Lung cancer with multiple lung abscesses: an unusual presentation

Lung abscess is caused due to localized suppuration in the lung usually caused by microbial infection of the lung. Here we are describing an interesting case of multiple lung abscess associated with non-small cell lung cancer. The diagnosis was suspected on CT scan thorax and was confirmed by fibreoptic bronchoscopy and endobronchial biopsy. Hence, lung cancer should be suspected in any case of lung abscess when it is showing no signs of resolution even after aggressive conservative management with broad spectrum antibiotics

A study on the prevalence of depression and the severity of depression in patients of chronic obstructive pulmonary disease in a semi-urban Indian population

Chronic obstructive pulmonary disease (COPD) is one of the few respiratory diseases which is associated with a number of comorbidities. Psychiatric disease like depression is a very important comorbidity of COPD because it decreases the feeling of wellbeing in the patient and also interferes with the compliance with medication thereby increasing the risk of hospitalization in the COPD patient. A cross-sectional study was done for two years in the department of pulmonary medicine at Era’s Lucknow medical college and hospital, Lucknow. A total of 150 patients were enrolled for the study after a clinico-radiological screening for the diagnosis confirmed on spirometry. After the confirmation of the diagnosis of COPD in these patients, they were screened for depression using the PHQ-9 scale in our department of pulmonary medicine. The confirmation of the diagnosis of depression was done according to the ICD-10 guidelines for depression and the severity of depression was graded using HAM-D scale in the department of psychiatry at our institute. The most common age group enrolled in the study was 51-60 years of age (40.67%). One hundred and fifteen patients (76.7%) of the enrolled patients were smokers while the remaining 35 patients (23.3%) were non-smokers. Depression was found to be present in 46 out of the total 150 patients in the study. Thus, the prevalence of depression in our study was 30.67%. Depression was seen in COPD groups B,C and D. Out of the 46 patients of COPD with depression,18 had mild depression (39.13%), 26 had moderate depression (56.52%) and 2 had severe depression (4.35%). Hence, depression of all grades (i.e., mild, moderate and severe depression) is seen in COPD groups B, C and D

Bacterial Etiologies and Antibiotic Sensitivities in Acute and Chronic Dacryocystitis: A Western U.P. Perspective

The current study aimed to assess and compare the bacteriological spectrum of acute and chronic dacryocystitis and the antibiotic susceptibility and resistance of the causative pathogens to commonly used antimicrobials. This was a prospective observational study. Cases of dacryocystitis were categorized as acute or chronic, based on clinical features. Specimens were obtained by sterile cotton swabs from the lower conjunctival fornix and from the puncta by applying pressure over the lacrimal sac area or by performing lacrimal syringing. Specimens were inoculated on appropriate culture media and incubated at 37ºC for 24-48 hours. Bacterial species were identified based on colony morphology and standard biochemical tests. Antibiotic Susceptibility Testing was assessed by Kirby Bauer disc diffusion technique using Mueller Hinton agar following Clinical and Laboratory Standards Institute guidelines. Out of 50 patients, 37 (74%) had chronic dacryocystitis and 13 (26%) had acute dacryocystitis. 35 bacterial species were recovered. Gram-positive organisms were the most isolated organisms i.e., 27 out of 35 (77.2%). In chronic dacryocystitis, the predominant bacterial species were Staphylococcus epidermidis (36%). In acute dacryocystitis, the predominant bacterial species were Staphylococcus aureus (40%). Against gram-positive organisms, Vancomycin and Linezolid were most effective (100%). Against gram-negative bacterial species, Amikacin was most effective (100%). High prevalence rate of antibiotic resistance was found, with 40% of the total bacterial species resistant to 5 or more antibiotics. The alarming rate of multi-drug resistance underscores the imperative need for tailored antibiotic strategies and continuous monitoring. Evidence based antibiotic therapy may also help to prevent failures of DCR, progression to chronicity and antibiotic resistance

Bronchiectasis in India:results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry

BACKGROUND: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India. METHODS: The Indian bronchiectasis registry is a multicentre, prospective, observational cohort study. Adult patients ( 6518 years) with CT-confirmed bronchiectasis were enrolled from 31 centres across India. Patients with bronchiectasis due to cystic fibrosis or traction bronchiectasis associated with another respiratory disorder were excluded. Data were collected at baseline (recruitment) with follow-up visits taking place once per year. Comprehensive clinical data were collected through the European Multicentre Bronchiectasis Audit and Research Collaboration registry platform. Underlying aetiology of bronchiectasis, as well as treatment and risk factors for bronchiectasis were analysed in the Indian bronchiectasis registry. Comparisons of demographics were made with published European and US registries, and quality of care was benchmarked against the 2017 European Respiratory Society guidelines. FINDINGS: From June 1, 2015, to Sept 1, 2017, 2195 patients were enrolled. Marked differences were observed between India, Europe, and the USA. Patients in India were younger (median age 56 years [IQR 41-66] vs the European and US registries; p<0\ub70001]) and more likely to be men (1249 [56\ub79%] of 2195). Previous tuberculosis (780 [35\ub75%] of 2195) was the most frequent underlying cause of bronchiectasis and Pseudomonas aeruginosa was the most common organism in sputum culture (301 [13\ub77%]) in India. Risk factors for exacerbations included being of the male sex (adjusted incidence rate ratio 1\ub717, 95% CI 1\ub703-1\ub732; p=0\ub7015), P aeruginosa infection (1\ub729, 1\ub710-1\ub750; p=0\ub7001), a history of pulmonary tuberculosis (1\ub720, 1\ub707-1\ub734; p=0\ub7002), modified Medical Research Council Dyspnoea score (1\ub732, 1\ub725-1\ub739; p<0\ub70001), daily sputum production (1\ub716, 1\ub703-1\ub730; p=0\ub7013), and radiological severity of disease (1\ub703, 1\ub701-1\ub704; p<0\ub70001). Low adherence to guideline-recommended care was observed; only 388 patients were tested for allergic bronchopulmonary aspergillosis and 82 patients had been tested for immunoglobulins. INTERPRETATION: Patients with bronchiectasis in India have more severe disease and have distinct characteristics from those reported in other countries. This study provides a benchmark to improve quality of care for patients with bronchiectasis in India. FUNDING: EU/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis Consortium, European Respiratory Society, and the British Lung Foundation

Lung cancer with multiple lung abscesses: an unusual presentation

Lung abscess is caused due to localized suppuration in the lung usually caused by microbial infection of the lung. Here we are describing an interesting case of multiple lung abscess associated with non-small cell lung cancer. The diagnosis was suspected on CT scan thorax and was confirmed by fibreoptic bronchoscopy and endobronchial biopsy. Hence, lung cancer should be suspected in any case of lung abscess when it is showing no signs of resolution even after aggressive conservative management with broad spectrum antibiotics

A Mediastinal Mass with Abdominal and Pulmonary Presentation

A 60-year-old male presented with the acute onset of breathlessness and dry cough. He had a documented weight loss of 5 kgs with the lack of appetite [...

Additional file 3: Table S1. of Genome-wide expression profiling establishes novel modulatory roles of vitamin C in THP-1 human monocytic cell line

Target gene expression of regulatory genes enriched in class ‘Regulation of gene expression’ at 8 h. (DOCX 95 kb

Additional file 2: Figure S2a. of Genome-wide expression profiling establishes novel modulatory roles of vitamin C in THP-1 human monocytic cell line

Fold expression values for the housekeeping genes. Heat map was generated using the fold expression values for ten housekeeping genes. Figure S2b. Raw gProcessed signal intensity values for housekeeping genes. The values shown on the Y-axis (log2 scale) are the background subtracted raw intensity values. UT, untreated; AA, ascorbic acid (vit C- treatment). The numbers in sample names refer to biological replicate numbers. (DOCX 262 kb