Publications by authors named "Nalin Joshi"

5 Publications

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Silicosis With Secondary Spontaneous Pneumothorax in the Western Rajasthan.

Cureus 2020 Nov 30;12(11):e11811. Epub 2020 Nov 30.

Psychiatry, Griffin Memorial Hospital, Norman, USA.

Objective Silicosis is one of the common occupational lung diseases caused by crystalline silica respiration. Pneumothorax is one of the most common and morbid complications of silicosis involving lung pleura. It is commonly seen unilaterally in chronic silicosis and can often be lethal. The purpose of this study is to report secondary spontaneous pneumothorax (SSP) in critically ill patients with silicosis. Methods A cross-sectional study was done between January 2019 and June 2019 at Sawai Man Singh (SMS) Medical College in Jaipur, India. A cohort of 50 patients with dyspnea and a history of silicosis were studied. A chest X-ray and sputum for acid fast bacilli were checked on all suspected cases. Results The present study showed that the mean age of patients was 38.7 years, all silicosis patients had dyspnea, and 96% of patients had severe chest pain. The results of chest X-rays concluded the evidence of silicosis. Bilateral pneumothorax was seen in three cases, right-sided pneumothorax in eight cases, and left-sided pneumothorax in 11 cases. The rate of pneumothorax incidence in silicosis patients was about 44%, which is higher than the current evidence. Six patients were managed conservatively with oxygen and bronchodilators, and 16 patients underwent through tube thoracostomy. Conclusion This study highlights the importance of considering spontaneous pneumothorax in patients who are presenting with shortness of breath and/or chest pain especially with a known history of silicosis, as the timely diagnosis can alter the management of this morbid condition which carries a high mortality rate if left untreated, compromising the lung expansion, venous return, cardiac output, oxygenation and eventually leading to death.
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November 2020

Silicosis with Bilateral Spontaneous Pneumothorax in Rajasthan.

Indian J Occup Environ Med 2019 Sep-Dec;23(3):112-116. Epub 2019 Dec 16.

Department of Chest and TB, Institute of Respiratory Disease, SMS Medical College, Jaipur, Rajasthan, India.

Background And Aims: Silicosis is an occupational lung disease caused by inhalation of crystalline silica. People working in occupations like sandblasting, surface drilling, tunnelling, silica flour milling, ceramic making are predisposed to develop silicosis. Unilateral spontaneous pneumothorax is a pleural complication that can develop in such cases. Our aim is to see the prevalence of bilateral pneumothorax in silicosis in Rajasthan and associated predisposing factors.

Methods: Fifty patients of silicosis prospectively reviewed by historical, clinical evaluation, and radiological evidence with increased dyspnea and chest pain in 1 year were included in the study. In all patients, chest X-ray was done immediately. Sputum for acid fast bacilli was done in all cases.

Results: Cough and shortness of breath were most common symptoms and present in all cases. All cases were smokers. Chest radiograph revealed reticulonodular density with B/L pneumothorax in all patients. Tube thoracostomy was done in all cases except one in which conservative management was done.

Conclusions: Cases with silicosis can develop complications like tuberculosis, lung cancer, progressive massive fibrosis, cor pulmonale, broncholithiasis, or tracheobronchial compression by lymph nodes. Pleural involvement in silicosis is rare. Spontaneous pneumothorax is a pleural complication that can develop in such cases. Usually in silicosis pneumothorax is unilateral. We report here an original article with silicosis who presented with bilateral spontaneous pneumothoraxes occurring simultaneously. The rarity of its clinical presentation in the form of bilateral simultaneous spontaneous pneumothorax combined with the typical clinical and radiological features of silicosis will make us to report this article.
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December 2019

Efficacy and Safety of Mycobacterium indicus pranii as an adjunct therapy in Category II pulmonary tuberculosis in a randomized trial.

Sci Rep 2017 06 13;7(1):3354. Epub 2017 Jun 13.

National Institute of Immunology, New Delhi, India.

Prolonged treatment of tuberculosis (TB) often leads to poor compliance, default and relapse, converting primary TB patients into category II TB (Cat IITB) cases, many of whom may convert to multi-drug resistant TB (MDR-TB). We have evaluated the immunotherapeutic potential of Mycobacterium indicus pranii (MIP) as an adjunct to Anti-Tubercular Treatment (ATT) in Cat II pulmonary TB (PTB) patients in a prospective, randomized, double blind, placebo controlled, multicentric clinical trial. 890 sputum smear positive Cat II PTB patients were randomized to receive either six intra-dermal injections (2 + 4) of heat-killed MIP at a dose of 5 × 10 bacilli or placebo once in 2 weeks for 2 months. Sputum smear and culture examinations were performed at different time points. MIP was safe with no adverse effects. While sputum smear conversion did not show any statistically significant difference, significantly higher number of patients (67.1%) in the MIP group achieved sputum culture conversion at fourth week compared to the placebo (57%) group (p = 0.0002), suggesting a role of MIP in clearance of the bacilli. Since live bacteria are the major contributors for sustained incidence of TB, the potential of MIP in clearance of the bacilli has far reaching implications in controlling the spread of the disease.
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June 2017

Pneumomediastinum, pneumothorax and subcutaneous emphysema during radiotherapy in primary cavitating bronchogenic carcinoma.

Indian J Chest Dis Allied Sci 2002 Jan-Mar;44(1):61-4

Department of Chest Diseases, J.L.N. Medical College, Ajmer, India.

An extremely rare case of cavitating large cell carcinoma lung is reported in a middle aged man who developed pneumomediastinum, pneumothorax and subcutaneous emphysema on thirteenth day of his tele cobalt radiotherapy to chest. Possible mechanisms of such complications during radiotherapy are also discussed.
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March 2002