Low-Nicotine Cigarettes Don’t Help Smokers Quit In The Long-Term
By Dr Deepu
HealthDay (7/25, Preidt) reported that a new study by researchers at the University of California San Francisco found that “low-nicotine cigarettes alone don’t help smokers quit over the long term.” The study “included 135 smokers who had no immediate plans to quit,” 80 of which were given “cigarettes with progressively lower levels of nicotine, eventually reaching just 5 percent of the level used in regular cigarettes,” while the rest continued to use their regular cigarettes. Researchers concluded that “while smokers who used low-nicotine cigarettes lowered their nicotine intake, they were unable to reduce their smoking in the long term.”
Sleep Apnea May Lead To Development, Attention Problems In Kids
By Dr Deepu
The New York Times (7/27) “Well” blog reports that “experts say that between 1 percent and 3 percent of children have sleep apnea that, if untreated, can disrupt far more than a family’s restful nights.” Children with the condition “simply do not get enough restorative sleep to assure normal development.” Sleep apnea, “if not corrected...can result in hyperactivity and attention problems in school that are often mistaken for attention deficit hyperactivity disorder.”
Patients With Advanced HIV May Not Benefit From Empiric Tuberculosis Treatment
By Dr Deepu
Medscape (7/28, Harrison) reports that a study suggests that “whether patients with advanced HIV receive empiric treatment for tuberculosis (TB), which they frequently die from, or isoniazid preventive therapy, there is no difference in mortality rates.” The findings were presented during the 8th International AIDS Society Conference.
COPD GUIDELINES
By Dr Deepu
An Official ATS/ERS Statement: Upper Limb Muscle Dysfunction in
COPD (2014)
COPD Guideline NICE COPD Guidelines 2010
Executive Summary: Prevention of Acute Exacerbations of COPD: American
College of Chest Physicians and Canadian Thoracic Society Guideline (April
2015)
Outcomes for
COPD pharmacological trials: from lung function to Biomarkers ATS / ERS Task Force 2008
Prevention of Acute Exacerbations of COPD: American
College of Chest Physicians and Canadian Thoracic Society Guideline (April
2015)
Standards
for the diagnosis and treatment of patients with COPD ATS / ERS Task Force
2004
Standards
for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS
position paper ATS / ERS Task Force 2004
ASTHMA GUIDELINES
By Dr Deepu
Asthma Guideline BTS
BTS/SIGN Asthma Guideline 2014 BTS/SIGN British Guideline on the Management
of Asthma, October 2014
Device Selection and Outcomes of Aerosol Therapy:
Evidence-Based Guidelines: American College of Chest Physicians/American
College of Asthma, Allergy, and Immunology (January 2005)
Diagnosis and Management of Work-Related Asthma: ACCP
Consensus Statement (September 2008)
Guidelines
for the management of work-related asthma ERS task Force Report 2012Eur
Respir J 2012; 39: 529-545
Monitoring
asthma in children ERS statement
2015 Eur Respir J 2015; 45: 906–925
CT Scans May Cause Cellular Damage.
By Dr Deepu
Fox News (7/23, Kwan) reports that research published in the Journal of the American College of Cardiology: Cardiovascular Imaging suggests that “computerized tomography (CT) scans may cause cellular damage.” Investigators “examined the blood of 67 patients undergoing cardiac CT angiograms (CTA), and measured biomarkers of DNA damage before and after undergoing the procedure.” The investigators “found an increase in DNA damage and cell death after a single CT scan, but most of the cells were repaired or eliminated.”
Medscape (7/23) reports that “in addition to DNA damage, the group also observed a significant increase in cellular apoptosis in 15 of 25 patients with measured levels oif apoptotic cell death before and after cardiac CT angiography.”
HealthDay (7/23, Preidt) points out that “in 2007, the U.S. National Cancer Institute predicted that 29,000 future cancer cases could be linked to the 72 million CT scans performed in the country that year alone.”
End-Stage Cancer Patients May Not Benefit From Chemotherapy.
By Dr Deepu
The New York Times (7/24, Belluck, Subscription Publication) reports that research published in JAMA Oncology suggests that patients with end-stage cancer “may not benefit from...chemotherapy — and that for many, their quality of life may worsen in their final weeks compared with patients who forgo last-ditch treatment.” Investigators “followed 312 adult patients with a prognosis of six months or less to live.”
On its website, CBS News (7/24, Welch) reports that the investigators found that “giving chemotherapy to end-stage cancer patients near death was associated with worse quality of life among those who could still perform many daily life functions.” The researchers “also found that chemotherapy had no effect on the quality of life on less-functional patients close to death.”
The Washington Post (7/24, Johnson) “Wonkblog” reports that “In an accompanyingeditorial, two physicians from the Oregon Health and Science University wrote that there are only two reasons to give a patient chemotherapy, which can be time-consuming, expensive, and have side effects: it should either extend their lives or make their lives better.”
TIME (7/24, Park) points out that some “groups like the” American Society of Clinical Oncology “recently advised” physicians “to be more judicious with their chemotherapy use in terminal patients.” Also covering the story are USA Today (7/24, Szabo), NPR (7/24, Harris), AFP(7/24), HealthDay (7/24, Preidt), and Medscape(7/24).
THESIS TOPICS AND SHORT TERM RESEARCH TOPICS
By Dr Deepu
A clinical study to compare the efficacy, safety and plasma
levels of two doses of theophylline in patients of bronchial asthma.
A clinical study to evaluate the safety and efficacy of
theophylline and its modulation by ascorbic acid in patients of bronchial
asthma.
A comparative evaluation of quality of life, dyspnoea, and
lung function abnormalities in asthma and COPD.
A Comparative Study Of Inhaled and Intravenous Magnesium
Sulphate As An Adjunct To Standard Treatment Protocol For Management Of Severe
Exacerbation Of Bronchial Asthma.
A comparative study of the efficacy and safety of
theophylline and doxofylline in patients of obstructive lung disease.
A prospective study comparing the outcome of chemical
Pleurodesis using TALC or Tetracycline in Patients with Pneumothorax.
A study of broncho-alveolar lavage cytology in patients of
rheumatoid arthritis.
A study of familial aggregation of cancer in the first
degree relatives of lung cancer patients.
A study of peak-expiratory flow rate in healthy school
children, 6-16 years of age.
A study of prevalence of hepatopulmonary syndrome in
patients with NCPF. ATT induced hepatitis: a study on prevalence and outcome
after re-introduction of drugs.
A study of prevalence of hepatopulmonary syndrome in
patients with cirrhosis.
A study of serum-fluid albumin gradient in evaluation of
pleural effusions.
A study of sleep-related breathing disorders in chronoc
obstructive pulmonary disease patients with or eithout cor-pulmonale.
A study of species spectrum of fungi causing systemic
mycoses in HIV patients in a New-Delhi Hospital and their antifungal
susceptibility pattern.
A study of the measurement of quality of life of lung cancer
patients.
A study of the smoking habits in patients of pulmonary
tuberculosis.
A study on Pulmonary function abnormalities in patients with
Carcinoma Breast following external radiation treatment.
A study to correlate the activity of ADAM33 gene protein
with oxidative stress in asthma.
A study to evaluate the occurrence of metabolic syndrome in
chronic obstructive pulmonary disease.
A Study to Monitor Adverse Drug Reactions in Patients of
Bronchial Asthma.
A study to monitor adverse drug reactions in patients of
chronic obstructive pulmonary disease.
Acute effects of tiotropium alone and in combination with
formoterol in patients with COPD: comparision of three regimens.
Adenosine metabolism in bronchial asthma: a study on
adenosine deaminase and 5'-nucleotidase activity and adenosine level in serum,
lymphocytes and erythrocytes.
Adverse symptoms reported by patients with HIV/TB
co-infection and taking both ATT and HAART
Airway obstruction, bronchial hyper-reactivity and
sensitivity to commonaeroallergen in allergic rhinitis.
Airway resistance in subjects exposed to environmental
tobacco smoke.
Airway response to acid application in oesophagus
(simulating gastro-esophageal reflux) in patients of bronchial asthma.
Airway response to fenoterol in hypothyroid patients before
and after treatment.
Airway response to provocation with methacholine aerosol in
different kinds of smokers.
Alveolar haemorrhage due to pulmonary renal syndrome. A case
series of 30 patients
Analysis of CT-chest of smokers with greater than 10 pack
years of smoking
Antimicrobial drug prescribing pattern in hospitalised
patients of community-acquired pneumonia: a retrospective study.
Arm span to height relationship for assessment of
spirometric functions.
Asbestos induced changes in some cellular and molecular
function in rat alveolar macrophages.
Assessment Airway response to broncho-constricting agents in
leprosy.
Assessment of airway responsiveness in asymptomatic
asthmatic women exposed to environmental smoke.
Assessment of health related quality of life and work
productivity in school going children with allergic rhinitis and/or asthma.
Assessment of lung function in health natives of Bhutan.
Assessment of nutritional status in COPD and asthma
Assessment of radiologically guided fine needle aspiration
cytology of mediastinal masses.
Assessment of severity of disease in patients with allergic
rhinitis when categorized as ‘sneezers and runners’ and ‘blockers’.
Asthma and Obesity – Comparing the pulmonary function of
obese and non- obese asthmatics
Biochemical Studies on Protein Kinase C In Peripheral Blood
Lymphocytes Of COPD Patients.
Blood carboxyhemoglobin levels in different types of
smoking.
Blood carboxyhemoglobin levels in different types of
smoking.
Breath carbon monoxide levels as a marker of clinical severity
and control of asthma.
Bronchial provocation with Parthenium hysterophorus pollen
extract in patients of bronchial asthma.
Bronchodilator mediated airway response in health.
Cardio Pulmonary Exercise testing in asymptomatic smokers
v/s Nonsmokers
Cardiorespiratory responses to exercise in patients with
mild to moderate bronchial asthma.
Case series of mediastinal masses.
Characterisation of lower respiratory tract inflammation and
its relationship with changes in pulmonary patho-physiology and thoracic imaging
in bronchial asthma.
Commonest side effects complained by the patients initiated
on HAART therapy
Comparative airway response to bronchodilators in patients
of leprosy with normoreactivity and hyporeactivity to methacholine.
Comparative study of high resolution CT versus bronchography
in the diagnosis of bronchiectasis.
Comparison of mometasone furoate and ciclesonide aqueous
nasal spray in adult and allergic rhinitis patients.
Compliance with asthma medications. The common cause of
non-adherence and predictor of compliance with recommended medications.
Correlation between morphological changes and impairment of
ventilatory function in patients suffering from bronchiectesis.
Correlation of fractional exhaled nitric oxide, nasal nitric
oxide with atopic status in bronchial asthma, allergic rhinitis.
Correlation of the partial pressure of arterial carbon
dioxide, End-Tidal carbon dioxide and transcutaneous carbon dioxide in patients
with respiratory diseases
Cough reflex threshold and diabetic autonomic neuropathy :
correlation with ECG parameters of vagal involvement.
Detection, identification and profiling of mycobacterial
isolates from patients of pulmonary and lymph node tuberculosis in Delhi.
Determination of maximal inspiratory and expiratory muscle
pressure at mouth in healthy Indian adults.
Determination of ventilatory minute volumes required to
maintain normocapnia in adult North Indian health subjects under anaesthesia.
Determination of ventilatory minute volumes, required to
maintain normocapnia under anaesthesia in adult North Indian subjects.
Diabetes in chronic liver disease
Diagnostic evaluation of cholesterol and various
lipoproteins in the pleural effusions.
Diagnostic Yield Of Induced Sputum And Various Bronchoscopic
Samples in Sputum Smear Negative Tuberculosis.
Diaphragmatic palsies – profile of 25 consecutive patients
Diurnal variations in pulmonary function tests in normal
healthy individuals.
Diurnal variations of peak expiratory flow and its
correlation with different morbidity indices in bronchial asthma.
Drug interactions between rifampicin and cotrimoxazole/
aspirin in patients on antituberculosis treatment.
Drug Resistance Profiling and Molecular Typing of
Mycobacterium tuberculosis Isolates from a DOTS center and a Private Hospital
in Delhi.
Echocardiographic evaluation of cardiac involvement in
sarcoidosis.
Echocardiographic evaluation of right and left ventricular
functions in corpulmonale with chronic obstructive pulmonary disease in acute
respiratory failure.
Effect of acetoxycoumarins and calcium channel blocking
dihydropyrimidone derivatives on protein kinase C activity of and lymphocytes
in COPD patients.
Effect of ciprofloxacin and ibuprofen on blood levels of
rifampicin in patients receiving antitubercular treatment.
Effect of domestic fuels on lung functions in females.
Effect of esophageal variceal sclerotherapy on lung
function.
Effect of glycemic control on outcome of acute exacerbation
of COPD.
Effect of ipratropium and salbutamol on heart rate variability
in chronic obstructive pulmonary disease.
Effect of irradiated lung volume on the pulmonary functions
following postoperative radiotherapy in carcinoma breast.
Effect of mechanical ventilation on surfactant levels in
patients with ARDS.
Effect of pulmonary rehabilitation on systemic inflammation,
muscle mass and functional status in post tuberculosis sequelae.
Effect of pulmonary rehabilitation on systemic inflammation,
oxidative stress and functional status in chronic obstructive and pulmonary
disease.
Effect of pulmonary rehabilitation on, systemic
inflammation, muscle mass and function status in interstitial lung diseases.
Empyema thoracis – Outcomes in a medical college hospital
Enalapril and bronchial responsiveness.
Endobronchial tuberculosis – presentation, diagnosis,
management and complications in 30 consecutive patients
Endobronchial ultrasound vs Positron Emission tomography in
the evaluation of malignant mediastinal masses
Epidemiological study and genetic diversity of PB1-F2 gene
in influenza and A virus isolates from Delhi and Kolkata. Factors associated
with poor asthma control and poor adherence to asthma treatment: self report by
patients in emergency room.
Erythrocyte (RBC) antioxidant enzyme levels in patients with
primary lung cancer.
Estimation of nitrate production by alveolar macrophages in
bronchogenic carcinoma.
Evaluation of predictors of duration of mechanical
ventilation.
Evaluation of pulmonary changes in patients of psoriasis on
methotrexate therapy.
Evaluation of systemic inflammatory markers,
oxidant-antioxidant status and sputum cytology in stages of chronic obstructive
pulmonary and diseases.
Evaluation of the effect of inhaled ciclesonide on the
allergic and inflammatory markers in and bronchial asthma.
Evaluation of vitamin D in asthma: its effect on
inflammatory markers and impact on management.
Factors affecting attainment of control in asthma.
Factors associated with primary drug resistance in
tuberculosis
Factors influencing survival time of Bronchogenic Carcinoma
in a tertiary Care Centre
Foreign bodies in airways – Profile of 30 consecutive
patients, interventions and outcomes
Gender differences in perception of dyspnoea, quality of
life and pattern of lung function abnormalities in asthma.
Hematological abnormalities in patients with sarcoidosis.
Hepatoxicity with INH and Rifampicin.
HRCT in heavy smokers with normal chest X-ray.
Hypothalmo-pituitary-adrenocortical axis in inhaled
corticosteroid users, not an oral corticosteroid: a longitudinal study.
Immunohistological studies in tubercular lymphadenitis.
Immunoregulatory effects mediated by CD4+ and gamma/delta
T-cells in pulmonary tuberculosis.
Incidence of laryngeal involvement in sputum positive
pulmonary TB
Incidence of TB among rheumatoid arthritis patients on
TNF-alpha antagonists
Incidence of tuberculosis during corticosteroid therapy.
Indications and Outcomes of Non invasive Ventilation in a
tertiary care hospital
Indices of morbidity and control of asthma in non smoking
women exposed to combustion of biomass fuels.
Influence of environmental tobacco smoke exposure on acute
exacerbations in known asthmatics.
Influence of environmental tobacco smoke exposure on
different morbidity indices in adult asthmatic women.
Inspiratory muscle training in chronic obstructive pulmonary
disease.
International guidelines for pneumococcal vaccination and
the Indian scenario. Pneumococcal vaccination status of COPD patients
presenting to a medical college hospital. Possible strategies to improve the
vaccination coverage.
Lung abscess – presentation, predisposing factors, organisms
isolated and management in 50 consecutive patients
Lung functions with relation to the fuels (biomass, LPG,
kerosene and mixed) used in the houses of children in the age group of 7-15
years.
Lung volumes in healthy non smoking adults belonging to
ethnic Punjabi population by CT volumetry
Measurement of bronchial hyperreactivity in patients with
idiopathic pulmonary fibrosis.
Mediastinal pathologies – 50 consecutive cases in a tertiary
care hospital
Narrow band Imaging guided bronchial biopsy vs white light
bronchoscopy guided bronchial biopsy
Nebulized salbutamol for acute hyperkalemia in renal failure
patients.
Neutrophil count and myeloperoxidase activity in smokers.
Neutrophil superoxide (free radical) levels and total
neutrophil count in peripheral blood of smokers (asymptomatic and symptomatic
with chronic obstructive pulmonary disease) of cigarette, bidi, hookah and
mixed product. Vitamin A, beta-carotene and vitamin C in patients of lung
cancer.
Nifedipine in bronchial asthma.
Non-invasive evaluation of cardiac abnormalities in
rheumatoid arthritis.
Obstructive sleep apnoea, oxidative stress and liver
function.
Obstructive sleep apnoea, oxidative stress and renal
function.
Occurrence of nasobronchial hypersensitivity in patients
having contact dermatitis to Parthenium hysterophorus.
Occurrence of upper airway symptoms and their impact on
quality of life (QoL) in patients with COPD.
Oxygen free radicals: their role in mycobacterial killing
and the mechanism of action.
Pattern of respiratory diseases and associated
co-morbidities in patients attending Vallabhbhai Patel Chest Institute.
Percentage of HIV seropositivity in smear positive
tuberculosis patients in a medical college hospital in western india
Phenotypic and molecular characterisation of clinical
isolates of Acinetobacter spp.
Phenotypic and molecular characterisation of clinical
isolates of Candida species with special reference to Candida dubliniensis.
Post bronchodilator reversibility in COPD and its
correlation with the stage of COPD as per GOLD guidelines and BODE score
Post op pulmonary complications in patient undergoing liver
transplant surgery
Prediction of blood carboxy-haemoglobin from expired air
carbon monoxide samples in "bidi" and cigarette smokers.
Prediction of pulmonary function for lung resection.
Predictors Of Emergency Department Use In Asthmatics.
Predictors of Oxygen derived - free radicals in non smoker
women exposed to environmental tobacco smoke.
Pre-op spirometry and post op pulmonary complications in
patients undergoing elective upper abdominal surgeries.
Presence of pulsus paradoxus in a population of severe COPD
as assessed by pulse oximetry.
Prevalence of components of Metabolic Syndrome in pregnant
women with obstructive sleep apnoea / hypopnoea Syndrome.
Prevalence of obstructive sleep apnea in patients admitted
for bariatric surgery
Production of anti-oxidant enzymes by pulmonary alveolar
macrophages in patients with lung cancer.
Production of oxygen derived free radicals by peripheral
blood polymorphonuclear leukocytes in different stages of Asthma in adults.
Production of oxygen free radicals by pulmonary alveolar
macrophages in patients with lung cancer.
Production of reactive nitrogen intermediates and L-cirtrulline
by peripheral blood polymorphonuclear leukocytes in bronchial asthma.
Profile of 50 consequent interstitial lung disease patient
attending tertiary care center.
Profile of hospital acquired pneumonia over a one year
period in a tertiary care hospital. The predisposing factors, organisms
isolated, antibiotics used and outcomes.
Profile of method and criteria used for weaning from
mechanical ventilation in Respiratory Critical Care Unit.
Pulmonary function changes after large volume paracentesis
in patients with cirrhosis of liver and ascites.
Pulmonary function in patients of idiopathic ulcerative
colitis.
Pulmonary function tests before and after transhiatal
oesophagectomy for carcinoma oesophagus.
Pulmonary hypertension in patients diagnosed with severe
obstructive sleep apnea.
Pulmonary insufficiency after skeletal trauma.
Quantification of cells recovered by bronchoalveolar lavage
in pulmonary tuberculosis.
Radiologic evaluation of total lung capacity.
Rapid molecular typing and Th1-Th2 cytokine profiling in
patients suffering from tubercular lymphadenopathy.
Reference values for Maximum Voluntary Ventilation for the
Indian adults.
Relative contribution of the parasympathetic and sympathetic
mechanisms in airway obstruction in bronchial asthma.
Respiratory complications in 50 HIV seropositive patients
followed over a period of one year
Respiratory symptoms among the farmers.
Retrospective study of road traffic accidents in patients
diagnosed with severe obstructive sleep apnea
Reversibility of FEV1 and FEV in COPD post bronchodilation
and its correlation with COPD stages.
Role of atopy in the etiology of non-smoker chronic
bronchitis.
Role of bronchoscopy in smear negative pulmonary tuberculosis.
Role of cardiopulmonary exercise testing (C-PET) in pre op
evaluation
Role of domestic fuels on the course of bronchial asthma in
nonsmoking women.
Role of epithelium in the airway responses to hyperosmotic
solutions in normal and sensitised guinea pigs
Role of HRCT in management of pulmonary infections in renal
transplant recipients.
Role of NIV in severe type 2 respiratory failure. Predictors
of success and failure with NIV use.
Role of Omalizumab in the management of asthma. Outcomes in
20 patients who were administered omalizumab
Role of some inflammatory markers in obstructive sleep
apnoea: effects of grape seed extract.
Role of TLR expression in innate activity during virus
infection in acute asthma.
Sensitisation with selected fungi in patients of asthma and
chronic obstructive pulmonary disease and its correlation with skin prick
testing and clinical presentation.
Sensitivity and specificity of tuberculin skin test for the
diagnosis of pulmonary tuberculosis in patients seeking treatment for
respiratory problems.
Serodiagnosis of tuberculosis in adults using ELISAS test
with antigen - 5.
Significance of the reactive nitrogen intermediates in the
pathophysiology of human pulmonary tuberculosis.
Skin hypersensitivity and precipitating antibodies against
Aspergillus fumigatus in patients of bronchial asthma.
Socio-demographic profile and B.M.I. characteristic of
patients with pulmonary tuberculosis attending chest clinic.
Socioeconomic class and compliance with asthma medications
Spectrum and outcome of acute lung injury in Respiratory
Critical Care Unit.
Spectrum of changes in computed tomography in chest in
pulmonary tuberculosis.
Spirometry in athletes versus normal individuals of same
height
Status of reactive oxygen species and antioxidant defense
system in alveolar macrophages of lung cancer patients.
Status of reactive oxygen species and anti-oxidant defense
system in alveolar macrophages and peripheral blood neutrophils of lung cancer
patients.
Studies on the role of lipids of lipid raft of erythrocyte membrane
in COPD patients.
Studies on T-Lymphocytes in tubercular pleural effusion.
Study of carcinoembryonic antigen and sialic acid levels
(total and lipid bound) in patients with lung cancer.
Study of cardiac autonomic dysfunction.
Study of cellular composition of bronchoalveolar lavage
fluid in patients with pulmonary tuberculosis using flow-cytometry.
Study of effects of 6 months' therapy with methotrexate on
pulmonary functions in patients of rheumatoid arthritis.
Study of non-specific airway responsiveness in patients of
rheumatoid arthritis.
Study of relationship of endobronchial and transbronchial
lung lesions in patients with clinical diagnosis of sarcoidosis.
Study of respiratory tract involvement in leprosy.
Study of sinonasal involvement in patients of interstitial
lung diseases.
Study of the occurrence and mechanisms of programmes cell
death (apoptosis) in peripheral blood mononuclear cells of pulmonary
tuberculosis patients.
Success rate of nicotine patch is a hospital based smoking
cessation program
Surfactant protein-A and nitric oxide derivatives in lung
lavage obtained from patients with idiopathic pulmonary fibrosis.
Suspicious nodules in asymptomatic smokers with greater than
30 pack years of smoking by low dose CT screening
The clinical, Radiological and function profile in diffuse
Parenchymal Lung Disease.
The effect of socioeconomic upbringing on the lung function
The impact of smoking on treatment outcome in patients of
bronchial asthma.
The incidence of cavities in 5000 chest x rays taken in a
medical college hospital. (Mass miniature radiography was used to detect TB
earlier)
The incidence of HIV in patients admitted for elective
surgery.
The occurrence of rhinosinusitis in patients with bronchial
asthma and/or allergic rhinitis.
The usefulness of bronchoscopic brush specimen versus biopsy
in the diagnosis of carcinoma of lung
The usefulness of Heliox in acute severe asthma
Thyroid function in smokers.
To compare the inflammatory mediator profiles, pulmonary
function tests and skin and reactivity in obese and non-obese bronchial asthma
patients.
To determine the occurrence and effect of nasal polyps in
patients with bronchial asthma and / or allergic rhinitis.
To test the reliability of a Hindi questionnaire designed
and validated for diagnosis of asthma for prevalence studies.
Transbronchial lung biopsy in sarcoidosis and relationship
of histological changes with pulmonary function tests.
Tuberculin sensitivity in patients with pulmonary
sarcoidosis.
Tuberculin sensitivity in patients with sarcoidosis.
Predicting outcome in respiratory intensive care: comparative evaluation of
three severity scoring systems.
Use of inhaled steroids and Inhaler technique among
asthmatics admitted with acute exacerbation.
Validity of new study questionnaire in Hindi for diagnosis
of asthma for epidemiological studies.
Visual analogue scales in assessing severity of bronchial
asthma.
Recent 2015 IPF Guidelines Update Adds New Agents.
By Dr Deepu
I have written this post giving an overview of the latest IPF guidlines.The update to the 2011 guidelines appeared in the July 15 issue of the American Journal of Respiratory and Critical Care Medicine. At the end I have provided download links for the article and supplements.
Pirfenidone and Nintedanib were recommended for use in idiopathic pulmonary fibrosis (IPF) with a moderate level of confidence, in a guideline update from ATS/ERS/JRS/ALAT
It also mentions that the methods used by guideline panels to appraise the evidence are different than those used by regulatory agencies like FDA when they review applications seeking market approval for the use of pharmacologic agents for treatment of IPF.
The guidline doesnot provide recommendations for one treatment regimen over another. The guideline does not provide suggestions for or against combination regimens or sequential therapies.
The updated guidline has given strong recommendation against using prednisone with azathioprine and N-acetylcysteine,The update also included strong recommendations against use of warfarin or other anticoagulants due to signals for harm in randomized trials in both cases. Both previously had been suggested as not appropriate for most patients but perhaps reasonable for some.
Imatinib and ambrisentan, not previously addressed in the guidelines, got strong recommendations against use in IPF patients. Sildenafil is included in the guidelines, and got a conditional recommendation against use.
The guidelines also updates on the dual endothelin receptor antagonists macitentan and bosentan , it has changed from a strong to a conditional recommendation against use.
The Lung transplantation which was not addressed in 2011 was also included but formulation of recommendation for single vs bilateral lung transplantation was deffered.
There is no change in the recommendation for anatacid therapy and N acetyl cysteine monotherapy which remains as conditional recommendation for use and conditional recommendation against use respectively.
Adverse effects were common with nintedanib therapy, particularly diarrhea, although serious adverse events were not increased and relatively few patients discontinued the drug due to adverse effects.
Pooled results from the pirfenidone trials showed more risk of photosensitivity, fatigue, stomach discomfort, and anorexia with the drug.
I have Provide the links to Download article from ATS.. Happy reading :)
1.http://www.atsjournals.org/doi/suppl/10.1164/rccm.201506-1063ST/suppl_file/executive_summary.pdf
2.http://www.atsjournals.org/doi/suppl/10.1164/rccm.201506-1063ST/suppl_file/raghu_data_supplement.pdf
3.http://www.atsjournals.org/doi/suppl/10.1164/rccm.201506-1063ST/suppl_file/raghu_data_supplement+2.pdf
I have written this post giving an overview of the latest IPF guidlines.The update to the 2011 guidelines appeared in the July 15 issue of the American Journal of Respiratory and Critical Care Medicine. At the end I have provided download links for the article and supplements.
Pirfenidone and Nintedanib were recommended for use in idiopathic pulmonary fibrosis (IPF) with a moderate level of confidence, in a guideline update from ATS/ERS/JRS/ALAT
It also mentions that the methods used by guideline panels to appraise the evidence are different than those used by regulatory agencies like FDA when they review applications seeking market approval for the use of pharmacologic agents for treatment of IPF.
 |
| Image Shows Comparison of 2015 and 2011 guidelines. Image published in AJRCCM |
The guidline doesnot provide recommendations for one treatment regimen over another. The guideline does not provide suggestions for or against combination regimens or sequential therapies.
The updated guidline has given strong recommendation against using prednisone with azathioprine and N-acetylcysteine,The update also included strong recommendations against use of warfarin or other anticoagulants due to signals for harm in randomized trials in both cases. Both previously had been suggested as not appropriate for most patients but perhaps reasonable for some.
Imatinib and ambrisentan, not previously addressed in the guidelines, got strong recommendations against use in IPF patients. Sildenafil is included in the guidelines, and got a conditional recommendation against use.
The guidelines also updates on the dual endothelin receptor antagonists macitentan and bosentan , it has changed from a strong to a conditional recommendation against use.
The Lung transplantation which was not addressed in 2011 was also included but formulation of recommendation for single vs bilateral lung transplantation was deffered.
There is no change in the recommendation for anatacid therapy and N acetyl cysteine monotherapy which remains as conditional recommendation for use and conditional recommendation against use respectively.
Adverse effects were common with nintedanib therapy, particularly diarrhea, although serious adverse events were not increased and relatively few patients discontinued the drug due to adverse effects.
Pooled results from the pirfenidone trials showed more risk of photosensitivity, fatigue, stomach discomfort, and anorexia with the drug.
I have Provide the links to Download article from ATS.. Happy reading :)
1.http://www.atsjournals.org/doi/suppl/10.1164/rccm.201506-1063ST/suppl_file/executive_summary.pdf
2.http://www.atsjournals.org/doi/suppl/10.1164/rccm.201506-1063ST/suppl_file/raghu_data_supplement.pdf
3.http://www.atsjournals.org/doi/suppl/10.1164/rccm.201506-1063ST/suppl_file/raghu_data_supplement+2.pdf
Two Medications May Be Effective Against XDR-TB, New Research Reveals
By Dr Deepu
MedPage Today (7/16, Smith) reports that researchers found that “a drug being studied as a treatment for extensively drug-resistant tuberculosis (XDR-TB) had durable efficacy in a small trial.” One “year after the end of treatment with linezolid (Zyvox), combined with a background regimen, 27 of 38 patients had negative results on sputum culture, according to Clifton Barry III, PhD, of the National Institute of Allergy and Infectious Disease in Bethesda, Md., and colleagues.” Meanwhile, “in another brief report, investigators said post-hoc analysis of three trials of the investigational drug delamanid – a mycobacterial cell wall synthesis inhibitor – suggests it, too, is effective against XDR-TB.” The findings were published in the New England Journal of Medicine.
Here are the link to the published article.
MELTING ICE(CUBE) SIGN
By Dr Deepu
The melting ice(cube) sign describes the resolution of. pulmonary haemorrhage following pulmonary embolism.
When there is pulmonary haemorrhage without infarction following PE, the typical wedge-shaped, pleural-based opacification (Hamptons Hump) resolves within a week while preserving its typical shape. It is named due to its resemblance with a melting ice cube.
1. Webb WR, Higgins CB. Thoracic Imaging: Pulmonary and Cardiovascular Radiology, North American Edition. Lippincott Williams & Wilkins. (2010) ISBN:1605479764.
Suggested Reading
1. Chest X Ray Part 1- Normal Anatomy And ItsVariants
The melting ice(cube) sign describes the resolution of. pulmonary haemorrhage following pulmonary embolism.
When there is pulmonary haemorrhage without infarction following PE, the typical wedge-shaped, pleural-based opacification (Hamptons Hump) resolves within a week while preserving its typical shape. It is named due to its resemblance with a melting ice cube.
1. Webb WR, Higgins CB. Thoracic Imaging: Pulmonary and Cardiovascular Radiology, North American Edition. Lippincott Williams & Wilkins. (2010) ISBN:1605479764.
Suggested Reading
1. Chest X Ray Part 1- Normal Anatomy And ItsVariants
FDA Issues New Warning About Risk Of Heart Attack, Stroke With NSAID Use
By Dr Deepu
The CBS Evening News (7/10, story 6, 1:35, Pelley) reported in continuing coverage on the FDA’s new “warning about common pain relievers.” According to the broadcast, “the FDA says everyone may be at risk, but the biggest concerns are for people with an underlying heart condition.”
The Washington Post (7/11, Cha) reported that the warning updates will apply to “nonsteroidal anti-inflammatory drugs (NSAIDs), a group of medications used for temporary relief of pain and inflammation,” and that include ibuprofen and naproxen. The article added that “consumers should be careful not to take more than one product that contains an NSAID at a time” and to watch for symptoms such as “chest pain, breathing trouble, sudden weakness in one part or side of the body or slurred speech.”
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