Day 2 :
- Lung cancer
Lady Hardinge medical college, India
Director Professor and Head Mycology&Deptt. of Microbiology Lady Hardinge medical college.Director Professor and Head of Mycology Division in the Deptt. of Microbiology at Maulana azad medical college for the last 2 decades
Respiratory infections remain a major cause of mortality and morbidity in HIV (Human Immunodeficiency Virus) infected persons. Hence, the main objective was to study the occurrence of Pneumocystis pneumonia (PCP) among HIV infected persons with respiratory problems.
Induced sputum samples were collected from 70 consecutive HIV positive patients with respiratory symptoms like cough, breathlessness, fever and so forth. Patients of all age group and both sexes recruited from the outpatient department, wards and Anti-retroviral treatment clinic (ART clinic) of Lok Nayak Hospital and GB Pant Hospital, New Delhi. Homogenized sputum samples were subjected to direct microscopic examination and direct immunofluorescence staining for Pneumocystis jirovecii by using Merifluor Pneumocystis antigen detection kit (Meridian Bioscience, Inc., Ohio).
Out of 70 patients, 14 patients (20.0%) were diagnosed positive for PCP. The mean age of the patients was 34.29±7.64 years with a range of 20–47 years. Males were predominant with a male to female ratio of 3.7:1. Among these PCP positive cases, CD4 cell count ranged from 16-324 cells/μl with mean CD4 cell count 138.5±105.48 cells/μl and median was 120±105.48, lower than the PCP negative patients. Pulmonary tuberculosis was seen in 8/14 (57.1%) cases. Cough 14 (100%), weight loss 11 (78.6%), oral ulcers 9 (64.3%), dyspnea 8 (57.1%) and fever 7 (50%) were the most common clinical symptoms. Pulmonary infiltrates 6/14 (42.9%) and Pneumothorax 3/14 (21.4%) was the most common chest X-ray findings.
- Respiratory Diseases
Dr Ahmed Sayeed is an internist graduated from Manipal University.He is also the member of Royal College of Physicians of United Kingdom.He has 12 years of experience working in the field of internal medicine.He is currently working as the specialist in the Department of Pulmonology in King Abdullah Medical City, Makkah which is quaternary JCI accredited Referral hospital.He has a special interest in research and medical education.He has published five articles in peer-reviewed journals.
A 35-year-old gentleman, a known asthmatic and with the history of smoking presented with the history of recurrent episodes of mild hemoptysis. On examination, there was an impaired note on the right infraclavicular area with decreased intensity of breath sounds. The Chest X-Ray and CT chest showed a mass in right upper lobe with nodules in the left upper lobe and right lower lobe. The video-assisted thoracoscopy revealed large heavily vascularized mass with surface laden with multiple nodules. The wedge resection of the nodules with lymph node dissection was taken and sent for histopathology examination. The biopsy result showed multiple lymphoid follicles with well-developed germinal centres localised to peribronchiolar interstitium suggestive of connective tissue disease associated follicular bronchiolitis. The patient did not have any signs or symptoms of connective tissue disease. However all the autoimmune work was sent, and he was positive for Rheumatoid factor, ANA, anti-RO, anti-CCP antibodies. The final diagnosis of connective tissue associated follicular bronchiolitis was made based on histopathology and autoimmune work up and started on steroids initially, and azathioprine was added later on. After 12 months of treatment, the size of the mass and nodules reduced by 50 % and ESR was reduced to 5 from 75.He is being followed up in the clinic.
Fathia Nabilla is one of the medical students in Medical Faculty of Universitas Indonesia. Currently she is in the process of internship at dr. Cipto Mangunkusumo Hospital as a co assistant to complete the study. This research was done to complete the first degree of her education in Universitas Indonesia.
Indonesia is the fourth country with highest tuberculosis cases among other countries all over the world. This problem become more serious because of strong relationship between tuberculosis and diabetes mellitus. The focus of this study is to look for the factor which can make the relationship happen. The main factor focused in this research was nutritional status using body mass index calculation. This qualitative research used analytical descriptive cross-sectional design. Among 236 tuberculosis patients, it was found that male was dominant, age of 21-44 was leading, and normal nutritional status was dominant. Result of this research showed that 65 (27,5%) of 236 tuberculosis patients were also diagnosed as a diabetes mellitus patients. After the data was analyzed using SPSS 20th version, the result showed a significant proportion difference in the prevalence of diabetes mellitus among tuberculosis patients with normal nutritional status and lower nutritional status as compared to other categories of nutritional status. This result might be caused of course of the disease. The researcher suggests the next research about this problem to be explored deeper and also the screening of patients either the patient’s diagnosed as a tuberculosis or diabetes mellitus patient should be done because of strong relationship between these diseases.
Mansoura university principal, Saudi Arabia
Ahmed Mohammed Abumossalam, lecturer of pulmonary and critical care medicine, faculty of medicine, Mansoura university principal manager of cardiopulmonary echography unit and interventional pulmonology unit.
Background: Pulmonary air-space containing cavities signify major dissuade that hold gas exchange functions back and bring about recurrent suppuration.
Purpose: The aim of this work is to evaluate the impact of percutaneous local inoculation of focal benign cavitary lung lesions with synthetic material (gelfoam) guided with chest computed tomography (CT) on the patient outcome based on clinical, laboratory, functional and radiological parameters.
Patients and methods: A prospective simple randomized controlled trial was conducted on twenty eight patients with focal benign cavitary lung lesion less than 10 cm in diameter in whom surgical resection was contraindicated or refused. They were subdivided into two groups: group I (medically treated): 14 patients were followed up for three months with medical prophylaxis with quinolone plus clindamycin and group II (gelfoam inoculated): 14 patients percutaneous locally injected with gelfoam under CT guidance for a single session.
Results: Gelfoam inoculated group (group II) presented more prevalence over medically treated group (group I) in the reduction of the frequency of infective exacerbations (71.42%), absence of leukocytosis (85.7%), functional improvement (42.85%), reduction of cavity size (57.14%) and cavitary obliteration (35.71%). Both groups were matched regarding the absence of hemoptysis and negative sputum cultures with high percentage (92.85%). However, reduction of the frequency of hospitalization predominated in group I. Significant statistical differences were present in radiological parameters only (reduction of size (0.042) and cavity obliteration (0.002). Success rate of procedure in the studied group was (35.71%).
Conclusion: Percutaneous gelfoam injection may share in staged palliation and weeding out of pulmonary cavitary lesions with simple noninvasive image guided procedure.