How to improvise post graduate training in respiratory medicine in India.

Current postgraduate training in India is as per the norms of National medical council of India. There is a need to improvise the postgraduate training because of rapid changes in the trend of respiratory diseases and advances in medical field. Here we have discussed how best we can improvise the postgraduate training in the field of respiratory medicine in India. Adapting CBME system is ideal. Subject seminars can be restricted to a few selected topics and moderator should conduct a formative assessment after the seminar. Group discussion should the choice for imparting theoretical knowledge which can also help in application of theory to practice. We should focus more on imparting practical knowledge by case discussions, grand rounds, workshops. Postgraduates should be encouraged to actively participate in conference presentations. We need to have a consensus of opinion by an expert committee regarding the improvisations required.

Study on Anatomical Variations in Fissures of Lung by CT Scan.

Introduction Refinements in the modern computed tomography (CT) imaging techniques have led to anatomical variations in the fissures of lung being diagnosed more frequently. So far, majority of the studies conducted are cadaveric. There is paucity of studies in this aspect based on chest CT images. Hence, we undertook this study to find the anatomical variations in the fissures. Prior detection of anatomical abnormalities is important to reduce postoperative complications in lung resection surgeries. Materials and Methods This was a cross-sectional study conducted over a period of 2 years. Data were collected from the patients who underwent CT scan thorax. Patients in whom normal anatomy of lung was distorted and cases where both lungs were not visualized completely were excluded from the study. All the CT images were reviewed by a single radiologist. The presence or absence of the normal and accessory pulmonary fissures, as well as the continuity of each fissure, was recorded by the radiologist. Data were compiled and analyzed. Results The study population consisted of 394 (70.4%) males and 166 (29.6%) females, totaling 560 cases. Fissural variations were detected in 22.9% ( n = 128). Also, 17.5% ( n = 98) fissural variations were seen in males and 5.4% ( n = 30) fissural variations were seen in females. Further, 54.7% ( n = 70) of variations were detected in the right lung and 45.3% ( n = 58) in the left lung. The most common fissural variation noted was right incomplete oblique fissure with a frequency of 8.4% cases ( n = 47). The most common accessory fissure detected was inferior accessory fissure. Total 22 cases were detected in both the lungs, 17 cases in male and 5 in female. Conclusion Anatomical variations in fissures were found to be more in the right lung than the left lung. Accessory fissures were detected in higher incidence on the right side.

A middle-aged man with generalised weakness and dyspnoea.

Can you diagnose this middle-aged man with generalised weakness and dyspnoea? http://ow.ly/mSuQ30dxQ5o.

A case of exertional breathlessness.

Can you diagnose this case of exertional breathlessness in a patient who underwent radical neck dissection? http://ow.ly/YvbN30dxyfs.

A rare cause for a common symptom.

A rare cause for cough and fever http://ow.ly/d6zy301yYDJ.