Rationale: Computed tomography (CT)-based lung density is used to quantitate the percentage of emphysema-like lung (hereafter referred to as percent emphysema), but information on its distribution among healthy nonsmokers is limited.Objectives: We evaluated percent emphysema and total lung volume on CT scans of healthy never-smokers in a multiethnic, population-based study. Methods:The Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study investigators acquired full-lung CT scans of 3,137 participants (ages 54-93 yr) between 2010-12. The CT scans were taken at full inspiration following the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) protocol. "Healthy never-smokers" were defined as participants without a history of tobacco smoking or respiratory symptoms and disease. "Percent emphysema" was defined as the percentage of lung voxels below 2950 Hounsfield units. "Total lung volume" was defined by the volume of lung voxels.Measurements and Main Results: Among 854 healthy neversmokers, the median percent emphysema visualized on full-lung scans was 1.1% (interquartile range, 0.5-2.5%). The percent emphysema values were 1.2 percentage points higher among men compared with women and 0.7, 1.2, and 1.2 percentage points lower among African Americans, Hispanics, and Asians compared with whites, respectively (P , 0.001). Percent emphysema was positively related to age and height and inversely related to body mass index. The findings were similar for total lung volume on CT scans and for percent emphysema defined at 2910 Hounsfield units and measured on cardiac scans. Reference equations to account for these differences are presented for never, former and current smokers.Conclusions: Similar to lung function, percent emphysema varies substantially by demographic factors and body size among healthy never-smokers. The presented reference equations will assist in defining abnormal values for percent emphysema and total lung volume on CT scans, although validation is pending.

Background: The aim of study is to evaluate the diagnostic value of the CBNAAT in BAL samples of smear negative for AFB or who could not produce an expectorated sputum sample.Methods: A prospective and observational study of in patient and out patient department in Department of Pulmonary Medicine of Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar during the period November 2017 to November 2018.Results: Bronchoalveolar lavage cartridge based nucleic acid amplification test in bronchoalveolar lavage was done for 60 samples of patients who were having history and chest x-ray suggestive of pulmonary tuberculosis with sputum AFB negative. Out of these sputum negative samples 25 were BAL CBNAAT positive and rest were negative.Conclusions: CBNAAT adds significantly to the diagnostic yield of PTB in comparison to sputum smear microscopy. It has additional advantage of identifying rifampicin resistance with high sensitivity and specificity.

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Background: To study the correlation of clinical features, spirometry, pulse oximetry assessment and haematocrit abnormalities in chronic obstructive pulmonary disease and to assess the severity of chronic obstructive pulmonary disease by spirometry.Methods: In the present study total 50 cases were selected on the basis of simple random sampling method from the Department of Pulmonary Medicine, Chalmeda Anand Rao Institute of Medical Sciences, Bommakal, Karimnagar, Telangana, India. During study period from June 2017 to December 2018.Results:  About 50 patients of chronic obstructive pulmonary disease were studied. Majority of the patients were in the age group of 50-70 years. COPD was seen predominantly in male patients and majorities were smoker. In the majority of patients, the duration of illness was 6-10 years, cough with expectoration was present in all patients. As the number of cigarettes/day and duration increases the severity of the disease also increases in the studied population. In the study, about 40 % of cases were in stage III disease. Computerised spirometry was found to be most sensitive investigation in diagnosing and assessing the severity of the disease in all these cases. As the severity and duration of the disease increases, they are more prone to develop hypoxia and polycythaemia as a complication. In present study 8 patients had hypoxia, as assessed by pulse oximeter.Conclusions: Computerized spirometry is a very useful investigation in the management of chronic obstructive pulmonary disease. Pulse oximetry is a useful tool in diagnosing periods of oxygen desaturation. Pulse oximetry also useful in monitoring the oxygen therapy during management. Haematocrit analysis is a useful adjunct in assessing the severity of the disease. Polycythaemia, even though uncommon in chronic obstructive pulmonary disease patients is one of the rare but preventable complication with early cessation of smoking and with oxygen therapy.

Background: Anemia is a global public health problem affecting both developing and developed countries with major consequences for human health as well as social and economic development. The aim was to identify iron deficiency state early before developing anemia and to analyze the clinical finding with iron deficiency state. Methods: Cross sectional study was done at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India. 100 children between 6 month to 5 years of age with normal haemoglobin were studied for iron deficiency state. After taking informed consent a detailed history and clinical examination was taken. In those children with normal Hb, investigations like serum ferritin, serum iron and transferrin saturation were done to diagnose the iron deficiency state. Results: Out of 100 children in the study, mean hemoglobin was 11.8 gm/dl, the mean serum ferritin level was 59.1ng/ml and transferrin saturation was 18.77%. The overall prevalence of iron deficiency in this study based on low serum ferritin was 16% and low transferrin saturation was 51%. 7 children has low DQ out of which 3 were ADHD, 2 had hyperactivity and 2 with learning problem. Among them one child has low ferritin and 5 had low transferrin saturation. Conclusions: Iron deficiency is an important public health problem. The findings in this study are consistent compared to other studies. Therefore, prompt screening for iron deficiency, even in non-anemic under five children in developing countries should be encouraged. If evaluation of iron status is done only by Hb early signs of iron depletion can go undetected. By monitoring the status of storage iron(ferritin), we can detect iron deficiency state earlier and initiate appropriate treatment to prevent IDA. Chithambaram NS et al. Int J Contemp Pediatr. 2017 Mar;4(2):530-533 In infancy and childhood iron deficiency even before developing anemia (i.e. during the iron deficiency state) can have long lasting detrimental effects on neurodevelopment, learning and behavior which sometimes may be irreversible. 4 Hence it is very important to detect and prevent the above problems in children. Hence, by identifying the children at prelatent stage and latent stage of iron deficiency, we can prevent these children from developing iron deficiency anemia. Keywords METHODSThis is a cross sectional study conducted at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India between January 2015 to March 2016, where 100 Indian children aged 6 month to 5 years who have normal hemoglobin for the age and sex were enrolled in the study. Children less than 6 months of age or with any evidence of inflammation, or who are already on iron supplements or who received transfusion within 1month or with pre-existing neurological deficits were excluded. In the children who were enrolled, after taking informed consent, a detailed history including development , any learning or behavioural problems and clinical examination were taken in a proforma. In these children with no...