Publications by authors named "Pranav Ish"

The kidneys and lungs, often studied in isolation, are integral organs in maintaining homeostasis within the human body. However, the lung and kidney have multiple shared physiological and pathological pathways. It is important to understand these complex interactions and the cross-talk to manage patients, especially in critical care.

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Non-small cell lung carcinoma (NSCLC), comprising 85% of lung cancers, remains a leading cause of cancer mortality despite advances in treatment. Immunotherapy, particularly immune checkpoint inhibitors targeting the PD-1/PD-L1 axis, has revolutionized therapy, though outcomes vary. This study aimed to explore the association between PD-L1 expression, CD8 tumor-infiltrating lymphocyte (TIL) density, and histopathological grading in NSCLC.

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Patients undergoing endobronchial ultrasound-guided fine needle aspiration may have multiple comorbidities, contributing to higher risks of hypoxia and adverse events, such as arrhythmias. The current study compared the efficacy of two oxygenation modalities: the high-flow nasal cannula (HFNC) vs. conventional oxygen therapy (CNC).

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A 23-year-old man presented to the ED with a history of respiratory distress, cough, and fever for 10 days. He was evaluated in the ED, where he received a diagnosis of pulmonary edema, secondary to mitral regurgitation with mitral valve prolapse syndrome. He was treated with antibiotics and diuretics and discharged to home.

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  • * A study on 40 NSCLC patients in north India found a 15% prevalence of EGFR mutations, noting distinct mutation patterns based on cancer type; squamous cell carcinoma had specific mutations, while adenocarcinoma had multiple mutation types.
  • * The research highlighted a notable discrepancy in common EGFR mutations, which were rare in the study population, suggesting that unique genetic factors in the Indian population might influence mutation patterns; further studies are recommended to explore these genetic differences.
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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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Asthma is an obstructive lung disease with high prevalence. Symptom control in asthma remains poor despite significant advancements in treatment guidelines and inhalational devices. This is often attributed to inadequate patient adherence to the inhaler technique and insufficient education on its long-term use.

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  • Tuberculosis (TB) is a major risk for healthcare workers in India, with a systematic review finding a prevalence of 2391.6 cases per 100,000 individuals.
  • Factors contributing to this high prevalence include poor ventilation, lack of personal protective equipment, and exposure to multidrug-resistant TB.
  • The study highlights the need for stricter infection control, regular TB screenings, and better training for HCWs, along with policy changes to support India's TB elimination goals by 2025.
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Oxygen, like all medicines, is a drug which needs moderation. Hypoxia, as well as excess oxygen supplementation, can be harmful in a patient with chronic obstructive pulmonary disease (COPD). Both the European and the British guidelines recommend a target oxygen saturation of 88-92% in patients with COPD.

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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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Patients with obstructive sleep apnea (OSA) remain physically inactive during the day, are deconditioned, and have an impaired health-related quality of life (HRQoL). The role of rehabilitation is not yet defined in OSA, despite proven effective modalities for chronic illnesses like chronic obstructive pulmonary disease. In this prospective study, over a period of one year, 30 individuals with sleep-disordered breathing were included.

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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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Ramaswamy A, Kumar R, Ish P, Gupta N. Author Response. Indian J Crit Care Med 2024;28(4):405.

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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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Dear Editor An article published in 2020 in this journal reported a rare case of a young medical student presenting with low-grade mucoepidermoid carcinoma of the central airway. Curative sleeve resection was done, with negative margins and no evidence of lymph nodal involvement. The current letter presents a 3-year follow-up of the same individual and a short review of the evidence available for post-resection monitoring in such patients.

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