Background: Inhalational therapy for patients with chronic respiratory disorder can greatly benefit. Nurses are one of the major components of health care system of hospital and have an important role in education and training of patients. This study was planned to assess knowledge, attitude, and practices of inhalational therapy among nurses.Methods: This questionnaire based cross sectional study was conducted after taking permission from the institutional ethics committee in all the nurses of a tertiary care teaching hospital. This questionnaire consists of few socio-demographic questions and other questions for assessing level of knowledge, attitudes, and practices related to inhalational therapy. Incompletely filled questionnaire were excluded out for data analysis. Data was interpreted in percentage.Results: Total 344 (87.31%) questionnaires were analysed. 334 (97.09%) have heard the term inhalational therapy and 310 (90.12%) responded that it is preferred in respiratory disease. 117 (34.01%) nurses could not mention single side effect of inhalational therapy. 178 (51.74%) nurses always assess/observe the patient and 211 (61.34%) always train the patients for correct inhalational technique. 165 (47.97%) nurses responded that knowledge of inhaler use came from attending meetings, courses or workshops organized by scientific bodies. 163 (47.38%) nurses considered ‘Disease to be treated’ the most important variable while prescribing an inhalational device.Conclusions: The knowledge of inhalational therapy was satisfactory while the demonstration of inhaler techniques to patients was moderate in this study. So regular training courses and workshop should be conducted for the nurses about inhalational therapy practical approach.

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Background: Silicosis is an occupational lung disease caused by inhalation of dust containing crystalline silica particles of size 0.5-5 microns in diameter. It commonly occurs in workers involved in quarrying, mining, sandblasting, tunneling, foundry work and ceramics. Pneumothorax is one of the complications of silicosis. The occurrence of pneumothorax in a patient with silicosis is a rare event, but it may be fatal. The incidence of secondary spontaneous pneumothorax (SSP) in silicosis as such is not known. This study aims to report the cases of secondary spontaneous pneumothorax in patients of silicosis in Southern part of Rajasthan.Methods: 50 patients of silicosis established by historical, clinical evaluation and radiological evidence with increased dyspnoea were included in the study. In all patients Chest X ray was done immediately.Results: Among 50 patients of silicosis with increased dyspnoea, Chest X ray showed pneumothorax in 20 patients of which 4 had bilateral pneumothorax, 7 had right pneumothorax and 9 had left pneumothorax. The mean duration of exposure to silica particles was 10 years (5 to 15 years). All the patients had various degrees of dyspnoea and chest pain. Tube thoracostomy was performed in 15 patients while 5 patients were managed conservatively with oxygen and bronchodilators.Conclusions: Our study showed an increased incidence of secondary pneumothorax in silicosis patients. The occurrence of pneumothorax, though rare in silicosis is a potentially life-threatening complication and may cause serious morbidity and mortality. The patients of silicosis who develop sudden onset of dyspnoea should be promptly investigated for this complication.

INTRODUCTIONLung cancer is the most commonly diagnosed malignancy across the globe, especially in males. It is the leading cause of cancer related deaths with an average 5 year survival rate of 16.8%.1 CT guided fine needle aspiration cytology (FNAC) and Biopsy are simple methods to diagnose lung cancer in a vast majority of patients, especially in peripherally situated lesions. FNAC was first used by Martin and Ellis as a diagnostic tool.2 FNAC can sub classify the type of bronchogenic carcinoma and the vast majority of lung malignancies can be confidently diagnosed with cyto-morphological characterization in right clinical context. 3 The purpose of our study was to evaluate the diagnostic utility of CT guided FNAC and to compare it with biopsy in diagnosis of lung cancer. METHODSThis is a cross sectional study, done in department of respiratory medicine, Geetanjali Medical College and Hospital , Udaipur, Rajasthan over a period of 12 months from august 2014 to July 2015. Study was approved by Institutional ethical committee. All the patients with suspected mass lesion on chest X-ray and clinical symptoms suggestive of lung cancer were included in the study. Written consent was taken from each patient. Clinical history was taken in detail and routine blood investigations were sent, including BT, CT and INR. ABSTRACTBackground: Lung cancer is the major cause of cancer related deaths all over the world. CT guided FNAC and/or Biopsy of lung mass is an effective modality to diagnose lung cancer, especially in peripherally situated lesions. This study was planned to compare the role of CT guided lung FNAC and Biopsy in diagnosis of Lung cancer. Methods: This is a cross sectional study, done in department of respiratory medicine of a tertiary care teaching hospital of Rajasthan over a period one year. All the patients with suspected mass lesion on chest X-ray and clinical symptoms suggestive of lung cancer were included in the study. CT guided FNAC and biopsy were done in each patient after explaining the risks. Results: CT guided procedures were done in 81 patients of suspected lung cancer. CT guided FNAC yielded positive results in 75 patients while it was negative in 6 patients. CT guided lung biopsy was positive in all patients. Squamous cell carcinoma was most common type encountered malignancy. Conclusions: CT guided lung FNAC and Biopsy is a simple and safe method with high diagnostic accuracy for diagnosis of Lung cancer.

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Objectives:To compare the efficacy and safety of febuxostat and allopurinol in pyrazinamide (PZA)-induced hyperuricemia in patients taking antitubercular therapy (ATT).Methods:This randomized controlled study was conducted at a tertiary care teaching institute of Rajasthan in all the sputum-positive tubercular patients aged between 18 and 65 years of either sex. Serum uric acid level was monitored at 0th, 2nd, 4th, 6th, and 8th week of ATT. Patients whose uric acid level was found to be increased at 2nd week were finally recruited in the study. Ninety patients who developed hyperuricemia due to ATT were divided randomly into three groups (Group A - febuxostat, Group B - allopurinol, and Group C - control) of thirty patients each. Mean serum uric acid levels were calculated at all the weeks in all the groups, and serum uric acid levels were compared by applying student's t-test and ANOVA.Results:Mean serum uric acid level decreased from 10.698 mg/dl (at 2nd week) to 7.846 mg/dl (at 8th week) in Group A and from 11.34 mg/dl (at 2nd week) to 7.280 mg/dl (at 8th week) in Group B. Numbers of adverse events encountered across both the treatment groups were same with both the drugs.Conclusion:Allopurinol and febuxostat were equally efficacious in lowering PZA induced raised serum uric acid level in tubercular patients, and it was possible to continue ATT without withdrawing PZA.

INTRODUCTIONPulmonary tuberculosis (PTB) is one of the leading cause of morbidity and mortality worldwide and in India. According to the recent estimates, the world had an estimated 10.4 million new TB cases as per the WHO estimates 2016. Over half of these were among men (5.9 million), and women constituted over a third (3.5 million). Ten percent of cases were among children. India had an estimated 2.84 million new cases of TB.1 India has more new TB cases annually than any other country. 2Direct sputum smear examination is being used as a basic diagnostic tool in the diagnosis of pulmonary TB.3 The WHO also recommends the detection of acid-fast bacilli (AFB) in respiratory specimens as the initial approach to the diagnosis of pulmonary TB. 4 Though AFB smear is the most rapid, highly specific (98-99%) and low cost test but has poor sensitivity (30-70%). 5,6 Early diagnosis to reduce the period of infectivity is considered to be one of the most effective TB control strategies. Mycobacterial cultures are more sensitive than AFB smears (80-85%) but cultures require 3-8 weeks. ABSTRACTBackground: Pulmonary Tuberculosis is one of the common infections in the world, especially in developing countries like India and is a leading cause of morbidity and mortality worldwide. Therefore, early diagnosis and microbiological confirmation of pulmonary TB is important. This study was done to assess the role of induced sputum with hypertonic saline in suspected pulmonary TB patients who produce no or inadequate sputum or who are sputum for AFB smear negative. Methods: 100 patients with clinical and radiological evidence of pulmonary TB with no or inadequate sputum or who are smear negative with spontaneous sputum were included in the study. Sputum was induced with 5ml of 3% hypertonic saline delivered through nebulizer and then was sent for Ziehl Neelsen staining examination. Results: 96 patients could produce adequate sputum after sputum induction. In 47 patients, sputum for AFB smear was found positive after induction. Conclusions: Sputum induction is a safe, cheap and non-invasive procedure and offers an alternative or additional approach in the diagnosis of sputum smear-negative suspected pulmonary tuberculosis patients and would enhance sensitivity for the diagnosis of tuberculosis.