Introduction: Chronic respiratory symptoms (dyspnoea, coughing, sputum production) associated with abnormalities of the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema) that result in persistent, frequently progressive airflow obstruction are the hallmarks of COPD, a diverse lung illness. The current investigation aimed to establish a clinical profile of patients with recently diagnosed COPD who present to a healthcare facility in Vadodara. Materials and Methods: The Department of Respiratory Medicine conducted an observational cross-section study on individuals with recently discovered COPD. The study comprised records of 50 participants, from September 2022 to January 2024. Along with the spirometry results, pertinent clinical data were gathered. Results: The study’s patient population presented with an average age of 61.52 years. The fact that every patient in the research was over 40 years old suggests that COPD is becoming more common in people over 40. There was a male majority among the 50 patients, with 40 (80%) male and 10 (20%) female. Most common age group was smokers accounted for 80% of the total cases, suggesting that their incidence of COPD is greater. Average FEV1 at presentation was 41 L/min for 50 patients. Among 50 patients, 6% falls under mild, 28% under moderate, 42% under severe, and 24% under very severe according to GOLD grading and severity of airflow obstruction. Conclusion: Despite the fact that tobacco smoke is thought to be the main cause of COPD. Indoor and outdoor air pollution are major issues in many nations, including India. One of the main risk factors for COPD is smoke from activities such as burning wood or biomass fuels in addition to work exposure. The ageing of the global population and ongoing exposure to COPD risk factors are expected to contribute to a rise in the prevalence and burden of COPD in the ensuing decades. The fact that most newly diagnosed patients in this research were older and more symptomatic and that most identified individuals had moderate to severe COPD, indicates the importance of spirometry programs in primary care for the early detection of COPD. Our findings suggest that a new campaign requiring patients to undergo spirometry and routine follow-up may be able to identify a sizable proportion of patients with undiagnosed COPD and perhaps improve their quality of life.
Right proximal subclavian artery pseudoaneurysms are uncommon conditions with a relatively small number of recorded instances to date. Such cases might be challenging to diagnose since the patient may have symptoms that are similar to those of other illnesses, including lung cancer. The diagnosis is aided by imaging methods including contrast-enhanced computed tomography (CECT) chest and computed tomography angiography, as well as a high level of clinical suspicion. We present a rare case of a 23-year-old man with no history of lung disease or trauma, who had a complaints of change in voice, difficulty in swallowing and haemoptysis. Right-sided upper zone homogeneous opacity was seen on the chest X-ray. CECT revealed large, well-defined solid cystic areas that extended up to the posterosuperior aspect of the right upper thoracic region. Aneurysm rupture with active contrast leak. Pulmonary angiography revealed the presence of a pseudoaneurysm in the middle mediastinum on the right side, originating from the right proximal subclavian artery. The patient was operated on, and the right subclavian artery and innominate artery pseudoaneurysm were repaired. If subclavian artery pseudoaneurysms are large, they can cause compression symptoms. For compressive symptoms, open surgical resection and vascular reconstruction are required. In a patient with hemoptysis and opacities on chest imaging, arterial aneurysm should be considered as a differential diagnosis alongside lung mass. Before considering a biopsy from the lesion, further evaluation with CECT should be performed.
Background: Chronic obstructive pulmonary disease (COPD) is heterogeneous lung condition presenting with chronic respiratory symptoms. Pathogenesis of the disease process includes exposure to noxious particles and gases starting accelerated inflammation. Individual genetic make-up and environmental factors play role in disease process. COPD shows persistent airflow limitation affecting airways and alveoli. They can be affected individually or at the same time. Hence, each patient experiences COPD as a different amalgamation of bronchitis, bronchiolitis, and emphysema. We set to find out individualized clinical profiles in COPD for same reason. Aims and Objectives: The aim of the study was to build a clinical and spirometric profile of diagnosed COPD patients presenting to a tertiary health care center in Vadodara. Materials and Methods: A retrospective analysis of records 425 COPD patients was conducted. Relevant clinical data were collected from excel sheet along with spirometric findings. Results: Average age of presentation was 58.10 years. Lowest age was 40 years. Out of 425 patients, 352 (82%) were males and 73 (18%) were females. Out of total, 263 (62%) were smokers and 162 (38%) non-smokers. Most common presenting symptom was cough with expectoration in 423 (99.5%) patients followed by breathlessness in 412 (96.9%), fever in 148 (34.8%), and pedal edema in 38 (8.9%). Average forced expiratory volume in 1s at presentation was 43.27 L/min. Out of total admissions, 61 (14.3%) were classified as very severe, 249 (58.5%) as severe, and 115 (27%) as moderate according to COPD Global initiative for obstructive lung diseases severity classification. Conclusion: COPD is considered as disease of old age and associated with smoking, our study showed more than one-fourth of the population as non-smoker. To avoid under-diagnosis, COPD should be considered in younger age group and non-smokers.
Bronchioloalveolar Carcinoma (BAC) also known as alveolar cell carcinoma is a subtype of adenocarcinoma that is more common in women and non smokers. It accounts for almost 5% of all lung cancers. Bronchioloalveolar carcinoma may appear as a wide variety ranging from solitary nodule to patchy, lobar or multilobar opacities. The mucinous, non mucinous, ambiguous or mixed are the histological types of BAC. The mucinous variety of BAC sometimes may present as a consolidation which is indistinguishable from an infective pneumonia on a radiological picture. Hereby, authors present a case of 65-year-old male patient, who was evaluated for non resolving pneumonia for a time span of one year. He presented to the Respiratory Medicine Outpatient Department with a cough and expectoration for the past nine months. Antibiotic courses did not provide the patient any sort of relief and there was no change in the size of the lesion. Chest X-ray has shown right sided non homogenous opacity and later Contrast Enhanced Computerised Tomography (CECT) thorax and biopsy (computed tomography-guided) was done from the same site for further evaluation. Cytology done from CT-guided biopsy sample showed typical lepidic growth pattern. Histopathologically, it showed mucinous variety of BAC. Usually, the patients have no symptoms but an abnormal chest X-ray, while a few have features like coughing with expectoration and pain in the chest. Only cytology or biopsy can help with a proper diagnosis, which can be done via needle biopsy (CT or fluoroscopy guided) or transbronchial biopsy and Bronchoalveolar Lavage (BAL). It has rarely been documented in the literature that BAC masquerades as a consolidation with very little change.
Pseudo-Meig’s syndrome is an unusual presentation in which a benign ovarian tumour develops with ascites and pleural effusion. Diagnosis of exclusion is made only after ovarian fibroma has been ruled out and confirmed by disappearance of pleural effusion. The present case report is of a 55-year-old female, who presented with progressive shortness of breath, on and off right chest pain, and abdominal distension, over a period of 2-3 months. Clinical examination and a chest radiograph confirmed pleural effusion as the cause of progressive dyspnea. Presence of a pelvic mass and an elevated serum Cancer Antigen-125 (CA-125) increased the probability of malignancy. After complete tumour resection, a pathological report confirmed a benign ovarian tumour. The authors highlight the importance of suspicion, careful general examination, radiological evaluation, and histologic examination to confirm the diagnosis of pseudo-Meig’s syndrome.