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.
Reduced COPD exacerbation risk correlates with improved FEV1: A meta-regression analysis.
A significant correlation between increased FEV1 and lower COPD exacerbation risk suggests airway patency is an important mechanism responsible for this effect
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.
Noninvasive Ventilation in Acute Hypoxemic Nonhypercapnic Respiratory Failure: A Systematic Review and Meta-Analysis
Noninvasive ventilation decreased endotracheal intubation rates and hospital mortality in acute hypoxemia nonhypercapnic respiratory failure excluding chronic obstructive pulmonary disease exacerbation and cardiogenic pulmonary edema patients. There is no sufficient scientific evidence to recommend bilevel positive airway pressure or helmet due to the limited number of trials available.
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.
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.
Pirfenidone Reduces Respiratory-related Hospitalizations in Idiopathic Pulmonary Fibrosis
In a pooled analysis of three phase 3 IPF clinical trials, patients receiving pirfenidone had a lower risk of non-elective respiratory-related hospitalization over 1 year. Among those hospitalized for any reason, pirfenidone was associated with a lower risk of death following hospital admission.
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
Associations of sleep duration and disturbances with hypertension in metropolitan cities of Delhi, Chennai and Karachi in South Asia: cross-sectional analysis of the CARRS study.
Self-reported snoring and insomnia were associated with hypertension in South Asia.