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author:("gothic, ipti")
1.  Consensus & Evidence-based INOSA Guidelines 2014 (First edition) 
Obstructive sleep apnoea (OSA) and obstructive sleep apnoea syndrome (OSAS) are subsets of sleep-disordered breathing. Awareness about OSA and its consequences amongst the general public as well as the majority of primary care physcians across India is poor. This necessiated the development of the INdian initiative on Obstructive sleep apnoea (INOSA) guidelines under the auspices of Department of Health Research, Ministry of Health & Family Welfare, Government of India. OSA is the occurrence of an average five or more episodes of obstructive respiratory events per hour of sleep with either sleep related symptoms or co-morbidities or ≥ 15 such episodes without any sleep related symptoms or co-morbidities. OSAS is defined as OSA associated with daytime symptoms, most often excessive sleepiness. Patients undergoing routine health check-up with snoring, daytime sleepiness, obesity, hypertension, motor vehicular accidents and high risk cases should undergo a comprehensive sleep evaluation. Medical examiners evaluating drivers, air pilots, railway drivers and heavy machinery workers should be educated about OSA and should comprehensively evaluate applicants for OSA. Those suspected to have OSA on comprehensive sleep evaluation should be referred for a sleep study. Supervised overnight polysomnography (PSG) is the “gold standard” for evaluation of OSA. Positive airway pressure (PAP) therapy is the mainstay of treatment of OSA. Oral appliances are indicated for use in patients with mild to moderate OSA who prefer oral appliances to PAP, or who do not respond to PAP or who fail treatment attempts with PAP or behavioural measures. Surgical treatment is recommended in patients who have failed or are intolerant to PAP therapy.
PMCID: PMC4248396  PMID: 25366217
Bariatric surgery; CPAP; Indian guidelines; OSA; OSAS; polysomnography; sleep apnoea; sleep study; Syndrome Z
2.  Correlation of BMI and oxygen saturation in stable COPD in Northern India 
Background:
Chronic obstructive pulmonary disease (COPD) is associated with clinically relevant extra pulmonary manifestations; one of them is weight loss. However, there are very few studies from North India available in relation to body mass index (BMI) and Oxygen saturation (SpO2) with COPD.
Aims:
To study the prevalence of undernutrition among stable COPD patients and correlation of COPD severity with SpO2 and BMI.
Settings and Design:
A prospective study was carried out at a tertiary care hospital.
Subjects and Methods:
COPD patients were diagnosed and staged as per global initiative for chronic obstructive lung disease (GOLD) guidelines. SpO2 was measured using pulse oxymeter and BMI categorization was done as per new classification for Asian Indians (2009). Statistical analysis was done using Statistical Package for Social Sciences Version 15.0.
Results:
Out of 147 COPD patients, 85 (57.8%) were undernourished. The prevalence of undernourished BMI was 25%, 50.8%, 61.7%, and 80% in stage I, II, III and IV respectively; statistically significant (P < 0.050). The mean SpO2 was 95.50 ± 1.41, 95.05 ± 2.42, 94.37 ± 2.28 and 93.05 ± 1.39 in stage I, II, III and IV respectively; statistically significant (F = 4.723; P = 0.004).
Conclusions:
The overall prevalence of under nutrition among COPD patients was 57.8%. With increasing COPD stage the BMI and median SpO2 value decreased in progressive manner. Association of SpO2 and COPD stages could be explored further in order to suggest an additional marker of disease severity that would add a new dimension in the management of COPD.
doi:10.4103/0970-2113.125891
PMCID: PMC3960805  PMID: 24669078
BMI; COPD; prevalence; SpO2; undernutrition
3.  Spectrum of High Resolution Computed Tomography Findings in Occupational Lung Disease: Experience in a Tertiary Care Institute 
Objective:
To study the spectrum of high resolution computed tomography (HRCT) findings in occupational lung disease in industrial workers and to assess the utility of International classification of HRCT for occupational and environmental respiratory diseases (ICHOERD).
Materials and Methods:
Retrospective analysis of radiological data (radiographs and computed tomography chest scans) gathered over a period of 3 years (January 2010- December 2012) of industrial workers in an organised sector who presented with respiratory complaints. The HRCT findings were evaluated using ICHOERD.
Results:
There were 5 females and 114 males in the study, with a mean age of 49 years. These workers were exposed to different harmful agents including silica, asbestos, cotton dust, metal dust, iron oxide, organic dust, rubber fumes, plastic fumes, acid fumes, and oil fumes. There were 10 smokers in the study. The radiograph of chest was normal in 53 patients. 46% of these normal patients (21.8% of total) demonstrated positive findings on HRCT. When the radiograph was abnormal, HRCT provided more accurate information and excluded the other diagnosis. The HRCT findings were appropriately described using the ICHOERD. Bronchiectasis was the most common finding (44.5%) with mild central cylindrical bronchiectasis as the most common pattern. Pleural thickening was seen in 41 patients (34.5%). Enlarged hilar or mediastinal lymphnodes were seen in 10 patients (8.4%) with egg-shell calcification in 1 patient exposed to silica. Bronchogenic carcinoma was seen in 1 patient exposed to asbestos.
Conclusions:
Occupational lung disease is a common work related condition in industrial workers even in the organized sector. Though chest radiograph is the primary diagnostic tool, HRCT is the undisputed Gold Standard for evaluation of these patients. Despite the disadvantage of radiation exposure, low dose CT may serve as an important tool for screening and surveillance. The ICHOERD is a powerful and reliable tool not only for diagnosis, but also for quantitative and analytical measurement of disease, thereby contributing to assessing the medical epidemiology of lung disease. It should always be used while evaluating HRCT of a patient with occupational lung disease.
doi:10.4103/2156-7514.124097
PMCID: PMC3935267  PMID: 24605259
Classification; high resolution computed tomography; ICHOERD; industrial worker; occupational lung disease
4.  A young smoker with hemoptysis 
A young man presented with complaints of dry cough, right lower chest pain, and streaky hemoptysis for duration of 3 months. A nonresolving opacity on chest radiograph and mass-like consolidation on computed tomography (CT), led to biopsy of the mass under CT guidance. Histopathology provided the diagnosis. The radiological features were retrospectively evaluated.
doi:10.4103/0970-2113.120627
PMCID: PMC3841702  PMID: 24339503
Hemoptysis; melting sign; pulmonary infarct
5.  Spectrum of high-resolution computed tomography imaging in occupational lung disease 
Damage to the lungs caused by dusts or fumes or noxious substances inhaled by workers in certain specific occupation is known as occupational lung disease. Recognition of occupational lung disease is especially important not only for the primary worker, but also because of the implications with regard to primary and secondary disease prevention in the exposed co-workers. Although many of the disorders can be detected on chest radiography, high-resolution computed tomography (HRCT) is superior in delineating the lung architecture and depicting pathology. The characteristic radiological features suggest the correct diagnosis in some, whereas a combination of clinical features, occupational history, and radiological findings is essential in establishing the diagnosis in others. In the presence of a history of exposure and consistent clinical features, the diagnosis of even an uncommon occupational lung disease can be suggested by the characteristic described HRCT findings. In this article, we briefly review the HRCT appearance of a wide spectrum of occupational lung diseases.
doi:10.4103/0971-3026.125564
PMCID: PMC3932567  PMID: 24604929
High-resolution computed tomography; occupational lung disease; pneumoconiosis
6.  An unusual interstitial lung disease 
Annals of Thoracic Medicine  2012;7(3):162-164.
doi:10.4103/1817-1737.98851
PMCID: PMC3425050  PMID: 22924076
7.  A 38-year-old man with lung cysts 
Annals of Thoracic Medicine  2011;6(4):231-234.
doi:10.4103/1817-1737.84779
PMCID: PMC3183642  PMID: 21977070

Results 1-7 (7)