UAPM Journal of Respiratory Diseases and Allied Sciences
type: channel
description: UAPM Journal of Respiratory Diseases and Allied Sciences is the official publication of the United Academy of Pulmonary Medicine (UAPM). This journal is published twice a year in both print and online formats in the English language since 2024 and features cutting-edge clinical information in the multidisciplinary specialty of Respiratory Medicine. The journal also features studies and scientific information related to basic sciences, and allied systems of pulmonary Medicine. The main aim of the journal is to disseminate scientific information related to respiratory diseases for the better well-being of mankind. This print journal publishes editorials, original articles, review articles, meta-analyses, case reports, etc., apart from radiology imaging, clinical images, brief communications, letters to the editors, book reviews, and other information related to the respiratory system. The manuscripts are accepted on the basis of significance, scientific merit, and applicability. Authors are requested to base their reports on the basis of original work carried out by themselves or with their colleagues. Title: UAPM Journal of Respiratory Diseases and Allied Sciences Frequency: Twice a year E-ISSN: 3107-4189 Owner: United Academy of Pulmonary Medicine Publisher: United Academy of Pulmonary Medicine Chief Editor: Dr Ramakant Dixit Copyright: United Academy of Pulmonary Medicine Starting year: 2024 Subject: Respiratory Medicine and allied subjects Language: English Publication format: Print + online Phone Number: 0145-2692257 Email ID: editor_uapmjournal@yahoo.com Mobile Number: 9413040257 Website: https://uapmjournal.in/index.php/uapmjrdas/index Address: C/O Daulat Ram Dixit 60-A Block O, Chandravardai Nagar Ajmer, 305001, Rajsthan.
publisher: United Academy of Pulmonary Medicine (UAPM)
language: en
publication name: UAPM Journal of Respiratory Diseases and Allied Sciences
issn: 3107-4189
items: Critical Care Medicine: The Journey Back to the Bedside
items: Assessment of Respiratory Function and Exercise Capacity Among Persons Having Occupational Exposure to Silica Dust
items: Losing the Voice to the Lungs: Ortner’s Syndrome in Pulmonary Vascular Disease
items: Clinical Efficacy of Bedaquiline-Containing Short-Course Regimens in Multi-Drug-Resistant Tuberculosis: Experience from Central Rajasthan
items: The Air We Exhale: Deciphering the Role of Fractional Exhaled Nitric Oxide (FeNO) in Airway Diseases
items: Shadows of Doubt: When Lung Adenocarcinoma Mimics Interstitial Lung Disease
items: A Case Report and Literature Review of Achalasia Cardia Presenting as Difficult-to-Treat Asthma
items: Pulmonary Sequelae of Moderate to Severe Atypical Pneumonia Caused by SARS - COV-2 Virus
items: Primary Tuberculous Parotitis with Facial Nerve Palsy: A Rare Presentation
items: Narcolepsy in a Young Adult Initially Misdiagnosed as Depression: A Case Report
items: A Study of Functional Changes of the Right Heart in Patients of COPD Acute Exacerbation with Respiratory Failure
items: The Heterogeneity of COPD: A Comprehensive Review of Clinical Phenotypes
items: An Unexpected Twist: Paradoxical Pleural Effusion during Pott’s Spine Management
items: Bronchoscopy: The Last Hope When Radiology Fails to Illuminate, A Case of Subglottic Stricture
items: Excessive Dynamic Airway Collapse: An Unusual Cause of Refractory Cough
items: Broncho-Pleuro-Cutaneous Fistula at Intercostal Chest Drain Site in a Patient having Silicotuberculosis
items: Burst or Bluff: A Bulla Masquerading as Tension Pneumothorax in a 2-Year-Old Child
items: Primary Pulmonary Synovial Sarcoma: A Rare Lung Tumor
items: Treatment Outcomes for Isoniazid-Resistant Pulmonary Tuberculosis Using a Shorter Regimen at a Tertiary Care Centre from the Western Part of India
items: Fungal Sensitization in Bronchial Asthma: Epidemiological Insights and Clinical Correlates from an Indian Cohort
items: Psychogenic Cough, Substance Abuse and Intellectual Disability- A Diagnostic Dilemma?
items: Asthma in School Children: Assessment of Prevalence And Risk Factors Among Rural and Urban Settings from the Western Part of India
items: An Assessment of Tracheal Index and Thoracic Cage Ratio in patients with Chronic Obstructive Pulmonary Disease
items: Correlation of 5-Repetition Sit-to-Stand Test with Borg Dyspnoea Scale and GOLD Spirometric Classification in Patients with COPD
items: Phantom Tumor of the Lung: A Radiological Masquerader of Pulmonary Mass Lesion
items: Treatment Outcome Analysis of Drug-Sensitive Pulmonary and Extrapulmonary Tuberculosis Among HIV Positive and HIV Negative Patients and their Correlation with CD4 Counts
items: Isolated Primary Tuberculosis of the Pectoralis Major Muscle
items: A Challenging Case of Ethambutol-Induced Optic Neuritis Manifesting with Perioptic Cystic Changes Diagnosed by Optic MRI
items: Deep Vein Thrombosis, Pulmonary Thromboembolism, and Pulmonary Infarction: All in one in a Young Male Patient with Pulmonary Tuberculosis
items: When Bullae Deceive: A Rare Case of Vanishing Lung Syndrome Misdiagnosed as Pneumothorax

Critical Care Medicine: The Journey Back to the Bedside
type: item
description: Critical care medicine is a relatively new specialty that has been growing over the past seven decades. The specialty has come a long way from the bag-ventilation of polio patients to the modern intensive care units. Over the years, with more understanding of physiology, critical care now means intervening less while monitoring the patient more closely. The article touches upon the evolution of the specialty and the Indian context; and the opportunities artificial intelligence may bring in the coming decades.
subject: Review Articles
  topic: section
subject: Critical care, History of medicine, Current updates in intensive care.
  topic: keywords
creator: Jacob George Pulinilkunnathil
rights: Copyright (c) 2026
date: 2026-07-15
publication date: 2026-07-15
starting page: 19
ending page: 25
doi: 10.70192/v3.i2.04

Assessment of Respiratory Function and Exercise Capacity Among Persons Having Occupational Exposure to Silica Dust
type: item
description: Background: Silica inhalation at the workplace remains a major public health concern, particularly in developing countries where large numbers of workers are engaged in mining, stone crushing, stone cutting, and drilling activities. Prolonged inhalation of silica dust can result in progressive pulmonary fibrosis, leading to deterioration in lung function and a decline in exercise capacity. While radiological assessment plays an important role in disease evaluation, measurements of pulmonary function and functional exercise capacity provide additional insight into the physiological impact and severity of silica-related lung disease. Methods: Workers exposed to silica dust were selected as study subjects over the time period of two years. Clinical history and examination in detail, along with chest radiography, spirometry, and six-minute walk test (6MWT), etc were done and results were correlated with chest x-ray findings. Results: The mean age of participants was 47.19 ± 11.18 years, and 78.08% were male. The mean duration of silica exposure was 14.64 ± 6.76 years, with 68.49% exposed for more than 10 years. Dyspnoea (98.63%) and cough (93.15%) were the predominant symptoms. Mean pre-bronchodilator FEV₁ and FVC were 46.32 ± 17.35% and 52.15 ± 16.54%, respectively, indicating severe ventilatory impairment. The mean six-minute walk distance was 263.41 ± 94.88 meters, with significant exercise-induced oxygen desaturation from 95.11 ± 1.66% to 92.34 ± 2.61%. Chest radiographic severity showed significant correlations with spirometric impairment (p <0.001), and reduced exercise capacity (p <0.001). Conclusion: Workers exposed to silica dust demonstrate significant impairment of respiratory function and exercise capacity. Pulmonary function testing and six-minute walk testing are valuable tools for assessing disease burden and should be incorporated into routine occupational health surveillance programs.
subject: Research Article
  topic: section
creator: Haseef Ahammed
creator: Ramakant Dixit
creator: Avesh Choudhary
creator: Suresh Khakhal
creator: Himanshu Mohan
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-07-15
publication date: 2026-07-15
starting page: 1
ending page: 6
doi: 10.70192/v3.i2.01

Losing the Voice to the Lungs: Ortner’s Syndrome in Pulmonary Vascular Disease
type: item
description: Ortner’s syndrome, also known as cardiovocal syndrome, is a rare clinical condition marked by left recurrent laryngeal nerve palsy. It is most commonly caused by mechanical compression or traction of the nerve between the aortic arch and the pulmonary artery, typically triggered by underlying cardiovascular diseases like aortic aneurysms or mitral stenosis. In 1897, Norbert Ortner elucidated the association between left recurrent laryngeal nerve palsy and severe mitral valve stenosis, which leads to hoarseness of voice. Although it was originally described in association with severe mitral stenosis, the syndrome may arise from several other causes. These include compression of the nerve by vascular conditions such as aortic aneurysm, aortic dissection, and pulmonary hypertension. We present a case of Ortner’s syndrome in a 41-year-old man, characterized by dysphonia from left recurrent laryngeal nerve compression, secondary to severe pulmonary arterial hypertension and embolic pulmonary occlusion. This case emphasizes the need to carefully consider cardiac causes in patients with vocal cord dysfunction and supports the use of a comprehensive, team-based approach to diagnosis and treatment.
subject: Case Report
  topic: section
subject: Ortner’s syndrome, Dysphonia, Pulmonary hypertension, Cardio-vocal syndrome.
  topic: keywords
creator: Haseef Ahammed
creator: Ramakant Dixit
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-07-15
publication date: 2026-07-15
starting page: 42
ending page: 44
doi: 10.70192/v3.i2.10

Clinical Efficacy of Bedaquiline-Containing Short-Course Regimens in Multi-Drug-Resistant Tuberculosis: Experience from Central Rajasthan
type: item
description: Background: Multidrug-resistant tuberculosis (MDR-TB) continues to pose a critical threat to global public health, with India bearing nearly one-fourth of the world’s total burden. The emergence of bedaquiline-containing regimens has significantly improved treatment outcomes in MDR-TB due to enhanced bactericidal activity and shorter treatment duration. Objectives: To evaluate the efficacy and treatment outcomes of a bedaquiline-containing short-course regimen in multidrug-resistant tuberculosis (MDR-TB) patients at a tertiary care center in Central Rajasthan. Methods: This observational study was conducted among 100 MDR-TB patients registered at our center. Patients underwent detailed pre-treatment clinical, radiological, biochemical, and microbiological evaluation. Demographic details, co-morbidities, socioeconomic status, addiction history, and previous anti-tuberculosis treatment (ATT) exposure were recorded. We initiated patients on a short-course bedaquiline regimen and followed them according to the Programmatic Management of Drug-Resistant Tuberculosis (PMDT) guidelines. Treatment outcomes were categorized as cured, treatment completed, treatment failure, loss to follow-up, regimen change, or death. Sputum conversion, clinical improvement, radiological response, and adverse drug reactions were also assessed. Results: Most patients (64%) were aged 21 to 50, the economically productive years, with a mean age of 34.97 ± 12.46 years. Males constituted 71% of the study population. Most patients were underweight (70%), and pulmonary tuberculosis was present in 92% of cases. Previous history of ATT was observed in 42% of patients. Smear conversion was achieved in 71% of patients, while radiological regression was noted in 62%. Complete clinical improvement occurred in 53% of cases. Final treatment analysis indicated a cure rate of 67%, with 11% died, 10% were lost to follow-up, 8% required regimen modification, and 4% experienced treatment failure. Adverse drug rea…
subject: Research Article
  topic: section
subject: Multidrug-resistant tuberculosis, MDR-TB, bedaquiline, short course regimen, treatment outcome, drug-resistant tuberculosis.
  topic: keywords
creator: Pallavi Pillai
creator: Rajveer Kuldeep
creator: Neeraj Gupta
creator: Ramakant Dixit
creator: Ranjeet Meghwanshi
creator: Elizabeth lalremmawii
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-07-15
publication date: 2026-07-15
starting page: 15
ending page: 18
doi: 10.70192/v3.i2.03

The Air We Exhale: Deciphering the Role of Fractional Exhaled Nitric Oxide (FeNO) in Airway Diseases
type: item
description: Fractional exhaled nitric oxide (FeNO) is an important indicator of type 2 inflammation, which is frequently utilized in the assessment and treatment of asthma. It is measured in exhaled breath and provides a simple, quick, and reproducible assessment of airway inflammation status. Elevated FeNO levels are strongly associated with eosinophilic airway inflammation. It represents the synthesis of nitric oxide in the airway epithelium, which is mainly caused by inducible nitric oxide synthase under the influence of cytokines like IL-4 and IL-13. FeNO is utilized in the assessment of symptoms in patients presenting with cough, wheezing, and dyspnoea. It plays a key role in phenotyping asthma, particularly in identifying the eosinophilic asthma phenotype, which is typically T2 high and steroid responsive. FeNO measurement is also valuable in predicting medication response, as it evaluates the possible reaction to anti-inflammatory drugs, mainly inhaled corticosteroids (ICS). Furthermore, it helps in guiding treatment changes in a step-wise manner, including stepping up or stepping down the ICS dose. FeNO is useful in assessing asthma control, especially in determining whether poor control is due to airway inflammation when other contributing factors such as rhinosinusitis, anxiety, gastroesophageal reflux, obesity, and ongoing allergen exposure are present. Additionally, variations in FeNO levels may serve as a helpful supplementary tool for identifying acute complications following lung transplantation. Emerging evidence in fractional exhaled nitric oxide (FeNO) has expanded its potential role beyond asthma, demonstrating its utility in evaluating conditions such as obstructive sleep apnoea, rhinoviral infection, and radiation pneumonitis. However, values may be impacted by things like smoking, illnesses, respiratory maneuvers, airway caliber and food. Standardized testing guarantees reliability. For the best possible care, FeNO should be read in conjunction with clinic…
subject: Review Articles
  topic: section
subject: FeNO, Type 2 airway inflammation, Asthma.
  topic: keywords
creator: Haseef Ahammed
creator: Ramakant Dixit
creator: Mohammed Akram Qureshi
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-07-15
publication date: 2026-07-15
starting page: 26
ending page: 29
doi: 10.70192/v3.i2.05

Shadows of Doubt: When Lung Adenocarcinoma Mimics Interstitial Lung Disease
type: item
description: Lung adenocarcinoma commonly presents as a peripheral pulmonary mass; however, atypical presentations mimicking interstitial lung disease (ILD) are rare and diagnostically challenging. We report a case of a 67-year-old female presenting with subacute respiratory symptoms and diffuse interstitial changes on imaging, initially suggestive of ILD. Bronchoscopic evaluation was inconclusive, but transbronchial lung biopsy confirmed adenocarcinoma. This case highlights the importance of considering malignancy in atypical ILD presentations and underscores the role of early tissue diagnosis in selected cases.
subject: Case Report
  topic: section
subject: Adenocarcinoma lung, Interstitial lung disease, Transbronchial lung biopsy.
  topic: keywords
creator: Ramakant Dixit
creator: Avesh Choudhary
creator: Ankur Gupta
creator: Rakesh C Gupta
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-07-15
publication date: 2026-07-15
starting page: 35
ending page: 37
doi: 10.70192/v3.i2.08

A Case Report and Literature Review of Achalasia Cardia Presenting as Difficult-to-Treat Asthma
type: item
description: Background: Achalasia cardia is a rare neurodegenerative disorder characterized by impaired esophageal peristalsis and failure of the lower esophageal sphincter to relax. Patients often present with dysphagia, regurgitation, or chest pain. However, atypical presentations can mimic respiratory disorders, particularly asthma, leading to diagnostic delay and inappropriate treatment. Case Presentation: We report the case of a 67-year-old male, non-smoker, who presented with recurrent exacerbations of bronchial asthma. Despite being on optimal bronchodilator therapy with both inhaled and oral corticosteroids for an adequate duration, he showed no clinical improvement. On further evaluation, barium contrast studies revealed features suggestive of achalasia cardia. Surgical intervention was advised; however, the patient deferred and was kept on follow-up. Conclusion: This case highlights achalasia cardia as an uncommon but important differential diagnosis in patients with difficult-to-treat or refractory asthma. Early consideration of esophageal motility disorders in such scenarios may prevent misdiagnosis, unnecessary prolonged asthma treatment, and allow timely targeted therapy.
subject: Case Report
  topic: section
subject: Achalasia cardia, Bronchial Asthma, esophageal motility disorder
  topic: keywords
creator: Rajendra Prasad
creator: Huda Shamim
creator: Nikhil Gupta
creator: Anil Kumar Singh
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-07-15
publication date: 2026-07-15
starting page: 38
ending page: 41
doi: 10.70192/v3.i2.09

Pulmonary Sequelae of Moderate to Severe Atypical Pneumonia Caused by SARS - COV-2 Virus
type: item
description: Background: Survivors of moderate to severe COVID-19 pneumonia frequently exhibit persistent pulmonary abnormalities, but the longitudinal radiological and biochemical evolution remains unclear. Methods: This observational study included 50 patients with moderate to severe COVID-19 pneumonia. Clinical symptoms, inflammatory markers, and serial chest CT scans were evaluated from day 1 to 180. CT patterns and severity scores were analyzed to assess temporal changes and post-COVID pulmonary sequelae. Results: The mean age was 52.4 ± 13.4 years, with male predominance (62%). Acute symptoms resolved within 30 days; however, breathlessness and fatigue persisted in 74% and 40% of patients at 6 months. CT imaging showed progressive resolution of ground-glass opacities and consolidation, while fibrotic-like changes, particularly parenchymal bands, reticulations, and traction bronchiectasis, increased over time, despite a significant decline in CT severity score (16.24–4.84). Inflammatory biomarkers normalized earlier than radiological findings, indicating persistent structural remodeling. Conclusion: Moderate to severe COVID-19 pneumonia is associated with lasting fibrotic-like lung sequelae, highlighting the need for structured long-term follow-up.
subject: Research Article
  topic: section
subject: COVID-19 pneumonia; post-COVID lung sequelae; chest CT; pulmonary fibrosis; parenchymal bands; traction bronchiectasis
  topic: keywords
creator: Rakesh Kumar Serawat
creator: Neeraj Gupta
creator: Ramakant Dixit
creator: Piyush Arora
creator: Ranjeet Meghwanshi
creator: Siddarth Mathur
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-07-15
publication date: 2026-07-15
starting page: 7
ending page: 14
doi: 10.70192/v3.i2.02

Primary Tuberculous Parotitis with Facial Nerve Palsy: A Rare Presentation
type: item
description: Parotid tuberculosis is a rare and often overlooked cause of chronic parotid swelling, particularly when accompanied by atypical features such as facial nerve palsy. Given its clinical and radiological resemblance to neoplasms, this case underscores the necessity of ruling out tuberculous parotitis when evaluating chronic parotid swellings in tuberculosis-endemic areas. Early use of FNAC combined with molecular diagnostic techniques such as Truenat or GeneXpert allows for timely and accurate confirmation, enabling prompt initiation of antitubercular therapy. Timely treatment not only prevents unwarranted parotidectomy but also improves the likelihood of recovery from associated facial nerve dysfunction. Ultimately, heightened clinical awareness and early diagnostic evaluation are crucial for optimizing outcomes in this rare condition.
subject: Case Report
  topic: section
subject: Tuberculous parotitis; Facial nerve palsy; Granulomatous
  topic: keywords
creator: Shubhangi Bohra
creator: Ramakant Dixit
creator: Mukesh Goyal
creator: Komal Srivastava
creator: Avesh Choudhary
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-07-15
publication date: 2026-07-15
starting page: 45
ending page: 47
doi: 10.70192/v3.i2.11

Narcolepsy in a Young Adult Initially Misdiagnosed as Depression: A Case Report
type: item
description: Narcolepsy is a chronic neurological sleep disorder characterized by excessive daytime sleepiness (EDS) and rapid eye movement (REM) sleep related phenomena such as cataplexy, hallucinations, and sleep fragmentation. Owing to significant overlap with psychiatric symptoms, particularly depression, narcolepsy is frequently misdiagnosed, resulting in delayed treatment and impaired functional outcomes. We report the case of a young adult male who presented with an 18-month history of severe daytime sleepiness, declining academic performance, and reduced motivation. He was initially diagnosed with major depressive disorder and treated with fluoxetine for six months without clinical improvement. Detailed sleep history later revealed episodes of cataplexy and hypnagogic hallucinations. Overnight polysomnography excluded obstructive sleep apnoea, and Multiple Sleep Latency Test (MSLT) demonstrated a mean sleep latency of four minutes with three sleep-onset REM periods, fulfilling ICSD-3 diagnostic criteria for narcolepsy type 1. The patient was started on modafinil therapy, resulting in marked improvement in alertness and academic performance within two weeks. This case highlights the importance of maintaining a high index of suspicion for narcolepsy in young patients with persistent fatigue unresponsive to antidepressants. Early recognition and appropriate sleep evaluation are essential to prevent prolonged misdiagnosis and ensure timely management.
subject: Case Report
  topic: section
subject: Narcolepsy
  topic: keywords
subject: MSLT
  topic: keywords
subject: Excessive daytime sleepiness
  topic: keywords
subject: Depression
  topic: keywords
creator: Eldhos Jacob
creator: Srishankar Bairy
creator: Carishma S
creator: Basil Behanan Mathews
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-07-15
publication date: 2026-07-15
starting page: 32
ending page: 34
doi: 10.70192/v3.i2.07

A Study of Functional Changes of the Right Heart in Patients of COPD Acute Exacerbation with Respiratory Failure
type: item
description: Background: Chronic obstructive pulmonary disease (COPD) is a common and treatable disease characterized by progressive airflow limitation and tissue destruction. COPD has considerable effects on cardiac functions, primarily by affecting the pulmonary vasculature and then the right ventricle, along with the left ventricle. During acute exacerbations, hypoxemia and hypercapnia may contribute to pulmonary hypertension and right ventricular (RV) dysfunction, which adversely affect prognosis. Methods: A prospective observational study was conducted on 61 patients admitted with acute COPD exacerbations to the respiratory intensive care unit (ICU) over a period of 6 months at a tertiary care hospital. After applying exclusion criteria, 56 patients were included. All underwent arterial blood gas (ABG) analysis, spirometry, and transthoracic echocardiography to assess RV systolic pressure (RVSP), pulmonary artery systolic pressure (PASP), right atrial size, RV ejection fraction (EF), fractional area change (FAC), and tricuspid annular plane systolic excursion (TAPSE). Clinical status was assessed with the modified Medical Research Council (mMRC) scale, COPD assessment test (CAT), BODE index, and GOLD ABCD tool. Results: Severe COPD patients exhibited higher PaCO₂ (72.6 ± 5.3 vs. 55.2 ± 3.5 mmHg), lower PaO₂ (56.5 ± 2.96 vs. 64.2 ± 4.6 mmHg), increased right atrial area (33.3 ± 6.5 vs. 21.5 ± 5.2 cm²), and elevated PASP (45.3 ± 3.5 vs.30.2 ± 2.3 mmHg) compared to moderate COPD. TAPSE was reduced, indicating RV dysfunction, and correlated positively with PaO₂ and negatively with PaCO₂. Conclusion: COPD exacerbations were strongly associated with pulmonary hypertension and RV dysfunction. Echocardiographic evaluation of pulmonary pressures and right heart parameters provides essential prognostic information and should be integrated into COPD management.
subject: Research Article
  topic: section
subject: COPD
  topic: keywords
subject: Acute exacerbation
  topic: keywords
subject: Heart dysfunction
  topic: keywords
subject: Respiratory failure
  topic: keywords
creator: Krupasagar Kalapala
creator: Mahip Saluja
creator: Rehbar Khan
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-02-25
publication date: 2026-02-25
starting page: 12
ending page: 16
doi: 10.70192/v3.i1.03

The Heterogeneity of COPD: A Comprehensive Review of Clinical Phenotypes
type: item
description: <a href="https://uapmjournal.in/index.php/uapmjrdas/Current understanding of the epidemiology and pathogenesis of chronic obstructive pulmonary disease (COPD) is limited by difficulties in defining and classifying the different phenotypes that make up this complex group of disorders. COPD is a multi-factorial and heterogeneous disease and not every patient responds to all available drugs. In order to approach this heterogeneity, an attempt to group patients with similar characteristics that could be associated to a differential clinical outcome has been done by using the term clinical phenotype. Such in-depth phenotyping can pave the way for personalized treatment regimens, ensuring that the most suitable therapies are provided. A phenotype can be broadly defined as ‘any observable characteristic of an organism,’ while a COPD phenotype can be more specifically defined as ‘a single or combination of disease attributes that describe differences between individuals with COPD as they relate to meaningful outcomes (symptoms, exacerbations, response to therapy, rate of disease progression, or death).’ Identifying such phenotypes (also described as phenotypic traits) allows grouping of patients according to their prognostic and therapeutic characteristics. Early classification of the COPD subtype will facilitate superior healthcare provision and early intervention where it is most required. The various phenotypes and associations of COPD that has been recognised in recent literature includes Emphysema phenotype, Chronic Bronchitis, Asthma-COPD overlap phenotype, Frequent Exacerbator phenotype, COPD with Bronchiectasis, Combined pulmonary fibrosis with Emphysema, COPD with Obstructive sleep Apnoea, Tuberculosis associated COPD, Respiratory Bronchiolitis with interstitial disease, HIV associated COPD, Obese COPD, nonsmoker phenotype, etc. In the recent years, clinicians also proved that the heterogeneity of COPD is associated with different clinical outcomes including sympto…
subject: Review Articles
  topic: section
subject: COPD, Clinical phenotypes, Disease heterogeneity.
  topic: keywords
creator: Ramakant Dixit
creator: Ranjeet Meghwanshi
creator: Devendra Singh
creator: Avesh Chaudhary
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-02-25
publication date: 2026-02-25
starting page: 17
ending page: 23
doi: 10.70192/v3.i1.04

An Unexpected Twist: Paradoxical Pleural Effusion during Pott’s Spine Management
type: item
description: Paradoxical pleural effusion refers to the appearance or worsening of a pleural effusion during anti-tubercular therapy (ATT), despite initial clinical or radiological improvement. It can manifest as a new or enlarging effusion, often contralateral to the primary disease focus. Paradoxical reactions are well-recognized complications of ATT, most commonly described in lymph node and central nervous system tuberculosis. Paradoxical pleural effusion, particularly in extrapulmonary TB such as spinal disease, is rare and under-reported. We describe the case of a 34-year-old female with thoracic spinal tuberculosis who developed a right-sided pleural effusion three weeks after initiation of ATT, despite a normal baseline chest X-ray. The case emphasizes the importance of recognizing this immune-mediated phenomenon to avoid unnecessary changes in therapy or invasive diagnostic procedures.
subject: Case Report
  topic: section
subject: Pott spine, Paradoxical response, Anti-tuberculosis therapy.
  topic: keywords
creator: Haseef Ahmad
creator: Ramakant Dixit
creator: Shubhangi Bohra
creator: Suryadev Singh
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-02-25
publication date: 2026-02-25
starting page: 37
ending page: 39
doi: 10.70192/v3.i1.09

Bronchoscopy: The Last Hope When Radiology Fails to Illuminate, A Case of Subglottic Stricture
type: item
description: Background: Subglottic stricture is a rare cause of upper airway obstruction in adults and is often misdiagnosed as asthma or chronic obstructive pulmonary disease due to nonspecific symptoms and normal routine imaging. Case Presentation: A 55-year-old female presented with progressive shortness of breath and wheezing for three months. Routine blood investigations, chest radiography, and contrast-enhanced computed tomography of the thorax were unremarkable. Spirometry revealed flattened inspiratory and expiratory limbs on the flow–volume loop, suggestive of fixed airway obstruction, with a reduced FEV₁/FVC ratio and preserved forced vital capacity. Flexible bronchoscopy subsequently demonstrated a subglottic stricture, confirming the diagnosis. Conclusion: This case emphasizes the importance of recognizing spirometric patterns of fixed airway obstruction and the role of bronchoscopy in diagnosing subglottic stricture when routine imaging is normal. Early identification allows appropriate management and improved outcomes.
subject: Case Report
  topic: section
subject: Subglottic stenosis
  topic: keywords
subject: Bronchoscopy
  topic: keywords
subject: spirometry
  topic: keywords
creator: Mukesh Goyal
creator: Swarna Poundrik
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-02-25
publication date: 2026-02-25
starting page: 34
ending page: 36
doi: 10.70192/v3.i1.08

Excessive Dynamic Airway Collapse: An Unusual Cause of Refractory Cough
type: item
description: Expiratory central airway collapse (ECAC) is characterized by excessive narrowing of the central airways during expiration. Excessive dynamic airway collapse (EDAC), a subtype of ECAC, involves inward bulging of the posterior membranous tracheal wall with preserved cartilaginous rings and its clinical presentation closely mimics asthma and chronic obstructive pulmonary disease. EDAC is frequently underdiagnosed with spirometry and chest imaging and often requires dynamic bronchoscopy, which remains the diagnostic gold standard. We report a 63-year-old non-smoker female with hypothyroidism, treated pulmonary tuberculosis, coronary artery disease status post percutaneous transluminal coronary angioplasty, and obstructive airway disease, who presented with a three-month history of troublesome productive cough, exertional dyspnea (mMRC grade 2). Physical examination revealed bilateral polyphonic wheeze. Spirometry showed a mixed ventilatory defect with moderate obstruction and no reversibility. Despite treatment with bronchodilators and antibiotics, symptoms persisted. High-resolution computed tomography of the chest findings was not helpful in making a sound diagnosis and warranted further evaluation. Cardiac evaluation was normal. Flexible bronchoscopy performed under conscious sedation revealed significant expiratory collapse of the posterior tracheal wall, confirming EDAC. This finding explained the patient’s refractory symptoms and poor response to conventional therapy. Continuous positive airway pressure was initiated as a pneumatic stenting measure, resulting in significant symptomatic improvement. This case shows that dynamic airway disorders should be considered in patients with persistent cough and wheeze, and that bronchoscopy plays a key role in making an early and accurate diagnosis and guiding proper treatment.
subject: Case Report
  topic: section
subject: Excessive dynamic airway collapse
  topic: keywords
subject: Intractable cough
  topic: keywords
subject: wheezing
  topic: keywords
subject: Bronchoscopy
  topic: keywords
subject: positive Airway pressure therapy
  topic: keywords
creator: Irfan Khan
creator: Sanjay Sogani
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-02-25
publication date: 2026-02-25
starting page: 31
ending page: 33
doi: 10.70192/v3.i1.07

Broncho-Pleuro-Cutaneous Fistula at Intercostal Chest Drain Site in a Patient having Silicotuberculosis
type: item
description: .
subject: Clinical-Radiological Image
  topic: section
creator: Ramakant Dixit
creator: Siddarth Mathur
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-07-15
publication date: 2026-07-15
starting page: 30
ending page: 31
doi: 10.70192/v3.i2.06

Burst or Bluff: A Bulla Masquerading as Tension Pneumothorax in a 2-Year-Old Child
type: item
description: This case highlights the diagnostic challenge of differentiating between a pneumothorax and a congenital pulmonary bulla, particularly in a malnourished paediatric patient presenting with chronic respiratory symptoms. Despite initial management with intercostal drainage under the impression of pneumothorax, the absence of lung expansion prompted further imaging, which confirmed congenital bullous disease. Definitive surgical management with an 80 mm linear stapler resection resulted in marked clinical improvement. Early consideration of bullous lung disease in children with atypical or non-resolving pneumothorax is essential to avoid unnecessary interventions and to ensure timely surgical correction for favourable outcomes.
subject: Case Report
  topic: section
subject: Giant bullae, Pneumothorax, Linear Stapler Resection
  topic: keywords
creator: Anurag Goyal
creator: Swarna Poundrik
creator: Chiranjeeb Deb Barma
creator: Ramakant Dixit
creator: Kanwar Singh
creator: Neeraj Gupta
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-02-25
publication date: 2026-02-25
starting page: 27
ending page: 30
doi: 10.70192/v3.i1.06

Primary Pulmonary Synovial Sarcoma: A Rare Lung Tumor
type: item
description: Pulmonary synovial sarcoma is an uncommon lung tumour when compared to other lung malignancies. The diagnosis of primary pulmonary sarcoma is usually made after ruling out the common primary lung malignancies and metastatic sarcomas. Metastatic pulmonary synovial sarcoma is more common than primary synovial sarcoma. The usual presentation will be cough, chest pain, breathlessness and radiologically a mass in the lung. Histopathological examination and immunohistochemical staining of the biopsy sample are needed to confirm the diagnosis; if possible genetic study should also be done. Considering the rarity of this tumour, we report a case of a 66-year-old female with a huge right lung mass with ipsilateral pleural effusion, which was diagnosed as primary pulmonary synovial sarcoma by USG-guided lung biopsy.
subject: Case Report
  topic: section
subject: Primary pulmonary synovial sarcoma
  topic: keywords
subject: TLE1
  topic: keywords
subject: surgical excision
  topic: keywords
creator: Sabarigirivasan Harish VK
creator: Venkateswara Babu R
creator: Banushree Chandrasekhar
creator: Srinivas Murthy
creator: Hariharan
creator: Loknath B
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-02-25
publication date: 2026-02-25
starting page: 24
ending page: 26
doi: 10.70192/v3.i1.05

Treatment Outcomes for Isoniazid-Resistant Pulmonary Tuberculosis Using a Shorter Regimen at a Tertiary Care Centre from the Western Part of India
type: item
description: Background: Drug-resistant tuberculosis has been associated with higher rates of morbidity and mortality. A global total of an estimated 4 lakh people with ‘multidrug resistant/rifampicin resistant’ tuberculosis (MDR/RR-TB) were detected and notified in 2023. In India, 63,929 MDR/ RR TB cases were diagnosed, with 23,019 patients diagnosed with isoniazid (H)-mono/poly drug-resistant tuberculosis (DR-TB). Objective: This study analyses the outcome of ‘Isoniazid Mono Resistance’ Tuberculosis patients and the adverse drug reaction (ADR) among those put on isoniazid (H) mono/poly regimen treatment. Method: ‘Isoniazid-mono-poly’ DR TB regimen duration is 6 to 9 months and started according to drug sensitivity testing (DST) among eligible patients. Follow-ups were done every two months for clinical, bacteriological and radiological parameters. Outcomes observed were cure, treatment completed, treatment failure, died, lost to follow-up, not evaluated, switch to another regimen and transfer out, etc., as per standard protocol. Results: 88 isoniazid-mono/poly patients were enrolled over the last two years. There were 62 male and 26 were females. Outcome for isoniazid mono/poly regimen was cure among 40 (45.5%), treatment completed in 34 (38.6%), lost to follow up in 2 (2.3%), treatment failure in 1 (1.1%), died in 9 (10.2%) and switched to another regimen in 2 (2.3%). The prevalence of katG mutation (High level Isoniazid resistance) was more than inhA (Low level Isoniazid resistance). A more favorable treatment outcome was observed among those with minimal/moderate lung disease compared to those with far advance disease with large cavitation (p = 0.029). This was also in line with better sputum conversion. Conclusion: Treating isoniazid ‘mono-resistant’ TB patients with levofloxacin, rifampicin, ethambutol, and pyrazinamide (LfxREZ) resulted in satisfactory outcomes and low toxicity. Ruling out the isoniazid drug resistance pattern is important for all bacteriologically confi…
subject: Research Article
  topic: section
subject: Tuberculosis
  topic: keywords
subject: Drug resistance
  topic: keywords
subject: Isoniazid
  topic: keywords
subject: Treatment-outcome
  topic: keywords
creator: Pradeep Chaudhary
creator: Neeraj Gupta
creator: Ramakant Dixit
creator: Rajveer Kuldeep
creator: Ranjeet Meghwanshi
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-02-25
publication date: 2026-02-25
starting page: 7
ending page: 11
doi: 10.70192/v3.i1.02

Fungal Sensitization in Bronchial Asthma: Epidemiological Insights and Clinical Correlates from an Indian Cohort
type: item
description: Background: Fungal sensitization is increasingly recognized as an important contributor to poor asthma control and disease severity, particularly in patients with severe asthma. Data from Indian populations remains limited, necessitating region-specific epidemiological and clinical insights. Objectives: To determine the prevalence of fungal sensitization in patients with bronchial asthma and to evaluate its association with clinical severity, spirometric parameters, and immunological markers. Methods: This cross-sectional study was conducted in the Department of Respiratory Medicine at a tertiary care center in western India. About 70 diagnosed bronchial asthma patients aged ≥12 years were enrolled. Clinical assessment, spirometry with bronchodilator reversibility testing, skin prick testing for fungal allergens, absolute eosinophil count, and serum IgE levels were performed. Asthma severity scores were correlated with lung function and immunological parameters using appropriate statistical analyses. Results: Fungal sensitization was identified in 11 patients (15.7%). Aspergillus fumigatus was the most common sensitizing fungus (11.43%), followed by Mucor mucedo (5.71%), while no sensitization was observed to several other fungal species. Spirometric indices showed significant improvement post-bronchodilator, confirming reversible airflow obstruction. Fungal sensitization demonstrated a strong positive correlation with asthma severity and an inverse relationship with lung function parameters, particularly FEV₁/FVC. Absolute eosinophil count and serum IgE levels showed significant positive correlations with both fungal sensitization and asthma severity, highlighting an underlying IgE-mediated inflammatory mechanism. Conclusion: Fungal sensitization, especially to A. fumigatus, is present in a significant subset of asthma patients and is associated with increased disease severity and impaired lung function. Early identification of fungal sensitization, along with immu…
subject: Research Article
  topic: section
subject: Asthma control
  topic: keywords
subject: Fungal sensitization
  topic: keywords
subject: Aspergillus fumigatus
  topic: keywords
subject: Spirometry
  topic: keywords
subject: Serum IgE
  topic: keywords
subject: Absolute eosinophil count
  topic: keywords
subject: Skin prick test
  topic: keywords
creator: Rishi Kumar Sharma
creator: Manvi Singh
creator: Gaurav Chhabra
creator: Amit Satish Gupta
creator: Rajwinder Kaur
creator: Chander Kumar
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-02-25
publication date: 2026-02-25
starting page: 1
ending page: 6
doi: 10.70192/v3.i1.01

Psychogenic Cough, Substance Abuse and Intellectual Disability- A Diagnostic Dilemma?
type: item
description: Psychogenic cough, substance abuse, and borderline intellectual functioning are distinct clinical entities that may coexist, complicating diagnosis and management. This case report explores the clinical presentation, diagnostic challenges, and therapeutic approach in an adolescent male exhibiting all three conditions simultaneously, emphasizing the importance of multidisciplinary evaluation.
subject: Case Report
  topic: section
subject: psychogenic cough
  topic: keywords
subject: substance abuse
  topic: keywords
creator: Meghal Gulati
creator: Varsha Chalavarya
creator: Ankush Sharma
creator: Piyush Pareek
creator: Hemant Saharan
rights: Copyright (c) 2026 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2026-02-25
publication date: 2026-02-25
starting page: 40
ending page: 41
doi: 10.70192/v3.i1.10

Asthma in School Children: Assessment of Prevalence And Risk Factors Among Rural and Urban Settings from the Western Part of India
type: item
description: Background: Asthma in children remains a significant global public health challenge, contributing extensively to paediatric hospitalizations, increased healthcare utilization, missed school days, and reduced caregiver productivity, apart from the problem of underdiagnosis and undertreatment of asthma. This study aimed to assess the prevalence of asthma in school children aged 5 to 15 years in urban and rural areas of the western part of India. Methods: The study was conducted to assess the prevalence and associated risk factors of asthma among school-going children aged 5 to 15 years in urban and rural regions. The cross-sectional survey included 6,959 children, with 4,553 from urban schools and 2,416 from rural schools. Data collection was based on a modified version of a standardized and validated questionnaire developed by the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh. Results: Among urban children, 645 (14.2%) were found to have different allergic disorders, with a higher prevalence among females (15.9%) compared to males (11.3%). The rural population showed a lower overall prevalence of allergic disorders (5.1%), again with female predominance (6.1 vs. 4.2% in males). In urban children, asthma was present in 26% of those with allergies compared to just 0.8% among non-allergic peers. 44.7% of rural children with allergic conditions had asthma, compared to 1.2% among those without allergic conditions. In urban areas, asthma was diagnosed in 8.7% of children with environmental tobacco smoke exposure compared to 5.9% in rural children. 278 (6.1%) urban children reported biomass fuel exposure, with an asthma prevalence of 4.3% (n = 8). 48.7% (n=1177) of rural children were exposed to biomass fuel, with an asthma prevalence of 6.03% in the exposed group. Conclusion: The prevalence of allergic disorders was significantly higher in urban children compared to their rural counterparts. The overall prevalence of asthma was markedly high…
subject: Research Article
  topic: section
subject: School children, allergic conditions, environmental tobacco smoke, biomass fuel, prevalence of asthma..
  topic: keywords
creator: Ritumbhara
creator: Sidharth Sharma
creator: Rakesh C Gupta
creator: Ramakant Dixit
rights: Copyright (c) 2025
date: 2025-09-23
publication date: 2025-09-23
starting page: 11
ending page: 16
doi: 10.70192/

An Assessment of Tracheal Index and Thoracic Cage Ratio in patients with Chronic Obstructive Pulmonary Disease
type: item
description: Introduction: Chronic obstructive pulmonary disease is a heterogeneous lung condition characterized by chronic respiratory symptoms due to abnormalities of the airways and/or alveoli that cause persistent, often progressive, airflow obstruction. Objectives: The present study was undertaken to assess the tracheal index and the thoracic cage ratio in patients with COPD. Methods: Male COPD patients diagnosed in accordance with GOLD guidelines were included; all study subjects had with smoking history of ≥ 20 pack years and age ≥ 40 years. Patients who had any evidence of coexisting lung disease other than COPD were excluded. Patients having comorbid systemic disorders were also excluded. High-resolution CT scans were obtained without using any contrast. Tracheal Index, defined as the ratio of transverse/anteroposterior diameter at a plane 1-cm above the aortic arch, was analyzed. A tracheal index is < 0.67 was considered as Saber-sheath trachea. In the present study, the thoracic cage ratio was evaluated at two planes: carina and 5 cm below the carina. Results: A total of 40 COPD patients completed the study. Their mean age was 59.86 ± 9.46 years. Mean smoking history of 37.67 ± 12.26 pack years. Total duration of illness due to COPD was a mean of 14.58 ± 4.86 years. Their FEV1/FVC ratio varied from 0.49 to 0.66 and the resting oxygen saturation was 87.6 to 95.6%. Saber Sheath Trachea was assessed in 14 patients, thoracic cage ratio > 0.75 at Carina was seen in 5 patients, and Thoracic Cage Ratio > 0.75 at 5 cm below Carina was found in 11 patients. Tracheal Index had significant correlations with age, duration of illness, pack years and FEV1/FVC Ratio. Thoracic Cage Ratio at carina and that 5 cm below carina had significant correlations with age, duration of illness, pack years and FEV1/FVC Ratio Conclusion: HRCT was observed to be a useful imaging modality to detect characteristics of pulmonary hyperinflation – Tracheal index and the thoracic cage ratio. These parame…
subject: Research Article
  topic: section
subject: COPD, HRCT, Tracheal index, Thoracic cage ratio, Lung hyperinflation, Saber Sheath Trachea, Airways disorders
  topic: keywords
creator: Saumya Gupta
creator: Prem Parkash Gupta
rights: Copyright (c) 2025 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2025-10-07
publication date: 2025-10-07
starting page: 5
ending page: 10
doi: 10.70192/

Correlation of 5-Repetition Sit-to-Stand Test with Borg Dyspnoea Scale and GOLD Spirometric Classification in Patients with COPD
type: item
description: Background: Chronic obstructive pulmonary disease (COPD) is a major global health problem associated with significant morbidity and mortality. Functional assessments such as the “5-repetition sit-to-stand test (5STS)” may serve as accessible tools to estimate disease severity, especially in resource-limited settings. This study assesses the relationship between the 5STS and the Borg dyspnoea scale, along with the GOLD spirometric classification, in Indian patients diagnosed with COPD. Methods: In this cross-sectional study, 71 stable COPD patients from a tertiary care center in Mumbai were evaluated. Participants underwent spirometry, 5STS, and dyspnoea assessment using the modified Borg scale. Patients were also classified according to the GOLD spirometric classification. Statistical correlations and comparisons were performed using Spearman’s correlation, ANOVA, and post-hoc Tukey tests. Results: Participants had a mean age of 65.7 ± 8.3 years, with males comprising 80.3% of the study population. The mean 5STS completion time was 14.98 ± 3.64 seconds. The 5STS demonstrated a strong positive correlation with the Borg dyspnoea scale (r = 0.857, p < 0.001). ANOVA revealed significant differences in 5STS times across GOLD spirometric categories (p < 0.001). Cronbach’s alpha demonstrated high reliability of 5STS in reflecting symptom severity (0.829). Conclusion: The 5STS test shows a strong correlation with established COPD severity indices and is a reliable, inexpensive, and rapid assessment tool. It holds potential as a surrogate marker for disease severity in resource-constrained settings.
subject: Research Article
  topic: section
subject: Chronic obstructive pulmonary disease, 5-Repetition sit-to-stand test, Borg dyspnoea scale, GOLD spirometric classification, Functional exercise capacity.
  topic: keywords
creator: Rajiv Jain
creator: R S Mathur
creator: Ambika Sharma
rights: Copyright (c) 2025
date: 2025-10-07
publication date: 2025-10-07
starting page: 1
ending page: 4
doi: 10.70192/

Phantom Tumor of the Lung: A Radiological Masquerader of Pulmonary Mass Lesion
type: item
description: Background: Phantom tumor, also referred to as a vanishing tumor or pseudotumor, is a rare radiological entity characterized by localized transudative pleural fluid accumulation within a pulmonary fissure, most often associated with congestive heart failure. Its mass-like appearance on chest radiographs can closely mimic pulmonary neoplasms, potentially leading to unnecessary diagnostic procedures if unrecognized. Case Presentation: We describe a 68-year-old male with a history of ischemic heart disease who presented with acute-onset breathlessness, orthopnea, and bilateral pedal edema. Chest radiography revealed a well-defined, homogeneous opacity in the right mid-zone, raising suspicion of encysted pleural effusion within the horizontal fissure. Electrocardiography demonstrated tachycardia with a right bundle branch block, while echocardiography revealed severe left ventricular systolic dysfunction. Following initiation of intravenous diuretic therapy for decompensated heart failure, repeat chest radiography subsequently showed complete resolution of the opacity, confirming the diagnosis of a phantom tumor. Conclusion: Phantom tumor should be considered in elderly patients with congestive heart failure presenting with fissural opacities on chest radiographs. Rapid radiological resolution after diuretic therapy is pathognomonic and aids in avoiding unnecessary investigations and interventions.
subject: Case Report
  topic: section
subject: Phantom tumor, Interlobar effusion, Congestive heart failure.
  topic: keywords
creator: Ramakant Dixit
creator: Shubhangi Bhora
creator: Manudev Mehta
creator: Himanshu Mohan
rights: Copyright (c) 2025 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2025-09-23
publication date: 2025-09-23
starting page: 57
ending page: 59
doi: 10.70192/

Treatment Outcome Analysis of Drug-Sensitive Pulmonary and Extrapulmonary Tuberculosis Among HIV Positive and HIV Negative Patients and their Correlation with CD4 Counts
type: item
description: Background: WHO guidelines recommended daily therapy in HIV-TB co-infected individuals. The study was aimed at comparing treatment outcomes of standard drug-sensitive anti-tuberculosis regimen in HIV seropositive and HIV seronegative patients with tuberculosis and their correlation with CD4 counts. Material & methods: The present observational and prospective study of 236 HIV-negative and 154 HIV-positive patients was conducted over two years. All the patients included in the study were reviewed regularly to enquire the compliance, symptom improvement and outcome analysis. Results: Among HIV-negative patients, pulmonary TB was more common, while among HIV-positive patients, extrapulmonary TB was observed more frequently. Notably high treatment success rate (82.6 vs. 65.5% at the end of treatment, p-value 0.002) and low mortality rate (8.0 vs. 20.1%, p-value 0.002) were observed among HIV-negative patients. Higher CD4 counts among HIV-positive patients was found to be noteworthy after 6 months treatment (194.85 vs. 288.18, p <0.001). Those HIV individuals who died had inadequate improvement in CD4 counts. Conclusions: Overall, HIV negative patients did better on the daily DOTS regimen than HIV positive patients in terms of treatment completion and success rates, treatment failure as well and mortality. Improvement in CD4 counts after treatment was statistically significant and indicates the effectiveness of combined ART and DOTS in tuberculosis treatment.
subject: Research Article
  topic: section
subject: Tuberculosis, HIV infection, Treatment outcome.
  topic: keywords
creator: Akhilesh Verma
creator: Rajveer Kuldeep
creator: Ramakant Dixit
creator: Neeraj Gupta
creator: Ranjeet Meghvanshi
creator: Mukesh Goyal
rights: Copyright (c) 2025 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2025-09-23
publication date: 2025-09-23
starting page: 17
ending page: 25
doi: 10.70192/

Isolated Primary Tuberculosis of the Pectoralis Major Muscle
type: item
description: Skeletal muscle tuberculosis is an extremely rare form of extrapulmonary TB, accounting for <1% of all cases, even in TB-endemic countries. We present the case of a 45-year-old female with isolated involvement of the right pectoralis major muscle, presenting as a painful, gradually enlarging anterior chest wall swelling. Computerized tomography scan revealed a soft tissue lesion within the muscle, and fine needle aspiration cytology from the lesion confirmed tuberculosis with granulomatous inflammation and acid-fast bacilli. The patient responded completely to standard anti-tuberculosis therapy. This case highlights the importance of considering tuberculosis in the differential diagnosis of soft tissue swellings at any site of body in endemic areas.
subject: Case Report
  topic: section
subject: Tuberculosis, Muscular TB, Pectoralis major, Extrapulmonary TB, Chest wall swelling.
  topic: keywords
creator: Ramakant Dixit
creator: Hanuman Prasad Sharma
creator: Swarnlata Ajmera
rights: Copyright (c) 2025 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2025-09-23
publication date: 2025-09-23
starting page: 54
ending page: 56
doi: 10.70192/

A Challenging Case of Ethambutol-Induced Optic Neuritis Manifesting with Perioptic Cystic Changes Diagnosed by Optic MRI
type: item
description: A 51-year-old female with a diagnosed case of Pott’s spine has been on regular antitubercular treatment for the last 9 months and presented with complaints of progressive blurring of vision for the past 3 months. Ophthalmological examination revealed decreased visual acuity and bilateral retro-orbital pain on gentle compression of the eyeballs. This case highlights the role of MRI in the early detection of optic neuritis and demonstrates that early discontinuation of ethambutol can lead to favourable outcomes by preventing irreversible optic nerve damage.
subject: Case Report
  topic: section
subject: Tuberculosis, Optic neuritis, Ethambutol, Pott’s Spine, Adverse drug reaction.
  topic: keywords
creator: Ronak Bainsla
creator: Tamizhan Sekar
creator: Anand Agrawal
creator: Kamaljeet Singh
creator: Sunaina Kharb
creator: Sumita Sethi
rights: Copyright (c) 2025 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2025-09-23
publication date: 2025-09-23
starting page: 51
ending page: 53
doi: 10.70192/

Deep Vein Thrombosis, Pulmonary Thromboembolism, and Pulmonary Infarction: All in one in a Young Male Patient with Pulmonary Tuberculosis
type: item
description: Pulmonary tuberculosis (PTB) is a known pro-inflammatory state that can predispose individuals to thromboembolic events. We present an uncommon case of a young male with active PTB who developed deep vein thrombosis (DVT), pulmonary thromboembolism (PTE), and pulmonary infarction as complications during the disease course. This case underscores the critical need for prompt identification of thromboembolic events in patients with tuberculosis, the diagnostic value of Doppler and CT pulmonary angiography, and the successful use of anticoagulation alongside modified ATT in achieving favourable outcomes.
subject: Case Report
  topic: section
subject:
  topic: keywords
  value: Pulmonary tuberculosis, deep vein thrombosis, pulmonary thromboembolism, pulmonary infarction, hypercoagulability, anticoagulation, CT pulmonary angiography, Doppler ultrasound, ATT modifications, venous thromboembolism.
creator: Manudev Mehta
creator: Ramakant Dixit
creator: Haseef Ahammed
creator: Piyush Arora
creator: Pradeep Chaudhary
rights: Copyright (c) 2025 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2025-09-23
publication date: 2025-09-23
starting page: 48
ending page: 50
doi: 10.70192/

When Bullae Deceive: A Rare Case of Vanishing Lung Syndrome Misdiagnosed as Pneumothorax
type: item
description: Background: Vanishing lung syndrome (VLS), also referred to as giant bullous emphysema, is an uncommon form of lung disease in which massive bullae replace a substantial portion (typically more than one third) of the hemithorax, leading to compression of surrounding healthy lung tissue. It typically occurs in young male smokers but may also arise in non-smokers with biomass exposure, making diagnosis and management particularly challenging. Case Presentation: We describe a case involving a 51-year-old non-smoking woman with long-term exposure to biomass fuel, who presented with dry cough, chest discomfort, and gradually worsening shortness of breath. An initial chest X-ray was interpreted as a left-sided pneumothorax, for which an intercostal chest drain was placed; however, clinical and radiological improvement was not achieved. Subsequent high-resolution computed tomography revealed a large emphysematous bulla occupying the left lower lobe and causing a contralateral mediastinal shift, findings consistent with vanishing lung syndrome. The patient underwent successful surgical management via left posterolateral thoracotomy and bullectomy, resulting in marked clinical improvement. Conclusion: This case highlights the critical need to distinguish vanishing lung syndrome from pneumothorax, particularly in individuals with non-traditional risk factors like prolonged biomass smoke exposure. Early recognition and surgical intervention can lead to substantial symptomatic and functional recovery.
subject: Case Report
  topic: section
subject: Vanishing lung syndrome, Pneumothorax, Mimic, Giant bullous emphysema, Biomass exposure, Bullectomy, Hyperlucent lung.
  topic: keywords
creator: Siddarth Mathur
creator: Anurag Goyal
creator: Ramakant Dixit
creator: Komal Shrivastava
rights: Copyright (c) 2025 UAPM Journal of Respiratory Diseases and Allied Sciences
date: 2025-09-23
publication date: 2025-09-23
starting page: 44
ending page: 47
doi: 10.70192/