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Introduction Interstitial lung disease (ILD) is a heterogeneous group of over 200 parenchymal lung diseases with a myriad of etiologies. Interstitial lung disease registries from around the world show varying prevalence and incidence of these diseases. The aim of this study was to determine the epidemiology and characteristics of ILD in Pakistan. Methods This web-based registry, which is the first multicenter registry of ILD from Pakistan, recruited patients from 10 centers of five major cities between January 2016 and March 2019. Results A total of 744 patients were enrolled in the registry. The five most frequent ILDs were idiopathic pulmonary fibrosis (IPF) 34.4%, hypersensitivity pneumonitis (HP) - 17.7%, idiopathic nonspecific interstitial pneumonitis (iNSIP) - 16.8%, connective tissue disease-associated ILD (CTD-ILD) - 16.3%, and sarcoidosis - 9.1%. Conclusion Idiopathic pulmonary fibrosis is the most prevalent ILD in Pakistan, followed by HP and iNSIP. An ongoing prospective registry with longitudinal follow-up will help us further elaborate on the clinical characteristics, treatment, and survival outcome of patients with ILD.
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Coronavirus disease (COVID-19) has grasped the world including Pakistan. Clinical features of this disease are variable, ranging from asymptomatic to critical disease. In this unprecedented global war, the Pakistan Chest Society has written a guideline for quick review for the specialists providing care to suspected or confirmed patients. This review highlights the approach to a patient with COVID-19, including definition of the various syndromes of the disease, the abnormal laboratory parameters and outlines the therapeutic measures which are currently under investigation.
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Betacoronavirus , Infecciones por Coronavirus/terapia , Neumonía Viral/terapia , Antivirales/efectos adversos , Antivirales/uso terapéutico , COVID-19 , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Humanos , Monitoreo Fisiológico , Pakistán , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Guías de Práctica Clínica como Asunto , Síndrome de Dificultad Respiratoria , SARS-CoV-2 , Sepsis , Tratamiento Farmacológico de COVID-19RESUMEN
This article reviews literature pertaining to community acquired pneumonia (CAP) in adults published over the last decade (2003-2013) and includes ten studies and one guideline document. The review was done to identify the trend in etiologies and antimicrobial susceptibilities in order to recognize the need to update treatment guidelines for CAP in adults. Except for one laboratory based study, no articles were published between 2003 and 2008. Thereafter, most of the studies are retrospective in nature and published with a time lag hence reducing the relevance of the data. Out of the ten studies, two were purely clinical and among those that presented microbiological data, sensitivities to antibiotics were demonstrated in five studies which too were mainly organism specific. Streptococcus pneumonia remains the most common etiology of CAP in adults. There is increased isolation of atypical organisms in mild to moderate CAP, possibly due to better detection techniques. Mortality related to CAP is on the rise and noted up to 51% in patients with severe disease. There is limited evidence to support increasing resistances of pathogens to antibiotics. Lack of updated data leaves Pakistan Chest Society guidelines 2010 for treatment of CAP applicable to date in its original form. However there is a need to conduct more comprehensive studies on CAP to help reduce morbidity and mortality associated with the disease.
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Neumonía/terapia , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/terapia , Humanos , Pruebas de Sensibilidad Microbiana , Neumonía/microbiología , Neumonía Bacteriana/epidemiología , Neumonía Bacteriana/terapiaRESUMEN
Chylothorax and chyloascites is the accumulation of chyle in pleural and peritoneal spaces and are rarely seen. This case report describes the occurrence and management in an old lady. However, she expired due to frank haematemesis and encephalopathy. Chylothorax/chyloascites are difficult to manage and associated with poor prognosis.