Anand R

A rare case of calcified pulmonary aspergilloma

Pulmonary aspergilloma is caused by colonization and proliferation of Aspergillus in the preexisting cavities in lungs. Diagnosis of pulmonary aspergilloma is usually made based on chest X-ray findings, presence of serum precipitins against aspergillus and sputum culture. Bronchoscopic visualization of aspergilloma is very infrequent and more over calcification is rarely seen. We report a case of pulmonary aspergilloma, which was both calcified and visualized endoluminally during bronchoscopy.

Comparison of Diaphragmatic Breathing Exercise, Volume and Flow Incentive Spirometry, on Diaphragm Excursion and Pulmonary Function in Patients Undergoing Laparoscopic Surgery: A Randomized Controlled Trial.

Objective. To evaluate the effects of diaphragmatic breathing exercises and flow and volume-oriented incentive spirometry on pulmonary function and diaphragm excursion in patients undergoing laparoscopic abdominal surgery. Methodology. We selected 260 patients posted for laparoscopic abdominal surgery and they were block randomization as follows: 65 patients performed diaphragmatic breathing exercises, 65 patients performed flow incentive spirometry, 65 patients performed volume incentive spirometry, and 65 patients participated as a control group. All of them underwent evaluation of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow Rate (PEFR), and diaphragm excursion measurement by ultrasonography before the operation and on the first and second postoperative days. With the level of significance set at p < 0.05. Results. Pulmonary function and diaphragm excursion showed a significant decrease on the first postoperative day in all four groups (p < 0.001) but was evident more in the control group than in the experimental groups. On the second postoperative day pulmonary function (Forced Vital Capacity) and diaphragm excursion were found to be better preserved in volume incentive spirometry and diaphragmatic breathing exercise group than in the flow incentive spirometry group and the control group. Pulmonary function (Forced Vital Capacity) and diaphragm excursion showed statistically significant differences between volume incentive spirometry and diaphragmatic breathing exercise group (p < 0.05) as compared to that flow incentive spirometry group and the control group. Conclusion. Volume incentive spirometry and diaphragmatic breathing exercise can be recommended as an intervention for all patients pre- and postoperatively, over flow-oriented incentive spirometry for the generation and sustenance of pulmonary function and diaphragm excursion in the management of laparoscopic abdominal surgery.

Level of Patient Satisfaction with Chest Physiotherapy Airway Clearance Techniques in Bronchiectasis-A Survey

Objective: There is a lack of retrievable data, on patient satisfaction with Chest Physiotherapy airway clearance techniques for individuals with Bronchiectasis in Indian population. Materials and Methods: A cross-sectional survey was conducted of 140 bronchiectasis patients. The questionnaire consisted of Section-I comprising of general questions and Section-II comprising of 21 questions related to satisfaction with chest physiotherapy techniques divided under 5 domains (efficacy, convenience, comfort, satisfaction and cost effectiveness). Results: A total of 140 subjects filled the questionnaire comprising 30.7 % males and 69.3% females of mean age 57.15 + 10.80 years. The overall patients satisfied with all airway clearance techniques were above 90%. The assertion was held that postural drainage, percussions and vibrations were effective overall by 97.9% of the subjects, being convenient and satisfactory by 95.7%, comfortable by 100% and being cost effective was held by 93.7% of the subjects. Active cycle of breathing technique being overall effective, convenient, comfortable and satisfactory was opined by 100% and cost effective by 91.3% of the subjects. Forced expiratory techniques being overall effective, convenient, comfortable and satisfactory was asserted by 100% and cost effective by 91.7% of the subjects. While mechanical devices being overall effective, convenient, comfortable was opined by 100%, satisfactory by 95.65%, and cost effective by 93.47% of the subjects. Conclusion: The findings of the study suggest a high level of patient satisfaction with Chest Physiotherapy airway clearance techniques in individuals with Bronchiectasis.