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Chetambath R, Kumar P, Nandini V, Chandran S, Chacko A. Catamenial haemothorax-A rare cause of pleural effusion. Lung India 2023; 40:541-544. [PMID: 37961963 PMCID: PMC10723198 DOI: 10.4103/lungindia.lungindia_144_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/10/2023] [Accepted: 04/26/2023] [Indexed: 11/15/2023] Open
Abstract
Common causes of haemorrhagic pleural effusions include malignancy (primary or metastatic), tuberculosis, pulmonary embolism, collagen vascular diseases, trauma and iatrogenic causes. Clinical history along with pathologic, microbiologic and biochemical evaluation of pleural fluid confirms the diagnosis in most cases. However, if there is recurrent haemorrhagic effusion without corroborative history or mass lesion in lung, or evidence of microorganisms, then we should think of uncommon causes. Catamenial haemothorax (CHt) is a rare cause of haemorrhagic pleural effusion, which recurs during each menstrual cycle. This is a manifestation of thoracic endometriosis syndrome (TES) caused by ectopic endometrial tissue in the thoracic cavity in women of child-bearing age. This extremely rare condition is difficult to diagnose, unless direct correlation with the menstrual cycle is established. TES consists of pleural forms such as catamenial pneumothorax, non-catamenial endometriosis-related pneumothorax and haemothorax; and parenchymal forms such as catamenial haemoptysis and lung nodules. Here we report a case of CHt in a 43-year-old female whose diagnosis was established by thoracoscopic pleural biopsy.
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Affiliation(s)
| | - Praveen Kumar
- Department of Pulmonology, Baby Memorial Hospital, Kozhikode, Kerala, India
| | - V Nandini
- Department of Pulmonology, Baby Memorial Hospital, Kozhikode, Kerala, India
| | - Shilpa Chandran
- Department of Pulmonology, Baby Memorial Hospital, Kozhikode, Kerala, India
| | - Anju Chacko
- Department of Pulmonology, Baby Memorial Hospital, Kozhikode, Kerala, India
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Munje R, Chawla R, Chetambath R, Christopher DJ, Dhar R, Ghoshal AG, Gupta N, Haldar I, Khilnani GC, Koul PA, Mishra G, Mohan A, Nene A, Paramez A, Pothal S, Roy DJ, Salvi SS, Samaria JK, Swarnakar R. Position statement of the Indian Chest Society on reinstatement of the Respiratory Medicine department in undergraduate medical colleges in India. Lung India 2023; 40:487-489. [PMID: 37961953 PMCID: PMC10723210 DOI: 10.4103/lungindia.lungindia_511_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Affiliation(s)
- Radha Munje
- 74 Hanuman Nagar, Above Bank of Maharashtra, Nagpur, Maharashtra, India
| | - Rakesh Chawla
- Chawla Respiratory Care &Sleep Centre 58, Pocket C-12, Sector–3, Rohini, Delhi, India
| | | | | | | | - Aloke G. Ghoshal
- Medical Director, National Allergy Asthma Bronchitis Institute, Kolkata, India
| | - Neeraj Gupta
- Opp. Savitri Girls College, Civil Line, Ajmer, Rajasthan, India
| | - Indranil Haldar
- Bandel Station Road, Opp. Water Tank (Children's Park) Bandel, P.O. Hooghly, Distt. Hooghly
| | | | - Parvaiz A. Koul
- Department of Pulmonary Medicine, SKIMS, Soura, Srinagar, India E-mail:
| | | | - Anant. Mohan
- Room No.-3098, 3rd Floor, Teaching Block, AIIMS, New Delhi, India
| | - Amita Nene
- 8d Ajanta Apts, ML DahanukarMarg, Pedder Road, Bombay, Maharashtra, India
| | - Ayyapath Paramez
- 7A, Trinity World Jupiter, Chittethukara, Csez. P.O. Kakkanad, Ernakulam, Kerala, India
| | - Sudarsan Pothal
- Associate Professor, Pulmonary Medicine, V.S.S. Medical College, Burla, Sambalpur, Orissa, India
| | - D. J. Roy
- G 16/8 Karunamoyee, Housing Estate Salt Lake City Calcutta, West Bengal, India
| | - Sundeep S. Salvi
- Chest Research Foundation Marigold Complex Kalyani Nagar, Pune, India
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Jindal SK, Aggarwal AN, Jindal A, Talwar D, Dhar R, Singh N, Singh V, Krishnaswamy UM, Chetambath R, Nath A, Bhattacharya P, Chaudhary D, Gupta PR, Gupta ML, Koul P, Swarankar R, Kant S, Ghoshal A. COPD exacerbation rates are higher in non-smoker patients in India. Int J Tuberc Lung Dis 2021; 24:1272-1278. [PMID: 33317671 DOI: 10.5588/ijtld.20.0253] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is common among non-smokers exposed to solid fuel combustion at home. Different clinical characteristics in these patients may have significant therapeutic and prognostic implications.METHODS: We used medical record review and a questionnaire among COPD patients at 15 centres across India to capture data on demographic details, different types of exposures and clinical characteristics. Chest radiography and pulmonary function testing were performed in all 1984 cases; C-reactive protein and exhaled breath nitric oxide were measured wherever available.RESULTS: There were 1388 current or ex-smokers and 596 (30.0%) non-smokers who included 259 (43.5%) male and 337 (56.5%) female patients. Sputum production was significantly more common in smokers with COPD (P < 0.05). The frequency of acute symptomatic worsening, emergency visits and hospitalisation were significantly higher (P < 0.05) in non-smokers with COPD; however, intensive care unit admissions were similar in the two groups. There was no significant difference with respect to the use of bronchodilators, inhalational steroids or home nebulisation among smoker and non-smoker patients. The mean predicted forced expiratory volume in 1 sec in smokers (43.1%) was significantly lower than in non-smokers (46.5%).CONCLUSION: Non-smoker COPD, more commonly observed in women exposed to biomass fuels, was characterised by higher rate of exacerbations and higher healthcare resource utilisation.
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Affiliation(s)
| | - A N Aggarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh
| | | | - D Talwar
- Metro Centre for Respiratory Diseases, Metro Hospitals, Noida
| | | | | | | | | | | | - A Nath
- Pulmonary Medicine, Sanjay Gandhi Institute of Medical Sciences, Lucknow
| | | | - D Chaudhary
- Pt BDS Postgraduate Institute of Medical Sciences, Rohtak
| | - P R Gupta
- Department of Respiratory Medicine, NIMS University, Jaipur
| | - M L Gupta
- Santokba Dabhji Memorial Hospital, Jaipur
| | - P Koul
- Shere Kashmir Medical RI, Srinagar
| | - R Swarankar
- Getwell Hospital & Research Institute, Nagpur
| | - S Kant
- Department of Respiratory Medicine, King George Medical University, Lucknow
| | - A Ghoshal
- National Asthma & Allergy Centre, Kolkata, India
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Singh S, Bairwa M, Collins BF, Sharma BB, Joshi JM, Talwar D, Singh N, Pilania K, Bhattacharya P, Gupta N, Chetambath R, Ghoshal AG, Kant S, Koul PA, Dhar R, Swarnakar R, Singh V, Raghu G. Survival predictors of interstitial lung disease in India: Follow-up of Interstitial Lung Disease India registry. Lung India 2021; 38:5-11. [PMID: 33402631 PMCID: PMC8066940 DOI: 10.4103/lungindia.lungindia_414_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: Predictors of survival for interstitial lung disease (ILD) in the Indian population have not been studied. The primary objective of the study was to assess the Modified-Gender Age and Physiology (M-GAP) score to predict survival in patients with ILD seen in clinical practice. We also analyzed the role of demographic and radiological characteristics in predicting the survival of patients with ILD. Materials and Methods: In the ILD India registry, data were collected from 27 centers across 19 cities in India between March 2012 and June 2015. A single follow-up was conducted at 18 centers who agreed to participate in the follow-up in 2017. M-GAP score (range 0–5) was calculated with the following variables: age (≤60 years 0, 61–65 years 1, and >65 years 2), gender (female 0, male 1), and forced vital capacity% (>75% 0, 50%–75% 1, and >75% 2). A score of 0–3 and score of 4 and 5 were classified into Stage 1 and 2, respectively. Other predictors of survival, such as the history of tuberculosis, smoking, and the presence of honeycombing on computed tomography scan, were also evaluated. Results: Nine hundred and seven patients were contacted in 2017. Among them, 309 patients were lost to follow-up; 399 were alive and 199 had died. M-GAP was significantly associated with survival. Similarly, other predictors of survival were ability to perform spirometry (hazard ratio [HR]: 0.49, 95% confidence interval [CI]: 0.34–0.72), past history of tuberculosis (HR: 1.57, 95% CI: 1.07–2.29), current or past history of smoking (HR: 1.51, 95% CI: 1.06–2.16), honeycombing (HR: 1.81, 95% CI: 1.29–2.55), a diagnosis of connective tissue disease -ILD (HR: 0.41, 95% CI: 0.22–0.76), and sarcoidosis (HR: 0.24, 95% CI: 0.08–0.77). Conclusion: In a subgroup of patients with newly diagnosed ILD enrolled in ILD India registry and who were available for follow-up, M-GAP score predicted survival. Honeycombing at the time of diagnosis, along with accurate history of smoking, and previous history of tuberculosis were useful indices for predicting survival.
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Affiliation(s)
- Sheetu Singh
- Department of Chest and Tuberculosis, SMS Medical College, Jaipur, Rajasthan, India
| | - Mohan Bairwa
- Department of Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Bridget F Collins
- Department of Medicine, Center for Interstitial Lung Diseases, University of Washington, Seattle, WA, USA
| | | | - Jyotsana M Joshi
- Department of Pulmonary Medicine, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India
| | - Deepak Talwar
- Department of Pulmonary and Sleep Care Medicine, Metro Multispeciality Hospital, Noida, Uttar Pradesh, India
| | - Nishtha Singh
- Department of Pulmonary Medicine, Asthma Bhawan, Jaipur, Rajasthan, India
| | | | | | - Neeraj Gupta
- Department of Respiratory Medicine, JLN Medical College and Hospital, Ajmer, Rajasthan, India
| | - Ravindran Chetambath
- Department of Pulmonary Medicine, Government Medical College, Kozhikode, Kerala, India
| | - Aloke G Ghoshal
- Department of Respiratory Medicine, National Allergy Asthma Bronchitis Institute, Kolkata, West Bengal, India
| | - Surya Kant
- Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Parvaiz A Koul
- Department of Internal and Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Raja Dhar
- Department of Pulmonology and Critical Care, Fortis Hospital, Kolkata, West Bengal, India
| | - Rajesh Swarnakar
- Department of Respiratory, Critical Care, Sleep Medicine and Interventional Pulmonology, Getwell Hospital and Research Institute, Nagpur, Maharashtra, India
| | - Virendra Singh
- Department of Pulmonary Medicine, Asthma Bhawan, Jaipur, Rajasthan, India
| | - Ganesh Raghu
- Department of Medicine, Center for Interstitial Lung Diseases, University of Washington, Seattle, WA, USA
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Chetambath R. Popcorn lung – Report of a rare case and its significance in a coffee-growing district of Kerala. Lung India 2019; 36:367-368. [PMID: 31290430 PMCID: PMC6625247 DOI: 10.4103/lungindia.lungindia_441_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Singh S, Collins BF, Sharma BB, Joshi JM, Talwar D, Katiyar S, Singh N, Ho L, Samaria JK, Bhattacharya P, Chaudhari S, Singh T, Pilania K, Pipavath S, Ahuja J, Chetambath R, Ghoshal AG, Jain NK, Gayathri Devi HJ, Kant S, Koul P, Dhar R, Swarnakar R, Katiyar SK, Jindal A, Mangal DK, Singh V, Raghu G. Hypersensitivity pneumonitis: Clinical manifestations - Prospective data from the interstitial lung disease-India registry. Lung India 2019; 36:476-482. [PMID: 31670294 DOI: 10.4103/lungindia.lungindia_263_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context Multiple environmental factors are associated with development of hypersensitivity pneumonitis (HP), and diagnostic algorithms for the diagnosis of HP have been proposed in recent perspectives. Aims We analyzed the data of patients with HP from interstitial lung disease (ILD)-India registry. The analysis was performed to (1) find the prevalence of HP, (2) reclassify HP as per a recently proposed classification criterion to assess the level of diagnostic certainty, and (3) identify the causative agents for HP. Setting and Designs This was a prospective multicenter study of consecutive, consenting adult patients with new-onset ILD from 27 centers across India (March 2012-April 2015). Materials and Methods The diagnoses were based on prespecified working clinical criteria and multidisciplinary discussions. To assess strength of diagnosis based on available clinical information, patients with HP were subclassified into definite HP, HP with high level of confidence, and HP with low level of confidence using a recent classification scheme. Results Five hundred and thirteen of 1084 patients with new-onset ILD were clinically diagnosed with HP and subclassified as HP with high level of confidence (380, 74.1%), HP with low level of confidence (106, 20.7%), and definite HP (27, 5.3%). Exposures among patients with HP were birds (odds ratios [OR]: 3.52, P < 0.001), air-conditioners (OR: 2.23, P < 0.001), molds (OR: 1.79, P < 0.001), rural residence (OR: 1.64, P < 0.05), and air-coolers (OR: 1.45, P < 0.05). Conclusions About 47.3% of patients with new-onset ILD in India were diagnosed with HP, the majority of whom were diagnosed as HP with a high level of confidence. The most common exposures were birds, cooling devices, and visible molds.
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Affiliation(s)
- Sheetu Singh
- Department Chest and Tuberculosis, SMS Medical College, Jaipur, Rajasthan, India
| | - Bridget F Collins
- Department of Medicine, Center for Interstitial Lung Diseases, University of Washington, Seattle, WA 98195, USA
| | - Bharat B Sharma
- Department of Medicine, SMS Medical College, Jaipur, Rajasthan, India
| | - Jyotsana M Joshi
- Department of Pulmonary Medicine, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India
| | - Deepak Talwar
- Department of Pulmonary and Sleep Care Medicine, Metro Multispeciality Hospital, Noida, Uttar Pradesh, India
| | - Sandeep Katiyar
- Department of Respiratory Medicine, Chest Care Centre, Kanpur, Uttar Pradesh, India
| | - Nishtha Singh
- Department of Pulmonary Medicine, Asthma Bhawan, Jaipur, Rajasthan, India
| | - Lawrence Ho
- Department of Medicine, Center for Interstitial Lung Diseases, University of Washington, Seattle, WA 98195, USA
| | - Jai K Samaria
- Department of Chest Disease, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Parthasarthi Bhattacharya
- Department of Respiratory Medicine, Institute of Pulmocare and Research, Kolkata, West Bengal, India
| | - Sudhir Chaudhari
- Department of Tuberculosis and Respiratory Diseases, GSVM Medical College, Kanpur, Uttar Pradesh, India
| | - Tejraj Singh
- Research Division, Asthma Bhawan, Jaipur, Rajasthan, India
| | - Khushboo Pilania
- Department of Radiodiagnosis, Jankharia Imaging, Mumbai, Maharashtra, India
| | - Sudhakar Pipavath
- Department of Radiology, Center for Interstitial Lung Diseases, University of Washington, Seattle, WA 98195, USA
| | - Jitesh Ahuja
- Department of Radiology, Center for Interstitial Lung Diseases, University of Washington, Seattle, WA 98195, USA
| | - Ravindran Chetambath
- Department of Pulmonary Medicine, Calicut Medical College, Kozhikode, Kerala, India
| | - Aloke G Ghoshal
- National Allergy Asthma Bronchitis Institute, Kolkata, West Bengal, India
| | - Nirmal K Jain
- Department of Respiratory Medicine, Jain Chest Care Center, Jaipur, Rajasthan, India
| | - H J Gayathri Devi
- Department of Respiratory Medicine, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Surya Kant
- Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Parvaiz Koul
- Department of Internal and Pulmonary Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Raja Dhar
- Department of Pulmonology and Critical Care, Fortis Hospital, Kolkata, West Bengal, India
| | - Rajesh Swarnakar
- Department of Pulmonology and Respiratory Medicine, Getwell Hospital and Research Institute, Nagpur, Maharashtra, India
| | - Subodh K Katiyar
- Department of Respiratory Medicine, Chest Care Centre, Kanpur, Uttar Pradesh, India
| | - Arpita Jindal
- Department of Pathology, SMS Medical College, Jaipur, Rajasthan, India
| | | | - Virendra Singh
- Department of Pulmonary Medicine, Asthma Bhawan, Jaipur, Rajasthan, India
| | - Ganesh Raghu
- Department of Medicine, Center for Interstitial Lung Diseases, University of Washington, Seattle, WA 98195, USA
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Chetambath R, Parengal J, Aslam M, Shivashankaran S. A rare clinical case presenting as right lower zone shadow. Lung India 2018; 35:173-175. [PMID: 29487258 PMCID: PMC5846272 DOI: 10.4103/lungindia.lungindia_99_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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8
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Singh S, Collins BF, Sharma BB, Joshi JM, Talwar D, Katiyar S, Singh N, Ho L, Samaria JK, Bhattacharya P, Gupta R, Chaudhari S, Singh T, Moond V, Pipavath S, Ahuja J, Chetambath R, Ghoshal AG, Jain NK, Devi HJG, Kant S, Koul P, Dhar R, Swarnakar R, Sharma SK, Roy DJ, Sarmah KR, Jankharia B, Schmidt R, Katiyar SK, Jindal A, Mangal DK, Singh V, Raghu G. Interstitial Lung Disease in India. Results of a Prospective Registry. Am J Respir Crit Care Med 2017; 195:801-813. [PMID: 27684041 DOI: 10.1164/rccm.201607-1484oc] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
RATIONALE Interstitial lung disease (ILD) is a heterogeneous group of acute and chronic inflammatory and fibrotic lung diseases. Existing ILD registries have had variable findings. Little is known about the clinical profile of ILDs in India. OBJECTIVES To characterize new-onset ILDs in India by creating a prospective ILD using multidisciplinary discussion (MDD) to validate diagnoses. METHODS Adult patients of Indian origin living in India with new-onset ILD (27 centers, 19 Indian cities, March 2012-June 2015) without malignancy or infection were included. All had connective tissue disease (CTD) serologies, spirometry, and high-resolution computed tomography chest. ILD pattern was defined by high-resolution computed tomography images. Three groups independently made diagnoses after review of clinical data including that from prompted case report forms: local site investigators, ILD experts at the National Data Coordinating Center (NDCC; Jaipur, India) with MDD, and experienced ILD experts at the Center for ILD (CILD; Seattle, WA) with MDD. Cohen's κ was used to assess reliability of interobserver agreement. MEASUREMENTS AND MAIN RESULTS A total of 1,084 patients were recruited. Final diagnosis: hypersensitivity pneumonitis in 47.3% (n = 513; exposure, 48.1% air coolers), CTD-ILD in 13.9%, and idiopathic pulmonary fibrosis in 13.7%. Cohen's κ: 0.351 site investigator/CILD, 0.519 site investigator/NDCC, and 0.618 NDCC/CILD. CONCLUSIONS Hypersensitivity pneumonitis was the most common new-onset ILD in India, followed by CTD-ILD and idiopathic pulmonary fibrosis; diagnoses varied between site investigators and CILD experts, emphasizing the value of MDD in ILD diagnosis. Prompted case report forms including environmental exposures in prospective registries will likely provide further insight into the etiology and management of ILD worldwide.
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Affiliation(s)
| | | | | | - Jyotsna M Joshi
- 4 Department of Pulmonary Medicine, Topiwala National Medical College & BYL Nair Hospital, Mumbai, India
| | - Deepak Talwar
- 5 Department of Pulmonary and Sleep Care Medicine, Metro Multispeciality Hospital, Noida, India
| | - Sandeep Katiyar
- 6 Department of Respiratory Medicine, Chest Care Centre, Kanpur, India
| | | | | | - Jai Kumar Samaria
- 8 Department of Chest Disease, Banaras Hindu University, Varanasi, India
| | | | - Rakesh Gupta
- 10 Department of Respiratory Medicine, JLN Medical College & Hospital, Ajmer, India
| | - Sudhir Chaudhari
- 11 Department of Chest and Tuberculosis, GSVM Medical College, Kanpur, India
| | - Tejraj Singh
- 12 Research Division, Asthma Bhawan, Jaipur, India
| | | | | | | | - Ravindran Chetambath
- 15 Department of Pulmonary Medicine, Government Medical College, Kozhikode, India
| | - Aloke G Ghoshal
- 16 National Allergy Asthma Bronchitis Institute, Kolkata, India
| | - Nirmal K Jain
- 17 Department of Respiratory Medicine, SoniManipal Hospital, Jaipur, India
| | - H J Gayathri Devi
- 18 Department of Chest Medicine, MS Ramaiah Medical College, Bangalore, India
| | - Surya Kant
- 19 Department of Pulmonary Medicine, King George's Medical University, Lucknow, India
| | - Parvaiz Koul
- 20 Department of Internal and Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Raja Dhar
- 21 Department of Pulmonology & Critical Care, Fortis Hospital, Kolkata, India
| | - Rajesh Swarnakar
- 22 Department of Pulmonology and Respiratory Medicine, Getwell Hospital and Research Institute, Nagpur, India
| | - Surendra K Sharma
- 23 Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Dhrubajyoti J Roy
- 24 Department of Respiratory Medicine, Pulmonary and Sleep Clinic, Kolkata, India
| | - Kripesh R Sarmah
- 25 Department of Pulmonary Medicine, Gauhati Medical College, Guwahati, India
| | - Bhavin Jankharia
- 26 Department of Radiology, Jankharia Imaging, Mumbai, India; and
| | - Rodney Schmidt
- 27 Department of Pathology, Center for Interstitial Lung Diseases, University of Washington, Seattle, Washington
| | - Santosh K Katiyar
- 6 Department of Respiratory Medicine, Chest Care Centre, Kanpur, India
| | - Arpita Jindal
- 28 Department of Pathology, SMS Medical College, Jaipur, India
| | - Daya K Mangal
- 29 Department of Research, IIHMR University, Jaipur, India
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Affiliation(s)
- Ravindran Chetambath
- Department of Pulmonology, DM Wayanad Institute of Medical Sciences, Wayanad, Kerala, India. E-mail:
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10
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Haridas N, K P S, T P R, P T J, Chetambath R. Medical Thoracoscopy vs Closed Pleural Biopsy in Pleural Effusions: A Randomized Controlled Study. J Clin Diagn Res 2014; 8:MC01-4. [PMID: 24995201 DOI: 10.7860/jcdr/2014/7476.4310] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 03/12/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pleural effusion is a common diagnostic dilemma for the pulmonologist. A histological diagnosis would many a time steer the way to an accurate diagnosis of the aetiologies of pleural effusions. This study has compared two methods for obtaining histological specimens in cases of undiagnosed pleural effusions. AIM To compare the efficacy of closed pleural biopsy with Abrahm's needle and medical thoracoscopic biopsy in the diagnosis of undiagnosed exudative pleural effusions at a tertiary care setting. STUDY DESIGN Randomized controlled study. STUDY PERIOD November 2008-October 2010. METHODOLOGY All patients who were admitted with pleural effusions underwent a clinical workup for pleural effusions. Light's criterion was used to differentiate between exudative and transudative pleural effusions. Those patients with exudative pleural effusions, who did not have a specific diagnosis, were included in the study. Fifty eight patients were included in the study and they were randomized into 2 Groups of 29 patients each. One group was subjected to medical thoracoscopic pleural biopsy and the other to closed pleural biopsy with Abrahm's needle. Demographic, clinical and biochemical characteristics, diagnostic yields and the complications among the two groups were compared. RESULT Medical thoracoscopy has a diagnostic yield of 86.2% with complication rate of 10.3% compared to 62.1% and 17.2% respectively in closed pleural biopsy group. CONCLUSION Medical thoracoscopic pleural biopsy had a better diagnostic yield with a lower complication rate as compared to closed pleural biopsy with Abrahm's needle.
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Affiliation(s)
- Nithya Haridas
- Assistant Professor, Department of Pulmonary Medicine, AIMS , Ponekara, Kochi, Kerala, India
| | - Suraj K P
- Additional Professor Department of Pulmonary Medicine, Institute of Chest Diseases, Government Medical College , Kozhikode, Kerala, India
| | - Rajagopal T P
- Professor, Department of Pulmonary Medicine, Institute of Chest Diseases, Government Medical College , Kozhikode, Kerala, India
| | - James P T
- Professor & HOD, Department of Pulmonary Medicine, Institute of Chest Diseases, Government Medical College , Kozhikode, Kerala, India
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Abstract
Non-resolving pneumonia leading to lung abscess is always a challenge to the treating physician especially in a diabetic patient. Atypical radiological features of lung abscess should raise the suspicion of unusual organisms. This is a case report of a 42 year old diabetic male presented with features suggestive of lung abscess and multiple target organ damage. Subsequent work up revealed that the etiological agent is a rare fungus – Basidiobolus. To the best of our knowledge this is the first case of Basidiobolus lung abscess reported from India.
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