Publications by authors named "Nitesh Gupta"

Aspiration of scarf pins is a common problem in specific geographical locations where the Muslim population is high, especially in countries like Egypt, Bangladesh, Middle Eastern countries, and certain regions in India. This condition is also referred to as hijab-pin syndrome. We discuss the largest experience of flexible bronchoscopic extraction of aspirated scarf pins from the tracheobronchial tree.

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Diffuse alveolar hemorrhage (DAH) is characterized by a syndrome of alveolar bleeding, a fall in hemoglobin, and respiratory failure. It can occur because of various immunologic and non-immunologic conditions. The etiology of DAH is important, as treatment varies with the etiology.

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Secondary spontaneous pneumothoraces occur in patients with known underlying lung disease. Patients with emphysema, bullae, and cystic lesions in the lungs are at high risk of developing pneumothorax. Cystic lung diseases like Langerhans cell histiocytosis (LCH) can present with complications like pneumothorax.

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Obstructive sleep apnea (OSA) encompasses a diverse population, manifesting with or without symptoms of excessive daytime sleepiness. There is contention surrounding the significance of non-sleepy OSA within clinical contexts and whether routine treatment is warranted. This study aims to evaluate epidemiological and clinical distinctions between sleepy and non-sleepy OSA patients.

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  • * Medical pleurodesis, done either through a chest tube or thoracoscopy, can effectively address these leaks, with thoracoscopy allowing better visualization and treatment directly at the leak site.
  • * The report includes two cases where patients with prolonged air leaks underwent thoracoscopy and received a direct autologous blood patch, leading to successful resolution of the leaks and complete lung recovery.
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  • Epigenetics, particularly histone modifications like acetylation, plays a crucial role in understanding and treating neurodegenerative diseases such as Alzheimer’s, Parkinson’s, and Huntington’s.
  • Imbalances in enzymes like histone acetyltransferases (HATs) and histone deacetylases (HDACs) can negatively affect gene expression and neurophysiological functions.
  • Recent therapeutic approaches focus on HDAC inhibitors that enhance acetylation levels, aiming to improve memory formation and neuronal plasticity, although concerns about their target specificity remain.
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Ramaswamy A, Kumar R, Ish P, Gupta N. Author Response. Indian J Crit Care Med 2024;28(4):405.

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  • * A 75-year-old man misdiagnosed with pneumonia due to fever and cough did not improve with standard treatments, prompting further imaging and evaluation.
  • * Advanced techniques like radial endobronchial ultrasound led to the correct diagnosis of NHL in this case, providing valuable ultrasound images for future reference.
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Central airway tumors presenting as critical airway stenosis is a medical emergency. Employing a cryoprobe, we successfully debulked a central airway tumor, providing rapid relief to a patient who came to the emergency room with severe breathlessness, hemoptysis, and respiratory failure. The current report underscores the efficacy of cryodebulking as an immediate and minimally invasive technique and a compelling alternative to conventional heat-based therapies.

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  • - This study aimed to investigate the relationship between SARS-CoV-2 variants and the severity of COVID-19 across India, using a nationwide platform for molecular epidemiology analysis.
  • - Conducted from September 2021 to December 2022, the cohort included nearly 5,000 participants, with successful sequencing of 2,723 samples, revealing key insights about different virus variants and their impacts on health outcomes.
  • - Findings demonstrated that the Delta variant significantly raised the risk of severe disease, while Omicron presented a milder illness, with age, comorbidities, and lack of vaccination identified as major risk factors for mortality.
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Endobronchial ultrasound (EBUS) guided mediastinal cryobiopsy, and intranodal forceps biopsy are newer modalities for sampling mediastinal lymph nodes. The data regarding the diagnostic yield of both modalities is scarce. Patients were recruited retrospectively from our existing database.

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Chronic pulmonary aspergillosis (CPA) is a progressive, debilitating clinical condition associated with significant morbidity. Surgery is the mainstay of treatment for life-threatening hemoptysis in symptomatic patients with simple aspergillomas. However, in patients with chronic cavitary pulmonary aspergillosis, surgical removal of aspergillomas is fraught with difficulty due to debilitating nature of the illness.

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  • Monitoring the thickness of the parasternal intercostal muscles can provide important insights into a patient's ability to wean off mechanical ventilation.
  • The study aimed to assess the effectiveness of parasternal intercostal muscle thickness fraction (PICTF%) as a predictor for weaning outcomes in patients who were intubated for over 48 hours.
  • Results showed that a PICTF% of 15.38% or higher accurately predicted extubation failure, with a sensitivity of 75% and specificity of 87.8%.
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  • This global study investigates the long-term outcomes of patients with tuberculosis (TB) and COVID-19, highlighting a lack of prior longitudinal data on this combined condition.
  • Data was collected from 788 patients across 31 countries from March 2020 to September 2022, showing a mortality rate of 10.8% during the study period.
  • Key factors influencing mortality included older age, HIV infection, and the need for invasive ventilation, with patients suffering from both diseases experiencing significantly lower survival rates compared to those with only one of the diseases.
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  • - The study aimed to compare immediate withdrawal of non-invasive ventilation (NIV) versus a stepwise reduction in patients with chronic obstructive pulmonary disease (COPD) experiencing acute hypercapnic respiratory failure (AHcRF).
  • - A total of 60 COPD patients were divided into two groups: Group A underwent immediate NIV withdrawal, while Group B had a gradual reduction in NIV duration.
  • - Results showed that both methods had similar success rates for NIV withdrawal, but Group A required less NIV time and had a shorter hospital stay compared to Group B, making immediate withdrawal a feasible option.
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The 77th National Conference of Tuberculosis and Chest Diseases was held on 27th February 2023. The workshop on Pulmonary rehabilitation and smoking cessation was conducted as a part of the various pre-conference workshops being conducted on the occasion. It helped the participants to know regarding the role, efficacy and benefits of pulmonary rehabilitation and smoking cessation for the management of Chronic respiratory diseases.

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  • The study investigates the effectiveness of high-flow nasal cannula (HFNC) compared to non-invasive ventilation (NIV) for weaning patients with hypercapnic respiratory failure after extubation.
  • A total of 62 patients were analyzed, with treatment failure rates being similar between the two groups (26.67% for HFNC and 25% for NIV), indicating that HFNC is as effective as NIV.
  • Additionally, HFNC offered better patient tolerance and a slightly shorter mean ICU stay, suggesting it could be a preferable option in managing respiratory failure in chronic obstructive pulmonary disease patients.
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Background: It is critical to identify high-risk groups among children with COVID-19 from low-income and middle-income countries (LMICs) to facilitate the optimum use of health system resources. The study aims to describe the severity and mortality of different clinical phenotypes of COVID-19 in a large cohort of children admitted to tertiary care hospitals in India.

Methods: Children aged 0-19 years with evidence of SARS-CoV-2 infection (real time polymerase chain reaction or rapid antigen test positive) or exposure (anti-SARS-CoV-2 antibody, or history of contact with SARS-CoV-2) were enrolled in the study, between January 2021 and March 2022 across five tertiary hospitals in India.

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A 33-year-old teacher from Ghana with no medical comorbidities and no relevant family history came to our pulmonology department with progressive difficulty in breathing, wheezing, and stridor for 6 months. Similar episodes had been treated previously as bronchial asthma. She was being treated with high-dose inhaled corticosteroids and bronchodilators but had no relief.

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Prolonged and repeated drought, as seen in India and other parts of South Asia, is a symptom of climate change, which is partially the result of human interventions. The performance of the widely used drought metrics Standardized Precipitation Index (SPI) and Standardized Precipitation Evapotranspiration Index (SPEI) are evaluated for 18 stations in Uttar Pradesh state for the period 1971 to 2018 in this study. Drought characteristics such as intensity, duration, and frequency of different categories are estimated and compared based on SPI and SPEI.

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Background: The aetiology of the major outbreak of COVID-19-associated mucormycosis (CAM) in India in spring 2021 remains incompletely understood. Herein, we provide a multifaceted and multi-institutional analysis of clinical, pathogen-related, environmental and healthcare-related factors during CAM outbreak in the metropolitan New Delhi area.

Methods: We reviewed medical records of all patients diagnosed with biopsy-proven CAM (n = 50) at 7 hospitals in the New Delhi, and NCR area in April-June 2021.

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