Clinical profile of 35 patients with allergic bronchopulmonary aspergillosis (ABPA) was analysed. The disease was found to be more frequent among females. Constitutional symptoms, expectoration, increased breathless and poor control of asthma were the main presenting features. Skin reactivity against aspergillin and Candida was positive in 30 and 2 cases, respectively. Precipitating antibodies against Aspergillus species was positive in 28 cases, and against Candida albicans in 2 cases. Sputum grew either Aspergillus or C. albicans or both in 19 patients. Absolute eosinophilia was observed only in one third of cases. Chest skiagram revealed characteristic central/proximal bronchiectasis and/or fleeting shadows in all cases. No specific pattern was observed on spirometry. There was no correlation between the duration of bronchial asthma, sputum culture and serology results. Most patients responded well to steroids. One striking feature of the study was that one third of the cases were misdiagnosed as pulmonary tuberculosis and were treated with antitubercular drugs for varying periods of time. A high index of clinical suspicion with appropriate laboratory tests are required to identify these cases.

Adolescent↗

PubMedDate not supplied

CT manifestations of tubercular mediastinal lymphadenopathy.

A retrospective analysis was done of computerized tomographic (CT) scans of 29 patients with image guided histologically proven mediastinal tubercular lymphadenitis. Amongst these 19 patients were males while 10 were females in the age range of 2-65 years. Plain radiographs of all the patients revealed mediastinal lymphadenopathy. There was a high incidence of involvement of right paratracheal and tracheobronchial lymph nodes. The lymph nodes larger than 2 cm showed central low density area with peripheral enhancing walls. However, nodes less than 2 cm in size were mostly homogenous.

Adolescent↗

PubMedDate not supplied

An analysis of effect of common domestic fuels on respiratory function.

Pulmonary function studies were carried out in 3318 healthy, nonsmoking asymptomatic housewives to evaluate the role of different cooking fuels in domestic use. The women used four different types of cooking fuels: biomass fuel, liquified petroleum gas (LPG), kerosene used in stoves, and a combination of two or more of these (mixed). Four parameters of ventilatory function (FVC, FEV1, PEFR and MMEF) were evaluated. A positive correlation was observed between all these parameters except PEFR with that of height, but a negative correlation was observed between the age, duration of cooking and exposure index. Mixed fuels and biomass fuels affected FVC values (F = 6.39, p = 0.0003) more adversely. Similar trend was observed for FEV1 also. Users of biomass fuel had the lowest mean value for PEFR. Small airways function represented by MMEF was the lowest in users of kerosene. In users of mixed fuels, there was a decline in FVC, FEV1 and PEFR, as the exposure increased. Thus, it is concluded that, mixed fuel has more deleterious effects on pulmonary function than other fuels.

Adult↗

PubMedDate not supplied

Pulmonary function abnormality in patients with portal hypertension with or without chronic liver disease.

Pulmonary function (FVC, FEV1, PEFR, MMEF) and arterial blood gases (ABG) were analysed in 30 patients of portal hypertension. The aetiology of portal hypertension included cirrhosis of liver (n = 10), non cirrhotic portal fibrosis (NCPF, n = 10) and extrahepatic portal vein obstruction (EHPVO). Ten patients with chronic active hepatitis (CAH) without portal hypertension were also studied. Most pulmonary functions were abnormal (low) in portal hypertension and the most affected parameters, were FEV1, PEFR and MMEF (p < 0.05). The same was also observed in CAH, although in less number of patients. Hypoaxemia (26.7%) and wide alveolar--arterial oxygen gradient were observed most frequently in patients of portal hypertension. These patients also had a more alkaline blood pH. EHPVO patients had better lung function and arterial blood gas values. Patients with NCPF had greater impairment in pulmonary function.

Adolescent↗