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Knowledge, attitude, and practices regarding COVID-19 among the postgraduate medical students: Correspondence 医学研究生对COVID-19的知识、态度和实践:函授
Pub Date : 2023-01-01 DOI: 10.4103/jacp.jacp_3_23
R. Mungmunpuntipantip, V. Wiwanitkit
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引用次数: 0
Expert opinion on the role of bilastine and bilastine-montelukast combination in the management of allergic rhinitis: An Indian perspective 印度专家对bilastine和bilastine-孟鲁司特联合治疗变应性鼻炎的看法
Pub Date : 2023-01-01 DOI: 10.4103/jacp.jacp_45_22
Subir Jain, S. Verma, S. Balamurugan, K. Reddy, D. Christopher
In India, the burden of allergic rhinitis (AR) is enormous, comprising 55% of all patients with allergies. Intranasal corticosteroids are the recommended first-line therapy for patients with moderate-to-severe AR, particularly when nasal congestion is the predominant symptom. However, second-generation antihistamines are the first line of treatment in mild AR and effectively improve symptoms, such as sneezing, itching, and rhinorrhoea. Bilastine is a second-generation H1-antihistamine indicated for the symptomatic treatment of allergic rhinoconjunctivitis in adults and adolescents over 12 years of age. Though it is an effective individual molecule for the management of AR, studies have shown that synergistic combination therapy of bilastine-montelukast has a dual action on early- and late-phase allergic reactions in AR patients with concomitant asthma. An advisory board meeting was conducted (on a virtual platform) to gain insights from Indian experts on the following: (i) burden of AR and AR with concomitant asthma in Indian settings; (ii) current unmet needs; and (iii) role and positioning of bilastine and bilastine plus montelukast combination in the management of AR and AR with concomitant asthma in adults and adolescents over 12 years of age. The experts shared their opinions based on the available scientific evidence and/or clinical expertise or experience. In this article, we have summarized the highlights of the expert panel discussion and available evidence for each of these topics.
在印度,过敏性鼻炎(AR)的负担是巨大的,占所有过敏患者的55%。对于中度至重度AR患者,尤其是以鼻塞为主要症状的患者,鼻内皮质类固醇是推荐的一线治疗。然而,第二代抗组胺药是治疗轻度AR的第一线药物,可有效改善打喷嚏、瘙痒、流涕等症状。Bilastine是第二代h1 -抗组胺药,适用于成人和12岁以上青少年变应性鼻结膜炎的对症治疗。虽然它是一种有效的治疗AR的个体分子,但研究表明,bilastin -孟鲁司特协同联合治疗对AR合并哮喘患者的早期和晚期过敏反应具有双重作用。(在虚拟平台上)举行了一次咨询委员会会议,以获取印度专家对以下方面的见解:(i)印度环境中急性呼吸道感染和急性呼吸道感染伴发哮喘的负担;目前未满足的需要;(iii) bilastine和bilastine +孟鲁司特联合治疗成人和12岁以上青少年AR和AR合并哮喘的作用和定位。专家们根据现有的科学证据和/或临床专业知识或经验分享了他们的意见。在这篇文章中,我们总结了专家小组讨论的亮点和每个主题的可用证据。
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引用次数: 0
Omicron variant coronavirus disease with rapid progression to ARDS 快速发展为ARDS的组粒变异冠状病毒病
Pub Date : 2022-07-01 DOI: 10.4103/jacp.jacp_4_22
R. Ravikanth
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引用次数: 0
Isolated hemorrhagic pleural effusion due to sarcoidosis in a patient with primary Sjogren syndrome 原发性干燥综合征患者结节病所致孤立出血性胸腔积液1例
Pub Date : 2022-07-01 DOI: 10.4103/jacp.jacp_60_21
M. Abdulla
Abstract Sarcoidosis is a multisystem disease which rarely involves pleura resulting in various manifestations including pleural effusion, pneumothorax, pleural thickening, hydropneumothorax, trapped lung, hemothorax, or chylothorax. Hemorrhagic Pleural effusion secondary to sarcoidosis is extremely rare. Sarcoidosis is considered to be exclusion criteria for diagnosis of sjogrens syndrome (SS).But there are reports showing coexistence of these two disorders in the past. We present a patient with SS who presented with isolated hemorrhagic pleural effusion due to sarcoidosis.
结节病是一种多系统疾病,很少累及胸膜,表现多样,包括胸腔积液、气胸、胸膜增厚、气胸积液、陷肺、血胸、乳糜胸等。结节病继发出血性胸腔积液极为罕见。结节病被认为是sjogrens综合征(SS)的排除标准。但过去也有报告显示这两种疾病共存。我们提出一个SS患者谁提出了孤立出血性胸腔积液由于结节病。
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引用次数: 0
Etiological profile and evaluation of DPLD in real-world: the perceived impression of the ILD treating doctors in India 现实世界中DPLD的病因概况和评估:印度治疗ILD的医生的感知印象
Pub Date : 2022-07-01 DOI: 10.4103/jacp.jacp_5_22
P. Bhattacharyya, Sikta Mukherjee, A. Mukherjee, Mintu Paul, S. Sengupta, Debkanya Dey, Ajoy Handa
Abstract Background The perceived etiologies and the evaluation practice of concerned physicians in the real-world are important for diffuse parenchymal lung disease (DPLD) care. Methods An identified cohort of DPLD treating physicians was given to respond to a set of questions regarding their perception of the relative presence of common etiologies of DPLD in India and also regarding the scope and pattern of evaluation of the condition by them in real-world practice with selective inquiries about the satisfaction and constraints. Results 122 physicians out of 150, mostly (93%) postgraduate and practicing in metropolitan and urban areas (86.07%), participated in the survey. There was the highest abstinence in reply for rare causes of DPLD. As per the highest number/percentage of responses, the perceived etiological distribution for idiopathic pulmonary fibrosis (IPF), non-IPF-ILD (interstitial lung disease), and connective tissue disease-associated ILD was between 11% and 25%, while that of sarcoidosis was 1% to 10 % and chronic hypersensitivity pneumonitis was 26% to 50%. The evaluation habit varied significantly from villages to urban and metropolitan cities. The access to high-resolution computed tomography (HRCT) chest and spirometry was almost universal (98.36%); it dropped to 86.06% and 47.54% for DLCO and multidisciplinary discussions (MDD) (multidisciplinary discussion), respectively. The access to other investigations was variable. The practice of HRCT was universal, but it dropped by 36.30% for spirometry, 67.41% for DLCO, and 62.51% for MDD. The overall satisfaction in evaluation and follow-up was low. Financial and logistic constraints appeared prevalent along with a lack of family support. Conclusion The perceived real-world DPLD practice appears far short of ideal and it needs further investigations to understand the reality to change for betterment.
背景对弥漫性肺实质疾病(DPLD)的病因认知和临床医师的评估实践对于弥漫性肺实质疾病(DPLD)的治疗非常重要。方法一组确定的DPLD治疗医师被要求回答一系列问题,这些问题涉及他们对印度DPLD常见病因的相对存在的看法,以及他们在现实世界实践中对病情评估的范围和模式,并有选择性地询问满意度和限制。结果150名医师中有122名参与调查,其中大部分(93%)为硕士研究生和在大城市执业的医师(86.07%)。对于罕见原因的DPLD,禁欲率最高。根据响应的最高数量/百分比,特发性肺纤维化(IPF),非IPF-ILD(间质性肺疾病)和结缔组织病相关ILD的感知病因分布在11%至25%之间,结节病为1%至10%,慢性过敏性肺炎为26%至50%。评价习惯在乡村、城市和大都市之间存在显著差异。高分辨率计算机断层扫描(HRCT)胸部和肺活量测量几乎普遍(98.36%);DLCO和多学科讨论(MDD)分别降至86.06%和47.54%。进入其他调查的途径是可变的。HRCT的使用是普遍的,但肺活量下降了36.30%,DLCO下降了67.41%,MDD下降了62.51%。总体满意度在评价和随访方面较低。财政和后勤方面的限制似乎普遍存在,同时缺乏家庭支持。结论对现实生活中DPLD实践的认知还远远不够理想,需要进一步的调查来了解现实,以改善现状。
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引用次数: 0
Knowledge, attitude, and practices regarding COVID-19 among the postgraduate medical students of a government medical college in Gujarat (India) 印度古吉拉特邦一所公立医学院研究生对COVID-19的知识、态度和实践
Pub Date : 2022-07-01 DOI: 10.4103/jacp.jacp_21_22
A. Parekh, J. Dave, S. Singhal, K. Deokar
Abstract Objective: To assess postgraduate students’ knowledge, attitude, and practices regarding COVID-19. Methods: A self-designed online questionnaire was circulated to the postgraduate students. Mean knowledge, attitude, and practice scores were calculated and compared among different study groups with the ANOVA test. Results: Out of 254 postgraduate students approached, 220 responses were received, so the final sample size was 220. Out of 220 students enrolled, 159 (72.27%) students had good knowledge and 61 (27.73%) students had poor knowledge; 167 (75.90%) students had a positive attitude, 51 (23.18%) students had a neutral attitude, and only two (0.92%) students had a negative attitude; 196 (89.09%) students observed good practices whereas 24 (10.91%) students observed poor practices. Conclusion: Most students had good knowledge, a positive attitude, and good practices.
摘要目的:评估研究生对新冠肺炎的知识、态度和实践。方法:采用自行设计的网络问卷对研究生进行问卷调查。计算不同研究组的平均知识、态度和实践得分,并用方差分析进行比较。结果:在254名研究生中,收到了220份回复,因此最终样本量为220份。在220名入学学生中,159名(72.27%)学生知识良好,61名(27.73%)学生知识较差;167名(75.90%)学生持积极态度,51名(23.18%)学生持中立态度,只有2名(0.92%)学生持消极态度;196名(89.09%)学生观察到良好做法,而24名(10.91%)学生则观察到不良做法。结论:大多数学生都有良好的知识、积极的态度和良好的实践。
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引用次数: 1
Recurrent syncope with hyponatremia as presentation of COVID-19 viral pneumonia: Case report 复发性晕厥伴低钠血症表现为COVID-19病毒性肺炎1例
Pub Date : 2022-07-01 DOI: 10.4103/jacp.jacp_1_22
S. Patil, G. Gondhali
Abstract Syncope is the most common neurological presentation in intensive care setting and has diverse etiological factors ranging from ischemic and nonischemic neurovascular, cardiac dysfunction related, infectious, electrolyte imbalance, inflammatory factors to simple viral fever, and other system-related illnesses. Coronavirus disease-19 (COVID-19) is known to cause pulmonary and extrapulmonary complications including effects on cardiovascular, gastrointestinal, renal, and neurovascular systems. In this case report, we have documented a 70-year-old male presented with recurrent syncope with flu-like illness, HRCT thorax suggestive of pneumonia involving bilateral lower lobe, COVID-19 real-time polymerase chain reaction (RT-PCR) positive, with abnormal laboratory parameters such as platelet count, CRP, serum sodium, and vitamin B12 level. Further investigations such as echocardiography, MRI brain and MRI angiography, and carotid Doppler were inconclusive. We have observed excellent clinical and radiological response to steroids, anticoagulants, antiplatelets, and remdesivir with other supportive care in critical care unit.
晕厥是重症监护室最常见的神经系统疾病,其病因多种多样,从缺血性和非缺血性神经血管、心功能障碍相关、感染性、电解质失衡、炎症因素到单纯的病毒性发热,以及其他系统相关疾病。冠状病毒病-19 (COVID-19)已知会导致肺部和肺外并发症,包括对心血管、胃肠道、肾脏和神经血管系统的影响。在本病例报告中,我们记录了一位70岁男性,表现为复发性晕厥并流感样疾病,HRCT胸腔提示肺炎累及双侧下肺叶,COVID-19实时聚合酶链反应(RT-PCR)阳性,实验室参数异常,如血小板计数、CRP、血清钠和维生素B12水平。进一步的调查,如超声心动图,MRI脑和MRI血管造影,颈动脉多普勒没有定论。我们观察到在重症监护病房对类固醇、抗凝剂、抗血小板和瑞德西韦进行其他支持性治疗的临床和放射学反应良好。
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引用次数: 1
National TB Elimination Program (NTEP): at a glance 国家消除结核病规划(NTEP):概览
Pub Date : 2022-07-01 DOI: 10.4103/jacp.jacp_22_22
S. Kundu, R. Ghosh
Abstract India has the highest burden of tuberculosis worldwide. Over the last six decades there was evolution of national programs on tuberculosis. The present national program on tuberculosis emphasized on elimination and prevention of tuberculosis.
印度是世界上结核病负担最重的国家。在过去的60年里,国家结核病规划不断发展。目前的国家结核病规划强调消除和预防结核病。
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引用次数: 1
25-OH vitamin D3 level in tuberculosis: A cross-sectional study in a tertiary care center 25-OH维生素D3在肺结核中的水平:三级保健中心的横断面研究
Pub Date : 2022-07-01 DOI: 10.4103/jacp.jacp_30_22
S. Chatterjee, Pratik Biswas, Rituparna Bose, Megha Agarwal
Abstract Introduction: The immunomodulatory role of 25-hydroxycholecalciferol (25-OH vitamin D3) has been under evaluation for a long time. As tuberculosis (TB) and MDR-TB continue to be global health problems, evaluation of the role of 25-OH vitamin D3 deficiency in TB and its relation with bacillary load may help us in formulating a preventive therapy for the disease. Aims and Objectives: To assess serum 25-OH vitamin D levels in patients suffering from TB for the first time and to find the relation between serum 25-OH vitamin D levels in patients with bacillary load in respiratory samples. Results: The serum 25-OH vitamin D level was analyzed for bacillary load in the respiratory specimen in this study, which revealed that as the serum 25-OH vitamin D level decreased, the bacillary load was found to increase in the respiratory specimen.
摘要简介:25-羟基胆骨化醇(25-OH维生素D3)的免疫调节作用已被长期研究。随着结核病(TB)和耐多药结核病(MDR-TB)继续成为全球健康问题,评估25-OH维生素D3缺乏在结核病中的作用及其与细菌负荷的关系可能有助于我们制定疾病的预防性治疗方案。目的:首次评价结核患者血清25-OH维生素D水平,探讨呼吸道细菌负荷患者血清25-OH维生素D水平之间的关系。结果:本研究分析了呼吸道标本中血清25-OH维生素D水平对细菌负荷的影响,发现随着血清25-OH维生素D水平的降低,呼吸道标本中细菌负荷增加。
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引用次数: 0
New onset adult asthma attributable to tuberculosis: A distinct phenotype? 肺结核引起的新发成人哮喘:一种不同的表型?
Pub Date : 2022-07-01 DOI: 10.4103/jacp.jacp_15_22
K. Mehta, Kiran A. Balani, T. Sahasrabudhe
Abstract Background: In clinical practice, we encounter cases of bronchial asthma the onset of which correlates with past tuberculosis (TB), either pulmonary or extrapulmonary. Our study attempts to validate this observation and assess likelihood of new asthma that is attributable to TB. Methods: It was a single visit, cross-sectional study of persons who had TB within last 5 years (group 1). Preexisting asthma before TB, COPD cases, smokers, and persons with any active infective or diffuse lung diseases were excluded. Their spouse (group 2) and first-degree relatives (group 3) served as controls. All participants were subjected to detailed history, examination, and spirometry. Sample size was 225 (75 in each group). Results: About 62/75 participants in group 1 had intermittent or persistent symptoms suggesting obstructive airway disease that started within a year of TB diagnosis. Obstructive spirometry pattern was observed in 23/75 (30.6%) post-TB cases, compared to 6/75 (8%) in group 2 and 4/75 (5.33%) in group 3 participants. While, 11/75 (14.66%) post-TB cases in comparison to 7/150 (4.66%) controls were diagnosed as asthma after clinical correlation. About 24% of persons with post-TB lung scarring, 16% without lung scarring, and 4% with only extrapulmonary TB were diagnosed as asthma. Attributable risk for post-TB asthma was significant (0.1). Conclusion: This study suggests causative association between TB and asthma rather than just comorbidity. Further large-scale studies are warranted.
背景:在临床实践中,我们遇到支气管哮喘病例,其发病与既往结核病(TB)相关,无论是肺还是肺外。我们的研究试图验证这一观察结果,并评估由结核病引起的新哮喘的可能性。方法:这是一项单次访问的横断面研究,研究对象是过去5年内患有结核病的人(第1组)。排除了结核病前存在的哮喘、COPD病例、吸烟者和任何活动性感染性或弥漫性肺部疾病的人。其配偶(第二组)和一级亲属(第三组)作为对照组。所有参与者都接受了详细的病史、检查和肺活量测定。样本量225例(每组75例)。结果:第1组中约62/75的参与者有间歇性或持续性症状,表明在结核病诊断后一年内开始出现阻塞性气道疾病。结核后患者中有23/75(30.6%)出现阻塞性肺量测定模式,而第2组为6/75(8%),第3组为4/75(5.33%)。与对照的7/150例(4.66%)相比,11/75例(14.66%)结核后病例经临床相关性诊断为哮喘。约24%的结核后肺瘢痕患者、16%的无肺瘢痕患者和4%的仅肺外结核患者被诊断为哮喘。结核病后哮喘的归因风险显著(0.1)。结论:本研究提示结核与哮喘之间存在因果关系,而不仅仅是合并症。进一步的大规模研究是必要的。
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引用次数: 0
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The Journal of Association of Chest Physicians
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