Expert panel opinion on adult pneumococcal vaccination in the post-COVID era (NAP- EXPO Recommendations-2024).

Introduction: Pneumococcal diseases pose a significant public health concern in India, with substantial morbidity and mortality, with the elderly and those with coexisting medical conditions being most at risk. Pneumococcus was also seen to be one of the main reasons for co-infection, pneumonia and complications in COVID. Current guidelines recommend vaccination for specific adult populations, but there is a lack of uniformity and guidance on risk stratification, prioritisation and optimal timing.

Small Airways, Big Problem: Extrafine beclomethasone/formoterol in asthma and chronic obstructive pulmonary disease.

Asthma and chronic obstructive pulmonary disease (COPD) are common chronic respiratory diseases characterized by an inflammatory process that extends from the central to peripheral airways. Conventional pressurized metered-dose inhalers and most dry-powder inhalers emit drug particles too large to target the small airways effectively. Advancements in drug formulation have given rise to a new generation of inhalers that can generate aerosols with extrafine drug particles that leads to more effective aerosol penetration into the lung periphery.

Conventional flexible bronchoscopy during the COVID pandemic: A consensus statement from the Indian Association for Bronchology.

During the times of the ongoing COVID pandemic, aerosol-generating procedures such as bronchoscopy have the potential of transmission of severe acute respiratory syndrome coronavirus 2 to the healthcare workers. The decision to perform bronchoscopy during the COVID pandemic should be taken judiciously. Over the years, the indications for bronchoscopy in the clinical practice have expanded.

Bronchial thermoplasty for severe asthma: A position statement of the Indian chest society.

Unlabelled: Bronchial thermoplasty (BT) is an interventional bronchoscopic treatment for severe asthma. There is a need to define patient selection criteria to guide clinicians in offering the appropriate treatment options to patients with severe asthma.

Methodology: An expert group formed this statement under the aegis of the Indian Chest Society.

Bronchoscopic lung cryobiopsy: An Indian association for bronchology position statement.

Background: Bronchoscopic lung cryobiopsy (BLC) is a novel technique for obtaining lung tissue for the diagnosis of diffuse parenchymal lung diseases. The procedure is performed using several different variations of technique, resulting in an inconsistent diagnostic yield and a variable risk of complications. There is an unmet need for standardization of the technical aspects of BLC.

Diagnostic value of core biopsy histology and cytology sampling of mediastinal lymph nodes using 21-gauge EBUS-TBNA needle.

Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the initial modality of choice in sampling mediastinal lymphadenopathy. It is possible to obtain both cytological and histological samples using both 21-gauge and 22-gauge EBUS-TBNA needles. The current study was undertaken to compare the diagnostic yield of cytology and histology samples obtained by the same EBUS-TBNA 21-gauge needle.

Multimodality management of primary diaphragmatic synovial sarcoma: First report.

Synovial cell sarcoma is an extremely rare tumor of mesenchymal origin. It commonly affects the soft tissues of the extremities but could possibly origin from the head and neck, heart, lung, pleura, mediastinum, esophagus, abdominal wall and the mesentery, and retroperitoneum. Primary synovial sarcoma of pleura, mediastinum, and lung have been reported.

Bronchoscopic and surgical management of rare endobronchial tumors.

Pure endobronchial neoplasms are a rare entity, and they may present with diverse pathological findings. Malignant diseases are more common than benign ones, and they mostly originate from the surface epithelium. Endobronchial tumors usually present with symptoms such as cough, hemoptysis, recurrent pneumonia, wheezing, and chest pain.

Parasitic infestation of lung: An unusual cause of interstitial pneumonitis.

Parasite infections are increasing worldwide due to increasing migration and traveling. Parasitic infections can affect lungs and present as a focal or diffuse lung diseases. High index of suspicion and detailed history are most important.

Mediastinal lymphadenopathy in malignancy: metastatic or granulomatous?

Mediastinal lymphadenopathy in patients with malignancy may not be always metastatic disease. We present three patients with proven thoracic or extra thoracic malignancies with mediastinal lymphadenopathy which were subsequently proven as granulomatous lymphadenitis by endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA). The objective of the current report is to emphasise that granulomatous lymphadenitis should be considered as an important differential diagnosis in such patients especially in tuberculosis endemic countries like India.

Massive hemoptysis during pregnancy.

We report a case of pulmonary carcinoid presenting as massive hemoptysis in a pregnant patient. In our patient, diagnosis of carcinoid tumor was suspected after ruling out other probable and possible causes of hemoptysis. It was confirmed provisionally on flexible fiber optic bronchoscopy and later confirmed on histopathology.