Background: Bronchial asthma is one of the common chronic respiratory illnesses worldwide, with a global disease burden that affects approximately 300 million individuals. It affects 5-10% of the population in developed countries. India constitutes approximately one-tenth of the global disease burden, where an estimated 7 million children are affected by this illness. Airway hyperresponsiveness or bronchial hyperreactivity in asthma is an exaggerated response to numerous exogenous and endogenous stimuli. In India, the most important endogenous stimuli is considered to be fungal antigens from the genus, Aspergillus. Positive skin reactions to Aspergillus fumigatus among individuals with atopic asthma is 10 to 20%; however, a causal relationship is yet to be established. A separate entity, termed “severe asthma with fungal sensitivity,” is often used to describe milder allergic reactions to fungal aeroallergens that has fungal sensitization as the starting point of pathogenesis than allergic bronchopulmonary aspergillosis. Methods: A total of 57 patients with bronchial asthma were prospectively enrolled and evaluated for Aspergillus sensitization and its impact on asthma control. Results: Symptoms were well controlled in a majority of patients (57.89%) and partly controlled in 14.04%. Uncontrolled symptoms were observed in only 28.07% of patients. The proportion of patients with uncontrolled symptoms was higher among patients who were sensitized (45.00%) compared with patients who were not sensitized (18.92%). The proportion of patients with well-controlled symptoms was higher in individuals who were not sensitized compared with individuals who were sensitized (62.16% versus 50.00%). Conclusion: The severity of asthma was associated with fungal sensitization, with sensitization to Aspergillus as a part of the pathogenesis. Aspergillus sensitization is significantly associated with bronchiectasis, even in the absence of clinical features.

Background:Oxidant-antioxidant imbalance forms a prime component in pathogenesis of chronic obstructive pulmonary disease (COPD). Studies of oxidative stress markers in South Asians were sparse.Methods:One hundred and eighty COPD patients and eighty healthy nonsmokers were enrolled in the study. Serum malondialdehyde (MDA) and iron levels were estimated for oxidative stress. Three antioxidant markers evaluated-catalase, superoxide dismutase (SOD), and serum copper. Patients on antioxidant therapy and with sepsis and chronic illness were excluded from the study.Results:The mean age of COPD patients was 59.29 ± 10.3 years. Serum levels of MDA and iron were significantly higher in COPD patients compared to controls (5.21 ± 1.9 vs. 0.71 ± 0.29 nmol MDA/ml, P = 0.0001 and 69.85 ± 85.49 vs. 79.32 ± 24.39 μg/dl, P = 0.0001, respectively). Mean level of all antioxidant enzymes catalase, SOD, and copper were significantly diminished in cases when compared to control population (P = 0.001). Levels of MDA and iron were found to be significantly elevated in higher Global Initiative for Chronic Obstructive Lung Disease (GOLD) classes (III, IV) when compared to lower GOLD Classes (I, II). The levels of serum antioxidants were significantly depleted in higher GOLD grades too. COPD patients who were male and smoked had significantly higher levels of oxidants and depleted antioxidant levels compared to female and nonsmoking compatriots. Serum MDA levels negatively correlated with forced expiratory volume 1 s and forced vital capacity (r = −0.19 and r = −0.21, P ≤ 0.01). The presence of a cough significantly correlated with higher levels of MDA and iron (P = 0.001). The levels of MDA negatively correlated with SOD and catalase levels.Conclusion:Oxidative markers (MDA and iron) are higher whereas antioxidants (catalase, copper, and SOD) are significantly reduced in patients of COPD. Serum MDA levels correlate with lung functions and disease severity.

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Background: Lung cancer now constitutes the majority of all cancer diagnosis in the world. It has the most unfavourable prognosis accounting for the maximum number of cancer related deaths worldwide. The objective of this study was to study the complete profile of lung cancer. Prevalence of EGFR mutation in adenocarcinoma. Methods: 116 lung cancer patients were enrolled. They were subjected to diagnostic procedures like transthoracic FNAC/biopsy, bronchoscopy, thoracoscopy, closed pleural biopsy, lymph node FNAC/biopsy, besides routine blood and sputum examinations and CECT thorax. Data was analysed retrospectively after 1 year. Results: Most patients presented in the sixth decade. Mean duration of symptoms was 7.24 months. 62% patients were smokers, 54.3% were exposed to non-smoke tobacco, 18.9% to environmental tobacco smoke (ETS) and biomass fuel. Mass as the single radiological lesion was the most common radiological finding. Pleural effusion was seen in 51.7% patients and was more common in females. Liver (3.4%) and brain (5.9%) were the most common sites of metastasis. EGFR mutation was positive in 34.2% of adenocarcinoma. Exon 19 deletion was more common. ALK was positive in 1 patient. Maximum number of patients (70.7%) presented in stage 4. Transthoracic biopsy could diagnose 61.2% of all lung cancers. Adenocarcinoma was the most common diagnosis (60.3%) and was more common in females and non-smokers. Conclusions: Most patients present in an advanced stage. Adenocarcinoma now seems to be the most common histological subtype of lung cancer in India. EGFR mutation is common in the Indian population. Biomass fuel exposure is a significant risk factor in females. Bronchoscopy is the procedure of choice for diagnosing central tumours and transthoracic FNAC and Biopsy for peripheral tumours.