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.
2000 classification of idiopathic interstitial lung diseases
The 2000 classification consists of seven entities of idiopathic interstitial diseases which are defined on clinical, radiological and pathological criteria: idiopathic pulmonary fibrosis, non-specific interstitial pneumonia, cryptogenic organizing pneumonia, acute interstitial pneumonia, respiratory bronchiolitis associated interstitial lung disease, desquamative interstitial pneumonia and lymphoid interstitial pneumonia. The most frequent is Idiopathic Pulmonary Fibrosis, which has a poor prognosis.
What is a chest infection and what causes it?
This is an infection of the large airways in the lungs (bronchi). Acute bronchitis is common and is often due to a viral infection. Infection with a germ (bacterium) is a less common cause.
This is a serious infection of the lung. Treatment with medicines called antibiotics is usually needed.
How common are chest infections?
Chest infections are very common, especially during the autumn and winter. They often occur after a cold or flu. Anyone can get a chest infection but they are more common in:
Young children and the elderly.
People who smoke.
People with long-term chest problems such as asthma.
What are the symptoms of a chest infection?
The main symptoms are a chesty cough, breathing difficulties and chest pain. You may also have headaches and have a high temperature (fever). The symptoms of an infection of the large airways (bronchi) in the lungs (acute bronchitis) and a serious lung infection (pneumonia) may be similar; however, pneumonia symptoms are usually more severe
Blood Eosinophils and Response to Maintenance Chronic Obstructive Pulmonary Disease Treatment. Data from the FLAME Trial.
indacaterol/glycopyrronium provides superior or similar benefits over salmeterol/fluticasone regardless of blood eosinophil levels in patients with COPD
The incidence of pneumonia was higher in patients receiving salmeterol/fluticasone than indacaterol/glycopyrronium in both the <2% and ≥2% subgroups
Indacaterol/glycopyrronium was significantly superior to salmeterol/fluticasone for the prevention of exacerbations
Can I prevent a chest infection?
There are measures you can take to help prevent chest infection and to stop the spread of it to others. You can pass a chest infection on to others through coughing and sneezing. So if you have a chest infection, it's important to cover your mouth when you cough or sneeze and to wash your hands regularly. Throw away used tissues immediately.
Immunisation against the pneumococcus germ (bacterium) - the most common cause of bacterial pneumonia - and the annual flu (influenza) virus immunisation are advised if you are at increased risk of developing these infections
Transbronchial lung cryobiopsy in the diagnosis of fibrotic interstitial lung diseases.
TBLC in the diagnosis of f-DPLD appears safe and feasible. TBLC has a good diagnostic yield in the clinical-radiological setting of f-DPLD without diagnostic HRCT features of usual interstitial pneumonia
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
Practical Recommendations for COPD: Evidence-Based Care
The treatment of patients with chronic obstructive pulmonary disease (COPD) depends on symptoms and history of exacerbation. These elements define the treatment strategies within the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines' ABCD assessment tool
• Although not taken into account in the ABCD tool, spirometry remains important for the diagnosis and assessment of airflow limitation.
Bronchodilators are first-line treatment, either as a single or dual bronchodilator treatment.
• The recently available combination of a long-acting beta agonist (LABA) and a long-acting muscarinic receptor antagonist (LAMA) into a single inhaler has demonstrated improvement in lung function, either in combination or with monotherapy.
In the SPARK study evaluating indacaterol/glycopyrrolate vs glycopyrronium and tiotropium (LABA/LAMA vs LAMA alone) for the prevention of exacerbation in patients with COPD, the combination therapy was superior to a single bronchodilator as measured by the reduction of exacerbations.
• LABA/LAMA was also shown to be superior in the ILLUMINATE study, which compared the patient-reported outcomes and the transition dyspnea index (TDI) for patients on LABA/LAMA with patients on LABA/ICS (inhaled corticosteroid).
Data from multiple studies show that ICS-containing regimens can also effectively reduce exacerbation rates.
Data from post-hoc analyses of clinical trials suggest that patients with high levels of blood eosinophils may respond better to ICS therapy, whereas patients with very low levels of eosinophils may not respond.
ICS therapy is associated with serious side effects, such as pneumonia.
In the WISDOM trial, patients who discontinued ICS experienced approximately 40 mL in forced expiratory volume over 1 second (FEV1), indicating that ICS should be withdrawn very carefully in some patients.
As exacerbations are more frequent and often more severe in winter months, it is recommended to not withdraw steroids during that period
Current evidence suggests that the combination of LABA/LAMA with ICS into a single inhaler will improve lung function, exacerbations, and symptoms
Other treatment options besides triple therapy exist for patients who still experience exacerbations after LABA/LAMA treatment.
• Roflumilast may be considered in patients with chronic bronchitis.
• The use of long-term macrolides is possible in a particular profile subset of patients who have frequent exacerbations with bronchiectasis, bronchial colonization, and frequent bacterial infections.