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Aim and objectives: To know the diagnostic yield of pleuroscopy (medical thoracoscopy) in cases of pleural effusions which remain undiagnosed after routine initial investigations. To notice the different gross pleuroscopic findings during the procedure. To observe various histopathological reports of pleural biopsy taken through medical thoracoscopy. To know the various complications of pleuroscopy in patients undergoing this procedure. Materials and methods: A total of 56 patients having undiagnosed pleural effusion were taken for study after informed written consent. All patients underwent medical thoracoscopy. The clinical, demographic, and radiological profile of patients was recorded. Gross pleuroscopic findings and histopathological reports of the pleural biopsy were noted. All patients were observed for any complications that occurred during or after the procedure. Result: Diagnostic yield of thoracoscopy in the present study was 91.07% (malignant pleural effusion 75% and tuberculous pleuritis 12.5%). Adenocarcinoma was the commonest malignancy in 60.71% of patients amongst malignant pleural effusion in the present study. Very few complications were recorded. The most common postprocedure complication was subcutaneous emphysema (12.5%) followed by pneumothorax (10.78%). Conclusion: Thoracoscopy gives excellent diagnostic yield in undiagnosed pleural effusion without major complications, and should be utilized wherever feasible.

Introduction: Two different validated scores are currently used to assess the severity of bronchiectasis: the FACED score and the Bronchiectasis Severity Index (BSI). The study was conducted to evaluate clinical etiology in bronchiectasis patients. And to compare the results of the assessment of bronchiectasis severity obtained via FACED and BSI scores. Methods: The study was conducted at a tertiary care hospital in the outpatients of the department of respiratory medicine. Detailed clinical history and necessary investigations were done. BSI and the FACED score were calculated. Statistical analysis was performed using the SPSS package. Results: According to the FACED score, we found 28 patients with mild bronchiectasis, 17 with moderate, and 5 with severe bronchiectasis. The frequency of patients with low, intermediate, and high BSI was 24, 21, and 5, respectively. Moreover, we observed a weak but statistically significant association of 43% agreement between FACED and BSI scores: Fisher’s exact test(p=0.399), tau-b de Kendall (-0.123; p = 0.337) and kappa test (0.032; p = 0.878). Conclusions: There is a small but significant correlation between the two scales (BSI and FACED). a tendency is observed for patients to be classified with a higher BSI compared to the FACED score.

Aims and objectives- To determine the impact of pulmonary rehabilitation program in patients with COPD regarding Clinical symptoms Status of exercise tolerance Status of physical and social performance Quality of life Method- 50 patients with stable COPD, who were willing to participate, were included in study. All patients were taught chest physiotherapy, bronchial hygiene, education about disease and its management and proper nutrition. All patients were assessed regarding any psychological problems. Daily 30-35 minute sessions were conducted at institute for initial 4 weeks and then home care was taught. Patient was assessed periodically for symptoms, quality of life and spirometric findings. All variables were recorded at baseline and after completion. Statistical analysis were performed using student’s‘t’ test and p values observed. Result- Dyspnea scale measured by Modified Medical Research Council (MMRC) (3.0 ± 0.66) improved after program (1.89 ± 0.83, p value less than 0.0001) which is statistically very significant. Health related quality of life measured by using St. George’s Respiratory Questionnaire 49.74 ± 5.17 improved significantly 40.92 ± 4.87 after program (p value less than 0.0001) 6 minute walk distance (280.9 ± 18.04) improved significantly after program (303 ± 17.34) (‘p’ value less than 0.0001) Spirometric parameters like FVC (p value 0.02), FEV1 (p value 0.17) and FEV1 / FVC ratio (p value 0.76) do not show any statistically significant changes after program.