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.
Diagnostic Yield and Complications of Transbronchial Lung Cryobiopsy for Interstitial Lung Disease. A Systematic Review and Metaanalysis
The diagnostic accuracy of transbronchial lung cryobiopsy cannot be determined given the absence of studies directly comparing cryobiopsy diagnoses with diagnoses derived from surgical lung biopsies interpreted within multidisciplinary discussions. The histopathological and multidisciplinary discussion-based diagnostic yield of transbronchial cryobiopsy appears high, but with variable frequencies of complications dominated by pneumothorax and moderate-to-severe hemorrhage.
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
Bronchoscopic Lung Cryobiopsy Increases Diagnostic Confidence in
the Multidisciplinary Diagnosis of Idiopathic Pulmonary Fibrosis
American Journal of Respiratory and Critical Care Medicine Volume 193 Number 7 | April 1 2016
BLC is a new biopsy method that has a meaningful
impact on diagnostic confidence in the multidisciplinary
diagnosis of interstitial lung disease and may prove useful in the
diagnosis of IPF.
Transbronchial Cryobiopsy in Diffuse Parenchymal Lung Disease: Retrospective Analysis of 74 Cases, Chest 2017, 151 (2): 400-408
Single-center cohort demonstrated a 51% diagnostic yield from TBC; the rates of pneumothorax and bleeding were 1.4% and 22%, respectively.
Comprehensive and Individualized Patient Care in Idiopathic Pulmonary Fibrosis:
Refining Approaches to Diagnosis, Prognosis, and Treatment
Implement multidisciplinary clinical and imaging approaches to achieve more timely and accurate diagnosis of IPF
Develop IPF treatment strategies based on key guideline recommendations and examine the supporting clinical trial data
Describe key elements of an individualized approach to IPF treatment that involves shared decision-making
Standard immunosuppressive therapy is no longer indicated, whereas pirfenidone, nintedanib, and antacid therapy are all conditionally recommended for use. Individualizing treatment is important in light of potential improved adherence to both drug therapy and health behaviors. An early referral to an interstitial lung disease center offers the advantages of comprehensive diagnostic and disease-management expertise, potential enrollment in a clinical trial, and evaluation for transplantation.
Multicentre evaluation of multidisciplinary team meeting agreement on diagnosis in diffuse parenchymal lung disease: a case-cohort study
Agreement between MDTMs for diagnosis in diffuse lung disease is acceptable and good for a diagnosis of IPF, as validated by the non-significant greater prognostic separation of an IPF diagnosis made by MDTMs than the separation of a diagnosis made by individual clinicians or radiologists. Furthermore, MDTMs made the diagnosis of IPF with higher confidence and more frequently than did clinicians or radiologists. This difference is of particular importance, because accurate and consistent diagnoses of IPF are needed if clinical outcomes are to be optimised. Inter-multidisciplinary team agreement for a diagnosis of hypersensitivity pneumonitis is low, highlighting an urgent need for standardised diagnostic guidelines for this disease.
An Update on Lymphocyte Subtypes in Asthma and Airway Disease
Inflammation is a hallmark of many airway diseases. Improved understanding of the cellular and molecular mechanisms of airway disease will facilitate the transition in our understanding from phenotypes to endotypes, thereby improving our ability to target treatments based on pathophysiologic characteristics. For example, allergic asthma has long been considered to be driven by an allergen-specific T helper 2 response. However, clinical and mechanistic studies have begun to shed light on the role of other cell subsets in the pathogenesis and regulation of lung inflammation.
A definitive diagnosis of pleural TB depends on the isolation of Mycobacterium tuberculosis in the sputum, pleural fluid or pleural biopsy specimens, or the demonstration of caseating granulomas in the parietal pleura. However, lymphocytic exudades with a high ADA content (>35–40 U/L) are generally accepted as tuberculous in the correct clinical context.
● When the cause of a pleural effusion remains obscure after the standard initial workup, which may eventually include pleural biopsy, medical history and all available diagnostic examinations should be revisited. Most of these effusions will resolve spontaneously
There are about 40% false negative pleural fluid cytological results in malignant effusions. In these cases, image-guided parietal pleural
biopsy is the diagnostic method of choice, provided there are nodules or pleural thickening >1 cm