A Case Report of Conservatively Managed Boerhaave Syndrome.

Boerhaave syndrome is an esophagal perforation due to a rupture of the esophagus wall caused by intense vomiting with mediastinitis and subcutaneous emphysema. It is a relatively rare and potentially life-threatening ailment that requires prompt diagnosis and treatment. This case presents an overview of the syndrome, including morbidity, mortality, and treatment strategy. In this case, a 56-year-old male presented to the hospital during emergency hours with shortness of breath, chest pain, and dullness in the neck and a history of binge alcohol abuse seven days ago, followed by a severe bout of vomiting. The patient was managed conservatively, requiring another hospitalization for surgery, and was later discharged from the hospital postoperatively without any complications.

A Clinical Encounter With Pickwickian Syndrome.

The clinical syndrome described in the literature as "Pickwickian syndrome" is characterized by a combination of sleep-disordered breathing, obesity, and daytime hypercapnia; the condition is also known as obesity hypoventilation syndrome (OHS). This syndrome is a diagnosis of exclusion after every other possible etiology is ruled out. Patients can present both with an exacerbation of or a chronic state of progressive dyspnea. In this report, we describe the case of a 62-year-old morbidly obese female with a BMI of 42 Kg/m2, who presented with progressively worsening breathlessness. An arterial blood gas (ABG) analysis revealed severe hypoxia with hypercarbia. A sleep study [polysomnography (PSG)] of the patient was performed, which revealed an apnea-hypopnea index (AHI) of 58.2, and the patient was diagnosed as having OHS after all other possible cardiorespiratory etiologies were ruled out. The patient was promptly managed with non-invasive ventilatory (NIV) support along with supportive management and was prescribed overnight NIV and subsequently discharged in stable condition.

Metastatic Prostatic Adenocarcinoma Masquerading as Pulmonary Tuberculosis: A Case Report.

Prostate carcinoma is one of the most common malignancies in the elderly male population in India as well as worldwide, and its incidence has been on the rise in the younger age groups as well. The annual incidence rate of prostate cancer in India ranges from 5.0 to 9.1 per 100,000 people. It commonly metastasizes to the bone, regional lymph nodes, and in rare cases, to the lung, liver, and brain. Pulmonary manifestations of metastatic prostate carcinoma are rare with pulmonary lesions being part of the initial pattern of metastasis in only 2% of prostate malignancies. We report the case of a 53-year-old male who presented with breathlessness and hemoptysis, which was initially diagnosed as pulmonary tuberculosis and later found to be a case of metastatic prostatic adenocarcinoma.

Evaluation of Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease.

BACKGROUND: Pulmonary hypertension (PH) is frequently underdiagnosed and under-evaluated in chronic obstructive pulmonary diseases (COPD) patients. As PH is linked to a high rate of mortality from disease-related complications like cor pulmonale, it is critical to have a unified approach to diagnosing and treating it with the aim of improving the patient's quality of life and prognosis in terms of therapeutic considerations. Early identification of this comorbidity in patients with COPD can lead to early initiation of treatment and better prognostic implications. This study was undertaken with the aim of estimating the prevalence of PH in COPD as well as assessing any statistically significant associations between the severity of PH and the severity of COPD. METHODS: This was an observational study undertaken at the Department of Respiratory Medicine, Acharya Vinoba Bhave Rural Hospital (AVBRH) in Wardha, Maharastra, India, from August 2019 to September 2021. A total of 100 patients diagnosed with COPD on the basis of spirometry were evaluated with two-dimensional (2D) echocardiography to screen for echocardiographic signs and evidence of PH and severity staging of PH if present. RESULTS: In our study, out of 100 diagnosed cases of COPD, the prevalence of PH was found to be 40% (40 patients) and amongst these, mild, moderate, and severe PH was seen in 26 patients (26%), nine patients (9%), and five patients (5%), respectively. The frequency of PH in moderate COPD was 25% and in severe COPD was 51.5%. CONCLUSIONS: PH was found in almost half the COPD patients in the study. Also, the degree and frequency of PH increased with the increase in COPD severity and this was found to be statistically significant.

Assessment of pulmonary function test in brick factory workers.

Background: Industrial workers are exposed to dust and pollutants and thus they get occupational disorders when exposed for a long duration. Occupational diseases mainly affect the respiratory system more than other systems. Some of the respiratory occupation disorders are asbestosis, silicosis, coal worker's pneumoconiosis, work-related asthma, and so on, as the duration of exposure of pollutants increases the pulmonary function decreases. Method: A total of 100 subjects working in the Brick factories near Wardha district, Maharashtra were examined using a portable spirometer. Their pulmonary function test was assessed three times and the best out of three values was taken. A pretested questionnaire was filled out by the workers which consisted of their sociodemographic details. Consent was obtained from all the subjects for this in their native language. Similarly, a pretested questionnaire was filled by 50 subjects among the normal population, that is, those not working in brick factories, and consent was obtained from all. And then, their pulmonary function test was carried out using a portable spirometer and the best out of the three values was taken. Statistical analysis was done by using descriptive and inferential statistics using the software. Results: As analyzed by the pulmonary function test data values collected among the brick factory workers and the control group, there was a significant decrease seen in the values of the pulmonary function test of brick factory workers. And as analyzed by the pulmonary function test values of smokers and non-smokers among the brick factory workers, it was seen that there was a significant P value of 0.0001, thus a decrease in pulmonary function test among smokers. Conclusion: In this study, we evaluate the respiratory function test among the brick factory workers and the control group and make the workers aware of the damage their habits have on their lung capacity and function based on the evaluation of the predicted and the actual value and thus helps them lead a better life. In this study, we also compare the values of pulmonary function tests among the brick factory workers and control groups.

Anterior mediastinal mass with superior vena cava syndrome: A rare presentation of germ cell tumor.

The objective of this case report is to highlight the clinical, radiological, and histopathological features of a case of a 33-year-old male patient, who presented to AVBRH, Sawangi (Meghe), Wardha, with an anterior mediastinal mass with superior vena cava syndrome and after detailed studies was diagnosed as a case of germ cell tumor which was further confirmed on immunohistochemistry staining.

A case series of malignant pericardial effusion.

The most common primary malignancies that affect the pericardium are lung cancers. Typically, pericardial involvement stays undiagnosed, with almost 1-20% of all tumor-related autopsies revealing invasion of the pericardium. Pericardial effusions are seldom the first location of metastasis and presentation of a primary malignancy. Malignant pericardial effusions are usually silent, although they cause dyspnea, chest discomfort, arrhythmias, cough, and, in rare cases, pericardial tamponade. In a patient with tamponade, a high index of tumor-related suspicion is crucial to rule out cancer. Emergency pericardiocentesis is indicated based on the clinical presentation, however, the patient frequently has a bad prognosis regardless of whether treatment is administered or not. In this case series, we report five cases of non-small cell lung cancer (NSCLC) with pericardial effusion as an initial presentation.