Abstract Context Post-coronavirus disease 2019 (COVID-19) disease patients are immunocompromised, especially those who have a history of hospitalization during the COVID time and steroid use during hospitalization. Such patients are very susceptible to opportunistic infections and must be assessed proactively. Patients and methods This was a cross-sectional study on 125 post-COVID-19-positive patients 28 days after being COVID negative confirmed by an RT-PCR test. Sputum/bronchoalveolar lavage samples were taken for analysis. Statistical analysis used SPSS, version 20.0 was used for the analysis. A P value less than 0.05 was considered statistically significant. Results Out of 119 sputum samples assessed, 15 were AFB positive, and Mycobacterium tuberculosis (MTB) was detected in 16 patients by the GeneXpert assay, out of which 15 were sensitive to rifampicin and one was resistant. Bronchoalveolar lavage was performed in nine patients where two were found AFB-positive, and MTB was detected in two patients by the GeneXpert, out of which one was rifampicin sensitive and one was rifampicin resistant. Conclusions A significant portion of the world population has latent tuberculosis (TB) infection, and the COVID-19 disease may have led to an increase in the incidence of active TB. A proactive approach is needed for the diagnosis of TB and to control the spread of TB.
{"title":"Prevalence of pulmonary tuberculosis in post-coronavirus disease patients","authors":"Sandeep Nain, Rajesh Gupta, Anupama Gupta, Sheetal Verma, Raghav Gupta, Aparna Parmar","doi":"10.4103/ecdt.ecdt_127_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_127_22","url":null,"abstract":"Abstract Context Post-coronavirus disease 2019 (COVID-19) disease patients are immunocompromised, especially those who have a history of hospitalization during the COVID time and steroid use during hospitalization. Such patients are very susceptible to opportunistic infections and must be assessed proactively. Patients and methods This was a cross-sectional study on 125 post-COVID-19-positive patients 28 days after being COVID negative confirmed by an RT-PCR test. Sputum/bronchoalveolar lavage samples were taken for analysis. Statistical analysis used SPSS, version 20.0 was used for the analysis. A P value less than 0.05 was considered statistically significant. Results Out of 119 sputum samples assessed, 15 were AFB positive, and Mycobacterium tuberculosis (MTB) was detected in 16 patients by the GeneXpert assay, out of which 15 were sensitive to rifampicin and one was resistant. Bronchoalveolar lavage was performed in nine patients where two were found AFB-positive, and MTB was detected in two patients by the GeneXpert, out of which one was rifampicin sensitive and one was rifampicin resistant. Conclusions A significant portion of the world population has latent tuberculosis (TB) infection, and the COVID-19 disease may have led to an increase in the incidence of active TB. A proactive approach is needed for the diagnosis of TB and to control the spread of TB.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135667896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nourane Y. Azab, Mahmoud M. El-Habashy, R. El-Helbawy, R. Habib, Sally Rezk
Background Diaphragm is a necessary respiratory muscle. In cases with pleural effusion, abnormal diaphragmatic functions may be observed. Thoracic ultrasound is a simple, accurate, and noninvasive method to investigate the relation between the quantity of pleural effusion and diaphragmatic functions. Aim The work was done to clarify the relation between the quantity of pleural effusion and diaphragmatic functions using ultrasound. Patients and methods A prospective case–control study, where patients were divided into two groups: GI (cases), 20 patients with pleural effusion for ultrasound evaluation of the relation between the quantity of pleural effusion and diaphragmatic functions, and GII, (controls) 20 healthy volunteers without pleural effusion for ultrasound assessment of diaphragmatic functions. Between 2019 and 2020, clinical assessment, routine investigations, and demographic and radiological data were reviewed for the two groups. Results Thoracic ultrasound for GI at different quantities of pleural effusions revealed significant differences in diaphragmatic functions such as thickness at the end of inspiration, diaphragm thickening fraction, excursion at deep breathing, and excursion at quiet breathing. The statistical comparison of sonographic findings between GI and GII showed significant differences in the thickness at the end of expiration, thickness at the end of inspiration, diaphragmatic thickening fraction, excursion at quiet breathing, and excursion at deep breathing. These changes are proportionate to the quantity of pleural effusion. Conclusion There is an adverse effect of pleural effusion at different quantities on diaphragmatic functions as observed by thoracic ultrasound.
{"title":"Ultrasound assessment of the relation between the quantity of pleural effusion and diaphragmatic functions","authors":"Nourane Y. Azab, Mahmoud M. El-Habashy, R. El-Helbawy, R. Habib, Sally Rezk","doi":"10.4103/ecdt.ecdt_26_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_26_22","url":null,"abstract":"Background Diaphragm is a necessary respiratory muscle. In cases with pleural effusion, abnormal diaphragmatic functions may be observed. Thoracic ultrasound is a simple, accurate, and noninvasive method to investigate the relation between the quantity of pleural effusion and diaphragmatic functions. Aim The work was done to clarify the relation between the quantity of pleural effusion and diaphragmatic functions using ultrasound. Patients and methods A prospective case–control study, where patients were divided into two groups: GI (cases), 20 patients with pleural effusion for ultrasound evaluation of the relation between the quantity of pleural effusion and diaphragmatic functions, and GII, (controls) 20 healthy volunteers without pleural effusion for ultrasound assessment of diaphragmatic functions. Between 2019 and 2020, clinical assessment, routine investigations, and demographic and radiological data were reviewed for the two groups. Results Thoracic ultrasound for GI at different quantities of pleural effusions revealed significant differences in diaphragmatic functions such as thickness at the end of inspiration, diaphragm thickening fraction, excursion at deep breathing, and excursion at quiet breathing. The statistical comparison of sonographic findings between GI and GII showed significant differences in the thickness at the end of expiration, thickness at the end of inspiration, diaphragmatic thickening fraction, excursion at quiet breathing, and excursion at deep breathing. These changes are proportionate to the quantity of pleural effusion. Conclusion There is an adverse effect of pleural effusion at different quantities on diaphragmatic functions as observed by thoracic ultrasound.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"1 1","pages":"80 - 85"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83661672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
WalaaG.E. Abo Koura, Ahmed Ali, Mahmoud Elhabashy, D. Serag, SamiS.A. El Dahdouh
Objective To detect pulmonary changes among asymptomatic smokers using an inspiratory and expiratory high-resolution computed tomography (HRCT) and pulmonary function tests (PFT). Pulmonary changes associated with smoking are now an increasing public health concern. Computed tomography, especially HRCT, is the best choice for visualizing lung morphology. Patients and methods The study was a cohort study conducted at Shebeen Chest Hospital from January 2019 to January 2021. The study was carried out on 120 adult males; 80 of them were asymptomatic smokers and 40 matched healthy nonsmokers served as the control group. All underwent routine chest radiograph, PA view, HRCT (inspiratory, expiratory) film, and PFTs in the form of forced expiratory vital capacity (FVC), forced expiratory volume after 1 s (FEV1), FEV1/FVC, mean forced expiratory flow, and peak expiratory flow. Comparison between the two groups was done according to HRCT and PFT. Result There was significant difference between inspiratory and expiratory HRCT regarding air trapping between cases. Inspiratory air trapping was present in 4% while expiratory air trapping was present in 18%. There was highly significant difference between cases and controls regarding emphysema and bronchial thickening, subpleural line. There was no statistically significant difference between the two groups regarding FVC, forced expiratory flow 25–75, and FEV1/FVC, while there was a significant difference between them regarding PFT pattern results (P<0.05). Conclusion HRCT is the most sensitive imaging modality for diagnosing early emphysema in asymptomatic smokers. HRCT of the lung can detect lung abnormalities noninvasively.
{"title":"Pulmonary changes among asymptomatic smokers using high-resolution computed tomography and pulmonary function tests","authors":"WalaaG.E. Abo Koura, Ahmed Ali, Mahmoud Elhabashy, D. Serag, SamiS.A. El Dahdouh","doi":"10.4103/ecdt.ecdt_43_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_43_22","url":null,"abstract":"Objective To detect pulmonary changes among asymptomatic smokers using an inspiratory and expiratory high-resolution computed tomography (HRCT) and pulmonary function tests (PFT). Pulmonary changes associated with smoking are now an increasing public health concern. Computed tomography, especially HRCT, is the best choice for visualizing lung morphology. Patients and methods The study was a cohort study conducted at Shebeen Chest Hospital from January 2019 to January 2021. The study was carried out on 120 adult males; 80 of them were asymptomatic smokers and 40 matched healthy nonsmokers served as the control group. All underwent routine chest radiograph, PA view, HRCT (inspiratory, expiratory) film, and PFTs in the form of forced expiratory vital capacity (FVC), forced expiratory volume after 1 s (FEV1), FEV1/FVC, mean forced expiratory flow, and peak expiratory flow. Comparison between the two groups was done according to HRCT and PFT. Result There was significant difference between inspiratory and expiratory HRCT regarding air trapping between cases. Inspiratory air trapping was present in 4% while expiratory air trapping was present in 18%. There was highly significant difference between cases and controls regarding emphysema and bronchial thickening, subpleural line. There was no statistically significant difference between the two groups regarding FVC, forced expiratory flow 25–75, and FEV1/FVC, while there was a significant difference between them regarding PFT pattern results (P<0.05). Conclusion HRCT is the most sensitive imaging modality for diagnosing early emphysema in asymptomatic smokers. HRCT of the lung can detect lung abnormalities noninvasively.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"38 1","pages":"112 - 119"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87709063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Allam, Sherif A. Eisa, Mahmoud El-Sayed Abd El-Rahim, N. Amin
Background Cancer of the lung is the leading cause of mortality worldwide. There is a continuing problem to treat patients with pulmonary lesions in the peripheral lung. Technology like virtual bronchoscopic imaging is based on assisted-computed tomography pictures that lead the bronchoscopist to the target peripheral lesion. Objectives The purpose of this research was to evaluate the safety and effectiveness of the lung point navigation system in the identification of peripheral pulmonary lesions. Patients and methods A total of 20 patients took part in this cross-sectional investigation, which used analytical methods. Finally, tissue samples from peripheral pulmonary lesions were collected using virtual bronchoscopic navigation. Results Overall, 90% of the cases analyzed were correctly diagnosed using lung point navigation, whereas 10% of the cases were incorrectly diagnosed. The lesion was on average 22.4 mm×23 mm in size, 17.2 mm away from the costal border, and 102.5 mm away from the diaphragm. The average navigation time was 7.4 min, whereas the average planning time was 5 min, and the overall examination duration was 31 min. Conclusion The navigation bronchoscopic method is a promising innovation in the field of lung disease diagnostics. Cost, operational skills, and the learning curve have all conspired to keep it from being widely used thus far.
{"title":"Role of lung point navigation bronchoscopy in diagnosis of peripheral pulmonary lesions","authors":"A. Allam, Sherif A. Eisa, Mahmoud El-Sayed Abd El-Rahim, N. Amin","doi":"10.4103/ecdt.ecdt_85_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_85_22","url":null,"abstract":"Background Cancer of the lung is the leading cause of mortality worldwide. There is a continuing problem to treat patients with pulmonary lesions in the peripheral lung. Technology like virtual bronchoscopic imaging is based on assisted-computed tomography pictures that lead the bronchoscopist to the target peripheral lesion. Objectives The purpose of this research was to evaluate the safety and effectiveness of the lung point navigation system in the identification of peripheral pulmonary lesions. Patients and methods A total of 20 patients took part in this cross-sectional investigation, which used analytical methods. Finally, tissue samples from peripheral pulmonary lesions were collected using virtual bronchoscopic navigation. Results Overall, 90% of the cases analyzed were correctly diagnosed using lung point navigation, whereas 10% of the cases were incorrectly diagnosed. The lesion was on average 22.4 mm×23 mm in size, 17.2 mm away from the costal border, and 102.5 mm away from the diaphragm. The average navigation time was 7.4 min, whereas the average planning time was 5 min, and the overall examination duration was 31 min. Conclusion The navigation bronchoscopic method is a promising innovation in the field of lung disease diagnostics. Cost, operational skills, and the learning curve have all conspired to keep it from being widely used thus far.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"57 1","pages":"86 - 91"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82883016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Nasal drug delivery is a well-known alternative to oral and parenteral drug delivery systems. Protein, peptides, hormones, and vaccines are the sensitive molecules for the oral route; hence those can be reached via nasal delivery. The nasal way has several advantages: higher permeability, more vasculature, less contact with enzymes due to less nasal space, and no hepatic first-pass metabolism. Therefore, it is a suitable route for sensitive drug molecules. Different applicators can deliver solid, liquid, and semisolid formulations for treating various diseases. The present review considers a brief introduction to the nasal route and problems associated with the nasal course for drug delivery, conventional and novel formulations, their applications, and evaluation parameters. Moreover, some of the marketed formulations for the nasal route of drug delivery systems and patented technologies are tabulated by reviewing the previous and updated literature.
{"title":"The nasal route, advanced drug delivery systems and evaluation: a review","authors":"Kaneriya Rutvik, Patel Meshva, Patel Dinal, Dholakia Mansi","doi":"10.4103/ecdt.ecdt_122_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_122_22","url":null,"abstract":"Abstract Nasal drug delivery is a well-known alternative to oral and parenteral drug delivery systems. Protein, peptides, hormones, and vaccines are the sensitive molecules for the oral route; hence those can be reached via nasal delivery. The nasal way has several advantages: higher permeability, more vasculature, less contact with enzymes due to less nasal space, and no hepatic first-pass metabolism. Therefore, it is a suitable route for sensitive drug molecules. Different applicators can deliver solid, liquid, and semisolid formulations for treating various diseases. The present review considers a brief introduction to the nasal route and problems associated with the nasal course for drug delivery, conventional and novel formulations, their applications, and evaluation parameters. Moreover, some of the marketed formulations for the nasal route of drug delivery systems and patented technologies are tabulated by reviewing the previous and updated literature.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135667616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Pulmonary Alveolar Proteinosis (PAP) is a rare disease of the lungs characterized by deposition of lipo-proteinaceous material in the alveoli. This leads to reduced lung compliance and V/Q mismatch, causing respiratory failure. Patients with PAP may be posted for Whole Lung Lavage (WLL) under anesthesia, which is a challenging case for anesthetists. Preexisting respiratory failure is complicated by requirement of single lung ventilation with the help of double lumen tube during the procedure. Intraoperative ventilation is difficult and is managed with blood gas and airway pressure monitoring. Some degree of hypoxemia and hypercapnia may have to be tolerated. Large volumes of fluid are instilled into the lung which may cause hypothermia, hypervolemia, and electrolyte disturbances. These patients frequently require elective ventilation and intensive care admission in the postoperative period. We report the case of a young woman with PAP, posted for unilateral WLL under anesthesia. We wish to highlight the possible challenges posed by this case and how to conduct a safe anesthesia for this patient.
{"title":"Anesthetic management of a case of pulmonary alveolar proteinosis for whole lung lavage","authors":"Manik Seth, Nishtha Kachru, Santvana Kohli, Ira Balakrishnan, Richa Chauhan, Virendra Kumar","doi":"10.4103/ecdt.ecdt_48_23","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_48_23","url":null,"abstract":"Abstract Pulmonary Alveolar Proteinosis (PAP) is a rare disease of the lungs characterized by deposition of lipo-proteinaceous material in the alveoli. This leads to reduced lung compliance and V/Q mismatch, causing respiratory failure. Patients with PAP may be posted for Whole Lung Lavage (WLL) under anesthesia, which is a challenging case for anesthetists. Preexisting respiratory failure is complicated by requirement of single lung ventilation with the help of double lumen tube during the procedure. Intraoperative ventilation is difficult and is managed with blood gas and airway pressure monitoring. Some degree of hypoxemia and hypercapnia may have to be tolerated. Large volumes of fluid are instilled into the lung which may cause hypothermia, hypervolemia, and electrolyte disturbances. These patients frequently require elective ventilation and intensive care admission in the postoperative period. We report the case of a young woman with PAP, posted for unilateral WLL under anesthesia. We wish to highlight the possible challenges posed by this case and how to conduct a safe anesthesia for this patient.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135667639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Obstructive sleep apnea (OSA) is a prevalent sleep disordered breathing in geriatrics but still frequently undiagnosed. Sleep architecture changes with ageing. Geriatrics spend more time in the N1, N2 than in N3, REM. Also, there are more frequent awakenings, arousals and sleep stage shifts. This leads to decrease in sleep efficiency. Geriatric patients with OSA have more affected sleep architecture than middle-aged adults. The aim This work aimed to assess and compare sleep architecture changes in geriatrics versus middle-aged adult patients with OSA syndrome. Patients and methods This comparative study conducted in chest department Menoufia University Hospitals included 50 patients divided to two equal groups; geriatric group age 65 years old or more and middle-aged adult group aged from 18 to 50 years old. All patients were complaining of symptoms suggestive of OSA. All patients underwent sleep questionnaires and Polysomnography using model; Philipsrespironic alice6. Results There was no statistically significant difference between the studied groups regarding sex, smoking, co morbidities, BMI and symptoms. Regarding changes in sleep architecture, geriatric group showed a significantly higher Sleep latency and wakefulness after sleep onset in comparison to middle-aged adults (P=0.004 and 0.039, respectively) versus significantly lower Sleep efficiency, N3%, REM% (P=0.009,0.011 and 0.001, respectively). The median Total Apnea-Hypopnea index was 40.2 (/h sleep) in geriatric group and 35.4 in middle-aged adult group. Regarding severity of OSA; geriatric group showed mild OSA in five (20%) patients, moderate in five (20%) patient and severe in 15 (60%) patients. Middle-aged adults showed mild OSA in 10 (40%) patients, moderate in two (8%) patients, and severe in 13 (52%) patients. Conclusions Sleep architecture is affected in all OSA patients, but these changes are more obvious in geriatric patients. Geriatric patients have higher wakefulness after sleep onset and sleep latency. On the other hand, they have a lower N3%, REM% and sleep efficiency.
{"title":"Effect of obstructive sleep apnea syndrome on sleep architecture: comparative study between geriatrics and middle-aged adult patients","authors":"Rana H El-Helbawy, Zeinab A Kasemy, Hanaa A Eid","doi":"10.4103/ecdt.ecdt_1_23","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_1_23","url":null,"abstract":"Background Obstructive sleep apnea (OSA) is a prevalent sleep disordered breathing in geriatrics but still frequently undiagnosed. Sleep architecture changes with ageing. Geriatrics spend more time in the N1, N2 than in N3, REM. Also, there are more frequent awakenings, arousals and sleep stage shifts. This leads to decrease in sleep efficiency. Geriatric patients with OSA have more affected sleep architecture than middle-aged adults. The aim This work aimed to assess and compare sleep architecture changes in geriatrics versus middle-aged adult patients with OSA syndrome. Patients and methods This comparative study conducted in chest department Menoufia University Hospitals included 50 patients divided to two equal groups; geriatric group age 65 years old or more and middle-aged adult group aged from 18 to 50 years old. All patients were complaining of symptoms suggestive of OSA. All patients underwent sleep questionnaires and Polysomnography using model; Philipsrespironic alice6. Results There was no statistically significant difference between the studied groups regarding sex, smoking, co morbidities, BMI and symptoms. Regarding changes in sleep architecture, geriatric group showed a significantly higher Sleep latency and wakefulness after sleep onset in comparison to middle-aged adults (P=0.004 and 0.039, respectively) versus significantly lower Sleep efficiency, N3%, REM% (P=0.009,0.011 and 0.001, respectively). The median Total Apnea-Hypopnea index was 40.2 (/h sleep) in geriatric group and 35.4 in middle-aged adult group. Regarding severity of OSA; geriatric group showed mild OSA in five (20%) patients, moderate in five (20%) patient and severe in 15 (60%) patients. Middle-aged adults showed mild OSA in 10 (40%) patients, moderate in two (8%) patients, and severe in 13 (52%) patients. Conclusions Sleep architecture is affected in all OSA patients, but these changes are more obvious in geriatric patients. Geriatric patients have higher wakefulness after sleep onset and sleep latency. On the other hand, they have a lower N3%, REM% and sleep efficiency.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135667895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Respiratory muscle weakness is proportional to the degree of thyroid function and is reversible by replacement therapy with thyroxine. Aim To evaluate the changes in pulmonary functions in newly diagnosed hypothyroid patients as compare with healthy controls by spirometry and to observe the improvement in pulmonary functions after hormone replacement therapy. Patients and methods A total of 30 newly diagnosed hypothyroid patients and 30 healthy controls of age between 18 to 50 years of either sex were included in our study. Clinical criteria and biochemical tests were registered, and spirometry was done. Results Approximately 17% of the hypothyroid patients were normal, whereas 33% had mild restrictive lung impairment and the rest 50% had moderate to severe restrictive impairment on spirometry. Conclusion On comparing the hypothyroid patients with normal healthy person of same age group through spirometer, the ventilatory functions were diminished and these pulmonary functions improved after levothyroxine therapy for 6 months but could not reach the normal healthy values. A spirometric evaluation should be considered in hypothyroid patients, even in the absence of respiratory illness.
{"title":"Evaluation of ventilatory functions in hypothyroid patients","authors":"N. Garg, Vipul Kumar, K. Gupta, S. Garg","doi":"10.4103/ecdt.ecdt_72_21","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_72_21","url":null,"abstract":"Introduction Respiratory muscle weakness is proportional to the degree of thyroid function and is reversible by replacement therapy with thyroxine. Aim To evaluate the changes in pulmonary functions in newly diagnosed hypothyroid patients as compare with healthy controls by spirometry and to observe the improvement in pulmonary functions after hormone replacement therapy. Patients and methods A total of 30 newly diagnosed hypothyroid patients and 30 healthy controls of age between 18 to 50 years of either sex were included in our study. Clinical criteria and biochemical tests were registered, and spirometry was done. Results Approximately 17% of the hypothyroid patients were normal, whereas 33% had mild restrictive lung impairment and the rest 50% had moderate to severe restrictive impairment on spirometry. Conclusion On comparing the hypothyroid patients with normal healthy person of same age group through spirometer, the ventilatory functions were diminished and these pulmonary functions improved after levothyroxine therapy for 6 months but could not reach the normal healthy values. A spirometric evaluation should be considered in hypothyroid patients, even in the absence of respiratory illness.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"53 1","pages":"65 - 69"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83095887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olfat M El-shinnawy, Mohamed Metwally, Nermeen Abdelaleem, Dina R R Gharieb
Abstract Context Patients in the intensive care unit (ICU) are at risk not only from their critical illness but also from secondary processes such as nosocomial infection. Pneumonia is the second most common nosocomial infection in critically ill patients. Indeed, diagnosis of ventilator-associated pneumonia (VAP) requires a high clinical suspicion combined with bedside examination, radiographic examination, microbiological analysis of respiratory secretions, and blood test. Aims This study aimed to evaluate the effectiveness and accuracy of lung ultrasound for VAP diagnosis and follow-up. Settings and design A prospective cohort study was conducted on 74 patients, with a total number of 54 with a high likelihood of VAP and 20 with a low likelihood of VAP. Methods and material Mechanically ventilated patients for 48 h or more were included. We calculated the clinical pulmonary infection score and the lung ultrasound was performed within 24 h. Statistical analysis Data were collected and analyzed using SPSS (Statistical Package for the Social Sciences, version 20, IBM, and Armonk, New York). Quantitative data were expressed as mean ±standard deviation (SD) and compared with Student’s t-test. Nominal data were given as number (n) and percentage (%). Chi 2 test was implemented on such data. Results Based on the clinical pulmonary infection score (CPIS) with a cutoff point of ≥6, the sensitivity of transthoracic ultrasound was 81.5%, the specificity was 82%, and the accuracy was 81.6%. Regarding sonographic signs, the highest sensitivity was for subpleural dots of consolidation (82%), then B-lines (56%), followed by pleural effusion, and air bronchogram (both 19%). The highest specificity was for air bronchogram (100%), then B-lines, and pleural effusion (both 90%), followed by subpleural dots of consolidation (80%). The positive predictive value for transthoracic ultrasound was 92%; the area under the receiver-operating characteristic (ROC) curve (AUC) for the total ultrasound score was 0.82. Conclusions Transthoracic ultrasound is an easy bedside tool for the diagnosis and follow-up of ventilator-associated pneumonia.
重症监护病房(ICU)的患者不仅面临危重疾病的风险，还面临院内感染等继发过程的风险。肺炎是危重病人第二大常见的医院感染。实际上，诊断呼吸机相关性肺炎(VAP)需要高度的临床怀疑，并结合床边检查、x线检查、呼吸道分泌物微生物学分析和血液检查。目的评价肺超声在VAP诊断及随访中的有效性和准确性。前瞻性队列研究纳入74例患者，其中高可能性VAP 54例，低可能性VAP 20例。方法和材料纳入机械通气48 h及以上患者。我们计算临床肺部感染评分，并在24 h内进行肺部超声检查。统计分析数据收集和分析使用SPSS (Statistical Package for the Social Sciences, version 20, IBM, Armonk, New York)。定量数据以均数±标准差(SD)表示，采用Student’s t检验进行比较。标称数据以数字(n)和百分比(%)表示。对这些数据进行Chi 2检验。结果基于截断点≥6的临床肺部感染评分(CPIS)，经胸超声诊断的敏感性为81.5%，特异性为82%，准确性为81.6%。关于超声征象，敏感度最高的是胸膜下实变点(82%)，其次是b线(56%)，其次是胸膜积液和支气管气征(均为19%)。特异性最高的是空气支气管图(100%)，其次是b线和胸膜积液(均为90%)，其次是胸膜下实变点(80%)。经胸超声阳性预测值为92%;超声总评分的受试者工作特征曲线下面积(AUC)为0.82。结论经胸超声是一种简便的诊断和随访呼吸机相关性肺炎的床边工具。
{"title":"Transthoracic ultrasound in the diagnosis and follow-up of ventilator-associated pneumonia","authors":"Olfat M El-shinnawy, Mohamed Metwally, Nermeen Abdelaleem, Dina R R Gharieb","doi":"10.4103/ecdt.ecdt_4_23","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_4_23","url":null,"abstract":"Abstract Context Patients in the intensive care unit (ICU) are at risk not only from their critical illness but also from secondary processes such as nosocomial infection. Pneumonia is the second most common nosocomial infection in critically ill patients. Indeed, diagnosis of ventilator-associated pneumonia (VAP) requires a high clinical suspicion combined with bedside examination, radiographic examination, microbiological analysis of respiratory secretions, and blood test. Aims This study aimed to evaluate the effectiveness and accuracy of lung ultrasound for VAP diagnosis and follow-up. Settings and design A prospective cohort study was conducted on 74 patients, with a total number of 54 with a high likelihood of VAP and 20 with a low likelihood of VAP. Methods and material Mechanically ventilated patients for 48 h or more were included. We calculated the clinical pulmonary infection score and the lung ultrasound was performed within 24 h. Statistical analysis Data were collected and analyzed using SPSS (Statistical Package for the Social Sciences, version 20, IBM, and Armonk, New York). Quantitative data were expressed as mean ±standard deviation (SD) and compared with Student’s t-test. Nominal data were given as number (n) and percentage (%). Chi 2 test was implemented on such data. Results Based on the clinical pulmonary infection score (CPIS) with a cutoff point of ≥6, the sensitivity of transthoracic ultrasound was 81.5%, the specificity was 82%, and the accuracy was 81.6%. Regarding sonographic signs, the highest sensitivity was for subpleural dots of consolidation (82%), then B-lines (56%), followed by pleural effusion, and air bronchogram (both 19%). The highest specificity was for air bronchogram (100%), then B-lines, and pleural effusion (both 90%), followed by subpleural dots of consolidation (80%). The positive predictive value for transthoracic ultrasound was 92%; the area under the receiver-operating characteristic (ROC) curve (AUC) for the total ultrasound score was 0.82. Conclusions Transthoracic ultrasound is an easy bedside tool for the diagnosis and follow-up of ventilator-associated pneumonia.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135667610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samar M A Elmonim, Dalia E Elsharawy, Raghda G Elsheikh, Mohamed G A Elkholy
Abstract Background Pulmonary hypertension (PH) presumably has an impact on 1% or less of the world’s population. Right Heart Catheterization (RHC) is essential for determining PH problems. RHC determines prognosis and offers helpful information on the degree of hemodynamic impairment. Therefore, this comparative study was carried out to determine the diagnostic role, pitfalls associated, and complications encountered during RHC in suspected cases of PAH and chronic thromboembolic pulmonary hypertension (CTEPH). Methods The observational cohort study was conducted on 75 patients with clinical suspicion of PH and CTEPH. All patients were subjected to full history taking, ECG, Echocardiography, and radiological investigations including Chest radiography (CXR), high-resolution computed tomography (HRCT), and computed tomography (CT) pulmonary angiography. Results The mean pulmonary artery mean pressure (PAMP) was 46.05 ± 9.631 mmHg, the mean Pulmonary artery dilatation (PAD) was 30.04 ± 1.082 mm the mean ejection fraction (EF%) was 63.87%, the mean right ventricular diameter was 45.83 ± 0.444 mm. The mean pulmonary artery wedge pressure (PAWP) was 10.91 ± 2.303 mmHg, and the mean cardiac output (CO) was 4.00 ± 0.773 L/min mean cardiac index (CI) was 1.94 ± 0.416 L/min/m 2 . Doppler echocardiographic estimated pulmonary artery systolic pressure (DE-ePASP) and estimated pulmonary, artery, end-diastolic pressure (ePADP) significantly positively correlated with RHC-PASP ( P < 0.001) and mean DE-ePAP significantly positively Correlated with mean RHC-PAP ( P < 0.001). Conclusions RHC is still the only method that can completely and accurately diagnose PAH. however, the combination between right cardiac catheterization and echocardiography provides a more accurate diagnosis of the diseases and their complications.
{"title":"Role of right heart catheterization in diagnosis of pulmonary arterial hypertension","authors":"Samar M A Elmonim, Dalia E Elsharawy, Raghda G Elsheikh, Mohamed G A Elkholy","doi":"10.4103/ecdt.ecdt_2_23","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_2_23","url":null,"abstract":"Abstract Background Pulmonary hypertension (PH) presumably has an impact on 1% or less of the world’s population. Right Heart Catheterization (RHC) is essential for determining PH problems. RHC determines prognosis and offers helpful information on the degree of hemodynamic impairment. Therefore, this comparative study was carried out to determine the diagnostic role, pitfalls associated, and complications encountered during RHC in suspected cases of PAH and chronic thromboembolic pulmonary hypertension (CTEPH). Methods The observational cohort study was conducted on 75 patients with clinical suspicion of PH and CTEPH. All patients were subjected to full history taking, ECG, Echocardiography, and radiological investigations including Chest radiography (CXR), high-resolution computed tomography (HRCT), and computed tomography (CT) pulmonary angiography. Results The mean pulmonary artery mean pressure (PAMP) was 46.05 ± 9.631 mmHg, the mean Pulmonary artery dilatation (PAD) was 30.04 ± 1.082 mm the mean ejection fraction (EF%) was 63.87%, the mean right ventricular diameter was 45.83 ± 0.444 mm. The mean pulmonary artery wedge pressure (PAWP) was 10.91 ± 2.303 mmHg, and the mean cardiac output (CO) was 4.00 ± 0.773 L/min mean cardiac index (CI) was 1.94 ± 0.416 L/min/m 2 . Doppler echocardiographic estimated pulmonary artery systolic pressure (DE-ePASP) and estimated pulmonary, artery, end-diastolic pressure (ePADP) significantly positively correlated with RHC-PASP ( P < 0.001) and mean DE-ePAP significantly positively Correlated with mean RHC-PAP ( P < 0.001). Conclusions RHC is still the only method that can completely and accurately diagnose PAH. however, the combination between right cardiac catheterization and echocardiography provides a more accurate diagnosis of the diseases and their complications.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135667819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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