Introduction: The majority of lung cancers are caused by tobacco use, which is linked to lung tum... more Introduction: The majority of lung cancers are caused by tobacco use, which is linked to lung tumors of all major histological types. A considerable fraction of lung cancer cases, the vast majority of which are adenocarcinomas, occur in "never smokers," who are characterized as having smoked fewer than 100 cigarettes in their lives. The primary objective was to assess risk factors for lung cancer in non-smokers. In contrast, secondary objectives included evaluating histological subtype, staging, and performance status and exploring associations between risk factors and common driver mutations. Material and methods: The study was a single-center, observational, case-control study done at All India Institute of Medical Science, Bhubaneswar, India that focused on non-smokers with lung cancer. It included 145 cases and 297 controls, with statistical analyses such as chi-square tests and logistic regression used to assess associations between risk factors and lung cancer, considering factors such as socioeconomic status, body mass index (BMI), occupation, outdoor and indoor air pollution, personal habits, and medical history. Results: The study, comprising 145 lung cancer cases in non-smokers and 297 controls, found that 92.4% (134/145) of cases had adenocarcinoma, 6.9% (10/145) had squamous cell carcinoma, and 0.7% (1/145) had small cell carcinoma. Significant associations were observed for high-risk occupations, indoor biomass use without proper ventilation, low BMI, and family history of lung cancer. Specific pre-existing lung conditions like old pulmonary tuberculosis and asthma were linked to increased and decreased odds of developing lung cancer, respectively. Environmental factors, living near heavy industry, and dietary habits showed significant associations. A significant association was not found between the driver mutations and the risk factors studied. Conclusion: This single-center study sheds light on significant risk factors influencing lung cancer development among non-smokers. The predominant occurrence of adenocarcinoma and associations with high-risk occupations, indoor biomass exposure, low BMI, and family history emphasize the multifaceted nature of non-smoking-related lung cancer. The findings underscore the importance of comprehensive risk assessment and targeted preventive strategies in this population.
International journal of innovative research in medical science, May 21, 2021
Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mort... more Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in India. The development of pulmonary hypertension (PH) in COPD adversely affects survival and exercise capacity and is associated with an increased risk of severe acute exacerbation. Aims and Objectives: Present study aimed to describe the distribution of echocardiographically assessed pulmonary artery systolic pressure in the COPD patients attending pulmonary medicine OPD, to estimate the proportion of PH among such patients and to identify associated factors. Methodology: This Cross sectional study was done on 145 patients of COPD fulfilling the inclusion criteria were included in this study. These patients were evaluated for the presence of PH using chest X-ray, 2D-Echocrdiography and electrocardiogram. Results: Pulmonary hypertension was present in 17 (29.8%) patients with moderate, 36 (60%) with severe and 18 (72%) with very severe COPD. Mild PH was seen in 52(73%), moderate in 11(15.4%) and severe in 8(11.2%) patients. Patient exposed to both smoking and biomass fuel smoke had more frequent occurrence of PH (56.8%) as compared to exposure to single risk factor of either tobacco smoke (47.1%) or biomass fuel (52.4%). Thus overall proportion of PH among reported cases of COPD patients was 48.6% in our study. Conclusion: With the increase in severity of COPD the proportion of PH rises. This study emphasizes the early detection of COPD and the importance of screening for PH through clinical assessment and non-invasive techniques 2-D Echocardiography.
International journal of innovative research in medical science, Mar 16, 2021
Introduction: Diagnosis of sputum negative pulmonary tuberculosis can be challenging and time con... more Introduction: Diagnosis of sputum negative pulmonary tuberculosis can be challenging and time consuming, with many patients being put on empirical anti-tuberculosis treatment. Bronchoscopy helps in early diagnosis in such patients. Aims and Objectives: To assess the diagnostic utility of bronchial washing CBNAAT for Mycobacterium Tuberculosis in sputum smear negative and sputum CBNAAT negative patients of suspected pulmonary tuberculosis. Methodology: This case series was conducted on 71 patients in the Department of Pulmonary Medicine, Goa Medical College from May 2018-February 2020. Patients with suspected pulmonary tuberculosis on chest radiograph and/or CT thorax, but with sputum smear as well as CBNAAT for Mycobacterium Tuberculosis negative were subjected to flexible video bronchoscopy. Bronchial washings were collected from the affected lobes and the specimen were subjected to fluorescent microscopy, CBNAAT, MGIT, bacterial and fungal culture. Results: The diagnosis of tuberculosis was established in 23 (32.4%) patients in bronchial washings specimen by CBNAAT. These patients were followed up after 6 months of anti-tuberculosis treatment and have shown significant clinical and radiological improvement. Conclusion: Bronchoscopy is a useful tool in diagnosis of pulmonary tuberculosis in sputum negative patients. It also play an important role in diagnosis of other infectious /malignant disorder which can mimic tuberculosis.
Pulmonary alveolar proteinosis is an uncommon lung disease characterized by the accumulation of s... more Pulmonary alveolar proteinosis is an uncommon lung disease characterized by the accumulation of surfactant in the lungs. Treatment is done by whole lung lavage. One-lung ventilation in diseased lungs is a challenge to anesthesiologists due to the rapid desaturation and hemodynamic fluctuations encountered during the procedure. A 24-year-old female, a known patient of pulmonary alveolar proteinosis, who had undergone previous lung lavage presented with a dry cough and shortness of breath. Our management of the case included complete lung isolation with a double-lumen tube (DLT), one-lung ventilation, and an appropriate hemodynamic management strategy during the procedure.
Indian Journal of Physiotherapy and Occupational Therapy—An International Journal, 2020
Introduction: Exercise has several benefits in general population in reducing risk of cardiovascu... more Introduction: Exercise has several benefits in general population in reducing risk of cardiovascular mortality. Aerobic, resistance and combined exercise are several forms of exercises suggested in CKD to improve quality of life. Circuit training and interval training are two important forms of high intensity aerobic resistance training. There is a limited data that compares these two forms of exercise and their benefits in CKD. Hence this study was designed to find and compare the effectiveness of circuit training and interval training in improving exercise capacity amongst CKD. Materials and Method: This was an intervention study. Patients aged between 36-71 years with CKD stage 2-5, who were hemodynamically stable, who could perform activities and not having associated co morbid conditions were included. Those with chronic heart failure and co morbid conditions were excluded. 82 patients were recruited, with 41 in each of circuit training and interval training group. The interven...
International Journal of Innovative Research in Medical Science, Mar 16, 2021
Introduction: Diagnosis of sputum negative pulmonary tuberculosis can be challenging and time con... more Introduction: Diagnosis of sputum negative pulmonary tuberculosis can be challenging and time consuming, with many patients being put on empirical anti-tuberculosis treatment. Bronchoscopy helps in early diagnosis in such patients. Aims and Objectives: To assess the diagnostic utility of bronchial washing CBNAAT for Mycobacterium Tuberculosis in sputum smear negative and sputum CBNAAT negative patients of suspected pulmonary tuberculosis. Methodology: This case series was conducted on 71 patients in the Department of Pulmonary Medicine, Goa Medical College from May 2018-February 2020. Patients with suspected pulmonary tuberculosis on chest radiograph and/or CT thorax, but with sputum smear as well as CBNAAT for Mycobacterium Tuberculosis negative were subjected to flexible video bronchoscopy. Bronchial washings were collected from the affected lobes and the specimen were subjected to fluorescent microscopy, CBNAAT, MGIT, bacterial and fungal culture. Results: The diagnosis of tuberculosis was established in 23 (32.4%) patients in bronchial washings specimen by CBNAAT. These patients were followed up after 6 months of anti-tuberculosis treatment and have shown significant clinical and radiological improvement. Conclusion: Bronchoscopy is a useful tool in diagnosis of pulmonary tuberculosis in sputum negative patients. It also play an important role in diagnosis of other infectious /malignant disorder which can mimic tuberculosis.
International Journal of Innovative Research in Medical Science
Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mort... more Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in India. The development of pulmonary hypertension (PH) in COPD adversely affects survival and exercise capacity and is associated with an increased risk of severe acute exacerbation. Aims and Objectives: Present study aimed to describe the distribution of echocardiographically assessed pulmonary artery systolic pressure in the COPD patients attending pulmonary medicine OPD, to estimate the proportion of PH among such patients and to identify associated factors. Methodology: This Cross sectional study was done on 145 patients of COPD fulfilling the inclusion criteria were included in this study. These patients were evaluated for the presence of PH using chest X-ray, 2D-Echocrdiography and electrocardiogram. Results: Pulmonary hypertension was present in 17 (29.8%) patients with moderate, 36 (60%) with severe and 18 (72%) with very severe COPD. Mild PH was seen in 52(73%), moderate...
Introduction: The majority of lung cancers are caused by tobacco use, which is linked to lung tum... more Introduction: The majority of lung cancers are caused by tobacco use, which is linked to lung tumors of all major histological types. A considerable fraction of lung cancer cases, the vast majority of which are adenocarcinomas, occur in "never smokers," who are characterized as having smoked fewer than 100 cigarettes in their lives. The primary objective was to assess risk factors for lung cancer in non-smokers. In contrast, secondary objectives included evaluating histological subtype, staging, and performance status and exploring associations between risk factors and common driver mutations. Material and methods: The study was a single-center, observational, case-control study done at All India Institute of Medical Science, Bhubaneswar, India that focused on non-smokers with lung cancer. It included 145 cases and 297 controls, with statistical analyses such as chi-square tests and logistic regression used to assess associations between risk factors and lung cancer, considering factors such as socioeconomic status, body mass index (BMI), occupation, outdoor and indoor air pollution, personal habits, and medical history. Results: The study, comprising 145 lung cancer cases in non-smokers and 297 controls, found that 92.4% (134/145) of cases had adenocarcinoma, 6.9% (10/145) had squamous cell carcinoma, and 0.7% (1/145) had small cell carcinoma. Significant associations were observed for high-risk occupations, indoor biomass use without proper ventilation, low BMI, and family history of lung cancer. Specific pre-existing lung conditions like old pulmonary tuberculosis and asthma were linked to increased and decreased odds of developing lung cancer, respectively. Environmental factors, living near heavy industry, and dietary habits showed significant associations. A significant association was not found between the driver mutations and the risk factors studied. Conclusion: This single-center study sheds light on significant risk factors influencing lung cancer development among non-smokers. The predominant occurrence of adenocarcinoma and associations with high-risk occupations, indoor biomass exposure, low BMI, and family history emphasize the multifaceted nature of non-smoking-related lung cancer. The findings underscore the importance of comprehensive risk assessment and targeted preventive strategies in this population.
International journal of innovative research in medical science, May 21, 2021
Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mort... more Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in India. The development of pulmonary hypertension (PH) in COPD adversely affects survival and exercise capacity and is associated with an increased risk of severe acute exacerbation. Aims and Objectives: Present study aimed to describe the distribution of echocardiographically assessed pulmonary artery systolic pressure in the COPD patients attending pulmonary medicine OPD, to estimate the proportion of PH among such patients and to identify associated factors. Methodology: This Cross sectional study was done on 145 patients of COPD fulfilling the inclusion criteria were included in this study. These patients were evaluated for the presence of PH using chest X-ray, 2D-Echocrdiography and electrocardiogram. Results: Pulmonary hypertension was present in 17 (29.8%) patients with moderate, 36 (60%) with severe and 18 (72%) with very severe COPD. Mild PH was seen in 52(73%), moderate in 11(15.4%) and severe in 8(11.2%) patients. Patient exposed to both smoking and biomass fuel smoke had more frequent occurrence of PH (56.8%) as compared to exposure to single risk factor of either tobacco smoke (47.1%) or biomass fuel (52.4%). Thus overall proportion of PH among reported cases of COPD patients was 48.6% in our study. Conclusion: With the increase in severity of COPD the proportion of PH rises. This study emphasizes the early detection of COPD and the importance of screening for PH through clinical assessment and non-invasive techniques 2-D Echocardiography.
International journal of innovative research in medical science, Mar 16, 2021
Introduction: Diagnosis of sputum negative pulmonary tuberculosis can be challenging and time con... more Introduction: Diagnosis of sputum negative pulmonary tuberculosis can be challenging and time consuming, with many patients being put on empirical anti-tuberculosis treatment. Bronchoscopy helps in early diagnosis in such patients. Aims and Objectives: To assess the diagnostic utility of bronchial washing CBNAAT for Mycobacterium Tuberculosis in sputum smear negative and sputum CBNAAT negative patients of suspected pulmonary tuberculosis. Methodology: This case series was conducted on 71 patients in the Department of Pulmonary Medicine, Goa Medical College from May 2018-February 2020. Patients with suspected pulmonary tuberculosis on chest radiograph and/or CT thorax, but with sputum smear as well as CBNAAT for Mycobacterium Tuberculosis negative were subjected to flexible video bronchoscopy. Bronchial washings were collected from the affected lobes and the specimen were subjected to fluorescent microscopy, CBNAAT, MGIT, bacterial and fungal culture. Results: The diagnosis of tuberculosis was established in 23 (32.4%) patients in bronchial washings specimen by CBNAAT. These patients were followed up after 6 months of anti-tuberculosis treatment and have shown significant clinical and radiological improvement. Conclusion: Bronchoscopy is a useful tool in diagnosis of pulmonary tuberculosis in sputum negative patients. It also play an important role in diagnosis of other infectious /malignant disorder which can mimic tuberculosis.
Pulmonary alveolar proteinosis is an uncommon lung disease characterized by the accumulation of s... more Pulmonary alveolar proteinosis is an uncommon lung disease characterized by the accumulation of surfactant in the lungs. Treatment is done by whole lung lavage. One-lung ventilation in diseased lungs is a challenge to anesthesiologists due to the rapid desaturation and hemodynamic fluctuations encountered during the procedure. A 24-year-old female, a known patient of pulmonary alveolar proteinosis, who had undergone previous lung lavage presented with a dry cough and shortness of breath. Our management of the case included complete lung isolation with a double-lumen tube (DLT), one-lung ventilation, and an appropriate hemodynamic management strategy during the procedure.
Indian Journal of Physiotherapy and Occupational Therapy—An International Journal, 2020
Introduction: Exercise has several benefits in general population in reducing risk of cardiovascu... more Introduction: Exercise has several benefits in general population in reducing risk of cardiovascular mortality. Aerobic, resistance and combined exercise are several forms of exercises suggested in CKD to improve quality of life. Circuit training and interval training are two important forms of high intensity aerobic resistance training. There is a limited data that compares these two forms of exercise and their benefits in CKD. Hence this study was designed to find and compare the effectiveness of circuit training and interval training in improving exercise capacity amongst CKD. Materials and Method: This was an intervention study. Patients aged between 36-71 years with CKD stage 2-5, who were hemodynamically stable, who could perform activities and not having associated co morbid conditions were included. Those with chronic heart failure and co morbid conditions were excluded. 82 patients were recruited, with 41 in each of circuit training and interval training group. The interven...
International Journal of Innovative Research in Medical Science, Mar 16, 2021
Introduction: Diagnosis of sputum negative pulmonary tuberculosis can be challenging and time con... more Introduction: Diagnosis of sputum negative pulmonary tuberculosis can be challenging and time consuming, with many patients being put on empirical anti-tuberculosis treatment. Bronchoscopy helps in early diagnosis in such patients. Aims and Objectives: To assess the diagnostic utility of bronchial washing CBNAAT for Mycobacterium Tuberculosis in sputum smear negative and sputum CBNAAT negative patients of suspected pulmonary tuberculosis. Methodology: This case series was conducted on 71 patients in the Department of Pulmonary Medicine, Goa Medical College from May 2018-February 2020. Patients with suspected pulmonary tuberculosis on chest radiograph and/or CT thorax, but with sputum smear as well as CBNAAT for Mycobacterium Tuberculosis negative were subjected to flexible video bronchoscopy. Bronchial washings were collected from the affected lobes and the specimen were subjected to fluorescent microscopy, CBNAAT, MGIT, bacterial and fungal culture. Results: The diagnosis of tuberculosis was established in 23 (32.4%) patients in bronchial washings specimen by CBNAAT. These patients were followed up after 6 months of anti-tuberculosis treatment and have shown significant clinical and radiological improvement. Conclusion: Bronchoscopy is a useful tool in diagnosis of pulmonary tuberculosis in sputum negative patients. It also play an important role in diagnosis of other infectious /malignant disorder which can mimic tuberculosis.
International Journal of Innovative Research in Medical Science
Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mort... more Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in India. The development of pulmonary hypertension (PH) in COPD adversely affects survival and exercise capacity and is associated with an increased risk of severe acute exacerbation. Aims and Objectives: Present study aimed to describe the distribution of echocardiographically assessed pulmonary artery systolic pressure in the COPD patients attending pulmonary medicine OPD, to estimate the proportion of PH among such patients and to identify associated factors. Methodology: This Cross sectional study was done on 145 patients of COPD fulfilling the inclusion criteria were included in this study. These patients were evaluated for the presence of PH using chest X-ray, 2D-Echocrdiography and electrocardiogram. Results: Pulmonary hypertension was present in 17 (29.8%) patients with moderate, 36 (60%) with severe and 18 (72%) with very severe COPD. Mild PH was seen in 52(73%), moderate...
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