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Case based approach for Pleural Effusion
Pleural effusion, referred to as build-up of excess fluid between the layers of the pleura outside the lungs. The pleura are thin membranes that line the lungs and the inside of the chest cavity and act to lubricate and facilitate breathing. The most common causes of pleural effusion are congestive heart failure, cancer, pneumonia, and pulmonary embolism. Pleural fluid puncture (pleural tap) enables the differentiation of a transudate from an exudate, which remains, at present, the foundation of the further diagnostic work-up. When a pleural effusion arises in the setting of pneumonia, the potential development of an empyema must not be overlooked. Lung cancer is the most common cause of malignant pleural effusion, followed by breast cancer. Alongside the treatment of the underlying disease, the specific treatment of pleural effusion ranges from pleurodesis, to thoracoscopy and video-assisted thoracoscopy to the placement of a permanently indwelling pleural catheter.
About the Speaker
Dr Deepak Muthreja
Consultant Interventional Pulmonologist, Vivek Hospitals,Nagpur
“Yes! We can end TB! World Tuberculosis Day “
Tuberculosis is a leading cause of death worldwide, with an estimated 1.5 million deaths in 2020, and is particularly prevalent in low- and middle-income countries. The DOTS (Directly Observed Treatment, Short-Course) regimen is the recommended treatment for tuberculosis (TB) by the World Health Organization (WHO). It is a six-month course of four first-line drugs: Isoniazid, Rifampicin, Ethambutol, and Pyrazinamide. The DOTS regimen is also cost-effective and feasible to implement in resource-limited settings, making it a critical component of global efforts to end TB.
Non Alcoholic Fatty liver Diseases: An Overview
Non-alcoholic fatty liver disease is the most common liver disease worldwide, affecting up to 25% of the global population. The exact cause is unknown, but it is often associated with obesity, insulin resistance, high blood pressure, and high cholesterol levels. It is divided into two types: simple fatty liver and non-alcoholic steatohepatitis (NASH). NASH is a more severe form of NAFLD that can lead to liver damage and cirrhosis. It is typically diagnosed through blood tests, imaging tests (such as ultrasound or MRI), and sometimes a liver biopsy. Treatment involves lifestyle changes such as losing weight, exercising regularly, and eating a healthy diet. In some cases, medications may be prescribed.
Practical Approach to COPD
The practical approach to COPD involves a combination of lifestyle modifications, medication, and pulmonary rehabilitation to manage symptoms and prevent exacerbations. In addition to smoking cessation, regular exercise, a healthy diet, and adequate sleep can also improve COPD symptoms and overall health. Medications for COPD include bronchodilators, corticosteroids, and phosphodiesterase inhibitors. These medications help to improve lung function, reduce inflammation, and prevent exacerbations. Pulmonary rehabilitation is a structured program that combines exercise, breathing techniques, and education to improve COPD symptoms and quality of life. Oxygen therapy may be necessary for some COPD patients with low oxygen levels. Oxygen therapy can improve exercise tolerance and reduce the risk of exacerbations.
Obstructive sleep Apnea
Obstructive sleep apnea (OSA) is a common sleep disorder characterized by repeated pauses in breathing during sleep. The main symptoms of OSA are loud snoring, frequent awakenings during the night, excessive daytime sleepiness, and a feeling of unrefreshed sleep. Most common cause is obesity, but other factors such as alcohol consumption, smoking, genetics, and age can also play a role. Treatment for OSA is continuous positive airway pressure (CPAP), which involves wearing a mask over the nose and/or mouth to deliver a constant stream of air to keep the airway open.
Asthma: ICU Management and protocols
GINA advises using short-acting beta2 agonists (SABAs) for children aged six to eleven and as-needed ICS/formoterol for adults to treat patients with mild intermittent asthma as needed. 4 However, the Focused Updates panel did not address this matter and continued to support the use of SABA as required. The whole alveolar surface of the lungs is coated with pulmonary surfactant, a special blend of lipids and proteins that are only found in surfactants. Surfactant is present in upper airway secretions and reaches terminal conducting airways in addition to the alveolar compartment.