Multidetector computed tomography and virtual bronchoscopy: Role ...

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Akshay Saxena. 2nd Akshay Saxena. 33.7 · Postgraduate ... Kushaljit Sodhi · Senthil Kumar Aiyappan · Akshay Saxena+1 more author... Meenu Singh · Read ...
[Downloaded free from http://www.lungindia.com on Wednesday, September 28, 2016, IP: 85.191.7.115] Letters to Editor

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Girling DJ. Adverse effect of anti mycobacterial drugs. Drugs 1982;23:56-74. Blajchman MA, Lowry RC, Pettit JE, Stradling P. Rifampicin – induced immune thrombocytopenia. Br Med J 1970;3:24-6. George JN. Drug induced thrombocytopenia: a systemic review of published case reports. Ann Intern Med 1998;129:886-90. Garg R, Gupta V, Mehra S, Singh R, Prasad R. Rifampicin induced thrombocytopenia. Indian J tuberc 2007;54:94-6. Poole G, Stradling P, Worrledge S. Potentially serious side effects of high-dose twice-weekly rifampicin. Br Med J 1971;3:343-7. Mehta YS, Jijina FF, Badakere SS, Pathare AV, Mohanty D. Rifampicin induced immune thrombocytopenia. Tuberc Lung Dis 1996;77:558-62. Banu Rekha VV, Adhilakshmi AR, Jawahar MS. Rifampicin-induced acute thrombocytopenia. Lung India 2005;22:122-4. Hadfied JW. Rifampicin-induced thrombocytopenia. Postgrad Med J 1980;56:59-60. Verma AK, Singh A, Chandra A, Kumar S, Gupta RK. Rifampicin-induced thrombocytopenia. Indian J Pharmacol 2010;42:240-2.

10. Bassi L, di Berardino L, Perna G, Silvestre LG. Antibodies against rifampicin in patients with tuberculosis after discontinuation of daily treatment (note). Am Rev Respir Dis 1976;114:1189-90. 11. Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method of estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30:239-45. 12. Bhasin DK, Sarode R, Puri S, Marwaha N, Singh K. Can rifampicin be restarted in patients with rifampicin- induced thrombocytopenia? Tubercle 1991;72:306-71.

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Website: www.lungindia.com DOI: 10.4103/0970-2113.92380

Multidetector computed tomography and virtual bronchoscopy: Role in bronchial obstruction in children Sir, We read with interest manuscript titled “Subcutaneous emphysema due to bronchial foreign body demonstrated by multidetector-row computed tomography (MDCT)’’, by Wani et al, published in Lung India. 2011:Oct;28(4): 291-3.[1] We wish to point out that MDCT virtual bronchoscopy (VB) is useful in evaluating bronchial stenosis and obstruction caused not only by endoluminal pathology but also by external compression and in addition it has the advantage of looking beyond stenosis. We agree with the authors that its main application lies in providing the exact location of suspected foreign body, prior to bronchoscopy. However, we would like to add that it still fails to disclose exact nature of obstructing pathology which is finally detected by rigid/ flexible bronchoscopy.[2,3] It is pertinent to add here that Sodhi et al,[2] in their study of 43 children evaluated the potential use of MDCT and VB) in the evaluation of tracheobronchial patency in children with suspected bronchial obstruction and compared its findings with fibreoptic / rigid bronchoscopy or surgery. They found obstructive pathology in 26 children, which included endoluminal foreign body, mucus plugs in 13 children, endobronchial tumor in three children and extrinsic compression (lymph node, aberrant Vessels, mediastinal cysts / tumors) of the tracheobronchial tree in 10 children. 92

In 17 children, no obstructive lesion was identified. Excellent positive correlation was obtained, between MDCT-VB and bronchoscopy/surgery. They concluded that MDCT-VB is useful in evaluating bronchial stenosis and obstruction caused by both endoluminal pathology and extrinsic causes. VB is a non-invasive technique that provides a 3D view of internal surface of the trachea and major bronchi by using MDCT images. [4] VB enables simultaneous visualization of inner and outer structures of the tracheo bronchial tree thus clearly depicting the cause of obstruction.[4,5] In another study by Adaletli, et al,[5] there were 82% true positives in VB when compared with bronchoscopy. Another aspect which we wish to emphasize is that this virtual technique does not require any additional radiation exposure in children, but provides additional information to the MDCT images, that is indicated anyway for suspected narrowing or compression of the tracheo bronchial tree. As opposed to fibreoptic bronchoscopy, the virtual technique is noninvasive and does not require general anaesthesia and can be performed with simple sedation. The other advantages of VB include visualization of airway distal to obstruction,[2,5] segmental and sub segmental bronchi can be evaluated easily with thin section MDCT images,[5] simultaneous evaluation of mediastinal and lung pathologies responsible for symptoms of the child, and evaluation of vascular anomalies in children. Lung India • Vol 29 • Issue 1 • Jan - Mar 2012

[Downloaded free from http://www.lungindia.com on Wednesday, September 28, 2016, IP: 85.191.7.115] Letters to Editor

Kushaljit Singh Sodhi, Akshay Kumar Saxena Departments of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh-160012, India. E-mail: [email protected]

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Haliloglu M, Ciftci AO, Oto A, Gumus B, Tanyel FC, Senocak ME, et al. CT virtual bronchoscopy in the evaluation of children with suspected foreign body aspiration. Eur J Radiol 2003;48:188-92. Adaletli I, Kurugoglu S, Ulus S, Ozer H, Elicevik M, Kantarci F, et al. Utilization of low-dose multidetector CT and virtual bronchoscopy in children with suspected foreign body aspiration. Pediatr Radiol 2007;37:33-40.

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Wani NA, Qureshi UA, Kosar T, Laway MA. Subcutaneous emphysema due to bronchial foreign body demonstrated by multidetector-row computed tomography. Lung India 2011;28:291-3. Sodhi KS, Aiyappan SK, Saxena AK, Singh M, Rao K, Khandelwal N. Utility of multidetector CT and virtual bronchoscopy in tracheobronchial obstruction in children. Acta Paediatr 2010;99:1011-5. Sodhi KS, Saxena AK, Singh M, Rao KL, Khandelwal N. CT virtual bronchoscopy: New non invasive tool in pediatric patients with foreign body aspiration. Indian J Pediatr 2008;75:511-3.

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Website: www.lungindia.com DOI: 10.4103/0970-2113.92381

Analysis of asthma research in India J. R. Shah

Sir, We read with interest the original article entitled “Mapping of Asthma Research in India: A scientometric analysis of publications output during 1999-2008” published in October 2011 issue of Lung India.[1] We wish to point out that the author has missed one of the most significant studiesfrom India which is ISAAC ‘The International Study of Asthma and Allergies in Childhood’. ISAAC study was carried out over ten years period from 1993 to 2003 to more than 20 centers in North, West, South and East of India by mostly full-time professors attached to medical colleges and hospitals. The study was done in three phases. The phase-I and phase-II were to evaluate epidemiology and changes in prevalence at an interval of 5-year period.Phase-I and Phase-III were published in Lancet as priority article with special editorial and more than 25 articles published in well-recognized U.K. and European journals by ISAAC coordination committee. Phase-I and Phase-III were published in Lancet as priority articles with special publication. The global Asthma report of 2011 published by ISAAC clearly shows Indian contribution.[2]

Department of Chest Diseases, Jaslok Hospital and Research Centre, Dr. G. DeshmukhMarg, Mumbai - 400 026, India E-mail: [email protected]

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Gupta BM, Bala A. Mapping of asthma research in India: A scientometric analysis of publications output during 1999-2008. Lung India 2011;28:239-46. Global Asthma report 2011. International Union against Tuberculosis and Lung Disease. Available from: http://www.globalasthmareport. org/sites/default/files/Global_Asthma_Report_2011.pdf [Last accessed on 2011].

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Website: www.lungindia.com DOI: 10.4103/0970-2113.92382

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