Role of flexible fiber-optic bronchoscopy in the diagnosis of pulmonary diseases in rural-based tertiary hospital

Abstract

Background: Flexible fiber-optic bronchoscopy (FFB) is a well-established procedure in pulmonary medicine but still underutilized in rural area of developing countries where patients are still managed without confirmation of diagnosis. It is considered as an important tool in the diagnosis and therapy of varieties of pulmonary diseases. Objective: To study the role of bronchoscopy in diagnosis of different pulmonary diseases such as tuberculosis, pneumonia, and lung cancer. Materials and Methods: All consecutive FFB were retrospectively reviewed using bronchoscopy reports and corresponding patient's charts over 2 years. Demographic data were recorded including age, gender with indication for procedure, radiographic findings, suspected diagnosis, bronchoscopy findings, and final diagnosis. Results: Infections including tuberculosis and malignancy were two main indications for performing bronchoscopy. The overall diagnostic yield with bronchoscope was 62%. Tuberculosis was diagnosed in 50% of suspected cases, whereas bacterial and fungal pneumonia were diagnosed in 60% of suspected lower respiratory tract infections (bacterial 83% and fungal 17%). Seventy-five percent of patients had community-acquired pneumonia and 25% had hospital-acquired pneumonia. Gram positive organisms were isolated in 25% cases, Gram negative in 70% of cases and in 5% cases mixed growth was present. Malignancy was confirmed in 68% of suspected cases (squamous cell 44%, adenocarcinoma 24%, small cell 4%, undifferentiated 24%, and metastatic carcinoma 4%). In other diseases, such as pulmonary eosinophilia, interstitial lung diseases, upper airway abnormality, and pseudo hemoptysis, it helped to establish the diagnosis. Conclusion: Diagnostic yield of FFB in our study is fairly comparable to other studies and its widespread use is recommended in order to achieve confirmation of diagnosis, to diagnose malignancy timely, and to prevent overenthusiastic empirical use of anti-tuberculoses drugs, which can eventually prevent resistance in rural area also.

Role of Flexible Fiber-Optic Bronchoscopy in the Diagnosis of Lung Cancer

“…In Kshatriya et al, diagnostic yield of bronchoscopy was 68% through BAL cytology, brush cytology and bronchoscopy guided biopsy. 10 Squamous cell carcinoma (44%) more common in this study as in our study adenocarcinoma was more common. Male were more common affected in this study as in our study also male were more common affected.…”

Association of serum level of vitamin D3 and pulmonary function in bronchial asthma Patients in tertiary care hospital of South Gujarat

“…There was no correlation between duration of asthma treatment and serum vitamin D3 level, grade of obstruction, FEV1 (%) predicted, and FEV1/FVC Ratio (%) were shows statistically significant corelation with vitamin D3 level. According to Nimit V. Khara et al [13],in 2016 conducted a study where total patients were divided into four groups that was <40 year 8(15.1%), 41-80 year in 12 (22.6%), 51-60 in 13 (24.5%), 61-70 in 14 (26.4%). In study by SN Jindal et al [14], in 2012 where 2.05% Patient are of > 15 year and 3.49 % adult aged ≥35 year.…”

Clinical profile of cases of lung malignancy- A retrospective analysis by department of pulmonary medicine at tertiary care hospital, Sola, Ahmedabad

“…In present study most common histological type is squamous cell carcinoma, followed by adenocarcinoma. While many studies showed squamous cell carcinoma is the most common type in lung malignancy (By Kshatriya et al, 15 Rabahi et al, 16 ), while other study shows adenocarcinoma is most common. (Bhavasar et al 13 ).…”

“…Similar Findings seen in many other studies. (By Bhavsar et al, 13 Kumar et al, 11 Kshatriya et al, 15 ). Aadenocarcinoma was more seen in female and non-smoker male.…”