Mayur Vikram Devraj

Abstract

Introduction: Inhalation mode of drug delivery is the mainstay treatment for COPD and asthma; however incorrect technique prevents patients from receiving proper benefits of inhalational drug therapy. Objective: The study was aimed to study the practice of rotahalor inhalation technique in patients with asthma and COPD and to determine the effects of interventions on these techniques through demonstration and videos. Materials and Methods: With the help of standardized checklist, patients were assessed initially. Then, they were trained with proper techniques using demonstrations and videos. Comparison of pre and postinterventional scores and FEV1 scores was done. Analysis: This was done using Paired “t” test. Pre and post-interventional values and FEV1 values were compared. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 21. Results: Overall, the Inhalation techniques of patients were found incorrect. Pre and post-interventional values and FEV1 values were compared and found highly significant. Post-interventional 54.54% patients could get all the 10 steps correct. Similarly, Mean FEV1 before and after intervention were found significantly different. Conclusion: Asthma and COPD patients still don’t use rotahalor inhalational technique correctly which therefore doesn’t provide maximal benefits of therapy. Keywords: COPD, Asthma, Rotahalor, Intervention.

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Background: Major risk factor causing worsening of function of lung is smoking. Several researchers had established changes of pulmonary function on outcome of spirometry test. Our intention was to learn influence of smoking on spirometry parameters of individual living in tribal region of our state. Methodology: Pulmonary function test was performed by group of 50 smoker and 50 nonsmoker subjects of age 20 to 60 years living in nearby tribal locality. Results: Pulmonary function parameters and result of test was compared between group of smoker & nonsmoker subjects. Conclusions: We conclude that mean FVC, FEV1 and PEFR were higher in nonsmoker. Smoking habit leads to definite pulmonary function impairments. Mixed pattern of lung function impairment turns out to be most common and obstruction pattern as 2nd most common among smokers. Keywords: Smoker; Nonsmoker; PFT.

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T-lymphoblastic lymphoma (T-LBL) is most commonly found in younger age group and rare. It is most aggressive form ofnon-Hodgkin’s lymphoma. T-lymphoblastic lymphoma (T-LBL) response rate to chemotherapy is very good although relapse is common with poor survival rates. A 25 years old female presented to emergency department of a tertiary care centre with dyspnoea and chest tube in left Hemothorax in situ. She had earlier history of pulmonary tuberculosis 3 years back and took anti tubercular treatment for 6 months. On general examination we found left supraclavicular lymphadenopathy of size 2 × 1.5cm and grade 2 clubbing. The pleural fluid was sent for analysis. It was reported as exudative pleural effusion with low ADA and negative for malignant cells. Lymph node biopsy was sent for histopathological examination which was reported as T Lymphoblastic lymphoma. NHL is a diverse category of cancers that originate from B or T cells at different stages of maturation. In relation to our case; earlier history of tuberculosis, pus from lymph node could mislead to infective aetiology; as lymph node necrosis is commonly found in Hodgkin’s disease. This fact reiterates the fact that through clinical examination and history leads to proper diagnosis and management of the patient and can save time of the patients.   Keywords: Lymphoma, Non­hodgkin's lymphoma, NHL, Lymph node, Pus.

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Abstract

Extra-pulmonary Tuberculosis (EPTB), 10% about is musculoskeletal cases. A middle age female who presented to outpatient department of tertiary care center (Medical college & Hospital) with swelling over volar surface of right distal forearm gradually increased in size over 9 to 10 months. She noticed difficulty to move fingers of right hand as size of swelling increasing. She had tingling sensation in the territory of median nerve. It was single swelling of 05cm x 07cm over the volar surface of right distal forearm with defined margins. Lesion was open surgically and rice bodies were found. Histopathological examination had shown caseous type of necrosis and granuloma formation suggestive of tuberculosis. Anti-tuberculosis treatment was given to her. Cases of TB tenosynovitis are uncommon and diagnosis is often missed causing delay of treatment to patient. Surgical intervention decided by symptoms and signs. Antitubercular therapy and excision of lesion produce good outcome. Keywords: Anti TB treatment; Rice Bodies; Surgical excision; Tenosynovitis.

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