Context:Chronic obstructive pulmonary disease (COPD) is not only restricted to the pulmonary inflammation and airway obstruction but is also associated with comorbidities, which affect the therapeutic intervention and the quality of life and survival. Markers that can predict the systemic inflammation and a decline in the pulmonary function are of scientific interest. Adiponectin (APN) appears to be one such biomarker and can be used as a potential indicator of severity and response to treatment in patients of COPD.Aims:The study aims to find out the role of APN as a marker of inflammation in the pathogenesis of COPD and explore its relationship with the severity of the disease.Settings and Design:This was a cross-sectional study.Subjects and Methods:The study group consisted of 60 patients of COPD, which included 30 males admitted with acute exacerbation of COPD (AECOPD) and 30 males with stable COPD. The study group was compared with 30 healthy, age-matched males. APN was estimated by commercially available ELISA kits. Pulmonary function tests were performed on all cases and controls using standardized protocols on SPIROLAB III.Statistical Analysis Used:Statistical analysis was performed using Student's t-test and Pearson's correlation coefficient.Results:The levels of APN were found to be significantly higher in patients with COPD as compared to the controls and the levels increased with the severity of the disease were 16.10 ± 4.97 ng/ml and 11.43 ± 4.22 ng/ml, respectively, in AECOPD and COPD. A significant positive correlation was found between the levels of APN and interleukin (IL)-8 in patients of COPD, while the levels correlated negatively with percentage of forced expiratory volume in 1 s (FEV1%).Conclusions:The results reveal that APN is associated with the inflammatory process of COPD as suggested by its significant inverse relationship with FEV1% and positive correlation with a marker of inflammation such as IL-8. It can thus be used as a biomarker for disease severity and progression in patients of COPD, therefore aiding in risk stratification and therapeutic intervention.
Pulmonary nocardiosis is a rising bacterial infection, with a high propensity for misdiagnosis. On account of a paucity of prospective studies, there is limited understanding on various aspects of its diagnosis and treatment. We present three patients with pulmonary nocardiosis, with emphasis on the predisposing factors, variable disease course, and treatment issues. There is a need to understand the basis of these discrepancies so as to rationalize the management of this potentially fatal infection.
Case finding, an important parameter in fight against Tuberculosis (TB) has always remained a challenge despite advances in diagnostic modalities, access to health care and administrative commitment. We are still far from reaching the goals so set as per End TB Strategy and National Strategic Plan 2017-2025, and case finding is of paramount importance for achieving the said targets. This article, after identifying the obstacles faced in case finding, explores the various case finding strategies in the perspective of diagnostics, feasibility, resource utilization and current recommendations. Need for prioritization of case finding in different settings with involvement and active participation of one and all has been discussed. Role of health education in an individual, general public and health care worker in the context of case finding has been highlighted. Research areas to strengthen case finding have been enumerated. The review concludes by bringing out the need for heightened efforts for case finding in TB as the resources are significantly diverted as the world is facing the corona virus disease 2019 (COVID-19) pandemic.
Background: Smoking amongst women is increasing in the developing countries like India. There is paucity of data on the knowledge, attitude and practices of smoking amongst females in India. Hence a study was planned to assess the same.Methods: It was a qualitative research using descriptive questionnaire, prepared using the basic protocols available as per WHO Global Adult Tobacco Survey, conducted by self-reporting, from February to March, 2018 in the University Institute of Applied Management Sciences, Panjab University, Chandigarh. It was administered to 111 females aged 18 to 35 years, residing in Chandigarh.Results: Total22.5% of the female respondents were current smokers. Majority of them belonged to the age group of 26-35years; were either employed or were studying and felt that females resorted to smoking for gaining pleasure and relieving stress. Most of them were aware of passive smoking. Majority felt that people who smoke should quit for their own health and for their families and street plays, public awareness camps, television and cinema halls are important mediums for helping to quit. Will power be found to be most important to help smokers quit. Some quoted the role of nicotine replacement therapy, exercise, individual counseling etc also. Majority of the females started smoking early, at an age of 16-25years, consuming 1-10cigarettes per day and had been smoking since more than a year when interviewed. Smoking was primarily introduced by peers. All the smokers were aware of different types of smoking hazards, most commonly reported as cancer and asthma. 16/25 smokers wanted to quit and 14/16 had tried in the past but were unsuccessful.Conclusions: This study gives an indication of rising smoking trend in females. Smoking cessation measures need to be made more gender-sensitive, targeting females in their early ages.
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