AR Advanced Respiratory HUBDr. Ranjit Singh is a Pulmonologist with specialized expertise in Sleep Apnea, NIV and ILD procedures and has an experience of 18 years in this field. Having laid the foundation of his career in 2001, Dr. Singh has come a long way in terms of professional experience. His present centres of consultation are RTIICS (Kolkata) and Advanced Respiratory Centre (Jharkhand) where one may visit with a prior appointment.. He completed MBBS from Ranchi University in 1996, DM - Pulmonary Medicine from SMS Medical College, Jaipur in 2001 and MRCP from Royal Colleges of Physicians, Uk in 2008. Faculty at CMC Vellore. Trained in interventional Bronchology from France Marsille. MRCP examiner since 2012. Some of the services provided by the doctor are Video Bronchoscopy, Endobronchial Ultrasound (EBUS) and Thoracoscopy, Cryo biopsy in ILD, Debulking of the Tumor, Management of central airways Tumor, Ultrasound chest etc. Diseases like Interstitial lung diseases, Lung cancer, severe COPD, Severe Uncontrolled Asthma.
1. Size short axis : less or more than 1cm
2. Shape : Oval or round ; when ratio of short axis vs . long axis of lymph node is smaller than 1.5cm , the lymph node defined as round. If ration more than 1..5cm it is oval.
3. Margin indistinct or distinct : if more than 50% is clearly visible with a high echoic border they are distinct . If less than 50% and margin unclear determined indistinct.
4.Echogenecity; Homogenous or heterogenous.
5. Presence or absence of central hilar structure CHS
CHS defined as linear flat hyperechoic area in the center of lymph node which indicate prediction of metastatic L node
Sleep apnoea and risk of post-operative infection: beyond cardiovascular impact.
the risk of pneumonia or sepsis is more than doubled in patients with a predominance of central, rather than obstructive, respiratory events
Obstructive Sleep Apnea and Diabetes
Obstructive sleep apnea (OSA) is a chronic treatable sleep disorder and a frequent comorbidity in patients with type 2 diabetes. Cardinal features of OSA, including intermittent hypoxemia and sleep fragmentation, have been linked to abnormal glucose metabolism.
The relationship between OSA and type 2 diabetes may be bidirectional in nature given that diabetic neuropathy can affect central control of respiration and upper airway neural reflexes promoting sleep-disordered breathing. Despite the strong association between OSA and type 2 diabetes, the effect of treatment with continuous positive airway pressure (CPAP) on markers of glucose metabolism has been conflicting. Variability with CPAP adherence may be one of the key factors behind these conflicting results. Lastly, accumulated data suggests an association between OSA and type 1 diabetes as well as gestational diabetes.