ABSTRACT
Obstructive sleep apnoea (OSA) and obstructive sleep apnoea syndrome (OSAS) are subsets of sleep-disordered breathing. Awareness about OSA and its consequences amongst the general public as well as the majority of primary care physcians across India is poor. This necessiated the development of the INdian initiative on Obstructive Sleep Apnoea (INOSA) guidelines under the auspices of Department of Health Research, Ministry of Health & Family Welfare, Government of India. OSA is the occurrence of an average five or more episodes of obstructive respiratory events per hour of sleep with either sleep related symptoms or comorbidities or >15 such episodes without any sleep related symptoms or comorbidities. OSAS is defined as OSA associated with daytime symptoms, most often excessive sleepiness. Patients undergoing routine health check-up with snoring, daytime sleepiness, obesity, hypertension, motor vehicular accidents and high risk cases should undergo a comprehensive sleep evaluation. Medical examiners evaluating drivers, air pilots, railway drivers and heavy machinery workers should be educated about OSA and should comprehensively evaluate applicants for OSA. Those suspected to have OSA on comprehensive sleep evaluation should be referred for a sleep study. Supervised overnight polysomnography (PSG) is the “gold standard” for evaluation of OSA. Positive airway pressure (PAP) therapy is the mainstay of treatment of OSA. Oral appliances are indicated for use in patients with mild to moderate OSA who prefer oral appliances to PAP, or who do not respond to PAP or who fail treatment attempts with PAP or behavioural measures. Surgical treatment is recommended in patients who have failed or are intolerant to PAP therapy.
ABSTRACT
A 40-year-old male presented with clinical and radiological manifestations of right lung atelectasis and post-obstructive pneumonia. Flexible bronchoscopy revealed gross narrowing of the right upper lobe bronchus and a smooth, white endobronchial mass completely occluding the right lower lobe bronchus. Endobronchial biopsy from the mass lesion yielded low grade B-cell non-Hodgkin’s lymphoma. This is one of the rarest presentation of non-Hodgkin’s lymphoma.
Subject(s)
Adult , Bronchial Neoplasms/diagnosis , Bronchial Neoplasms/drug therapy , Bronchial Neoplasms/diagnostic imaging , Bronchoscopy , Humans , Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, Non-Hodgkin/drug therapy , Lymphoma, Non-Hodgkin/diagnostic imaging , Male , Tomography, X-Ray ComputedABSTRACT
Co-infection with Pneumocystis jirovecii and Mycobacterium tuberculosis is rarely reported in patients without human immunodeficiency virus (HIV) infection. We describe the case of a 33-year-old HIV-negative female patient who was on long-term oral corticosteroids for rheumatoid arthritis and admitted with for respiratory distress and diffuse infiltrative pneumopathy in whom concurrent infection with Mycobacterium tuberculosis and Pneumocystis jiroveci was confirmed by bronchoalveolar lavage (BAL) fluid examination.
Subject(s)
Adult , Female , Humans , Pneumocystis carinii , Pneumonia, Pneumocystis/complications , Tuberculosis, Pulmonary/complicationsABSTRACT
We report a young girl who presented to us with chest discomfort and had a paracardiac mass on chest radiograph. Computerised tomographic (CT) scan of the thorax was suggestive of pericardial cyst. Hydatid serology was negative. The cyst was excised.
Subject(s)
Adolescent , Diagnosis, Differential , Echinococcosis, Pulmonary/diagnosis , Female , Humans , Mediastinal Cyst/diagnosisABSTRACT
We encountered a case of tuberculous lymphadenitis with erythema nodosum presenting with an unusual manifestation as subungual erythema in all the digits. Relevant literature and the possible explanation for the subungual erythema have been discussed.
Subject(s)
Adolescent , Arthritis, Reactive/microbiology , Erythema Nodosum/microbiology , Female , Humans , Nail Diseases/microbiology , Tuberculosis, Lymph Node/diagnosisABSTRACT
A case of wood smoke inhalation related lung disease presenting with miliary mottling on radiography is described. Transbronchial lung biopsy showed the presence of coal macules.
Subject(s)
Adult , Female , Humans , Lung Diseases/etiology , Smoke/adverse effects , WoodABSTRACT
A case of ulcertaive colitis on long-term corticosteroid therapy presenting with mediastinal widening and diagnosed to have mediastinal lipomatosis an thoracic computed tomography is presented.