Users Online: 1237
Home
Current Issue
Ahead of Print
Search
About Us
Publishing Ethics
Editorial Board
Archives
Submit Article
Instructions
Subscribe
Contacts
Reader Login
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
Access statistics : Table of Contents
2017| January-March | Volume 11 | Issue 1
Online since
January 24, 2017
Archives
Previous Issue
Next Issue
Most popular articles
Most cited articles
Show all abstracts
Show selected abstracts
Export selected to
Viewed
PDF
Cited
AIRWAY DISEASES - ORIGINAL ARTICLES
The relationship between metabolic syndrome and chronic obstructive pulmonary disease
Therese Ghatas
January-March 2017, 11(1):11-15
DOI
:10.4103/1687-8426.198983
Background
Metabolic syndrome is a condition frequently found among individuals. It predisposes affected individuals to systemic inflammation and physical inactivity. The aim of the present study was to investigate the frequency of metabolic syndrome and C-reactive protein (CRP) levels as markers of systemic inflammation in stable chronic obstructive pulmonary disease (COPD) patients with different severity levels and in an age-matched and sex-matched control group.
Patients and methods
One hundred COPD patients and 50 controls were included in this study. The severity level in patients with COPD was determined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I−IV, we measured the characteristics of the metabolic syndrome and systemic inflammation (high-sensitivity C-reactive protein).
Results
The frequency of metabolic syndrome was found to be higher in the patient group than in control individuals, especially in GOLD stages I and II. Abdominal obesity, hypertension, and hyperglycemia components of metabolic syndrome were significantly more prevalent in the patient group (
P
<0.05 for all). Increased CRP levels were higher in control and patient groups in all GOLD stages, with metabolic syndrome than without metabolic syndrome.
P
-values for control group and GOLD stages I–IV were 0.044, 0.483, less than 0.01, 0.048, and 0.076, respectively.
Conclusion
Metabolic syndrome is substantial among stable COPD patients, especially in the early stages (GOLD stages I−II). Abdominal obesity, hypertension, and hyperglycemia were significantly more in COPD patients with metabolic syndrome. An impaired profile of CRP levels was found in patients and control groups with metabolic syndrome than in individuals without metabolic syndrome.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
2,363
355
9
PLEURAL DISEASES - ORIGINAL ARTICLE
Value of C-reactive protein in differentiation between tuberculous and malignant pleural effusion
Sherif A.A. Mohamed, Gamal R Agmy, Safaa M Wafy, Montaser G.A. Abd El-Hameed
January-March 2017, 11(1):49-55
DOI
:10.4103/1687-8426.198999
Background
Few studies had reported the value of C-reactive protein (CRP) in differentiating between tuberculous pleural effusion (TBPE) and malignant pleural effusion (MPE).
Aim
The aim of this study was to investigate the diagnostic value of CRP in differentiating between TBPE and MPE.
Settings and design
This prospective study was conducted in a University Hospital.
Patients and methods
During a period of 18 months, a prospective study included 59 adult patients with pleural effusion. The study included two groups: group I, which included 29 patients with TBPE, and group II, which included 30 patients with MPE. Serum C-reactive protein (s-CRP) and pleural fluid C-reactive protein (p-CRP) were measured and compared in both groups, using enzyme-linked immunosorbent assay.
Results
The mean values of s-CRP were 28.34±14.41 and 27.87±13.21 mg/dl in TBPE and MPE, respectively, with no significant difference. The mean values of p-CRP were 36.51±3.91 and 26.39±7.57 mg/dl in TBPE and MPE, respectively, with a highly significant difference (
P
=0.001). There were significantly positive correlations between s-CRP and p-CRP in both TBPE and MPE (
r
=0.685 and
P
=0.001;
r
=0.594 and
P
=0.006, respectively). With the use of cutoff values of 31.6 and 43.3 mg/l for p-CRP and s-CRP, sensitivity and specificity were 89.47 and 80.00% for p-CRP, and 15.79 and 100.00%, respectively, for s-CRP. The area under the receiver operating characteristic curve of p-CRP was 0.888, superior to that of s-CRP (0.525).
Conclusion
Measurement of CRP levels in the pleural fluid has a good utility in the diagnostic workup of patients with pleural effusion. p-CRP can be a useful adjunctive test, as a potential differentiator between TBPE and MPE.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
2,489
209
1
CASE REPORTS
Granulomatosis with polyangiitis: Rheumatoid arthritis overlap syndrome: A case report
Ashraf E Sileem, Ahmed M Said
January-March 2017, 11(1):56-61
DOI
:10.4103/1687-8426.198995
Antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) may rarely be associated with other immune-mediated diseases. Knowledge of these overlap syndromes is important in early recognition of potential complications and differences in clinical courses and management pathways. In this paper we describe the case of a male Egyptian patient, 52 years old, with hypertension and rheumatoid arthritis on disease-modifying antirheumatic drugs, with a recent history of ocular and renal manifestations suggesting vasculitis, who presented to our Emergency Department with acute interstitial pneumonitis, which was successfully treated with high-dose steroids. His clinical course had deteriorated because of self-stoppage of the maintenance dose of steroid and appearance of bilateral nodular infiltrates in the lungs on the chest radiographs. His cytoplasmic c-ANCA autoantibodies were positive, in addition to the histopathological examination of open lung biopsy, which was consistent with granulomatosis with polyangiitis. He was successfully treated with high-dose steroids and cyclophosphamide. We reported a new case of granulomatosis with polyangiitis developing during adalimumab therapy for rheumatoid arthritis. This clinical observation must be considered in all patients treated with antitumor necrosis factor. On the basis of the previously published cases of AAV associated with rheumatoid arthritis as well as our case, the suggestion of a rare form of an AAV autoimmune overlap should be recognized and investigated for rapid initiation of appropriate management.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
2,265
149
-
PULMONARY INFECTIONS - ORIGINAL ARTICLE
Role of chest ultrasonography in the diagnosis and follow-up of community-acquired pneumonia at Zagazig University Hospitals
Mohammad Walaa Saied Moghawri, Waleed Mansour, Khaled Ahmad Lakouz, Rabieh Mohammad M Hussein
January-March 2017, 11(1):29-35
DOI
:10.4103/1687-8426.198991
Background
Pneumonia is one of the most common diseases with a high hospitalization rate and is potentially life threatening. Chest ultrasound (US) is increasingly being used as a valuable bedside tool in the diagnosis of various thoracic conditions, especially pneumonia.
Patients and methods
A total of 120 patients clinically suspected as having pneumonia were selected. Chest US was performed for the number, location, shape, size, breath-dependent movement of pneumonia, incidence of necrotic areas, positive air bronchogram, fluid bronchogram, and pleural effusion either simple or septated. Follow-up was carried out on days 1, 5, 8, and 14.
Results
Patientsʼ ages ranged from 24 to 85 (58.5±15.2) years. Of them, 73 (60.8%) were male and 47 (39.2%) were female. Chest US showed positive findings in 116 (96.7%) patients, with a sensitivity of 97.4%, specificity of 25%, and accuracy of 95%. There was a highly significant difference (
P
<0.001) between chest US and plain chest radiography in detecting pneumonia, whereas there was no significant difference (
P
>0.5) between chest US and chest computed tomography. Chest US had a high significant difference (
P
<0.001) in detecting minimal pleural effusion over plain radiography. Moreover, it had a sensitivity of 93.8%, specificity of 99%, and accuracy of 98.3% in detecting complex septated pleural effusion. Improvement in pneumonia was detected in 111 patients (95.7%) with chest US, whereas improvement was detected in 76 (75.2%) patients with plain chest radiography after 14 days; this was highly significant (
P
<0.001).
Conclusion
Chest US is a quick, bedside, noninvasive, nonionizing, and highly sensitive tool to detect and follow-up cases of pneumonia and parapneumonic effusion.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
2,027
193
1
AIRWAY DISEASES - ORIGINAL ARTICLES
Single-breath diffusion capacity of the lung for carbon monoxide in chronic obstructive pulmonary disease
Waleed M El-Sorougi, Maha M Fathy
January-March 2017, 11(1):23-28
DOI
:10.4103/1687-8426.199002
Background
Chronic obstructive pulmonary disease (COPD) is defined by progressive, irreversible airflow limitation and an inflammatory response of the lungs, usually to cigarette smoke. However, COPD is a heterogenous disease in terms of clinical, physiological, and pathological presentation. The pathological hallmarks of COPD are inflammation of the small airways (bronchiolitis) and destruction of lung parenchyma (emphysema). The functional consequence of these abnormalities is airflow limitation.
Aim of work
The aim of the study was to measure diffusion capacity in different stages of COPD.
Patients and methods
Sixty outpatients with COPD with mild to very severe obstruction were included in the study.
Results
There was a statistically significant negative (inverse) correlation between TLCO%, TLCO/VA, PCO
2
, and HCO
3
and there was a statistically significant positive (direct) correlation between TLCO%, TLCO/VA, PO
2
, and arterial oxygen saturation. There was a statistically significant positive (direct) correlation between FVC%, FEV1%, FEF25%, FEF50%, FEF75%, TLCO%, and TLCO/VA.
Conclusion
Reduced diffusion capacity of the lung for carbon monoxide plus airflow obstruction together identifies a group of individuals with significantly worse lung function.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
2,043
161
-
REVIEW ARTICLE
Screening of Tuberculosis patients for possible diabetes mellitus in India: a systematic review
Janmejaya Samal
January-March 2017, 11(1):1-6
DOI
:10.4103/1687-8426.199003
Background
Tuberculosis (TB) and diabetes mellitus (DM) are both the greatest public health problems in the world. Although India ranks fourth in TB burden, the incidence of diabetes in the country is also rising. The bidirectional association between TB and DM is established by many epidemiological studies elsewhere in the world.
Objective
The aim of this study was to understand the utility and importance of screening patients with TB for possible DM in Indian settings through systematic literature review.
Methodology
For the search of articles, PubMed and Google Scholar search engines were primarily used. Few articles were also obtained from the cross-references of the selected articles. Of 108 articles obtained by the end of this search process, eight full-texts articles were finally selected for the purpose of this review.
Results
Of the eight titles, six articles focused on screening of patients with TB for DM (unidirectional screening), whereas two articles focused on bidirectional screening, that is, screening of patients with TB for DM and vice versa. Of the eight studies obtained, six studies are from South Indian states (Andhra Pradesh, Tamil Nadu, and Karnataka), one from West Indian state (Gujarat), and one covers pan-India sample. The prevalence of DM among patients with TB ranged from 2.9% (lowest) to 21.2% (highest). Similarly, the number needed to screen ranged from 16 (lowest) to 40 (highest) as reported by various studies conducted in India.
Conclusion
Screening of patients with TB for DM is feasible at the level of existing health system without any additional resources as demonstrated by the studies conducted in different parts of India.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1,938
227
2
INTERVENTIONAL BRONCHOLOGY AND PULMONOLOGY - ORIGINAL ARTICLE
Doxycycline poudrage in pleurodesis of malignant pleural effusion: a novel modality for an old agent
Tamer A Elhadidy, Ahmed M Abumossalam, Mohamed S Elashry
January-March 2017, 11(1):7-10
DOI
:10.4103/1687-8426.199001
Context
Malignant pleural effusion is a common presentation of several malignancies. Chemical pleurodesis is important in its management, but no consensus exists on the optimal agent or methods of pleurodesis.
Aim
This work aimed to evaluate the outcome of oral doxycycline capsules in a poudrage form through a medical thoracoscope as a therapeutic approach for pleurodesis in patients with malignant pleural effusion.
Setting and design
This study was a prospective quasiexperimental one.
Patients and methods
This prospective quasiexperimental study was conducted on 70 patients with metastatic pleural effusion. They underwent pleurodesis with thoracoscopic doxycycline poudrage.
Results
The success of doxycycline powder poudrage was complete in 75.7% of cases and partial in 10% of cases; however, failure was observed in 14.3%. Thus, total success rate was 85.7%. As regards complications, they were irrelevant; pain was the predominant feature in 81.4% of cases, fever in 11.4% of cases, and empyema in only 4.3% of cases.
Conclusion
Using oral doxycycline with thoracoscopic poudrage yielded a remarkable success rate and may alternate the need for talc powder with less complications and more safety.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1,789
161
1
CASE REPORTS
Ethionamide-induced gynecomastia: A rare case report
Sourindra N Banerjee, Rupam K Ta, Md. Salim Mallick, Manish K Munda
January-March 2017, 11(1):70-73
DOI
:10.4103/1687-8426.198998
Gynecomastia is a rare side effect of antitubercular chemotherapy. A 22-year-old male patient was diagnosed as a multidrug-resistant tuberculosis case and was put on standard second-line antituberculosis drugs. Two months later, the patient developed painful enlarged left breast with size 2×3 cm
2
, mobile, tender, and normal nipple-areola without any discharge. Common endocrinological and biochemical tests were normal. Ethionamide-induced gynecomastia was suspected. Ultrasonography of the breast showed hypoechoic shadow suggesting glandular tissue hyperplasia without any deeper tissue infiltration. On discontinuing ethionamide, gynecomastia reduced gradually. On reintroduction, gynecomastia reappeared and again disappeared within weeks after withdrawal. Thus, painful gynecomastia induced by ethionamide was concluded. We report this case of unilateral painful gynecomastia because of its rarity and for the purpose of documentation and awareness.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,751
96
-
A child with recurrent pallor and hemoptysis: Diagnostic challenges
Chaitali Patra, Shatanik Sarkar, Malay K Dasgupta
January-March 2017, 11(1):62-65
DOI
:10.4103/1687-8426.198993
A 7-year-old girl presented with severe pallor, cough, and massive hemoptysis. She had been previously hospitalized twice within the time span of 2 years for severe pallor and hemoptysis, each time requiring 2 U of blood transfusion. In the recent episode, blood examination was suggestive of iron deficiency anemia, chest radiograph yielded bilateral pulmonary infiltrate, computed tomography scan of lungs showed ground glass pattern, and bronchoalveolar lavage revealed hemosiderin-laden macrophages. Investigations to exclude any secondary causes of pulmonary hemosiderosis were negative. The child was diagnosed as a case of idiopathic pulmonary hemosiderosis and treated with prednisolone.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,632
103
-
AIRWAY DISEASES - ORIGINAL ARTICLES
INFLOW study: a prospective observational study for assessment of indacaterol and other bronchodilators in symptomatic chronic obstructive pulmonary disease patients from Egypt
Waleed M El-Sorougi, Dina Abouelwafa
January-March 2017, 11(1):16-22
DOI
:10.4103/1687-8426.199000
Background
The
IN
dacaterol e
F
fectiveness and uti
L
izati
O
n in COPD: real-
W
orld evaluation (INFLOW) study demonstrated significant improvements in health status with decreasing Clinical COPD Questionnaire (CCQ) scores in routine clinical practice with indacaterol (IND) and other bronchodilators from 12 countries in Asia, the Middle East and South Africa. Here, we report the data on real-life effectiveness of IND and other bronchodilators from Egypt.
Methods
In this 6-month, noninterventional, open-label study, patients were prescribed IND (150 or 300 μg) or other long-acting β
2
-agonists (LABAs) or tiotropium (TIO) (monotherapy or in combination with IND or LABAs) as a part of routine medical care. Health status (CCQ scores), patient and physician satisfaction and safety were assessed.
Results
Data were analysed from 152 patients (IND,
n
=88; IND+TIO,
n
=27; other-LABAs,
n
=6; TIO,
n
=10; and other-LABAs+TIO,
n
=21). At the end of the study, reduction from baseline CCQ total score was significant (
P
<0.0001) with IND and other treatments. Approximately 80% of patients were satisfied and physicians rated the current prescribed treatments as ‘good’ or ‘very good’ for over 70% of the patients. More than 80% of patients rated the indacaterol inhaler (Breezhaler) device as ‘easy’ and ‘very easy to use’, and physicians rated over 70% of patients as ‘clearly understood the use of the device’. No adverse events related to premature discontinuation were reported.
Conclusion
In real-world settings, IND as monotherapy or in combination with TIO was effective in improving the health status in COPD patients and is well tolerated. The majority of patients reported that the Breezhaler device was easy to use.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,539
126
-
CASE REPORTS
Bronchoscopy as a salvage therapy in a mechanically ventilated status asthmaticus patient: A case report
Animesh Ray, Vivek Nangia, Rajat Chatterji, Navin Dalal
January-March 2017, 11(1):66-69
DOI
:10.4103/1687-8426.198985
A 23-year-old male patient presented with acute exacerbation of asthma with type 2 respiratory failure. He was mechanically ventilated and started on intensive medical therapy including nebulization with β2 agonists and antimuscarinic drugs, steroids, antibiotics and magnesium sulphate as per standard protocol. As there was no response to the above-mentioned line of treatment, other nonstandard therapies such as intramuscular adrenaline and ketamine were also tried but to no avail. After a meticulous literature search, bronchoscopy was planned to look for any alternative diagnoses as well as to perform bronchial toileting. The patient showed dramatic improvement after the procedure, was subsequently extubated and discharged in stable condition. This case essays the significant role of bronchoscopy in refractory status asthmaticus patients, discusses the pathophysiological mechanisms addressed by bronchoscopic toileting and, furthermore, reviews the contemporary literature for evidence in its favour.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,538
103
-
SLEEP MEDICINE - ORIGINAL ARTICLES
Study of the value of percutaneous nocturnal oximetry in the monitoring of obese hypoventilation syndrome patients under non invasive home ventilation
Amr Shoukri
January-March 2017, 11(1):44-48
DOI
:10.4103/1687-8426.199005
Background
Nocturnal noninvasive ventilation (NIV) is often a treatment option for obesity hypoventilation syndrome (OHS). Monitoring this treatment is important to verify its efficacy.
Aim
The aim of the present study was to assess the role of overnight pulse oximetry in the monitoring of OHS patients under NIV.
Patients and methods
Twenty patients with OHS using nocturnal bilevel positive airway pressure therapy without supplemental oxygen were included in the present study. Overnight pulse oximetry study was performed, and according to the results, the patients were divided into two groups: group I (normal study) and group II [abnormal study showing nocturnal percutaneous oxygen saturation (SpO
2
) <90% in ≥10% of the total recorded time]. Group II patients were subjected to respiratory polygraphy for more detailed assessment, and then, appropriate therapeutic modifications were done, after which a second overnight pulse oximetry study was performed to verify the efficacy of ventilation after these modifications.
Results
Twenty OHS patients using nocturnal NIV were included in the present study. There were eight (40%) male patients and 12 (60%) female patients, with a mean age of 58.7±7.39 years. The mean BMI was 45.86±3.71 kg/m
2
. Group I consisted of 11 (55%) patients and group II had nine (45%) patients. Respiratory polygraphy performed to group II detected airway obstruction in two patients, insufficient ventilation in five patients and significant nonintentional leaks in two patients. Therapeutic modifications were done, and then a second overnight pulse oximetry performed showing normal results in seven patients, whereas two patients showed lesser desaturations but results were still abnormal.
Conclusion
Overnight pulse oximetry is a very useful tool in assessment of NIV efficacy in OHS patients, it is portable, simple, and it can detect oxygen desaturations that direct to perform further tests to apply appropriate therapeutic modifications to optimize NIV.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,259
98
-
Predictor factors of sleep-disordered breathing in heart failure
Suzan Salama, Amany Omar, Yasser Ahmed, Mahmoud Abd El Sabour, Mohamed Ismail Seddik, Doaa Magdy
January-March 2017, 11(1):36-43
DOI
:10.4103/1687-8426.198988
Background
Heart failure (HF) is characterized by its high mortality, frequent hospitalizations, and reduced quality of life. Sleep-disordered breathing (SDB), one of the common comorbidities, accelerates the progression of HF.
Objectives
The objectives of the study were (a) to investigate the prevalence and type of SDB in HF patients and (b) to determine the predictors of SDB.
Materials and methods
In a cross-sectional analytic study, all eligible patients of Assiut Chest and Cardiology Department admitted (100 patients) during the period from August 2015 to March 2016 were included in this study. Clinical assessment, full-night attended polysomnography, and echocardiography were recorded and compared between patients with (SDB) (85 patients) and those without SDB (15 patients).
Results
SDB was found in 85% of patients [53% had obstructive sleep apnea (OSA) and 32% had central sleep apnea (CSA)]. OSA patients are characterized by higher BMI and neck and waist circumference. There was a higher prevalence of hypertension, as well as mean blood pressure, systolic blood pressure, diastolic blood pressure, in OSA patients. Loud snoring was the only clinical symptom associated with OSA as compared with CSA. CSA patients had a significant reduction in PaCO
2
. OSA patients showed a significant increase in desaturation index and time spent with oxygen saturation less than 90%. Maximum heart rate and brady/tachy index were significantly increased in OSA. Cycle length was significantly increased in CSA.
Conclusion
The prevalence of sleep apnea was high in patients with stable HF (85%). OSA was the predominant type (53%). The predictors of SDB were BMI (≥30), systemic hypertension, neck circumference more than 40 cm, waist circumference more than 110 cm, and ejection fraction (left ventricular ejection fraction) (≤45%).
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
1,208
91
-
Feedback
Sitemap
|
What's New
|
Feedback
|
Disclaimer
|
Privacy Notice
© Egyptian Journal of Bronchology | Published by Wolters Kluwer -
Medknow
Online since 31st Dec, 2013