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   Table of Contents - Current issue
Coverpage
July-December 2017
Volume 5 | Issue 2
Page Nos. 65-90

Online since Tuesday, July 4, 2017

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EDITORIAL  

The shorter regimen for MDR TB: Myth or reality p. 65
Kaushik Saha
DOI:10.4103/jacp.jacp_16_17  
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REVIEW ARTICLES Top

Family perspectives in the care and support of tuberculosis patients: An Indian context p. 67
Janmejaya Samal
DOI:10.4103/2320-8775.202899  
Tuberculosis (TB) has been a major public health crisis throughout the globe, so also in India. Around one-fourth of TB cases are found in India. Currently, the Government of India implements TB control program through a centrally sponsored program known as the Revised National Tuberculosis Control Program (RNTCP). The program is being implemented at community level through Directly Observed Treatment Short-course (DOTS) strategy and is provided though DOTS providers. Despite all these efforts in the country, failures, relapses, and treatment defaulters are common throughout the nation. Families play a greater role in TB control, as the treatment duration of TB is protracted compared to other clinical conditions. Furthermore, TB patients require a great degree of support in terms of care, nutritional and livelihood support. Sometimes, long-term treatment and more pills on a daily or intermittent basis make the patient uncomfortable to continue with the treatment, and the patient discontinues the therapy in the middle of the course. Thus, to increase treatment adherence, a great degree of family support is necessary. In this study, the role of families in TB care has been narrated, in which both the positive and negative aspects of families have been delineated in an Indian perspective.
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Use of corticosteroids in tuberculosis Highly accessed article p. 70
Saurabh K Singh, Kamlesh K Tiwari
DOI:10.4103/jacp.jacp_40_16  
Tuberculosis (TB) is considered as a lethal disease in the present era. Effective antituberculous therapy is available, which has reduced significantly the morbidity and mortality due to TB. Literature advocates the use of corticosteroids in TB. Use of corticosteroids in conjunction with antituberculous therapy showed a reduction in mortality and morbidity in pericardial and central nervous system TB. Signs and symptoms in pleural and severe pulmonary TB improve rapidly with the addition of corticosteroids. Corticosteroid should be used cautiously with antituberculous therapy in view of drug interaction seen between them.
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ORIGINAL ARTICLE Top

Chest X-ray of lung cancer: Association with pathological subtypes p. 76
Arnab Saha, Kaushik Saha, Santanu Ghosh, Mrinmoy Mitra, Prabodh Panchadhyayee, Aditya P Sarkar
DOI:10.4103/jacp.jacp_38_16  
Background: Chest radiography is an essential initial investigation for the suspected cases of bronchogenic carcinoma and can be a predictor of malignancy. Aims: To assess the radiographic presentation and distribution of the different pathological cell types of lung cancer in our hospital. Materials and Methods: A total of 125 consecutive suspected patients with lung cancer, who had initial chest X-ray lesions suspicious of malignancy (mass lesion, nodules, pleural effusion, evidence of bronchial obstruction such as collapse, unresolved consolidation, etc.), were selected as the study population. The contrast-enhanced computed tomography (CT) scan of the thorax, CT-guided fine-needle aspiration cytology, fiberoptic bronchoscopy and Tru-cut biopsy were performed in the patients as feasible to find out the pathological cell type of bronchogenic carcinoma. Then, the chest X-rays were clinically correlated in all the lung cancer cases. In addition, the relationship of chest X-ray with the pathological cell types was assessed in the cases of lung cancer. The data were presented and analysed by the standard statistical method. Results: In our study, squamous cell carcinoma was the predominant cell type (47.12%) followed by adenocarcinoma (29.81%). Squamous cell carcinoma and small cell carcinoma commonly presented as central lesions, whereas adenocarcinoma and large cell carcinoma manifested most frequently as peripheral lesions. The common radiographic presentation of squamous cell carcinoma was collapse (38.78%) followed by unresolved consolidations (28.57%) and masses, whereas adenocarcinoma mostly presented as nodules (38.71%) followed by pleural effusion (29.03%). Small cell carcinoma, large cell carcinoma and undifferentiated carcinoma mostly manifested as mass lesion on chest radiography. Conclusion: Chest roentgenography can provide a clue about the pathological cell types of bronchogenic carcinoma, especially in the cases of hilar or parahilar lesions, collapse, non-resolving consolidations and effusions.
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CASE REPORTS Top

Unusual complication of intercostal chest drainage insertion: Retained surgical blade in liver p. 81
Anshuman Darbari, Devender Singh, Subramanian Paulvannan
DOI:10.4103/2320-8775.202900  
Intercostal chest tube drainage or tube thoracostomy procedure is widely used by the medical, surgical and critical care specialists. Despite being relatively a minor procedure, devastating complications can occur owing to inadequate knowledge of thoracic anatomy, improper training and lack of experience. Iatrogenic or technical complications are however rare, but can often be life-threatening. Here, we are reporting a case of an accidentally retained surgical blade in the right lobe of liver during chest tube insertion for the management of post-traumatic right pneumothorax. To the best of our knowledge, this is the first ever case report of a retained surgical blade in the liver as a complication of tube thoracostomy procedure, which was later successfully removed using laparoscopy.
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Pneumothorax in a case of community-acquired pneumonia due to Acinetobacter p. 83
Babaji Ghewade, Elen Ann Abrahm, Swapnil Chaudhari, Bharat Agrawal
DOI:10.4103/2320-8775.177510  
Acinetobacter baumannii is an uncommon but important cause of severe community-acquired pneumonia (CAP), especially in tropical/subtropical regions and in patients with underlying lung disease. Here, we present a case of acute fulminant CAP in a young female patient with underlying cystic lung disease which presented with secondary spontaneous pneumothorax. The patient went into acute respiratory failure and recovered completely with treatment.
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LETTER TO THE EDITOR Top

Chikungunya and the pulmonologist – What we must know p. 87
Arjun Khanna, Ankit Kumar Sinha, Kamal Kishore Pandey
DOI:10.4103/jacp.jacp_43_16  
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CHEST IMAGE Top

Klebsiella pneumoniae liver abscess with metastatic spread to lung p. 89
Mansoor C Abdulla
DOI:10.4103/2320-8775.202901  
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