A 11 year old female was referred from ophthalmology clinic to pulmonary medicine department for further evaluation of a case of unilateral conjunctivitis not responding to treatment as suspected case of conjuctival tuberculosis. In the right eye, bulbar conjunctiva in supranasal quadrant polypoidal appearance was seen and there was subconjunctival cystic nodular mass in the superior conjunctival fornix. Systemic examination was unremarkable. Microbiological and histopathological examination of excision biopsy of the subconjunctival cyst revealed a granulomatous inflammation but acid fast bacilli was negative. Tissue sample was subjected to CBNAAT (Cartridge based nucleic acid amplification technique) examination in which mycobacterium tuberculosis was detected and sensitive to rifampicin. Patient was started on anti tuberculosis treatment under NTEP (national tuberculosis elimination programme) and full remission was achieved with 6 months of anti tuberculosis treatment. Although primary tuberculous conjunctivitis is a very rare condition, it should be considered in the differential diagnosis of treatment-resistant unilateral conjunctivitis. For definitive diagnosis, microbiological, histopathological and molecular examinations should be performed in conjunctival samples.
INTRODUCTION: The term "weaning" is used to describe the gradual process of decreasing ventilator support. Usually the criteria used are improvement of gas exchange, improvement of mental status, neuromuscular functional assessment and radiographic signs [2]. METHODOLOGY: In this Longitudinal study patients were recruited based on vitals, such as orientation(according to time, place and person), Respiratory Rate(>30/min), low saturation of oxygen, etc.. further follow up was done for criteria and methods of weaning over a period of 18 months and data analysis was conducted over the period of 6 months. RESULT: In our study The Mean ± SD age of the patients was 61.2±19.5 years (Range: 28- 88 years).25 (62.5%) were male and 15 (38.5%) were female. Most common diagnosis was COPD - 18 (45.0%) patients followed by bilateral pneumonia - 11 (27.5%) patients, ILD - 4 (10.0%), Koch's - 3 (7.5%) and 2 (5.0%) patients in each diagnosis of bronchial asthma and bronchiectasis. 11 (27.5%) patients had past history of ventilator support. There was no association between success of treatment and past history of ventilatory support. 23 (57.5%) patients had elective intubation whereas 17 (42.5%)patients had emergency intubation. spontaneous breathing (SBT) trial was successful in 24 (60.0%) patients. 25 (62.5%) patients were extubated and 15 (37.5%) patients were expired. CONCLUSION: Successful weaning from mechanical ventilation in the ICU depends on the application of skilled judgment, decision making, and medical and nursing interventions. On the other hand, overly aggressive and premature discontinuation of ventilatory support can precipitate ventilatory muscle fatigue, gas-exchange failure, and loss of airway protection.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.