Archives of Respiratory Research

For most people on our planet, the beginning of the current COVID-19 pandemic was a complete surprise and looks like a sudden disaster. However, experts do not have the right to argue in this way, since the cause of this disaster has long been known to medicine. Moreover, similar epidemics of this infection have already been observed in the recent past, had a very similar scenario, but with less coverage of the population and territories. The identity of the causative agent of today’s pandemic with the two previous outbreaks, SARS in 2002-2004 and MERS in 2012-2013, is even reflected in the terminology-CoV, CoV-1 and CoV-2 [1].

We are delighted to unveil the latest edition of the Archives of Respiratory Research, a platform dedicated to showcasing the remarkable strides being taken in the realm of respiratory science. As we present the carefully curated collection of articles in this issue, it is evident that our mission to foster innovation and knowledge exchange in respiratory research continues to bear fruit.
Within these pages, our contributors delve into a diverse spectrum of topics, spanning from elucidating the intricate molecular mechanisms underlying lung diseases to investigating novel therapeutic interventions that hold the promise of transforming patient care. The collaborative efforts of researchers, clinicians, and healthcare practitioners are vividly reflected, reaffirming our commitment to advancing the frontiers of respiratory health.

Introduction:
LRTIs are a common cause of death in both children and adults worldwide. It has significant burden on healthcare resources. These infections can be caused by a variety of microorganisms, including bacteria, viruses, fungi, and parasites. The diagnosis of LRTIs can be challenging, as the symptoms can be nonspecific and the underlying cause can be multifactorial. Bronchoscopy allows the identification and management of LRTIs by allowing for the collection of lower respiratory tract specimens for microbiological evaluation. Bronchoscopy can provide valuable information about the diagnosis and management of LRTIs, as it can provide valuable information about the underlying pathology and the causative organism. The aim of this study is to investigate 100 Broncho-alveolar lavages in LRTI patients, with a focus on Broncho-alveolar lavage Acid Fast Bacilli smear and gram stain culture sensitivity.
Methods:
This study retrospectively analysed the microbiological profile of 100 patients with suspected LRTIs who underwent bronchoscopy at our institution.
Results:
Out of the 100 patients included in the study, 59 underwent AFB smear evaluation for mycobacterium tuberculosis. Out of 59 patients, 40 patients tested negative for tuberculosis, while 19 patients were positive.
Out of 100 patients, 39 had no organisms grow in their BAL fluid culture, indicating that their pneumonia may have been caused by non-infectious factors such as aspiration or other non-infectious causes. However, 43 patients had positive cultures, with Klebsiella and pseudomonas being the most common bacterial species identified. Fungal culture evaluation was performed in 17 patients, and only one patient was positive for aspergillus. Biopsy specimens were collected in 16 patients, with squamous cell carcinoma being the most common finding. This suggests that some cases of pneumonia may be caused by underlying malignancies, which may have been missed by other diagnostic methods.
Conclusion:
In conclusion, the results of this study indicate that bronchoscopy is a valuable diagnostic tool for evaluating lower respiratory tract infections. The study also highlights the prevalence of tuberculosis and bacterial species. Furthermore, the study suggests that some cases of pneumonia may be caused by non-infectious factors such as aspiration, as well as underlying malignancies such as squamous cell carcinoma and adenocarcinoma. These findings highlight the importance of a comprehensive diagnostic approach to identify the underlying cause of pneumonia and guide appropriate treatment.

In the present era a tremendous increase in industries is found which directly linked to raising human population and their associated needs. This industrial revolution brings changes in human life on one hand and have negative impacts on the human life on other hand as these industries are source of tons of wastes that released into the atmosphere. Emissions includes particulate matters (aflatoxins, endotoxins and dust), heavy metals (Cr, Cd, Pb, Hg and Ni), gases (NH3, SO2, NOx, H2S and CO), and volatile organic compounds.

The current review study emphasized on emissions from four major industries such as poultry, leather, brick kiln and paint industry and its influence on worker’s health. It is well known the emissions produced significant negative impact on the respiratory system of the workers particularly those which are continuously exposed to particulate enriched environments. The emissions can cause bronchopulmonary aspergillosis, chronic bronchitis and coal workers’ pneumoconiosis.

The acute and chronic symptoms also depend on time and duration of exposure and concentration of emissions. It is reported in literature studies most of the respiratory issues are due to lack of proper precaution measures, awareness and personal protective equipment’s in these industries. So, there is need to highlight these industries related problems to create general awareness among people and to aware regulatory bodies so that they bring strictness on the use of proper personal equipment and to control the impacts of industrial emissions on the lungs of the workers.

Connective tissue diseases (CTDs) can cause a myriad of pulmonary complications, including bronchiolitis and bronchiectasis, pleuritis, and pulmonary hypertension. Interstitial lung disease (ILD) is one of the most serious pulmonary complications associated with CTDs characterized by various patterns of inflammation and fibrosis on high-resolution CT (HRCT) scans and in lung biopsy specimens.

American College of Rheumatology (ACR) recently released a guideline summary for screening, monitoring, and treatment of CTD-associated ILDs [1].

The purpose of this review is to analyse above guidelines and the evidence behind the recommendations.

Screening and Monitoring of ILD in Systemic Autoimmune Rheumatic Disease (SARDs)

Screening for ILD using Pulmonary Functions Tests (PFTs) and HRCT Chest in patients with SARDs who are at increased risk of developing ILD.

Abstract

Bronchiectasis is a suppurative lung disease of varied etiology out of which Common Variable immunodeficiency (CVID) is a unique cause. Generally, most cases do not require routine workup unless suspecting Primary Immunodeficiency disorders like CVID. The clinical presentation of bronchiectasis in CVID constitutes recurrent exacerbations, severe non-resolving pneumonias and permanent structural damage predisposing to infections with resistant organisms. CVID is characterized by low levels of immunoglobulins coupled with a failure to mount adequate immunologic response after vaccination with pneumococcal and tetanus vaccines. Management poses significant challenges with control of bronchiectasis exacerbations along with IV immunoglobulin infusion. A high index of suspicion should be maintained when dealing with severe cases of bronchiectasis that span over a prolonged period in early adulthood that lack strong predisposing factors.

Keywords:

Common Variable Immunodeficiency (CVID), Primary Humoral Immuneodificiency (PHI), High Resolution Computed Tomography (HRCT), Bronchiectasis, Broncho Alveolar Lavage (BAL), IV Immunoglobulins (IVIG)

Abbreviations

Common Variable Immunodeficiency (CVID), Intravenous Immunoglobulins (IVIG), Non-Contrast Computed Tomography (NCCT), High Resolution Computed Tomography (HRCT),Primary Humoral Immunodeficiency (PHI),Modified Medical Research Council (mMRC),Broncho Alveolar Lavage (BAL), Primary Ciliary Dyskinesia (PCD),Cystic Fibrosis (CF),Non‑Tuberculous Mycobacterial (NTM) infection.