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Papers by Gajanan Gaude

International Journal of Medicine and Public Health, Sep 1, 2016

Introduction: Bronchial asthma is a chronic airway disease that affects a significant children po... more Introduction: Bronchial asthma is a chronic airway disease that affects a significant children population with limitation of their activities and school absenteeism. The objective of the present study was to assess the knowledge and attitude of the parents towards the disease in their children. Materials and Methods: A hospital based cross-sectional study was conducted in Pulmonary Medicine department in a tertiary care hospital with diagnosed asthmatic children and their parents were enrolled. Two questionnaire one comprising clinical aspects including etiology and other regarding knowledge and attitude among parents regarding asthma were administered. Results: A total of 150 children with confirmed diagnosis of asthma were included in this study. On an average, each child had already visited 3 doctors prior to coming to us. Out of 150 patients, 77% parents were ignorant regarding disease etiology, 41% parents thought that their disease is fatal, 54% parents were reluctant to accept the diagnosis of asthma. Regarding precipitating factors, 46% parents attributed the disease exacerbations due to multiple causes. Almost half of the parents had sought alternative for of medicine for management of disease with nearly one-third opting for homeopathic treatment. Oral medications were preferred by 79% patients, while inhalers were used by only 21% of children. The compliance rate in using inhalation therapy in children was very low. Conclusion: Asthma awareness among parents of asthmatic children is inadequate. Controller medications and aerosol therapy is underused and unnecessarily blamed. Awareness raising strategies are needed in community. Patient education program should augment awareness; eliminate social stigma, and misconcepts in the community regarding bronchial asthma.

The Indian journal of chest diseases & allied sciences, Nov 17, 2022

Isolated pleural effusion is a rare presentation of ovarian hyperstimulation syndrome following o... more Isolated pleural effusion is a rare presentation of ovarian hyperstimulation syndrome following ovulation induction therapy. We hereby report the case of a 24-year-old female who presented with unilateral moderate pleural effusion following ovulation induction therapy. Therapeutic thoracentesis was performed to relieve the breathlessness in this case.

Journal of Evolution of medical and Dental Sciences, 2014

BACKGROUND: Gastro-esophageal reflux disease (GERD) is a chronic disorder of the upper gastrointe... more BACKGROUND: Gastro-esophageal reflux disease (GERD) is a chronic disorder of the upper gastrointestinal tract with global distribution. GERD often coexists with asthma, COPD and is often responsible for their exacerbations. In India, we do not have any clinical data on GERD either in bronchial asthma or COPD. OBJECTIVE: To investigate the prevalence of GERD in adult patients with asthma, COPD and to determine its correlates. MATERIALS AND METHODS: A total of 40 subjects each in bronchial asthma and COPD groups underwent assessment with the frequency scale for the symptoms of GERD (FSSG) Questionnaire for GERD. A score of 8 and above was taken as positive for GERD. The confirmation of GERD was done by Gastroesophageal endoscopy to all GERD positive cases. Grading of GERD was done with endoscopy report according to Los Angeles grading. FSSG score was evaluated in detail and the risk factors were analyzed. RESULTS: The prevalence of GERD in bronchial asthma patients was 40%, while in C...

Journal of the Scientific Society, 2020

Background: Acute exacerbations of COPD (AECOPD) are known to be associated with increased morbid... more Background: Acute exacerbations of COPD (AECOPD) are known to be associated with increased morbidity and mortality and have a significant socioeconomic impact. The factors that determine frequent hospital readmissions for AECOPD are poorly understood. The aim of this study was to ascertain the factors responsible for the repeated admissions for AECOPD. Methodology: We conducted a prospective study of 235 patients with COPD with one or more admissions for acute exacerbations in a tertiary care hospital. Frequency of previous readmissions for AECOPD in the past year, and clinical characteristics, including spirometry were ascertained in the stable state both before discharge and at 6-month post discharge. All the patients were followed up for a period of two years after discharge to evaluate the readmissions for the acute exacerbations. Results: Among 149 COPD patients who were admitted and assessed for AECOPD, there were 278 readmissions for AECOPD over a follow-up period of 24 mont...

Background: In late March 2009, an outbreak of respiratory illness, later proved to be caused by ... more Background: In late March 2009, an outbreak of respiratory illness, later proved to be caused by swine origin influenza A (H1N1) virus (S-OIV) was identified in Mexico. Thereafter many countries worldwide have reported the incidence of this pneumonia. The present study was undertaken to evaluate the clinical characteristics and radiological features of positive cases of confirmed Influenza A H1N1 (2009) infection in a tertiary care hospital in northern part of Karnataka. Material and Methods: A retrospective analysis of medical charts, laboratory investigations and radiographs of 57 positive cases of Influenza A H1N1 (2009) infection was done. Throat swab of all these patients were confirmed by real time RT- PCR assay (reverse transcriptase polymerase chain reaction method). Results: A total of 57 cases were infected with influenza A H1N1 (2009) virus. They belonged to 20 to 40 years of age, with the mean age being 35. Acute onset cough, fever and breathlessness were the most common...

The Indian journal of chest diseases & allied sciences, 2016

Isolated pleural effusion is a rare presentation of ovarian hyperstimulation syndrome following o... more Isolated pleural effusion is a rare presentation of ovarian hyperstimulation syndrome following ovulation induction therapy. We hereby report the case of a 24-year-old female who presented with unilateral moderate pleural effusion following ovulation induction therapy. Therapeutic thoracentesis was performed to relieve the breathlessness in this case.

Indian Journal of Health Sciences and Biomedical Research (KLEU), 2019

BACKGROUND AND OBJECTIVES: Bronchial asthma is one of the most common chronic diseases. In India,... more BACKGROUND AND OBJECTIVES: Bronchial asthma is one of the most common chronic diseases. In India, bronchial asthma has 66% frequency of reported exacerbations. Vitamin D has action on pro-inflammatory mediators and smooth muscle function and proliferation, which has a direct relevance for lung function in asthma. This study was done to investigate the prevalence of Vitamin D deficiency in patients presenting with asthma exacerbations and to assess the correlation between decreased levels and various indicators of severity of exacerbations. MATERIALS AND METHODS: A total of 118 participants of whom 93 patients had acute exacerbations of bronchial asthma were included in this study. Vitamin D levels were analyzed among different subgroups based on asthma control, severity, and severity of exacerbations. Vitamin D levels were correlated to forced expiratory volume in 1 s (FEV1)% predicted, body mass index (BMI), steroid use, and number of exacerbations in the previous 1 year. RESULTS: ...

Background: Gastro-esophageal reflux disease (GERD) is a chronic disorder of the upper gastrointe... more Background: Gastro-esophageal reflux disease (GERD) is a chronic disorder of the upper gastrointestinal tract with global distribution. GERD often coexists with asthma and is often responsible for the repeated exacerbations. In India, there is limited data on the exact prevalence of GERD in bronchial asthma. Objective: To investigate the prevalence of GERD in adult patients with bronchial asthma. Materials and Methods: A total of 60 patients with confirmed diagnosis of bronchial asthma underwent assessment for GERD with the frequency scale for the symptoms of GERD (FSSG) Questionnaire. A score of 8 and above was taken as positive for GERD. Then confirmation of GERD was done by Gastro-esophageal endoscopy in all GERD positive cases. Grading of GERD was done with endoscopy report according to Los Angeles grading. FSSG score was evaluated in detail and the risk factors were analyzed. Results: The prevalence of GERD in bronchial asthma patients was 40%. It was observed that by using FSS...

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH

Bronchial asthma is one of the most common chronic respiratory disease worldwide, and is characte... more Bronchial asthma is one of the most common chronic respiratory disease worldwide, and is characterised by different phenotypic variations. Acute exacerbations in bronchial asthma are common and leads to repeated hospitalisations leading to increase in direct costs of asthma and thus preventing exacerbations should be an important consideration. Vitamin D has an immunomodulatory action and its deficiency has been associated with asthma epidemics. We hereby critically review the clinical benefits of vitamin D in the control of bronchial asthma and in exacerbations.

Journal of Clinical Sciences

Tuberculosis (TB), due to Mycobacterium tuberculosis(MTB), remains a major public health issue. I... more Tuberculosis (TB), due to Mycobacterium tuberculosis(MTB), remains a major public health issue. It causes ill health for approximately 10 million people each year and is one of the top ten causes of death worldwide. For the past 5 years, it has been the leading cause of death from a single infectious agent, ranking above HIV/AIDS. Effective diagnosis of pulmonary TB requires the availability – on a global scale – of standardized, easy-to-use, and robust diagnostic tool that would allow the direct detection of both the MTB complex and the resistance to key drugs, such as rifampicin. The latter result can serve as a marker for multidrug-resistant (MDR) MTB and has been reported in >95% of the MDR-TB isolates. Here, we review some of the recent molecular methods in the diagnosis of TB.

Indian Journal of Health Sciences and Biomedical Research (KLEU)

Background: Sleep Disordered Breathing has become one of the primary causes of mortality in espec... more Background: Sleep Disordered Breathing has become one of the primary causes of mortality in especially obese individuals owing to the modern lifestyle Material and methods: 60 patients coming to outpatient clinic of a tertiary care hospital with Epworth sleepiness scale between 8 to 24 representing increasing levels Results: There were 60 (34 males and 26 females) subjects with mean age 56.45±12.51years and BMI 28.7±3.1. 16, 9, 22 subjects had mild, moderate Conclusions: OSA predominantly affects middle aged men who are overweight with many having high neck circumference. Severe OSA patients had longer.

Indian Journal of Physical Therapy and Research

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2018

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH

Lung India

Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common and ... more Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common and often fatal; however, accurate prognosis of patients hospitalized with an exacerbation is difficult. The Dyspnea, Eosinopenia, Consolidation, Acidemia, and Atrial Fibrillation (DECAF) score uses indices routinely available at the time of hospital admission and can accurately predict the inhospital mortality and outcomes in patients hospitalized with AECOPD. Methodology: A cross-sectional study was conducted in Jawaharlal Nehru Medical College, Belagavi, from January 2016 to June 2018. Consecutive patients hospitalized with an exacerbation of chronic obstructive pulmonary disease were included. DECAF indices and inhospital death rates were recorded. The prognostic value of DECAF was assessed by comparing the total score with the inhospital mortality. Statistical analysis was done using SPSS version 20. Results: Two hundred and twenty-eight patients were recruited. The mean (standard deviation) age was 61.09 ± 10.6 years; 73.68% were male and 48 patients (21.05%) died in hospital. One hundred and twelve patients were identified as low risk (DECAF: 0–1) with 6 (5.4%) patients dying in the hospital and 56 patients were identified as high risk (DECAF: 3–6) with an inhospital mortality of 60.1%. Length of stay for scores of 0–1, 2, and ≥3 was 6.42, 7.47, and 9.64 days, respectively, with P < 0.05. The receiver operating characteristic curve analysis showed P < 0.001, thereby proving that the DECAF is a significant predictor of mortality in AECOPD. Conclusion: This study proved that with an increase in the DECAF score, the mortality among patients in AECOPD increased. The DECAF score helps clinicians predict prognosis accurately by identifying low-risk patients potentially suitable for home-based care or early hospital discharge and high-risk patients requiring escalated palliation with high-level care to improve their outcome.

International Journal of Advances in Medicine

Background: Tuberculosis is the most common cause of exudative lymphocytic pleural effusion in In... more Background: Tuberculosis is the most common cause of exudative lymphocytic pleural effusion in India. Residual pleural thickening (RPT) is observed in about 50 percent of patients even after proper treatment with ATT. Pleural fluid drainage either with simple aspiration or with intercostal drainage and addition of corticosteroids along with antitubercular drugs have not shown to influence the incidence of RPT. The present study was undertaken to study the complications and residual effects of tubercular pleural effusion on the patients during the follow up period following intrapleural streptokinase instillation.Methods: Clinical profile, hospital course and outcome of tuberculous pleural effusion patients at the end of six months of anti-tubercular treatment of 50 patients from January 2009 to June 2010 were analyzed. These patients were randomly divided into two groups. One group (n=25) received intrapleural streptokinase via pigtail catheter and the other group (n=25) received in...

Asian Journal of Oncology

A chylothorax results when the lymphatic duct becomes disrupted. It is an uncommon and poorly des... more A chylothorax results when the lymphatic duct becomes disrupted. It is an uncommon and poorly described complication of both Hodgkin’s and non-Hodgkin’s lymphomas of any histological type and grade. A 62-year-old female presented with dyspnea on exertion and dry cough for 15 days. Chest radiograph showed left-sided effusion. Pleural fluid reports were suggestive of chylothorax. Fluid was drained and CT thorax was performed which revealed multiple supra- and infradiaphragmatic lymphadenopathy. Left supraclavicular lymph node biopsy revealed chronic inflammation. Immunohistochemistry of the same sample was reported as non-Hodgkin’s lymphoma of follicular type grade I/III (2008). Positron emission tomography-computed tomography (PET-CT) showed hypermetabolic areas in supra- and infradiaphragmatic lymph nodes and also in multiple bones (with surrounding regions encasement). Patient has received two cycles of chemotherapy with Bendamustine and Rituximab. She is on regular follow-up with ...

Journal of Evolution of Medical and Dental Sciences

BACKGROUND Exacerbations in chronic obstructive pulmonary disease is common and frequent in natur... more BACKGROUND Exacerbations in chronic obstructive pulmonary disease is common and frequent in nature. The present study was done to evaluate the clinical efficacy of nebulised budesonide over parenteral/oral steroids in patients with acute exacerbations of COPD. MATERIALS AND METHODS A randomised controlled study was conducted in a tertiary care teaching hospital. A total of 125 patients with acute exacerbations due to COPD were included in the study. The patients were randomised into study and control groups. The study group patients received inhaled budesonide along with the standard treatment for 5 days, while the control group received standard treatment for acute exacerbation of COPD. The primary outcome variables studied for the treatment efficacy were change in post bronchodilator FEV1, FVC, FEV1/FVC, PEFR. Secondary end points included the changes in dyspnoea score (MMRC grade, SPO2 and SGRQ score). RESULTS A total of 125 patients were finally assessed. Sixty five patients belonged to study group and 60 in the control group. Baseline characteristics were similar and well matched in both the groups. Mean age was 64.20 ± 9.11 years while in control group it was 62.40 ± 11.31 years. There were no improvements in the lung functions (FEV1, FVC, FEV1/FVC, PEFR) at the end of 5 days of nebulised budesonide as compared to the standard therapy. As far as secondary outcome is concerned, it was observed that patients in study group showed better improvement in health related quality of life (HRQL) score as compared to control group at day 5 (p<0.01). Duration of hospitalisation also was lesser in the study group as compared to the control group. No serious adverse effects were observed during the course of the study. CONCLUSION Overall with the nebulised budesonide for the AECOPD, there was not much improvement in the lung functions, but there was improvement in the quality of life and the duration of hospitalisation in the study group. These findings should be confirmed by conducting a larger population based clinical study.

International Journal of Advances in Medicine

Background: Tuberculosis is the most common cause of exudative lymphocytic pleural effusion in In... more Background: Tuberculosis is the most common cause of exudative lymphocytic pleural effusion in India. The present study was undertaken to evaluate the efficacy of intrapleural instillation of streptokinase with pigtail catheter drainage in the treatment of tuberculous pleural effusion.Methods: Clinical profile, hospital course and outcome of tuberculous pleural effusion patients at the end of six months of anti-tubercular treatment of 50 patients from January 2009 to June 2010 were analyzed. These patients were randomly divided into two groups. One group (n=25) received intrapleural streptokinase via pigtail catheter and the other group (n=25) received intercostal drainage without intrapleural streptokinase instillation. All the patients received standard daily anti TB regimen of 2HERZ/4HR for a total duration of six months.Results: Majority of the patients were above 40 years of age (60%). The male to female ratio was 2.3:1. The major symptoms of the patients were, fever in 44 pati...

International Journal of Medicine and Public Health, Sep 1, 2016

Introduction: Bronchial asthma is a chronic airway disease that affects a significant children po... more Introduction: Bronchial asthma is a chronic airway disease that affects a significant children population with limitation of their activities and school absenteeism. The objective of the present study was to assess the knowledge and attitude of the parents towards the disease in their children. Materials and Methods: A hospital based cross-sectional study was conducted in Pulmonary Medicine department in a tertiary care hospital with diagnosed asthmatic children and their parents were enrolled. Two questionnaire one comprising clinical aspects including etiology and other regarding knowledge and attitude among parents regarding asthma were administered. Results: A total of 150 children with confirmed diagnosis of asthma were included in this study. On an average, each child had already visited 3 doctors prior to coming to us. Out of 150 patients, 77% parents were ignorant regarding disease etiology, 41% parents thought that their disease is fatal, 54% parents were reluctant to accept the diagnosis of asthma. Regarding precipitating factors, 46% parents attributed the disease exacerbations due to multiple causes. Almost half of the parents had sought alternative for of medicine for management of disease with nearly one-third opting for homeopathic treatment. Oral medications were preferred by 79% patients, while inhalers were used by only 21% of children. The compliance rate in using inhalation therapy in children was very low. Conclusion: Asthma awareness among parents of asthmatic children is inadequate. Controller medications and aerosol therapy is underused and unnecessarily blamed. Awareness raising strategies are needed in community. Patient education program should augment awareness; eliminate social stigma, and misconcepts in the community regarding bronchial asthma.

The Indian journal of chest diseases & allied sciences, Nov 17, 2022

Isolated pleural effusion is a rare presentation of ovarian hyperstimulation syndrome following o... more Isolated pleural effusion is a rare presentation of ovarian hyperstimulation syndrome following ovulation induction therapy. We hereby report the case of a 24-year-old female who presented with unilateral moderate pleural effusion following ovulation induction therapy. Therapeutic thoracentesis was performed to relieve the breathlessness in this case.

Journal of Evolution of medical and Dental Sciences, 2014

BACKGROUND: Gastro-esophageal reflux disease (GERD) is a chronic disorder of the upper gastrointe... more BACKGROUND: Gastro-esophageal reflux disease (GERD) is a chronic disorder of the upper gastrointestinal tract with global distribution. GERD often coexists with asthma, COPD and is often responsible for their exacerbations. In India, we do not have any clinical data on GERD either in bronchial asthma or COPD. OBJECTIVE: To investigate the prevalence of GERD in adult patients with asthma, COPD and to determine its correlates. MATERIALS AND METHODS: A total of 40 subjects each in bronchial asthma and COPD groups underwent assessment with the frequency scale for the symptoms of GERD (FSSG) Questionnaire for GERD. A score of 8 and above was taken as positive for GERD. The confirmation of GERD was done by Gastroesophageal endoscopy to all GERD positive cases. Grading of GERD was done with endoscopy report according to Los Angeles grading. FSSG score was evaluated in detail and the risk factors were analyzed. RESULTS: The prevalence of GERD in bronchial asthma patients was 40%, while in C...

Journal of the Scientific Society, 2020

Background: Acute exacerbations of COPD (AECOPD) are known to be associated with increased morbid... more Background: Acute exacerbations of COPD (AECOPD) are known to be associated with increased morbidity and mortality and have a significant socioeconomic impact. The factors that determine frequent hospital readmissions for AECOPD are poorly understood. The aim of this study was to ascertain the factors responsible for the repeated admissions for AECOPD. Methodology: We conducted a prospective study of 235 patients with COPD with one or more admissions for acute exacerbations in a tertiary care hospital. Frequency of previous readmissions for AECOPD in the past year, and clinical characteristics, including spirometry were ascertained in the stable state both before discharge and at 6-month post discharge. All the patients were followed up for a period of two years after discharge to evaluate the readmissions for the acute exacerbations. Results: Among 149 COPD patients who were admitted and assessed for AECOPD, there were 278 readmissions for AECOPD over a follow-up period of 24 mont...

Background: In late March 2009, an outbreak of respiratory illness, later proved to be caused by ... more Background: In late March 2009, an outbreak of respiratory illness, later proved to be caused by swine origin influenza A (H1N1) virus (S-OIV) was identified in Mexico. Thereafter many countries worldwide have reported the incidence of this pneumonia. The present study was undertaken to evaluate the clinical characteristics and radiological features of positive cases of confirmed Influenza A H1N1 (2009) infection in a tertiary care hospital in northern part of Karnataka. Material and Methods: A retrospective analysis of medical charts, laboratory investigations and radiographs of 57 positive cases of Influenza A H1N1 (2009) infection was done. Throat swab of all these patients were confirmed by real time RT- PCR assay (reverse transcriptase polymerase chain reaction method). Results: A total of 57 cases were infected with influenza A H1N1 (2009) virus. They belonged to 20 to 40 years of age, with the mean age being 35. Acute onset cough, fever and breathlessness were the most common...

The Indian journal of chest diseases & allied sciences, 2016

Isolated pleural effusion is a rare presentation of ovarian hyperstimulation syndrome following o... more Isolated pleural effusion is a rare presentation of ovarian hyperstimulation syndrome following ovulation induction therapy. We hereby report the case of a 24-year-old female who presented with unilateral moderate pleural effusion following ovulation induction therapy. Therapeutic thoracentesis was performed to relieve the breathlessness in this case.

Indian Journal of Health Sciences and Biomedical Research (KLEU), 2019

BACKGROUND AND OBJECTIVES: Bronchial asthma is one of the most common chronic diseases. In India,... more BACKGROUND AND OBJECTIVES: Bronchial asthma is one of the most common chronic diseases. In India, bronchial asthma has 66% frequency of reported exacerbations. Vitamin D has action on pro-inflammatory mediators and smooth muscle function and proliferation, which has a direct relevance for lung function in asthma. This study was done to investigate the prevalence of Vitamin D deficiency in patients presenting with asthma exacerbations and to assess the correlation between decreased levels and various indicators of severity of exacerbations. MATERIALS AND METHODS: A total of 118 participants of whom 93 patients had acute exacerbations of bronchial asthma were included in this study. Vitamin D levels were analyzed among different subgroups based on asthma control, severity, and severity of exacerbations. Vitamin D levels were correlated to forced expiratory volume in 1 s (FEV1)% predicted, body mass index (BMI), steroid use, and number of exacerbations in the previous 1 year. RESULTS: ...

Background: Gastro-esophageal reflux disease (GERD) is a chronic disorder of the upper gastrointe... more Background: Gastro-esophageal reflux disease (GERD) is a chronic disorder of the upper gastrointestinal tract with global distribution. GERD often coexists with asthma and is often responsible for the repeated exacerbations. In India, there is limited data on the exact prevalence of GERD in bronchial asthma. Objective: To investigate the prevalence of GERD in adult patients with bronchial asthma. Materials and Methods: A total of 60 patients with confirmed diagnosis of bronchial asthma underwent assessment for GERD with the frequency scale for the symptoms of GERD (FSSG) Questionnaire. A score of 8 and above was taken as positive for GERD. Then confirmation of GERD was done by Gastro-esophageal endoscopy in all GERD positive cases. Grading of GERD was done with endoscopy report according to Los Angeles grading. FSSG score was evaluated in detail and the risk factors were analyzed. Results: The prevalence of GERD in bronchial asthma patients was 40%. It was observed that by using FSS...

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH

Bronchial asthma is one of the most common chronic respiratory disease worldwide, and is characte... more Bronchial asthma is one of the most common chronic respiratory disease worldwide, and is characterised by different phenotypic variations. Acute exacerbations in bronchial asthma are common and leads to repeated hospitalisations leading to increase in direct costs of asthma and thus preventing exacerbations should be an important consideration. Vitamin D has an immunomodulatory action and its deficiency has been associated with asthma epidemics. We hereby critically review the clinical benefits of vitamin D in the control of bronchial asthma and in exacerbations.

Journal of Clinical Sciences

Tuberculosis (TB), due to Mycobacterium tuberculosis(MTB), remains a major public health issue. I... more Tuberculosis (TB), due to Mycobacterium tuberculosis(MTB), remains a major public health issue. It causes ill health for approximately 10 million people each year and is one of the top ten causes of death worldwide. For the past 5 years, it has been the leading cause of death from a single infectious agent, ranking above HIV/AIDS. Effective diagnosis of pulmonary TB requires the availability – on a global scale – of standardized, easy-to-use, and robust diagnostic tool that would allow the direct detection of both the MTB complex and the resistance to key drugs, such as rifampicin. The latter result can serve as a marker for multidrug-resistant (MDR) MTB and has been reported in >95% of the MDR-TB isolates. Here, we review some of the recent molecular methods in the diagnosis of TB.

Indian Journal of Health Sciences and Biomedical Research (KLEU)

Background: Sleep Disordered Breathing has become one of the primary causes of mortality in espec... more Background: Sleep Disordered Breathing has become one of the primary causes of mortality in especially obese individuals owing to the modern lifestyle Material and methods: 60 patients coming to outpatient clinic of a tertiary care hospital with Epworth sleepiness scale between 8 to 24 representing increasing levels Results: There were 60 (34 males and 26 females) subjects with mean age 56.45±12.51years and BMI 28.7±3.1. 16, 9, 22 subjects had mild, moderate Conclusions: OSA predominantly affects middle aged men who are overweight with many having high neck circumference. Severe OSA patients had longer.

Indian Journal of Physical Therapy and Research

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2018

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH

Lung India

Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common and ... more Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common and often fatal; however, accurate prognosis of patients hospitalized with an exacerbation is difficult. The Dyspnea, Eosinopenia, Consolidation, Acidemia, and Atrial Fibrillation (DECAF) score uses indices routinely available at the time of hospital admission and can accurately predict the inhospital mortality and outcomes in patients hospitalized with AECOPD. Methodology: A cross-sectional study was conducted in Jawaharlal Nehru Medical College, Belagavi, from January 2016 to June 2018. Consecutive patients hospitalized with an exacerbation of chronic obstructive pulmonary disease were included. DECAF indices and inhospital death rates were recorded. The prognostic value of DECAF was assessed by comparing the total score with the inhospital mortality. Statistical analysis was done using SPSS version 20. Results: Two hundred and twenty-eight patients were recruited. The mean (standard deviation) age was 61.09 ± 10.6 years; 73.68% were male and 48 patients (21.05%) died in hospital. One hundred and twelve patients were identified as low risk (DECAF: 0–1) with 6 (5.4%) patients dying in the hospital and 56 patients were identified as high risk (DECAF: 3–6) with an inhospital mortality of 60.1%. Length of stay for scores of 0–1, 2, and ≥3 was 6.42, 7.47, and 9.64 days, respectively, with P < 0.05. The receiver operating characteristic curve analysis showed P < 0.001, thereby proving that the DECAF is a significant predictor of mortality in AECOPD. Conclusion: This study proved that with an increase in the DECAF score, the mortality among patients in AECOPD increased. The DECAF score helps clinicians predict prognosis accurately by identifying low-risk patients potentially suitable for home-based care or early hospital discharge and high-risk patients requiring escalated palliation with high-level care to improve their outcome.

International Journal of Advances in Medicine

Background: Tuberculosis is the most common cause of exudative lymphocytic pleural effusion in In... more Background: Tuberculosis is the most common cause of exudative lymphocytic pleural effusion in India. Residual pleural thickening (RPT) is observed in about 50 percent of patients even after proper treatment with ATT. Pleural fluid drainage either with simple aspiration or with intercostal drainage and addition of corticosteroids along with antitubercular drugs have not shown to influence the incidence of RPT. The present study was undertaken to study the complications and residual effects of tubercular pleural effusion on the patients during the follow up period following intrapleural streptokinase instillation.Methods: Clinical profile, hospital course and outcome of tuberculous pleural effusion patients at the end of six months of anti-tubercular treatment of 50 patients from January 2009 to June 2010 were analyzed. These patients were randomly divided into two groups. One group (n=25) received intrapleural streptokinase via pigtail catheter and the other group (n=25) received in...

Asian Journal of Oncology

A chylothorax results when the lymphatic duct becomes disrupted. It is an uncommon and poorly des... more A chylothorax results when the lymphatic duct becomes disrupted. It is an uncommon and poorly described complication of both Hodgkin’s and non-Hodgkin’s lymphomas of any histological type and grade. A 62-year-old female presented with dyspnea on exertion and dry cough for 15 days. Chest radiograph showed left-sided effusion. Pleural fluid reports were suggestive of chylothorax. Fluid was drained and CT thorax was performed which revealed multiple supra- and infradiaphragmatic lymphadenopathy. Left supraclavicular lymph node biopsy revealed chronic inflammation. Immunohistochemistry of the same sample was reported as non-Hodgkin’s lymphoma of follicular type grade I/III (2008). Positron emission tomography-computed tomography (PET-CT) showed hypermetabolic areas in supra- and infradiaphragmatic lymph nodes and also in multiple bones (with surrounding regions encasement). Patient has received two cycles of chemotherapy with Bendamustine and Rituximab. She is on regular follow-up with ...

Journal of Evolution of Medical and Dental Sciences

BACKGROUND Exacerbations in chronic obstructive pulmonary disease is common and frequent in natur... more BACKGROUND Exacerbations in chronic obstructive pulmonary disease is common and frequent in nature. The present study was done to evaluate the clinical efficacy of nebulised budesonide over parenteral/oral steroids in patients with acute exacerbations of COPD. MATERIALS AND METHODS A randomised controlled study was conducted in a tertiary care teaching hospital. A total of 125 patients with acute exacerbations due to COPD were included in the study. The patients were randomised into study and control groups. The study group patients received inhaled budesonide along with the standard treatment for 5 days, while the control group received standard treatment for acute exacerbation of COPD. The primary outcome variables studied for the treatment efficacy were change in post bronchodilator FEV1, FVC, FEV1/FVC, PEFR. Secondary end points included the changes in dyspnoea score (MMRC grade, SPO2 and SGRQ score). RESULTS A total of 125 patients were finally assessed. Sixty five patients belonged to study group and 60 in the control group. Baseline characteristics were similar and well matched in both the groups. Mean age was 64.20 ± 9.11 years while in control group it was 62.40 ± 11.31 years. There were no improvements in the lung functions (FEV1, FVC, FEV1/FVC, PEFR) at the end of 5 days of nebulised budesonide as compared to the standard therapy. As far as secondary outcome is concerned, it was observed that patients in study group showed better improvement in health related quality of life (HRQL) score as compared to control group at day 5 (p<0.01). Duration of hospitalisation also was lesser in the study group as compared to the control group. No serious adverse effects were observed during the course of the study. CONCLUSION Overall with the nebulised budesonide for the AECOPD, there was not much improvement in the lung functions, but there was improvement in the quality of life and the duration of hospitalisation in the study group. These findings should be confirmed by conducting a larger population based clinical study.

International Journal of Advances in Medicine

Background: Tuberculosis is the most common cause of exudative lymphocytic pleural effusion in In... more Background: Tuberculosis is the most common cause of exudative lymphocytic pleural effusion in India. The present study was undertaken to evaluate the efficacy of intrapleural instillation of streptokinase with pigtail catheter drainage in the treatment of tuberculous pleural effusion.Methods: Clinical profile, hospital course and outcome of tuberculous pleural effusion patients at the end of six months of anti-tubercular treatment of 50 patients from January 2009 to June 2010 were analyzed. These patients were randomly divided into two groups. One group (n=25) received intrapleural streptokinase via pigtail catheter and the other group (n=25) received intercostal drainage without intrapleural streptokinase instillation. All the patients received standard daily anti TB regimen of 2HERZ/4HR for a total duration of six months.Results: Majority of the patients were above 40 years of age (60%). The male to female ratio was 2.3:1. The major symptoms of the patients were, fever in 44 pati...