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.
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
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
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
Panic Attacks and Sleep Disorders
Tests such as overnight sleep studies, manometry, pH monitoring, or electroencephalography can help physicians determine if patients complaining of nocturnal panic attacks have possible sleep disorders
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.
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.
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.
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.
Use of Biological Agents in Asthma:
Despite advances in asthma initiatives, there continues to be a large population of patients with severe asthma whose condition remains uncontrolled despite the use of inhaled combination corticosteroids and long-acting beta-agonist treatment. For this population, which may include as many as one-third of all patients with asthma, biological therapy is often a treatment consideration in specialist clinics.