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Background: Transbronchial lung cryobiopsy (TBLC) in the diagnosis of diffuse parenchymal lung disease (DPLD) has shown a promising yield in recent times, with low post-procedural mortality and morbidity. Objectives: To compare the yield of TBLC and conventional transbronchial forceps lung biopsy (TBLB). Methods: A prospective study was carried out in patients with DPLD over a period of 1 year in a tertiary respiratory care institute in New Delhi, India. All 87 patients enrolled underwent both TBLB and TBLC. The procedures were performed in the bronchoscopy suite under conscious sedation and local anaesthesia, with an attempt to take a minimum of three biopsy specimens by conventional TBLB followed by TBLC. A 1.9 mm cryoprobe with a freezing time of 4 - 5 seconds was used. An Arndt endobronchial blocker was used to control bleeding along with locally administered medications. Results: TBLB and TBLC led to a definitive diagnosis in 27 (31.0%) and 69 (79.3%) cases, respectively. The commonest diagnoses were hypersensitivity pneumonitis, sarcoidosis and pulmonary tuberculosis. TBLC led to additional diagnoses in 42 cases (48.3%). Pneumothorax was observed in 12 cases (13.8%), and moderate bleeding occurred in 63 (72.4%). There were no procedure-related deaths. Conclusion: TBLC had a better diagnostic yield than conventional TBLB in DPLD. It has the potential to become a safe day-care procedure in a resource-limited setting, if certain precautions are taken. Study synopsis: What the study adds. Compared with transbronchial forceps lung biopsy, transbronchial lung cryobiopsy (TBLC) led to additional diagnoses in 42 (48.3%) of 87 patients with clinicoradiological features of diffuse parenchymal lung disease. Pneumothorax was observed in 12 cases (13.8%) and moderate bleeding in 63 (72.4%). TBLC without rigid bronchoscopy or advanced airway devices under conscious sedation had a good diagnostic yield with an acceptable adverse events profile.Implications of the findings. TBLC under conscious sedation is not resource intensive and can be carried out in settings with limited resources.

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Background: Most patients with lung cancer are diagnosed at advanced stages of the disease, where chemotherapy plays an important role. This prospective study was conducted to determine the impact of palliative chemotherapy on quality of life (QOL) in advanced-stage lung cancer patients. Methods: QOL in lung cancer out-patients was assessed at diagnosis and end of treatment using the EORTC QLQ-C30 questionnaire. Changes in mean QOL scores were calculated. The correlation between patients' tumor response and change in QOL scores was also studied. Scoring was done according to the EORTC manual and results were analyzed using SPSS statistical package. Results: Out of 52 patients, 46 (88.46%) were men and six (11.54%) were women. After chemotherapy, patients' overall QOL score improved significantly (P = 0.005). Cognitive functioning significantly worsened (P = 0.01). Physical functioning (PF) and emotional functioning (EF) scores improved, while role functioning (RF) and social functioning (SF) scores worsened. Pain, dyspnea, and sleep significantly improved (P = 0.001, P = 0.001, and P = 0.005 respectively). On the other hand, nausea, vomiting (P = 0.000), diarrhea (P = 0.004), and financial difficulties (P = 0.009) worsened. Overall QOL improved in patients with partial tumor response (PR) and stable disease (SD) (P = 0.044 and P = 0.000, respectively), but worsened in progressive disease group (PD) (P = 0.648). Symptom scores improved markedly in PR and SD groups. Chemotherapy toxicity was maximum in PD group (P = 0.028). Conclusion: Global quality of life and symptom control significantly improved in lung cancer patients after chemotherapy. Deterioration of cognitive functioning, increased financial burden, and chemotherapy-related toxicity were noteworthy. Changes in QOL were coherent with patients' tumor response.

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Clostridium perfringens is an anaerobic, spore-forming bacterium that may lead to necrotic enteritis, resulting in poor feed efficiency and increased mortality in chickens. It is estimated that C. perfringens infects almost 1 million people in the United States every year. The objective of this research was to compare the Fung double tube (FDT) and conventional Petri plates using 3 different media to detect and enumerate Clostridium spp. in chicken intestines. Nine Cobb 500 broilers were randomly selected and euthanized at 21 and 42 d of age for a total of 18 samples. The jejunum and ileum from each broiler were harvested and studied in 2 methods and 3 media combinations, utilizing a 2 × 3 factorial totaling 6 treatments. The 2 methods were FDT and conventional Petri plates, and the 3 media were Shahidi-Ferguson Perfringens (SFP) with egg yolk supplement, polymyxin B, and kanamycin (E); SFP with polymyxin B and kanamycin (P); and SFP with d-cycloserine (C). Enumerations were performed after 24 h of incubation at 37°C. At 21 d, counts using medium C with FDT (4.51 log10 cfu/g) and plates (2.38 log10 cfu/g) were higher (P < 0.05) than using media E or P. On d 42, there were no differences among plate treatments and medium E had the highest counts (0.98 log10 cfu/g). Of all the FDT, medium C (5.35 log10 cfu/g) had the highest counts (P < 0.05), followed by medium P (3.54 log10 cfu/g). This study illustrates that the FDT method is able to enumerate Clostridium spp. at higher levels (P < 0.001) than the conventional Petri plate method; therefore, the FDT should be implemented and further explored.

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BACKGROUND: A study to determine the prevalence of human immunodeficiency virus (HIV) infection among tuberculosis patients and to compare the clinico-radiological spectrum of tuberculosis among HIV seropositive and seronegative patients was carried out in the Department of TB and Chest Diseases, CSM Medical University, Lucknow (Uttar Pradesh), India. METHODS: A total of 1105 radiologically and/or bacteriologically confirmed patients of tuberculosis were screened for HIV infection during the years 1995 to 1997 and from 2000-2001. RESULTS: Out of a total 1105 patients screened, 31(2.8%) were found to be HIV seropositive. Tuberculin positivity was less among HIV seropositive patients as compared to HIV seronegative patients (22.6% vs 76.4%; p < 0.001). There was no statistically significant difference in sputum smear positivity for acid-fast bacilli (AFB) among HIV seropositive and seronegative patients. Among HIV seropositive patients, mid and lower zone involvement, exudative lesions and mediastinal lymphadenopathy was more common as compared to the seronegative patients. CONCLUSION: HIV seropositivity rates among tuberculosis patients was 2.8 percent. The presentation of tuberculosis was more often atypical among these patients.

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