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Background: Tobacco use is a recognized risk factor for many chronic diseases such as chronic obstructive pulmonary disease (COPD), hypertension, cardiovascular disease, atherosclerosis, diabetes, cancer and microbial infections (respiratory tract infections, bacterial meningitis), etc. Material and Methods: A community-based "One group" interventional study was conducted to see the effect of cognitive behavioural therapy in reducing tobacco usage and its dependency among all the adult males population aged 18 years and above residing in Palam area of Delhi. Data was collected using a semi-structured, self-designed interview schedule to collect information from study subjects. Fagerstrom and Modified Fagerstrom questionnaire was used to assess the subject's nicotine dependence status. Result: The total population study was 274 out of which 105 were tobacco users. Out of 105,2 did not give consent for cognitive behaviour therapy.A total of 103 study subjects were given cognitive behavioral therapy and then followed at 2 weeks, 4 weeks, 3 months, and 6 months respectively, and analyzed for quitting at each follow-up. Study subjects who had quitted tobacco was 11 i.e. 10.6%. Change in Nicotine dependency was statistically significant. Conclusion: Cognitive behaviour therapy is found to be a very effective tool in reducing tobacco usage as well as nicotine dependency. [ABSTRACT FROM AUTHOR]

This document summarizes a study on the sleep quality of patients with chronic obstructive pulmonary disease (COPD). The study found that COPD patients in urban Delhi had a high prevalence of poor sleep quality compared to healthy controls. The study suggests that addressing the causes of poor sleep in COPD patients could improve their overall well-being. However, the study acknowledges limitations such as a small sample size and subjective assessment of sleep. Further research using objective measures is needed to better understand sleep quality in COPD patients. [Extracted from the article]

Diffuse alveolar hemorrhage (DAH) is characterized by a syndrome of alveolar bleeding, a fall in hemoglobin, and respiratory failure. It can occur because of various immunologic and non-immunologic conditions. The etiology of DAH is important, as treatment varies with the etiology. This retrospective observational study evaluates the diverse etiologies, time to diagnosis from symptom onset, management strategies, and outcome of DAH in a span of 12 months at our tertiary care center. A total of 8 patients were identified with 8 different etiologies. 6/8 (75%) patients had immunologic causes, and 2/8 (25%) had non-immunologic causes of DAH. 6/8 (75%) patients were females, the mean time to DAH diagnosis was 4.25 months from symptom onset, 6/8 (75%) patients improved, and 2/8 (25%) died due to complications. It is necessary to differentiate between the etiologies of DAH and establish an early diagnosis to plan management and improve outcomes.

Persistent air leaks in patients with pneumothorax can lead to significant morbidity. If a patient with persistent air leak is medically unfit for thoracic surgery, medical pleurodesis via chest tube or thoracoscopy is either an option. Thoracoscopy offers the advantage of visualizing the site of the air leak and enabling direct instillation of the pleurodesis agent or glue at that location. Autologous blood patch instillation via chest tube has been reported to be a cheap and very effective technique for the management of persistent air leaks. However, thoracoscopic blood patch instillation has not been reported in the literature. We report two cases of secondary spontaneous pneumothorax in which patients had persistent air leaks for more than seven days and were subjected to thoracoscopy to locate the site of the leak. In the same sitting, 50 mL of autologous blood patch was instilled directly at the leak site. Post-procedure, the air leak subsided in both patients, and the chest tube was removed with complete lung expansion. We also conducted a systematic review of the use of medical thoracoscopic interventions for treating persistent air leaks.

Background: Exfoliation of bronchioloalveolar carcinoma (BAC) cells with small cell morphology in respiratory specimens can cause a diagnostic dilemma, particularly in patients with a history of bronchorrhea., Case: A 59-year-old man presented with cough, breathlessness, and bronchorrhea. Clinically, he was diagnosed to have right-sided pulmonary consolidation. His sputum and bronchial washing specimens examined on multiple occasions revealed a varied number of single and loose aggregates of atypical cells, along with rare micropapillary and glandlike structures. The cells were small, round, and fairly monomorphic with a high nucleus to cytoplasm ratio and scant to moderate cytoplasm. Chromatin was uniformly distributed, with no appreciable nucleoli. At places, a vague nuclear molding was noted. Clinically, bronchorrhea and the diffuse infiltrative nature of the lesion favored BAC. Cytologically, prominent small cell morphology and nuclear molding suggested a possibility of small cell neuroendocrine tumor. However, careful cytologic examination of subsequent respiratory samples and biopsy revealed features of a nonmucinous type of BAC., Conclusion: Despite the small cell morphology of neoplastic cells on exfoliative respiratory cytology, a clinical history of bronchorrhea should prompt a cytodiagnosis of BAC. A glandlike arrangement of cells and greater amount of cytoplasm should also assist avoiding misinterpretation in such instances.