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   Table of Contents - Current issue
Coverpage
July-December 2018
Volume 6 | Issue 2
Page Nos. 45-87

Online since Tuesday, July 10, 2018

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ORIGINAL ARTICLES  

Assessment of Sleep and Quality of Life Among Chronic Obstructive Airways Disease Patients p. 45
Mahima Malhotra, Ruchi Sachdeva, Sandeep Sachdeva
DOI:10.4103/jacp.jacp_20_17  
Objective: To assess sleep and quality of life among chronic obstructive airway disease patients. Materials and Methods: Patients with primary, mild-to-moderate, stable chronic obstructive airways disease [asthma and chronic obstructive pulmonary disease (COPD)] on treatment visiting outpatient department of a government hospital were interviewed using a predesigned, pretested, semi-structure schedule. The patients were then administered standardized Pittsburgh sleep quality index (PSQI), St. George’s respiratory questionnaire (SGRQ), and Epworth sleepiness scale (ESS) questionnaires. Patients with any other known chronic disease, chest deformity, or long-term oxygen therapy were excluded. Using purposive sampling frame, 120 chest patients (asthma and COPD) and in addition, 30 ambulatory patients without having any underlying chronic respiratory diseases were also recruited for comparison purpose. Results: Mean age was 50.2 years. Mean duration of sleep during night was 5.40 h [±1.6; 95% confidence interval (CI) = 4.98–5.82] for patients with COPD; 5.53 h (±1.6; 95% CI = 5.11–5.95) for patients with asthma, and 6.97 h (±1.0; 95% CI = 6.57–7.36) for control patients (P < 0.001). It was noticed that 63.3% of control patients had at least 6 h of night sleep in comparison to 23.3% of chest patients (P < 0.01). Good PSQI score (up to 5 points) was found in 86.6% of control patients while it was found only in 35.0% of chest patients (P < 0.01); mean PSQI score among asthma was 8.08, 8.06 (COPD), and 3.46 among control patients, respectively. All the control patients (100%) reported good score for quality of life while chest patients reported good score for SGRQ (activity, impact, and symptoms) as 64.1, 83.3, and 82.5%, respectively (P < 0.01). Based on ESS, none of the patients complained of daytime sleepiness. To conclude, poor sleep was noticed in our study sample.
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Clinical, Radiological, and Histopathological Profile of Patients with Endobronchial Lesions on Fiber-Optic Bronchoscopy p. 53
Sandeep Rana, Brig Debajyoti Bhattacharyya, CDS Katoch, Kislay Kishore, Anand Arora
DOI:10.4103/jacp.jacp_27_17  
Background: Fiberoptic bronchoscopy is very important tool for evaluating the profile of endobronchial lesion. Endobronchial profile provides important clue regarding likely pathology which is of immense help for clinician and pathologist to reach definitive diagnosis. Aim and Objectives: To study the clinical, radiological, and histopathological profile of endobronchial lesions detected during bronchoscopy. Materials and Methods: A cross-sectional prospective observational study was conducted at a tertiary respiratory center. Demographic, clinical, and radiological profile was prepared for all patients above 18 years of age, and relevant blood and radiological investigations were conducted. Patients detected to have endobronchial lesion during fiberoptic bronchoscopy were selected for the study. Bronchoalveolar lavage, bronchial biopsy, and bronchial brushing were done and sent for examination. Patients were observed postprocedure for any complication. Results: Male patients were more in number (70%) with most of patients above 40 years of age (80%). Most common symptom was cough (48%) with smoking history present in 48% patients. Mass lesion was most common radiological presentation (52%). Right lung was most commonly involved (52%), and upper lobe involvement was most common (50%). Exophytic growth was most common endobronchial lesion (46%) with carcinoma lung most common diagnosis (74%). Hemoptysis was most common complication (80%), which resolved on its own, followed by postprocedure hypoxemia (8%). Conclusion: Clinical, radiological, and bronchoscopic profile of endobronchial lesion is an important information which helps clinician and pathologist to reach final diagnosis. Carcinoma lung is most common diagnosis made in our study as most common endobronchial lesions at age of our patients are malignant as reported in literature.
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CASE REPORTS Top

Cannonballs in the Lung—A Rare Presentation p. 61
Jijin Satheesh, Deepak R Vangipuram, K. Madhavan
DOI:10.4103/jacp.jacp_33_17  
Pulmonary tuberculosis is one of the most prevalent and rampant communicable infectious diseases in the Southeast Asian region. Often the disease has an unusual presentation that diverts our attention toward other diseases. We describe such a case, wherein a 54-year-old male, chronic smoker and a known patient of chronic obstructive airway disease presented with fever, weight loss, and radiographic evidence showing well-circumscribed lesions resembling cannonballs. This was suggestive of secondaries in the lung, which on further diagnosis was determined to be disseminated tuberculosis. The patient was treated with antituberculous medication, following which his symptoms resolved, as evidenced by a radiological examination of his primary disease.
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A Case of Pulmonary Sarcoidosis Misdiagnosed as Tuberculosis p. 65
Srijna Rana, Rajwinder Kaur, Nirmal C Kajal, Nishanth PS
DOI:10.4103/jacp.jacp_32_17  
Sarcoidosis is a chronic inflammatory multisystem disease, most commonly involving the lungs, that usually affects middle-aged adults. Due to its clinicoradiological resemblance with tuberculosis (TB), in countries such as India, sarcoidosis is often misdiagnosed and mistreated as TB. We report a case of 62-year-old female with sarcoidosis, which was misdiagnosed as TB.
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Silent Sinistrous Asymptomatic Anterior Mediastinal Mass Diagnosed With EBUS-TBNA p. 68
Deepak Prajapat, Rahul Kumar Sharma, Deepak Talwar
DOI:10.4103/jacp.jacp_13_17  
The most common cause of asymptomatic anterior mediastinal mass in young patient is thymoma. We present an unusual case of asymptomatic anterior mediastinal mass in a young male who was incidentally discovered to have aggressive precursor T-cell adult lymphoblastic lymphoma (T-ALL). Routine bronchoscopy and transthoracic needle aspiration were noncontributory, and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) provided the adequate amount of tissue for histopathology and immunohistochemistry, thus establishing the diagnosis of T-ALL. Our case highlights T-cell lymphoma as a cause of silent anterior mediastinal mass and the potential role of EBUS-TBNA as safe and relatively less invasive modality to obtain tissue for pathological diagnosis and saved the patient from potential thoracotomy/mediastinoscopy.
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Absent Unilateral Pulmonary Artery: A Report of Two Cases p. 72
Govind S Rajawat, Manoj Meena, Manohar L Gupta, Piyush Arora
DOI:10.4103/jacp.jacp_23_17  
Unilateral absent pulmonary artery is an uncommon condition and may be associated with other congenital cardiac defect. Patients without associated cardiac abnormality usually present in adulthood with symptoms of dyspnea, hemoptysis, etc. We encountered two adults with absent right pulmonary artery who presented with hemoptysis and on investigations found to have absent right pulmonary artery. Considering the rarity of this entity, we found it worthy of reporting.
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A Rare Case of a Tracheal Bronchus Highly accessed article p. 76
Ravi A Dosi, Arpit Jain, Prakash Joshi, Satish Motiwale, Ashwin Songara
DOI:10.4103/jacp.jacp_28_17  
Here, we report a case of the right tracheal bronchus that presented with a right upper and middle lobe consolidation and a mild pleural effusion. Bronchoscopy revealed a right upper lobe bronchus arising from trachea. On a high suspicion of pulmonary Koch’s, antitubercular drug was started to which she responded well and was cured.
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Diffuse Alveolar Hemorrhage: A Very Rare but Catastrophic Complication After Percutaneous Transluminal Coronary Angioplasty p. 80
Ravi A Dosi, Siddhant Jain, Arpit Jain, Satish Motiwale, Prakash Joshi, Arun Chandelkar
DOI:10.4103/jacp.jacp_1_18  
In this write-up, we report a case of persistent hemoptysis after percutaneous transluminal coronary angioplasty (PTCA), which was diagnosed as diffuse alveolar hemorrhage (DAH). DAH is a life-threatening medical emergency that can be caused by numerous disorders and it, further, presents with hemoptysis, anemia, and diffuse alveolar infiltrates. Early diagnosis is usually required for this noninfectious cause in post PTCA patient, as it is very rare complication.
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LETTER TO THE EDITOR Top

Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) with Interstitial Lung Disease—An Unusual Association p. 84
Arjun Khanna, Ankit K Sinha, Kamal K Pandey
DOI:10.4103/jacp.jacp_36_17  
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CHEST IMAGE Top

Middle Lobe Syndrome p. 86
Amit Panjwani, Thuraya Zaid
DOI:10.4103/jacp.jacp_3_18  
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