Unilateral hyper-translucent lung: a rare case report of bronchial atresia.

A young female patient with chronic left side chest pain warranted a work-up. Chest X-ray suggested left hyper-translucency. High resolution computed tomography scan revealed left atretic apicoposterior segmental bronchus with an area of hyper-translucency suggestive of bronchial atresia. Fiberoptic bronchoscopy findings were normal. Spirometry showed moderate restriction with mild obstruction. It is a rare developmental anomaly characterised by interruption of normal bronchial continuity. Most commonly, it involves the apicoposterior segmental bronchus of left upper lobe as seen in our case. Since it is a benign condition, surgical treatment or any aggressive method of treatment is not required. However, intervention may be required in case of life threatening complications.

Integrated solutions to manage new normals in healthcare-lessons from corona virus disease 2019.

Global outbreak of the corona virus disease 2019 (COVID19) has not only challenged the existing healthcare systems but is also a threat to the world economy and stability. In the recent times the world has seen the best healthcare systems collapsing due to the overwhelming burden. Thus, it shows that there have been major lacunae in the pandemic preparedness across the globe. Hence, there is an urgent need to identify the problems, learn from failures and to prepare for future pandemics to reduce the loss of lives and livelihood. In the modern era, blend of public healthcare systems, medical sciences and technology can be put to use to provide solutions. In this article, the authors propose a developmental model of international integrated database software which would connect all the players involved in the management of a pandemic. Better networking and warning system is a key to successful containment of a new viral outbreak.

Squat-to-stand test in functional assessment of stable chronic obstructive pulmonary disease patients.

BACKGROUND: Assessment of functional status is vital for proper therapy and rehabilitation programs in chronic obstructive pulmonary disease (COPD) patients. Traditionally, 6 min walk test (6MWT) has been used but it by itself may not reflect the total functional status in these patients as it poorly correlates to the disease severity. A sit-to-stand test (STST) has been proposed as a better alternative to 6MWT but to test their ability to stand from the squatting position, i.e., a squat-to-stand test (SqTST) will be more appropriate in rural patients. MATERIAL AND METHODS: All patients, diagnosed to have stable COPD, after exclusion of asthma and other respiratory or nonrespiratory diseases were evaluated by applying 6MWT, STST, and SqTST in them. Data so obtained were statistically analyzed. RESULTS: Ninety patients and twenty healthy controls were studied. Sixteen, 24, 23, and 27 of the patients were classed as COPD risk category A, B, C, and D, respectively. The mean post bronchodilator forced expiratory volume in 1st second (PB FEV1) and body mass index (BMI) were significantly lower in category D as compared to the rest. The cutoff values for 6MWT, STST, and SqTST were derived as 184M, 11, and 07, respectively. 6MWT correlates poorly to disease severity (P = 0.109) but there was a strong correlation between disease severity and SqTST and STST (P = 0.000). CONCLUSION: SqTST is a feasible and effective tool to assess functional status of COPD patients residing in rural areas. BMI is an important surrogate marker of the functional status in these patients.

Diaphragmatic rupture precipitated by intercostal chest tube drainage in a patient of blunt thoraco-abdominal trauma.

Blunt thoraco-abdominal trauma in collision injuries in road traffic accident (RTA) occasionally results in diaphragmatic injury and rupture besides other serious multisystem injuries. These diaphragmatic injuries (DI) frequently go undetected specially when occur on the right side. DI associated with hemothorax need insertion of intercostal tube drainage (ICTD). ICTD has never been reported to precipitate diaphragmatic rupture and hernia. We are reporting such a rare case for the first time in medical literature.

Pulmonary Vasculitis: Indian Perspective.

Pulmonary vasculitis is an uncommon disease. Patients present with unexplained haemoptysis, pulmonary infiltrates and constitutional symptoms. Pulmonary vasculitis often goes undiagnosed due to lack of awareness and the disease is often mis-diagnosed as tuberculosis in India. Delayed or missed diagnosis leads to disease progression to a catastrophic event like diffuse alveolar haemorrhage which carries a high mortality. The outcome of appropriately treated cases, on the contrary, is good with excellent long-term survival. The present narrative review attempts to provide an overview of pulmonary vasculitis as it is seen in India.