Pneumothorax is a frequently encountered entity in pulmonary practice and can be primary or secondary. Traumatic and iatrogenic causes also account for a minority of cases presenting to the chest physician. The most common therapeutic intervention done is a tube thoracostomy in all but the mildest of cases. Pneumothorax ex vacuo is a distinctly uncommon entity that differs considerably from the rest of the pneumothorax cases in its pathogenesis, clinical manifestations, radiological findings, and management. Pneumothorax in this entity results from the sucking in of air into the pleural space caused by an exaggerated negative intrapleural pressure, which is most frequently secondary to acute lobar collapse. Symptoms attributable to pneumothorax per se are distinctly mild and the vital aspect of treatment is to relieve the bronchial obstruction. Tube thoracostomy fails to relieve the pneumothorax in such cases and should be avoided. We share three cases of pneumothorax ex vacuo encountered in our institution and alert clinicians of the presentation, radiology, and management of this uncommon condition.
Asthma is a complex and heterogeneous disease. Severe asthma makes up only a minority of asthma patients encountered in clinical settings but accounts for substantial healthcare utilisation in terms of manpower as well as economic allocation. The availability of monoclonal antibodies has a major impact on severe asthmatics and has provided excellent clinical results in properly selected patients. The discovery of new molecules might present uncertainties to clinicians as to the best agent to institute in an individual patient. The practice scenario in India is unique when it comes to the commercial availability of monoclonal antibodies, patient attitudes, and allocation of the healthcare budget. The present review dissects and summarises the available monoclonal antibodies for asthma treatment in India, the perspectives of Indian patients on biological therapy, and the challenges encountered by patients and physicians in this regard. We provide practical suggestions for utilising monoclonal antibodies and deciding on the optimal agent for a given patient.
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.