Jindal chest is a specialty centre for one stop consultations in pulmonary medicine. The establishment of this centre has brought to the fore an expertise sorely missing from the region. The centre is spread over two premises comprising an Outpatient block (SCO 21, Sector 20-D, Chandigarh) and an intervention wing alongside the well-known Jindal IVF and Sant Memorial Hospital (# 3050, Sector 20D, Chandigarh), which is the premier institute in the region for the treatment of infertility.
The following facilities are available: Pulmonary function testing (spirometry) Bronchoscopy Sleep studies (polysomnography) Thoracoscopy Lung cancer chemotherapy.
Spirometry is a specialised test of lung function. It is essential in the diagnosis and follow-up of respiratory disorders such as asthma, chronic obstructive pulmonary disease, interstitial lung disease, etc. It is also needed before major surgery in patients with respiratory diseases to assess the preoperative fitness for surgery.
The procedure essentially involves breathing through a mouthpiece into a pipe which is attached to the spirometer. The volume or flow of air being breathed is then measured and used to derive further values as illustrated in the following graph.
It is not at all painful. One only needs to blow out as hard and as fast as possible.
1. Bronchoscopy involves the introduction of a bronchoscope into the airways. A bronchoscope is a specialised endoscope for entering and imaging the respiratory tract. It is required for internal inspection of the respiratory tract and to obtain biopsies and other materials from the diseased parts. Important procedures commonly done with bronchoscopy include taking pieces of any growth or tumour in the airway for diagnostic purposes (endobronchial biopsy – EBB), taking pieces of lung tissue (trans-bronchial lung biopsy – TBLB) and taking samples from abnormally enlarged lymph nodes (trans-bronchial needle aspiration –TBNA). Bronchoscopy is especially required for the management of diseases such as lung cancer, sarcoidosis, interstitial lung diseases, etc.
No, it not an operation; it is an endoscopic procedure. The procedure is done under local anaesthesia.
Depending on the procedure required it usually lasts from 30 min to 1 hour.
No, it is not painful.
All medical procedures have associated risks. Bronchoscopy is a relatively safe procedure. The amount of risk increases with the presence of underlying diseases such as diabetes, hypertension, heart problems, etc.
Endobronchial ultrasound (EBUS) is a new bronchoscopic technique which involves the use of a specialised bronchoscope for performing airway procedures. It has been specially designed to access the remote structures of the mediastinum, which is an enclosed space, much like a landlocked country in between the two lungs. It is available at this centre. Jindal Clinics can claim to be among the first private institutes to install this facility in this region.
To understand the use of this new instrument one first has to understand the anatomy of the mediastinum which is relevant. The mediastinum is the space in the chest between the two lungs. The wind pipe, or trachea, normally divides into two smaller wind pipes, or main bronchi, for the purpose of supplying each individual lung. The trachea and the major bronchi lie in the space between the two lungs, i.e. the mediastinum. In addition to the airways, the mediastinum also contains other structures such as lymph nodes, blood vessels, nerves and most importantly, the heart. Lymph nodes are soft tissue structures located adjacent to the airways. They are commonly involved in many respiratory disorders such as tuberculosis, sarcoidosis, lung cancer, lymphoma and some other rare conditions. The mediastinum is an enclosed space, much like a landlocked country. Though radiological investigations such as computed tomographic (CT) scans provide detail about the anatomy, access to the mediastinum is limited. Such an access is essential to obtain biopsy materials for histo/cytological examinations for diagnosis. Using a routine bronchoscope, one can obtain samples from certain mediastinal structures such as lymph nodes. However, locating the lymph nodes from inside the airways is difficult. It is in this situation that the EBUS scope comes into its use.
The essential difference is the presence of an ultrasound transducer at the tip in the EBUS scope. With this, the mediastinal anatomy can be imaged from within the airways. Lymph nodes can be located based on the ultrasonic image and sampled under ultrasonic vision. This has manifold benefits: i. Lymph nodes can be easily and accurately located ii. Blood vessels and other mediastinal structures can be avoided iii. Blood vessels within the lymph nodes can also be avoidedTherefore, the success rates are better and complications fewer with EBUS guided procedures.
One of the most common pulmonary disorders is the accumulation of fluid in the pleural cavity or pleural effusion. Some of the common diseases which are associated with the development of pleural effusions include pneumonia, tuberculosis, lung cancer, etc. The examination of the pleural cavity is done by means of chest X-rays and CT scans. However, in certain cases these investigations are not sufficient; thoracoscopy is needed in such situations. The thoracoscope is a specialised endoscope for examining and taking tissue samples from the pleural cavity. The procedure is done under local anaesthesia like bronchoscopy.
During a full-fledged sleep study (polysomnography), patients are required to stay overnight in the hospital. Their sleep pattern is analysed with the help of the polysomnograph, which measures multiple parameters such as brain wave patterns, breathing patterns, abdominal wall movements, heart rate, etc. All these parameters are recorded and then reviewed and analysed. Depending upon the report, the patient may have to stay another night for the application and titration of appropriate treatment.
Sleep is characterised by its own set of medical problems and disorders, which are among the most common affecting human beings. Snoring is a common phenomenon and almost every family has a person who snores loudly while sleeping. However, it is not generally known that snoring accompanied by breathing difficulty may be due to a sleep disorder called obstructive sleep apnoea (OSA). OSA is an important cause of daytime sleepiness, mental dullness and frequent episodes of drowsiness while working or driving, which may sometimes result in accidents. In the long run, it may result in hypertension, cardiac problems and intellectual deterioration.
t is not necessary that all persons who snore need to undergo a sleep study. There should be associated features to label it a disease. You should seek consultation from a sleep specialist in this case, who will screen you appropriately.
Besides sleep-hygiene measures, the treatment of OSA essentially requires the regular use of continuous positive airway pressure (CPAP) during sleep which is administered with the help of a CPAP/BiPAP machine and a tight-fitting face mask.
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