Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
 
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   2008| July-September  | Volume 3 | Issue 3  
    Online since July 16, 2008

 
 
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REVIEW ARTICLE
Tuberculosis of the breast
Salim Baharoon
July-September 2008, 3(3):110-114
DOI:10.4103/1817-1737.41918  PMID:19561892
Tuberculosis of the breast is an uncommon disease even in countries where the incidence of pulmonary and extrapulmonary tuberculosis is high. Clinical presentation is usually of a solitary, ill-defined, unilateral hard lump situated in the upper outer quadrant of the breast. This disease can present a diagnostic problem on radiological and microbiological investigations, and thus a high index of suspicion is needed. Incorporating a highly sensitive technique like polymerase chain reaction (PCR) may be helpful in establishing the usefulness of such technology and can aid in conforming the diagnosis early. The disease is curable with antitubercular drugs, and surgery is rarely required
  17 10,882 1,235
ORIGINAL ARTICLES
Using arm span to derive height: Impact of three estimates of height on interpretation of spirometry
SK Chhabra
July-September 2008, 3(3):94-99
DOI:10.4103/1817-1737.39574  PMID:19561887
Background: When standing height required to calculate forced vital capacity (FVC) cannot be measured, it can be derived from arm span using different methods. Objectives: To compare three different estimates of height derived from arm span and investigate their impact on interpretation of spirometric data. Methods: In a cross-sectional study, 517 subjects aged 7 to 76 years, with various respiratory diseases underwent spirometry. Three estimates of height were obtained from arm span: (a) by direct substitution (Ht AS ); (b) estimated height (Ht est ), obtained from the mean arm span:standing height ratio; and (c) predicted height (Ht pred ), obtained from arm span by linear regression analysis. Predicted values of forced vital capacity (FVC) obtained from these estimates were compared with those obtained from actual standing height (Ht act ), followed by Bland Altman analysis of agreement in the patterns of ventilatory impairment. Results: The arm span was 5%-6% greater than the height. The difference increased with increasing height. Ht AS and the FVC predicted from it were significantly greater than the other measures of height and the related predicted FVCs respectively. Compared to Ht act , Ht AS gave a misclassification rate of 23.7% in taller subjects (Ht act > 150 cm) and 14.2% in shorter subjects in the patterns of ventilatory impairment. Misclassification rates were 6%-8% with Ht est and Ht pred . Agreement analysis showed that FVCs predicted from Ht pred had the best agreement with the FVC predicted from Ht act . Conclusions: Among several methods of estimating height from the arm span, prediction by regression is most appropriate as it gives least errors in interpretation of spirometric data
  9 21,139 1,046
CASE REPORTS
Spontaneous pneumothorax: An unusual complication of pregnancy - A case report and review of literature
Rajiv Garg, Sanjay , Vinita Das, Kauser Usman, Sumit Rungta, R Prasad
July-September 2008, 3(3):104-105
DOI:10.4103/1817-1737.41915  PMID:19561889
Spontaneous pneumothorax complicating pregnancy is rare. Only 55 cases have been reported till now. We describe a case of a 30-year-old Indian woman with spontaneous pneumothorax during her 28 th week of pregnancy.
  8 7,900 671
BRIEF REVIEW
Role of nitric oxide in management of acute respiratory distress syndrome
AH Akmal, Mohd Hasan
July-September 2008, 3(3):100-103
DOI:10.4103/1817-1737.41914  PMID:19561888
The current mortality rate of patients suffering from acute respiratory distress syndrome (ARDS) is between 45% and 92%, with most dying within the first two weeks of the illness. In an effort to combat such an alarmingly high mortality rate, various treatment therapies such as low tidal volume ventilation strategies, corticosteroid therapy, and use of nitric oxide (NO) have been attempted in the management of patients with ARDS. Three cases which were admitted to the ICU and confirmed to have ARDS were unable to be weaned from ventilatory support, and nitric oxide therapy was initiated. It improved patients' oxygenation for short periods of time but did not affect the mortality. The patients could not be weaned from the ventilator and expired.
  7 10,198 1,071
ORIGINAL ARTICLES
Correlation between high-resolution computed tomography features and patients' characteristics in chronic obstructive pulmonary disease
Prem P Gupta, Rohtash Yadav, Manish Verma, Dipti Agarwal, Manoj Kumar
July-September 2008, 3(3):87-93
DOI:10.4103/1817-1737.39676  PMID:19561886
Background: During the last few decades, high-resolution computed tomography (HRCT) has come up as a new diagnostic modality to diagnose emphysematous and chronic bronchitis components of chronic obstructive pulmonary disease (COPD). The present study was undertaken to evaluate for various quantitative and qualitative HRCT features in patients with COPD, and to detect patients' characteristics that correlate with these HRCT features. Materials and Methods: Forty male patients with COPD attending the COPD clinic at a tertiary referral hospital and postgraduate medical institute were included in the study. Various HRCT features, including tracheal index, thoracic cage ratio, sterno-aortic distance, thoracic cross-sectional area, vascular attenuation, vascular distortion, mosaic attenuation pattern, and directly visible small airways, were evaluated and correlated with patients' characteristics, including age, duration of illness, quantum of smoking, dyspnea score, quality-of-life index, and various spirometric indices. Results: We found significant correlations of various quantitative and qualitative HRCT features with age, duration of illness, quantum of smoking, quality-of-life index, and the spirometric indices showing the extent of airways obstruction. Conclusions: Various quantitative and qualitative HRCT features were found to correlate with patients' characteristics, spirometric indices, and health-related quality-of-life score, suggesting that HRCT is useful not only in detecting emphysema and its various subtypes but also in predicting the extent and severity of COPD
  7 9,181 860
CASE REPORTS
Colopleural fistula: Case report and review of the literature
A Haleem A El Hiday, Fahmi Y Khan, Ahmed M Almuzrakhshi, Hani EI Zeer, Fatima A Rasul
July-September 2008, 3(3):108-109
DOI:10.4103/1817-1737.41917  PMID:19561891
We report a 28-year-old woman, pregnant, at 24 weeks, with 3-day history of right-sided chest pain and shortness of breath. Few hours after admission, she delivered a dead baby. She had a history of right partial hepatic lobotomy and cholecystectomy at UK on May 2004 because of multiple pyogenic liver abscesses. Chest examination revealed signs of hydrothorax on the right side. Chest X-ray showed pleural effusion on the right side. Pleural fluid was exudative with high neutrophils. Gram stain and culture showed multiple organisms. CT scan chest and abdomen with contrast, combined with barium enema, revealed right colothorax communication. Colothorax fistula was closed surgically. On the following days, the patient's symptoms resolved, and she was consequently discharged.
  5 4,819 506
ORIGINAL ARTICLES
HRCT score in bronchiectasis: Correlation with pulmonary function tests and pulmonary artery pressure
Abdulaziz H Alzeer
July-September 2008, 3(3):82-86
DOI:10.4103/1817-1737.39675  PMID:19561885
Background: High resolution CT scan (HRCT) and its score have an important role in delineating pathological changes and pulmonary functional impairment in patients with bronchiectasis. Aims: To assess pulmonary function tests (PFTs) in patients with cystic and cylindrical bronchiectasis. To correlate HRCT score with PFTs and systolic pulmonary artery pressure (SPAP) in both radiological types. Materials and Methods: A cross-sectional study of patients with bronchiectasis diagnosed by HRCT was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia. PFTs, HRCT score and SPAP were measured in both types. Results: We studied 94 patients with bronchiectasis: 62 were cystic and 32 were cylindrical. Their mean age was 53.417.5 SD years. Forced vital capacity (FVC %) and forced expiratory volume in 1 second (FEV1%) were significantly lower in cystic patients ( P < .0001) compared with cylindrical and Diffusion capacity (DLCO %) was also significantly lower ( p < 0.01). In cystic group PaO2 was significantly lower and PaCO2 higher ( P < 0.0001). HRCT score was correlated with FEV1% (r= -0.51). HRCT score was significantly lower in the cystic group ( P =0.002)and correlated with SPAP ( r =0.23). Global HTCT score of 10.32.5 was associated with SPAP ≥40mmHg( P =0.011). Conclusion: Patients with cystic bronchiectasis have significant impairment of pulmonary physiology compared with cylindrical bronchiectasis patients. HRCT score correlated with PFTs and SPAP.
  5 12,069 1,147
CASE REPORTS
Unusual variant of Cantrell's pentalogy?
Basant Kumar, SB Sharma, Deepak K Kandpal, LD Agrawal
July-September 2008, 3(3):106-107
DOI:10.4103/1817-1737.41916  PMID:19561890
A 12-hour-old male infant presented with prolapsed abdominal content through a defect on left side of chest wall with respiratory distress. A thorough clinical examination suggested absence of ectopia cordis, abdominal wall defect, and any bony anomaly. The child expired after 6 hours of admission because of respiratory distress and electrolyte imbalance. Is congenital defect of chest wall associated with diaphragmatic hernia without ectopia cordis and omphalocele, an unusual variant of Cantrell's pentalogy?
  2 3,673 560
EDITORIAL
International cooperation to promote advances in medicine
Ghazwan Butrous
July-September 2008, 3(3):79-81
DOI:10.4103/1817-1737.41913  PMID:19561884
  - 3,811 452
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