology in endoscopically non-visible lung cancers.

Diagnostic yield of broncho-alveolar lavage (BAL) fluid and postbronchoscopic sputum (PBS) cytology is very high in endoscopically visible bronchogenic carcinoma, but they are also helpful in diagnosis of those lung cancers which are not visible bronchoscopically. Objective of this prospective study is to analyse the diagnostic yield of BAL fluid and PBS cytology in endoscopically non-visible lung cancer. Thirty patients with chest radiographic abnormality suspicious of lung cancer without endobronchial abnormality underwent BAL fluid and PBS cytology examination in the department of respiratory medicine of Calcutta National Medical College and Hospital over 1 year and 3 months. The final diagnosis was bronchogenic carcinoma in 21, tuberculoma/tuberculosis in 5, bacterial pneumonia in 3 and encysted empyema in 1. Among the 21 patients with bronchogenic carcinoma, BAL was positive for malignant cell in 13 patients (62%). The diagnostic yield of the BAL was influenced by size, location, radiographic pattern and cell type of the tumour. PBS cytology was positive in 3 patients (14%) only, all of which were positive with BAL fluid also. BAL fluid cytology proved to be a valuable diagnostic tool in diagnosis of endoscopically non-visible lung cancer. Size, location, radiographic pattern and cytological type of the lesions were important determinants of the diagnostic yield. PBS cytology provided no additional benefit.

Serum magnesium and stable asthma: Is there a link?

BACKGROUND: Although magnesium is used through intravenous and inhalation route in the management of asthma, actual prevalence of hypomagnesemia in asthma is not known. We conducted this study: 1) to detect the prevalence of hypomagnesemia in stable asthma and 2) to assess the significance of hypomagnesemia in these patients. DESIGN: Prospective clinical study. SETTING: Department of Respiratory Medicine, Calcutta National Medical College, Kolkata. PERIOD OF STUDY: Four months from January, 2007, to April, 2007. MATERIALS AND METHODS: Fifty patients attending outpatients department of respiratory medicine with stable asthma were randomly selected. They were assessed clinically and their serum magnesium levels were measured. This was compared with the serum magnesium values of 45 nonasthmatic healthy controls. RESULTS: Out of 50 patients, 14 had hypomagnesemia. Possible relationship of hypomagnesemia with tachycardia, tachypnoea, severity of asthma, medication use, and previous and future exacerbations were analyzed. CONCLUSION: There was statistically significant association of hypomagnesemia with tachypnoea, severe asthma, use of long-acting ß-agonist, inhaled corticosteroids, theophylline, use of ≥ 3 medications, previous and future exacerbations but not with tachycardia or use of short-acting ß(2) -agonist or montelukast.

Tuberculosis in a bronchogenic cyst.

Bronchogenic cyst is one of the subtypes of congenital pulmonary cyst. Superadded infection, mostly bacterial is the commonest complication. Myobacterial infection is very rare. Here a case of tuberculosis in a bronchogenic cyst is reported because of its rarity.

A case of haemoptysis due to endobrnchial fibroma, a rare benign tumour of lung.

A case of recurrent haemoptysis due to fibroma is described in a 55 years old male patient. Clinical examination revealed anaemia and bilateral basal crepitations. Chest X - ray showed no abnormality. Bronchoscopy revealed polypoid fibroma in left main bronchus. It was removed bonchoscopically with no recurrence during 12 months follow up.

A study of comparison of efficacy and safety of talc and povidone iodine for pleurodesis of malignant pleural effusions.

Pleurodesis is considered as the best palliative therapy for the treatment of symptomatic malignant pleural effusion. Several chemical agents are used for this purpose with variable efficacy and safety. The present study is to compare the effectiveness and safety of talc and povidone iodine as chemical agents for pleurodesis in patients of malignant pleural effusion. Fifty-two patients with malignant pleural effusion admitted in the department of chest of Calcutta National Medical College, Kolkata were selected for the study. Pleurodesis with povidone iodine and talc in slurry was done in 28 and 24 patients respectively. Efficacy and safety of these agents were assessed during a follow-up period of six months. Among the 52 patients, 42 were males and 10 females. Age ranged from 40 to 64 years with mean age of 56.4 years. In 41 patients effusion was secondary to bronchogemic carcinoma, 8 had effusion secondary to breast carcinoma, 1 had effusion due to non-Hodgkin's lymphoma, while primary malignancy was unknown in 2 patients. Among the 24 patients treated with talc pleurodesis, 20 had bronchogenic carcinoma, 3 had breast carcinoma and 1 had unknown primary malignancy. Out of the 28 patients treated with povidone iodine pleurodesis, bronchogenic carcinoma was present in 21 patients, breast carcinoma in 5 patients, non-Hodgkin's lymphoma and unknown primary malignancy was present in 1 patient each. Pleurodesis with talc showed complete success in 19 patients, partial success in 3 patients and failure in 2 patients. Pleurodesis with povidone iodine showed complete response in 24 patients, partial response in 1 patient and failure in 3 patients. Chest pain occurred in 4 patients of talc pleurodesis and 5 patients of povidone iodine pleurodesis, 3 patients of each group had fever. There was no death in the peripleurodesis period. During the 6 months follow-up, 12 patients of talc pleurodesis and 18 patients of povidone iodine pleurodesis died. Talc is slurry and povidone iodine is equally effective and safe pleurodesing agent for symptomatic malignant pleural effusion. However povidone iodine can be preferred option because of easy availability and low cost.