Indian Journal of Public Health Research & Development

Abhishek Chauhan ¹, Jai Kishan ², Sameer Singhal ³, Achchhar Singh ⁴, Aditi Gupta ⁵, Pankaj Saini ¹

Affiliations
1 Junior Resident, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
2 Prof and Head, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
3 Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
4 Associate Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
5 Assistant Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN

Abstract

Tuberculosis is an infectious disease. It is caused by bacteria Mycobacterium Tuberculosis. It can be diagnosed by demonstrating AFB by either phenotypic method like sputum smear microscopy, culture or by genotypic method like NAAT or LPA. For better results there should be a good quality sputum sample. Induction of sputum is a method for improving the quality of sample. The most commonly used method is induction using 3% saline. It has been seen that during taking throat swab specimen patients usually produce cough. This induced cough can produce better quality of sputum. The following study was done to know about the role of throat swab as a method of sputum induction.

Keywords

AFB, CBNAAT, LPA, Mycobacterium Tuberculosis.

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Vishvdeep Saini ¹, Sameer Singhal ², Sukhjinder Pal Singh ³, Achchhar Singh ⁴, Aditi Gupta ⁵

Affiliations
1 Junior Resident, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
2 Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
3 Senior Resident, Department of Respiratory Medicine, MMMC & H, Kumarhatti, Solan, Himachal Pradesh, IN
4 Associate Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
5 Assistant Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN

Abstract

Introduction: Spirometry helps us to differentiate between obstructive and restrictive disease, body plethysmography tells about lung volumes and DLCO about diffusion defect. Determining which tests to do depends on the clinical question to be answered i.e. whether test is being done to diagnose a disease or for evaluation for lung surgery or some other reason. Material and Method: 46 patients coming to department of respiratory medicine, who were diagnosed with obstructive lung disease by PFT as per GOLD guidelines were considered for the study. Chest X-ray and CT chest were also done. Then DLCO was performed in every patient. Single breath hold method was used in the study. The report of the DLCO was interpreted according to the American Thoracic Society/European Respiratory Society statement on PFT interpretation. Results: Male preponderance was seen in study cases with 65.2% males to 34.8% females. Mean age of the study group was 54.39 years with most cases (18) from 31-50 years of age group. Most common diagnosis was COPD emphysema (22) followed by chronic bronchitis (12), bronchial asthma (10) and bronchiectasis (2). Among obstructive lung diseases, B. asthma had the highest mean DLCO percentage predicted of 102.20 ± 14.36 followed by COPD-Bronchitis (76.33±5.57), COPD–Emphysema (37.80±13.41) and bronchiectasis (62±4.48). Conclusion: DLCO can be helpful beyond spirometry in classification of obstructive lung diseases. DLCO values in COPD Emphysema variant are decreased, COPD bronchitis variant remains normal or slightly reduced and asthma either normal or increased. So, DLCO can help in differentiation or sub categorization of obstructive disease more than spirometry.

Keywords

DLCO, Obstructive diseases, Lung function test, COPD, Emphysema, Bronchial Asthma.

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Ajit Yadav ¹, Jai Kishan ², Sameer Singhal ³, Achchhar Singh ⁴, Aditi Gupta ⁵

Affiliations
1 Junior Resident,Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
2 Prof and Head, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
3 Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
4 Associate Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
5 Assistant Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN

Abstract

Aim: To study the prevalence of obstructive airway disease in patient of OSA diagnosed by polysomnography. Method: This study is a descriptive cross-sectional and was carried out in patients admitted in the department of Respiratory Medicine who were diagnosed with OSA after polysomnography. Total 41 patients who were diagnosed as cases of obstructive sleep apnea were clinically evaluated and investigated by history taking and final diagnosis were made as either COPD, Asthma on basis of GOLD and GINA guidelines respectively. Results: Mean age of the study participants was 50.95 years. Prevalence of Asthma and COPD among cases with OSA was 58.5% and 14.6%.Mean AHI and ESS score was 42.45 and 16.80 respectively. The most common co-morbid condition was GERD (19.5%). Conclusion: Present study concluded that asthma is more prevalent than COPD in patients of obstructive sleep apnea. The main factors associated with Obstructive lung diseases and its pathogenesis is the obesity, hypertension, smoking habits, adenoids, tonsillitis, musculoskeletal changes, weakness and atrophy of muscles of upper respiratory tract.

Keywords

Asthma, COPD, Obstructive Sleep Apnea, Polysomnography

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Abhishek Chauhan ¹, Jai Kishan ², Sameer Singhal ³, Achhar Singh ⁴, Aditi Gupta ⁵

Affiliations
1 Resident, Department of Respiratory Medicine, M.M. (Deemed to be) University, Mullana, Ambala, IN
2 Prof. and Head, Department of Respiratory Medicine, M.M. (Deemed to be) University, Mullana, Ambala, IN
3 Professor, Department of Respiratory Medicine, M.M. (Deemed to be) University, Mullana, Ambala, IN
4 Associate Professor, Department of Respiratory Medicine, M.M. (Deemed to be) University, Mullana, Ambala, IN
5 Assistant Professor, Department of Respiratory Medicine, M.M. (Deemed to be) University, Mullana, Ambala, IN

Abstract

Sputum examination is the most widely used test for diagnosis of TB. Under RNTCP two samples of sputum are required for examinations which are preferably 1st spot and early morning sample or two spot samples collected on the same day. Patients usually come from far off places at the tertiary care centre and frequent visits are usually not possible. Giving an early morning sample is usually defaulted by the patient due to various reasons. The present study was aimed at studying the delay in giving the early morning sample and barriers in accessing the sputum smear microscopy services at a tertiary care hospital. In this study 300 presumptive TB patients were studied. Patients were asked to give a 1st spot sample for sputum smear examination and asked to bring early morning sputum sample. Patients who refused to give early morning sample were asked to give 2nd spot sample and the reason for not coming early morning were noted. The patients who did not come despite agreeing to come were noted. If they came after a delay of few days, then also the reason of delay were noted. It was found that nearly one third (31%) of the patients agreed and came on the next day to give early morning sample. A large number of patients (16%) did not come at all to give the early morning sample.

Keywords

Pulmonary tuberculosis, presumptive TB patient, sputum microscopy, spot sample, early morning sample, RNTCP.

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Ajit Yadav ¹, Jai Kishan ², Sameer Singhal ³, Achchhar Singh ⁴, Aditi Gupta ⁴

Affiliations
1 Junior Resident, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
2 Prof. and Head, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
3 Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
4 Associate Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN

Abstract

Cough as symptom to diagnose achalasia cardia. Achalasia typically presents with dysphagia and regurgitation of undigested food. Diagnosis is usually performed with esophageal manometry, barium swallow before macroscopic anatomical changes appear. But sometime cough as a symptom can diagnose. We present a 45-year old women whose diagnosis was suspected with chest-x-ray showing enlargement of right mediastinum. Diagnosis was then confirmed with upper endoscopy and barium swallow.

Keywords

Cough, Dyspnoe Achalasia; Dysphagia; Barium swallow; Heller myotomy; Pneumatic dilatation.

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