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.
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.
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
Oxygen therapy for interstitial lung disease: a systematic review
Eur Respir Rev 2017; 26: 160080
This systematic review showed no effects of oxygen therapy on dyspnoea during exercise in ILD, although exercise capacity was increased.
Lung cancer (cancer of the lung) is common worldwide. Around 8 in 10 cases develop in people over the age of 60 years, usually in smokers. If lung cancer is diagnosed at an early stage, there is a chance of a cure. In general, the more advanced the cancer (the more it has grown and spread), the less chance that treatment will be curative. However, treatment can often slow the progress of the cancer.
COPD (Chronic obstructive pulmonary diseases or chronic bronchitis)
Assessment of the risk of death in this patients depend on their BODE Index B stand for BMI, O- Obstruction depending on FEV1, D - Shortness of breath OR dyspnea using MMRC scale , E - Exercise capacity, measured by 6 minutes walk test 6MWT.This index calculated using a scale of 0 to 3 for each parameter, depending on severity. except BMI scale different < 21 is 0 and more than >21 is 1. BODE score of 7 to 10 falls in the higher chance of mortality.
Other factors have also been associated with increased moribidity and mortality in COPD , For example : acute exacerbation of COPD, Hospitalization, cardiac comorbidities
Survival benefit are smoking cessation and lung volume reduction surgery in selected patients .Oxygen is beneficial who are hypoxemic on room air. None of the medications consistently demonstrated to prolong life.
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
Postoperative Pulmonary Complications
Br J Anaesth. 2017;118(3):317-334.
Changes to the respiratory system occur immediately on induction of general anaesthesia: respiratory drive and muscle function are altered, lung volumes reduced, and atelectasis develops in > 75% of patients receiving a neuromuscular blocking drug..The respiratory system may take 6 weeks to return to its preoperative state after general anaesthesia for major surgery.
clinicians should be aware of non-modifiable and modifiable factors in order to recognize those at risk and optimize their care.Preventative measures include preoperative optimization of co-morbidities, smoking cessation, and correction of anaemia, in addition to intraoperative protective ventilation strategies and appropriate management of neuromuscular blocking drugs. Protective ventilation includes low tidal volumes, which must be calculated according to the patient's ideal body weight.
the most beneficial level of PEEP is required,