Title: Pulmonary Rehabilitation – The art of medical practice
Pulmonary rehabilitation (PR) is the “art of medical practice wherein an individually tailored, multidisciplinary program is formulated, which through accurate diagnosis, therapy, emotional support, and education stabilizes or reverses both the physio- and psychopathology of pulmonary diseases and attempts to return the patient to the highest possible functional capacity allowed by his or her pulmonary handicap and overall life situation.” The general goals of pulmonary rehabilitation are to control and alleviate symptoms, restore functional capabilities as much as possible, and improve quality of life. Pulmonary rehabilitation does not reverse or stop the progression of the disease, but it can improve a patient’s overall quality of life. Health care providers from various disciplines are needed to reach these goals. The success of PR will be judged by patient outcomes, including improved health related quality of life, reduced breathlessness, increased daily life activities.
Mr. Kishore Kumar has completed his Bachelors in Respiratory Therapy from Chettinad Academy and Masters from Symbiosis International University, India. Currently, he is a full-time Ph.D. researcher in Chettinad Academy of Research and Education and he is the board member of the Indian Academy of Respiratory Care, an academic wing of the Indian Association of Respiratory Care. He is a fellow of the International non-invasive ventilation academy. He is also working as a Respiratory therapist in CMR homecare and rehabilitation center.
Title: Interstitial Lung Disease: - Progress and Problems
Interstitial lung disease involves all areas of medicine as it often occurs in patients with comorbidities or as a consequence of systemic diseases and their treatment. Typically, the physician is faced with a breathless patient, a diffusely abnormal chest radiograph, and a wide differential diagnosis. Progress has been made in using high-resolution computed tomography as the key investigation in characterizing the pattern and extent of the disease. Bronchoalveolar lavage is particularly important in excluding infection as a cause of diffuse lung infiltrates. Surgical lung biopsies have led to a new classification system for the range of histopathological patterns of disease that were previously known by the collective term cryptogenic fibrosing alveolitis. Problems persist in deciding when a surgical lung biopsy is clinically justified, in understanding the pathogenesis of these diseases, and in finding more effective treatments.
Progressive fibrosis is associated with worsening respiratory symptoms, lung function decline, limited response to immunomodulatory therapies, decreased quality of life, and, potentially, early death. Idiopathic pulmonary fibrosis may be regarded as a model for other progressive-fibrosing ILDs. Here we focus on other ILDs that may present a progressive-fibrosing phenotype, namely idiopathic nonspecific interstitial pneumonia, unclassifiable idiopathic interstitial pneumonia, connective tissue disease-associated ILDs (e.g., rheumatoid arthritis-related ILD), fibrotic chronic hypersensitivity pneumonitis, fibrotic chronic sarcoidosis, and ILDs related to other occupational exposures. Differential diagnosis of these ILDs can be challenging and requires detailed consideration of clinical, radiological, and histopathological features. Accurate and early diagnosis is crucial to ensure that patients are treated optimally.
Ayush Pandey is currently a post-graduate resident in the Department of Pulmonary Medicine at SGT University, Gurugram, Haryana, India. He obtained a Bachelor of Medicine and Bachelor of Surgery (MBBS) at KIMSDU, Karad, Maharashtra, India. He obtained a Diploma in Clinical Counselling (DCC) from Apollo Hospitals, India. He did Post Graduate Diploma in Clinical Cosmetology (PGDCC) from the University of Greifswald, (ILAMED), Germany. He also did Post Graduate Diploma in Sexology and Psychosexual Counselling (PGDS) from WNHO Institute of Sexology (Affiliated to American College of Sexology, ACS), India
Title: Liberation from Mechanical ventilation
Liberation from Mechanical ventilation: Mechanical ventilation is associated with many complications which result in failure to wean the patient off from the ventilator. The objective of this presentation is to discuss the variables that are used to indicate readiness to wean the patient from mechanical ventilation, to discuss the use of protocols to wean patients from ventilatory support, to discuss the criteria used to indicate readiness for extubation, and to discuss the most common reasons why patients fail to wean from mechanical ventilation. 75% of mechanically ventilated patients are easy to be weaned off the ventilator with simple process 10-15% of patients require the use of a weaning protocol over a 24-72hours 5-10% require gradual weaning over longer time 1% of patients become chronically dependent on mechanical ventilation. The presentation includes a Structured Spontaneous Breathing Trial developed by a team member in 2015 at Hamad General Hospital, Doha, Qatar. The source of clinical practice guidelines was adapted from AARC (American Association of Respiratory care)
Thiruppathi chockalingam is a highly qualified respiratory therapy professional with more than 35 years of work experience. July 1987 to Jan 2021 worked as assistant director / respiratory therapy clinical specialist at Hamad medical corporation, Doha, Qatar. Currently working as a consultant at Ababil health care, Chennai, India. Registered respiratory therapist, national board for respiratory care, Kansas, USA. Master degree in science from Annamalai University, India
Title: Long term changes in pulmonary function test in recovered moderate to severe covid patients
Coronavirus disease 2019 (COVID-19) is a recently emerged infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)1. As of 9th May 2022 517,301,451 accumulative confirmed cases and 6,276,522 confirmed deaths were reported globally. Among patients with COVID-19, about 14% cases were severe and 5% cases were critical. Severe patients had a higher incidence of diffusion capacity of the lung for carbon monoxide (DLCO) impairment and encountered more total lung capacity (TLC) decrease and these lung function gradually improved over time. Thus, we collected and analyzed the clinical data Post discharge to investigate the long-term impact of severe COVID-19 on pulmonary function. Method: This is prospective cohort study conducted at Moolchand hospital New Delhi from december 2020 to november 2021. Patients 15 years and above who have survived an episode of moderate or severe COVID-19, have reverse transcriptase-polymerase chain reaction (RT-PCR) positive for COVID 19 (nasopharyngeal or oropharyngeal) included. Pulmonary function assessed using spirometry and diffusion lung capacity for carbon monoxide (DLCO) at 1 month 3 month and 6-months interval from the time of discharge from the hospital. Study aims to determine long term impact of covid 19 on lung function capacity. Results: 96 patients were included in study, 64 were admitted in HDU and 32 in ICU. Lung function measures showed significant improvement between 30 days and 6 months, both in WARD and ICU groups in VC, FVC, FEV1, total lung capacity, 6MW distance measures.The improvement in the proportions of the altered functional parameters was significant in the ICU group. Conclusion: Six months follow-up of patients with the severe forms of COVID-19 showed significant improvement in the lung function measures compared to 30 days post hospital discharge. The difference was more evident in those requiring ICU admission.
Bhagwan Mantri has completed his Post Graduation in Respiratory medicine in 2014. He has been trained at the prestigious National Institute of Tuberculosis and Respiratory Disease, New Delhi. Currently, he is working as a Consultant Pulmonologist and Critical care specialist in Moolchand Hospital, New Delhi. He has been Covid in Incharge of tertiary Center throughout the pandemic. He has published more than 10 papers in reputed journals and also written many chapters in national and international books. He also has been serving as faculty and guide of Diplomats of the National Board in India.