A 40 year old woman developed recurrent Kikuchi's disease 12 years after the original episode. The recurrence aVected the same site (axilla) and occurred after the longest delay so far recorded in a European resident. Care must be taken to avoid misdiagnosis of Kikuchi's disease as lymphoma. (J Clin Pathol 2000;53:157-158)
Pulmonary hypoplasia, a congenital malformation, is characterized by incomplete development of the lungs, leading to an abnormally less number or dimensions of bronchopulmonary segments / alveoli resulting in small fibrotic and nonfunctional lung. It is usually diagnosed in the neonatal period or in early childhood. Hypoplasia may be primary (idiopathic) or secondary. Primary pulmonary hypoplasia, not related to other congenital anomalies is extremely seldom diagnosed in adults. We report the case of a 32-year-old married female with two kids presented to us with chief complaints of cough and fever for past nine months. Chest radiograph showed opacification of the left hemi-thorax with decrease in its size and marked ipsilateral mediastinal displacement with an increase in volume of right lung. After investigations she was diagnosed as a case of left lung primary pulmonary hypoplasia. High level of excellent clinical judgement needed to spot and diagnose this congenital aberration, often wrongly diagnosed in adults. Hence, once confronted with an opaque hemi-thorax in a young person with ipsilateral shift of the mediastinum, differential diagnosis of "lung hypoplasia" ought to be kept in mind.
Background: Tuberculosis (TB) is one of the common communicable disease affecting human beings since ancient times. Though effective chemotherapy emerged during 20th century had raised hope towards eliminating TB burden, it still remains as a distant goal. Awareness about TB among close contacts of active disease is of paramount importance in preventing its spread and promoting early diagnosis and treatment. This study aimed to assess the knowledge about tuberculosis among caregivers of tuberculosis patients.Methods: This was a cross sectional study that enrolled 300 subjects who were then caregivers of tuberculosis patients admitted in the Department of Pulmonary Medicine. Subjects were interviewed according to a predesigned panel of questions meant to assess their basic knowledge and perceptions about tuberculosis symptomatology, diagnostic modalities, treatment and prevention.Results: About 90.3% (n=271) of subjects had heard about TB previously and about 37.7% (n=113) considered themselves to be well aware of it. Most of them believed TB to be communicable (90.3%, n=271). Majority believed that TB affects lungs only (n=206, 68.7%), with most commonly perceived symptom being cough (n=285, 95%). Knowledge regarding disposal of sputum was poor (n=110, 36.7%). About 168 (56%) subjects considered usage of face mask by the patient as an effective tool for TB prevention.Conclusions: Caregivers of tuberculosis patients lack proper knowledge about major aspects of the disease. Public awareness and care giver education programs needs to be implemented along with standard TB care to reduce transmission of TB among close contacts.
Background: Chronic respiratory diseases are among the leading causes of morbidity and mortality worldwide with chronic obstructive pulmonary disease (COPD) and asthma being the most common. There is under-utilization of the basic tools of inhalation therapy technique(s) in their management. Implementation of a personalized educational and demonstrational intervention by the attending physician during regular follow-up visits of these patients will substantially improve the treatment outcome.Methods: This prospective interventional study was conducted on 239 diagnosed cases of asthma and COPD. Inhaler technique was assessed in accordance to standard checklist and errors were corrected by a practical demonstration. A follow-up assessment was conducted for the same after 2 weeks. Data thus collected was evaluated.Results: Out of 239 patients, 47.6% (n=114) reported for follow-up assessment. Average reporting time for follow-up assessment was 27.4 days. Amongst them, an improvement of at least one step was found in 86.8% (n= 99) and about 28% (n=32) patients performed all steps correctly. Average number of steps improved was 2.1.Conclusions: Majority of the patients showed an improvement in the inhaler technique during follow-up assessment after an educational intervention and practical demonstration. Near perfection was achieved by about more than quarter of the patients. Regular practical demonstration of the inhalation technique during subsequent follow-up sessions unequivocally improves results.
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