Publications by authors named "Inderpaul Singh Sehgal"

Background: Various methods are available to screen for allergic bronchopulmonary aspergillosis (ABPA) in asthma, but their comparative performance remains uncertain.

Objectives: To identify the optimal screening algorithm for ABPA in asthmatic patients and evaluate the crude cost of various diagnostic approaches.

Methods: We performed a post hoc analysis of prospectively collected data from consecutive adult asthmatic patients evaluated for ABPA.

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Objective: Aspergillus sensitisation (AS) is seen in many patients with chronic pulmonary aspergillosis (CPA). However, the clinical relevance of AS in CPA remains unclear. In this study, we assess the clinical significance of AS in CPA.

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Objectives: Allergic bronchopulmonary aspergillosis (ABPA) is a complex lung disease associated with significant morbidity. The ABPA Working Group (AWG) of the International Society for Human and Animal Mycology (ISHAM) revised their management guidelines in 2024, but there is currently no standardised tool to assess adherence to these recommendations.

Methods: We extracted key recommendations from the updated 2024 ISHAM-AWG guidelines, focusing on critical areas: screening and diagnosis of ABPA, managing acute and treatment-dependent ABPA, and monitoring treatment response.

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  • Dermatomyositis is a complex disease where about 7-10% of patients have the Anti MDA-5 antibody, often leading to severe symptoms like skin ulcers and quickly worsening lung disease.
  • A case study highlights a 22-year-old male who experienced severe respiratory distress and ultimately died from complications related to both dermatomyositis and H1N1 influenza.
  • Postmortem tests revealed the presence of Anti MDA-5 and Ro-52 antibodies, suggesting they are significant biomarkers for diagnosing and assessing the prognosis of patients with related inflammatory conditions, particularly those involving lung issues.
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  • The study examined the effects of sex on outcomes of allergic bronchopulmonary aspergillosis (ABPA) by analyzing data from 731 subjects over 13 years.
  • Researchers compared various factors including clinical features and exacerbation rates between men and women, focusing on whether women had higher exacerbation rates.
  • While women had a slightly higher exacerbation rate (44.5% vs. 38.2%), the difference wasn't statistically significant, prompting the need for further prospective studies to confirm these results.
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Background: Several genetic variants are associated with the risk of idiopathic pulmonary fibrosis (IPF). These have not been systematically reviewed.

Methods: We searched the PubMed, Embase and GWAS Catalog databases for studies indexed between inception and 15 January 2024 describing genetic variants associated with IPF susceptibility.

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  • Anticholinergic toxicity and neuroleptic malignant syndrome (NMS) are both serious conditions that can occur together, but this combination is rare and complicated to treat.* * A 23-year-old male with a history of substance dependence was admitted due to toxicity from both trihexyphenidyl and risperidone, leading to a diagnosis of dual toxidrome.* * Treatment involved medications like lorazepam and bromocriptine for NMS, while intrathecal neostigmine was used as an alternative when the preferred antidote, physostigmine, wasn't available; the patient eventually recovered.*
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  • Allergic bronchopulmonary aspergillosis (ABPA) was analyzed in relation to asthma severity among 543 adult patients categorized as mild, moderate, or severe according to GINA guidelines.
  • The study found that ABPA prevalence was 11.1% in mild asthma, 21% in moderate asthma, and 20.7% in severe asthma, indicating that severity does not significantly influence ABPA occurrence (P = .12).
  • The research emphasizes the need for screening all asthma patients for ABPA, regardless of their asthma severity, and suggests further studies to confirm these results.
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Background And Objective: There is a need for simple functional test to assess treatment response in chronic pulmonary aspergillosis (CPA) in resource-constrained settings. The one-minute-sit-to-stand test (1-min-STS) is one such test. However, the minimal important difference (MID) for 1-min-STS in subjects with CPA remains unknown.

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Background: The role of 2-deoxy-2-18(F) fluoro-D-glucose (FDG) positron emission tomography (PET)-computed tomography (CT) in assessing treatment response in chronic pulmonary aspergillosis (CPA) remains to be determined.

Objective: To compare changes in FDG-PET/CT parameters in CPA subjects with treatment success or failure.

Methods: We treated consecutive treatment-naïve CPA subjects with six months of oral itraconazole.

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Background: Sensitization to Aspergillus fumigatus (AS) has been recently described in chronic obstructive pulmonary disease (COPD) patients. However, there is no data on the community prevalence of AS in COPD.

Objectives: To assess the prevalence of AS among COPD subjects.

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Background: Three techniques have been described for aspirating the bronchoalveolar lavage (BAL) fluid, namely the wall mount suction (WMS), manual suction (MS), and manual suction with tubing (MST). However, there is no direct comparison among the 3 methods.

Methods: We randomized patients undergoing flexible bronchoscopy and BAL in a 1:1:1 ratio to one of the 3 arms.

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Background: Post-tuberculosis lung abnormality (PTLA) is the most common risk factor for chronic pulmonary aspergillosis (CPA), and 14%-25% of the subjects with PTLA develop CPA. The pathogenesis and the host immune response in subjects with PTLA who develop CPA need to be better understood.

Methods: We prospectively compared the innate and adaptive immune responses mounted by patients of PTLA with or without CPA (controls).

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  • A study analyzed mixed mould infections in patients with COVID-19-associated pulmonary mucormycosis (CAPM) to determine the prevalence of co-existing COVID-19-associated pulmonary aspergillosis (CAPA) and its impact on early mortality.
  • Among 105 patients with CAPM, 20% had mixed mould infections, and those with CAPA experienced significantly higher early mortality rates (42.9%) compared to those without (17.9%).
  • The findings suggest that co-existing CAPA worsens the prognosis for CAPM patients, highlighting the need for further research on mixed mould infections globally.
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Background: Patients with persistent air leak (PAL) pose a therapeutic challenge to physicians, with prolonged hospital stays and high morbidity. There is little evidence on the efficacy and safety of bronchial valves (BV) for PAL.

Methods: We systematically searched the PubMed and Embase databases to identify studies evaluating the efficacy and safety of BV for PAL.

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  • A study was conducted to compare the effectiveness of 19-gauge (G) and 22-G needles in diagnosing sarcoidosis using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).
  • Both needles did not show a significant difference in diagnostic sensitivity, with 75.0% for the 19-G compared to 69.6% for the 22-G.
  • The 19-G needle made puncturing the lymph nodes more difficult, while both groups had similar sample adequacy and safety profiles, with the only complication being transient hypoxemia.
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  • The International Society for Human and Animal Mycology (ISHAM) has updated guidelines for managing allergic bronchopulmonary aspergillosis (ABPA) and allergic bronchopulmonary mycosis (ABPM) due to improvements in diagnostic and therapeutic methods.
  • An expert group utilized a modified Delphi method to reach a consensus on the recommendations, which include screening practices and diagnostic criteria for ABPA and ABPM in both adults and children.
  • Key recommendations include routine screening for fungal sensitization in specific patient groups, clear diagnostic criteria for ABPA and ABPM, and suggested treatments such as oral prednisolone or itraconazole for acute cases, while noting that asymptomatic ABPA patients do not require treatment.
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Background: Post-tuberculosis lung abnormality (PTLA) is the most common risk factor for developing chronic pulmonary aspergillosis (CPA). However, the prevalence and incidence of CPA in PTLA patients in India remain unknown.

Objectives: We aimed to ascertain the incidence and prevalence of CPA in subjects with PTLA.

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Background: Aspergillus fumigatus-specific IgG estimation is crucial for diagnosing allergic bronchopulmonary aspergillosis (ABPA). A point-of-care LDBio immunochromatographic lateral flow assay (LFA) had 0%-90% sensitivity to detect IgG/IgM antibodies against A. fumigatus.

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  • The study aims to compare COVID-19-associated pulmonary mucormycosis (CAPM) with COVID-19-associated rhino-orbital mucormycosis (CAROM), identify factors linked to CAPM, and determine 12-week mortality predictors in CAPM patients.
  • Researchers conducted a retrospective analysis involving 1724 COVID-19 patients, assessing demographics and illness details, and found that CAPM had higher rates of male sex, hypoxemia, and certain health conditions compared to CAROM.
  • Results showed that CAPM had higher 12-week mortality (52.3%) than CAROM (30.5%), with factors like hypoxemia and Aspergillus co-infection increasing mortality risk, while
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