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6. Risk factors, mortality, and predictors of survival in COVID-19-associated pulmonary mucormycosis: a multicentre retrospective study from India

Author

Muthu, Valliappan, Agarwal, Ritesh, Rudramurthy, Shivaprakash Mandya, Thangaraju, Deepak, Shevkani, Manoj Radhakishan, Patel, Atul K., Shastri, Prakash Srinivas, Tayade, Ashwini, Bhandari, Sudhir, Gella, Vishwanath, Savio, Jayanthi, Madan, Surabhi, Hallur, Vinaykumar, Maturu, Venkata Nagarjuna, Srinivasan, Arjun, Sethuraman, Nandini, Singh Sibia, Raminder Pal, Pujari, Sanjay, Mehta, Ravindra, Singhal, Tanu, Saxena, Puneet, Gupta, Varsha, Nagvekar, Vasant, Prayag, Parikshit, Patel, Dharmesh, Xess, Immaculata, Savaj, Pratik, Sehgal, Inderpaul Singh, Panda, Naresh, Rajagopal, Gayathri Devi, Parwani, Riya Sandeep, Patel, Kamlesh, Deshmukh, Anuradha, Vyas, Aruna, Gandra, Raghava Rao, Sistla, Srinivas Kishore, Padaki, Priyadarshini A., Ramar, Dharshni, Sarkar, Saurav, Rachagulla, Bharani, Vallandaramam, Pattabhiraman, Premachandran, Krishna Prabha, Pawar, Sunil, Gugale, Piyush, Hosamani, Pradeep, Dutt, Sunil Narayan, Nair, Satish, Kalpakkam, Hariprasad, Badhwar, Sanjiv, Kompella, Kiran Kumar, Singla, Nidhi, Navlakhe, Milind, Prayag, Amrita, Singh, Gagandeep, Dhakecha, Poorvesh, and Chakrabarti, Arunaloke

Published
2024
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17. EQUAL ABPA Score 2024: A Tool to Measure Guideline Adherence for Managing Allergic Bronchopulmonary Aspergillosis.

Author

Sehgal, Inderpaul Singh, Muthu, Valliappan, Seidel, Danila, Sprute, Rosanne, Armstrong‐James, Darius, Asano, Koichiro, Chalmers, James D., Gangneux, Jean‐Pierre, Godet, Cendrine, Salzer, Helmut J. F., Cornely, Oliver A., and Agarwal, Ritesh

Subjects
*PULMONARY aspergillosis, *DRUG monitoring, *CYSTIC fibrosis, *MEDICAL screening, *LUNG diseases
Abstract

Objectives: Allergic bronchopulmonary aspergillosis (ABPA) is a complex lung disease associated with significant morbidity. The ABPA Working Group (AWG) of the International Society for Human and Animal Mycology (ISHAM) revised their management guidelines in 2024, but there is currently no standardised tool to assess adherence to these recommendations. Methods: We extracted key recommendations from the updated 2024 ISHAM‐AWG guidelines, focusing on critical areas: screening and diagnosis of ABPA, managing acute and treatment‐dependent ABPA, and monitoring treatment response. Each item was assigned a score ranging from zero to three. We assigned negative scores to interventions not recommended by the guidelines. Results: We identified 38 items indicative of optimal clinical care for patients with ABPA. The score for screening asthmatics for ABPA was set at three points. For diagnosing ABPA, 16 items were included, with a score ranging from 12 to 16 points, depending on the specific components used (predisposing conditions, serum A. fumigatus‐specific IgE and IgG, serum total IgE, blood eosinophil count and chest computed tomography). The management of acute ABPA comprised 11 items, with a maximum score of three points. For treatment‐dependent ABPA, there were nine items (scores ranging from −3 to 6). Follow‐up care comprised 10 items with a maximum score of 10–13 points, covering imaging, spirometry, testing serum total IgE levels and therapeutic drug monitoring. Conclusions: The EQUAL ABPA score has been developed as a comprehensive tool to quantify guideline adherence. Future studies will evaluate to which extent guideline adherence is associated with improved clinical outcomes for patients with ABPA. [ABSTRACT FROM AUTHOR]

Published
2024
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19. The minimal important difference of one-minute-sit-to-stand test in subjects with chronic pulmonary aspergillosis.

Author

Sehgal, Inderpaul Singh, Dhooria, Sahajal, Muthu, Valliappan, Prasad, Kuruswamy Thurai, Soundappan, Kathirvel, Aggarwal, Ashutosh Nath, Chakrabarti, Arunaloke, Rudramurthy, Shivaprakash Mandya, and Agarwal, Ritesh

Subjects
*PULMONARY aspergillosis, *VISUAL analog scale
Abstract

Background and objective: There is a need for simple functional test to assess treatment response in chronic pulmonary aspergillosis (CPA) in resource-constrained settings. The one-minute-sit-to-stand test (1-min-STS) is one such test. However, the minimal important difference (MID) for 1-min-STS in subjects with CPA remains unknown. Herein, we estimate the MID for 1-min-STS for CPA subjects. Materials and Methods: We retrospectively reviewed the clinical details of CPA subjects treated with oral azoles for 6 months. We included only subjects who completed the 1-min-STS test at baseline and 6 months. We used the change in VAS (visual analogue scale, for overall improvement) as an external anchor. We used the anchor and the distribution (standard deviation-based) methods to determine the MID estimates. We used the anchor-based method only if there was correlation of 0.3 with the 1-min-STS test. Results: One hundred-eight subjects completed the 1-min-STS test at baseline and 6 months. We did not find significant correlation between the change in VAS for overall improvement (r² = 0.024, P value = 0.809) and the 1-min-STS test. The MID for the 1-min-STS test was 2 repetitions (range, 1.5--2.8 repetitions). Conclusion: The MID for the 1-min-STS test in subjects with CPA was 2 repetitions. Future studies using a global rating of change scale as an anchor must confirm our findings. [ABSTRACT FROM AUTHOR]

Published
2024
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20. Aspergillus sensitization in non-smokers versus smokers with chronic obstructive pulmonary disease.

Author

Muthu, Valliappan, Kumar, Ravinish, Prasad, Kuruswamy Thurai, Sehgal, Inderpaul Singh, Dhooria, Sahajal, Soundappan, Kathirvel, Rudramurthy, Shivaprakash Mandya, Chakrabarti, Arunaloke, Aggarwal, Ashutosh N., and Agarwal, Ritesh

Subjects
CHRONIC obstructive pulmonary disease, BRONCHIECTASIS, COUGH, NON-smokers, ASPERGILLUS, PULMONARY aspergillosis
Abstract

The article focuses on assessing the prevalence of allergic sensitization to Aspergillus fumigatus (AS) in chronic obstructive pulmonary disease (COPD) patients, comparing smokers and non-smokers. It explores the association between AS and factors like tobacco smoking, biomass fuel exposure, and the prevalence of allergic bronchopulmonary aspergillosis (ABPA), particularly in those who smoke bidis or cigarettes.

Published
2024
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21. Airway Foreign Bodies: Rigid vs Flexible Approach

Author

Sehgal, Inderpaul Singh, Dhooria, Sahajal, Goyal, Rajiv, Agarwal, Ritesh, Rounds, Sharon I. S., Series Editor, Dixon, Anne, Series Editor, Schnapp, Lynn M., Series Editor, Turner, Jr., J. Francis, editor, Jain, Prasoon, editor, Yasufuku, Kazuhiro, editor, and Mehta, Atul C., editor

Published
2021
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24. Indian Guidelines on Nebulization Therapy

Author

Katiyar, S.K., Gaur, S.N., Solanki, R.N., Sarangdhar, Nikhil, Suri, J.C., Kumar, Raj, Khilnani, G.C., Chaudhary, Dhruva, Singla, Rupak, Koul, Parvaiz A., Mahashur, Ashok A., Ghoshal, A.G., Behera, D., Christopher, D.J., Talwar, Deepak, Ganguly, Dhiman, Paramesh, H., Gupta, K.B., Kumar T, Mohan, Motiani, P.D., Shankar, P.S., Chawla, Rajesh, Guleria, Randeep, Jindal, S.K., Luhadia, S.K., Arora, V.K., Vijayan, V.K., Faye, Abhishek, Jindal, Aditya, Murar, Amit K., Jaiswal, Anand, M, Arunachalam, Janmeja, A.K., Prajapat, Brijesh, Ravindran, C., Bhattacharyya, Debajyoti, D'Souza, George, Sehgal, Inderpaul Singh, Samaria, J.K., Sarma, Jogesh, Singh, Lalit, Sen, M.K., Bainara, Mahendra K., Gupta, Mansi, Awad, Nilkanth T., Mishra, Narayan, Shah, Naveed N., Jain, Neetu, Mohapatra, Prasanta R., Mrigpuri, Parul, Tiwari, Pawan, Narasimhan, R., Kumar, R. Vijai, Prasad, Rajendra, Swarnakar, Rajesh, Chawla, Rakesh K., Kumar, Rohit, Chakrabarti, S., Katiyar, Sandeep, Mittal, Saurabh, Spalgais, Sonam, Saha, Subhadeep, Kant, Surya, Singh, V.K., Hadda, Vijay, Kumar, Vikas, Singh, Virendra, Chopra, Vishal, and B, Visweswaran

Published
2022
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25. Bronchial Valves for Persistent Air Leak

Author

Damaraju, Vikram, primary, Sehgal, Inderpaul Singh, additional, Muthu, Valliappan, additional, Prasad, Kuruswamy Thurai, additional, Dhooria, Sahajal, additional, Aggarwal, Ashutosh Nath, additional, and Agarwal, Ritesh, additional

Published
2024
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26. Computed tomography findings of COVID-19-associated pulmonary mucormycosis: Data from a multicenter retrospective study (Mucovi2), India

Author

Muthu, Valliappan, primary, Agarwal, Ritesh, additional, Rudramurthy, Shivaprakash Mandya, additional, Thangaraju, Deepak, additional, Shevkani, Manoj Radhakishan, additional, Patel, Atul K, additional, Shastri, Prakash Srinivas, additional, Tayade, Ashwini, additional, Bhandari, Sudhir, additional, Gella, Vishwanath, additional, Savio, Jayanthi, additional, Madan, Surabhi, additional, Hallur, Vinaykumar, additional, Maturu, Venkata Nagarjuna, additional, Srinivasan, Arjun, additional, Sethuraman, Nandini, additional, Sibia, Raminder Pal Singh, additional, Pujari, Sanjay, additional, Mehta, Ravindra, additional, Singhal, Tanu, additional, Saxena, Puneet, additional, Gupta, Varsha, additional, Nagvekar, Vasant, additional, Prayag, Parikshit, additional, Patel, Dharmesh, additional, Xess, Immaculata, additional, Savaj, Pratik, additional, Sehgal, Inderpaul Singh, additional, Panda, Naresh, additional, Rajagopal, Gayathri Devi, additional, Parwani, Riya Sandeep, additional, Patel, Kamlesh, additional, Deshmukh, Anuradha, additional, Vyas, Aruna, additional, Gandra, Raghava Rao, additional, Sistla, Srinivas Kishore, additional, Padaki, Priyadarshini A, additional, Ramar, Dharshni, additional, Panigrahi, Manoj Kumar, additional, Sarkar, Saurav, additional, Rachagulla, Bharani, additional, Vallandaramam, Pattabhiraman, additional, Premachandran, Krishna Prabha, additional, Pawar, Sunil, additional, Gugale, Piyush, additional, Hosamani, Pradeep, additional, Dutt, Sunil Narayan, additional, Nair, Satish, additional, Kalpakkam, Hariprasad, additional, Badhwar, Sanjiv, additional, Kompella, Kiran Kumar, additional, Singla, Nidhi, additional, Prayag, Amrita, additional, Singh, Gagandeep, additional, Dhakecha, Poorvesh, additional, and Chakrabarti, Arunaloke, additional

Published
2024
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33. Population prevalence of aspergillus sensitization and allergic bronchopulmonary aspergillosis in COPD subjects in North India.

Author

Soundappan, Kathirvel, Muthu, Valliappan, Dhooria, Sahajal, Sehgal, Inderpaul Singh, Prasad, Kuruswamy Thurai, Rudramurthy, Shivaprakash Mandya, Chakrabarti, Arunaloke, Aggarwal, Ashutosh N., and Agarwal, Ritesh

Subjects
PULMONARY aspergillosis, CHRONIC obstructive pulmonary disease, ASPERGILLUS fumigatus, ASPERGILLOSIS, LUNGS, EOSINOPHILIA
Abstract

Background: Sensitization to Aspergillus fumigatus (AS) has been recently described in chronic obstructive pulmonary disease (COPD) patients. However, there is no data on the community prevalence of AS in COPD. Objectives: To assess the prevalence of AS among COPD subjects. The secondary objectives were to (1) assess the prevalence of allergic bronchopulmonary aspergillosis (ABPA) in COPD and (2) compare the lung function in COPD subjects with and without AS. Methods: We conducted a cross‐sectional study in rural (29 villages) and urban (20 wards) communities in North India. We identified individuals with respiratory symptoms (IRS) through a house‐to‐house survey using a modified IUATLD questionnaire. We then diagnosed COPD through specialist assessment and spirometry using the GOLD criteria. We assayed A.fumigatus‐specific IgE in COPD subjects. In those with A. fumigatus‐specific IgE ≥0.35 kUA/L (AS), ABPA was diagnosed with raised serum total IgE and raised A.fumigatus‐specific IgG or blood eosinophil count. Results: We found 1315 (8.2%) IRS among 16,071 participants >40 years and diagnosed COPD in 355 (2.2%) subjects. 291 (82.0%) were men and 259 (73.0%) resided in rural areas. The prevalence of AS and ABPA was 17.7% (95% CI, 13.9–21.8) and 6.6% (95% CI, 4.4–8.8). We found a lower percentage predicted FEV1 in COPD subjects with AS than those without (p =.042). Conclusions: We found an 18% community prevalence of AS in COPD subjects in a specific area in North India. Studies from different geographical areas are required to confirm our findings. The impact of AS and ABPA on COPD requires further research. [ABSTRACT FROM AUTHOR]

Published
2024
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34. Diagnostic Yield and Safety of the 19-Gauge versus 22-Gauge Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Needle in Subjects with Sarcoidosis (GUESS).

Author

Dhooria, Sahajal, Sehgal, Inderpaul Singh, Prasad, Kuruswamy Thurai, Muthu, Valliappan, Dogra, Pooja, Saini, Mandeep, Gupta, Nalini, Bal, Amanjit, Aggarwal, Ashutosh Nath, and Agarwal, Ritesh

Subjects
*SARCOIDOSIS diagnosis, *PATIENT safety, *STATISTICAL sampling, *VISUAL analog scale, *SARCOIDOSIS, *ENDOSCOPIC ultrasonography, *RANDOMIZED controlled trials, *OPERATIVE surgery, *NEEDLE biopsy, *BRONCHOSCOPY, *HYPODERMIC needles, *COMPARATIVE studies, *HEALTH outcome assessment, *SENSITIVITY & specificity (Statistics), *HYPOXEMIA
Abstract

Introduction: Observational data suggest that the 19-gauge (G) needle for endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) offers a higher diagnostic yield than the 22-G needle in sarcoidosis. No randomized trial has compared the yield of the two needles. Methods: We randomized consecutive subjects with suspected sarcoidosis and enlarged thoracic lymph nodes to undergo EBUS-TBNA with either the 19-G or the 22-G needle. We compared the study groups for diagnostic sensitivity (primary outcome) assessed by the yield of granulomas in subjects finally diagnosed with sarcoidosis. We also compared the sample adequacy, difficulty performing the needle puncture assessed on a visual analog scale (VAS), the subject's cough intensity on an operator-rated VAS, and procedure-related complications (secondary outcomes). Results: We randomized 150 (mean age, 43.0 years; 55% women) subjects and diagnosed sarcoidosis in 116 subjects. The diagnostic sensitivity of the 19-G needle (45/60, 75.0%) was not higher (p = 0.52) than the 22-G needle (39/56, 69.6%). We obtained adequate aspirates in 90.0% and 85.7% of subjects in the respective groups (p = 0.48). The operators had greater difficulty puncturing lymph nodes with the 19-G needle (p = 0.03), while the operator-assessed cough intensity was similar in the groups (p = 0.41). Transient hypoxemia was the only complication encountered during EBUS-TBNA (two subjects in either group). Conclusion: We did not find the 19-G needle superior to the 22-G in diagnostic sensitivity, specimen adequacy, or safety of EBUS-TBNA in sarcoidosis. Puncturing the lymph nodes was more difficult with the 19-G needle. [ABSTRACT FROM AUTHOR]

Published
2024
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38. Incidence and prevalence of chronic pulmonary aspergillosis in patients with post‐tuberculosis lung abnormality: Results from a community survey in North India

Author

Soundappan, Kathirvel, primary, Sehgal, Inderpaul Singh, additional, Prabhakar, Nidhi, additional, Rana, Samriti, additional, Raju, Rajesh, additional, Dhooria, Sahajal, additional, Prasad, Kuruswamy Thurai, additional, Muthu, Valliappan, additional, Rudramurthy, Shivaprakash M., additional, Chakrabarti, Arunaloke, additional, Garg, Mandeep, additional, and Agarwal, Ritesh, additional

Published
2024
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39. Sensitivity and specificity of LDBioAspergillusICT lateral flow assay for diagnosing allergic bronchopulmonary aspergillosis in adult asthmatics

Author

Sehgal, Inderpaul Singh, primary, Muthu, Valliappan, additional, Dhooria, Sahajal, additional, Prasad, Kuruswamy Thurai, additional, Rudramurthy, Shivaprakash M., additional, Aggarwal, Ashutosh Nath, additional, Garg, Mandeep, additional, Gangneux, Jean‐Pierre, additional, Chakrabarti, Arunaloke, additional, and Agarwal, Ritesh, additional

Published
2024
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41. Risk factors, mortality, and predictors of survival in COVID-19-associated pulmonary mucormycosis: a multicenter retrospective study from India

Author

Muthu, Valliappan, primary, Agarwal, Ritesh, additional, Rudramurthy, Shivaprakash Mandya, additional, Thangaraju, Deepak, additional, Shevkani, Manoj Radhakishan, additional, Patel, Atul K., additional, Shastri, Prakash Srinivas, additional, Tayade, Ashwini, additional, Bhandari, Sudhir, additional, Gella, Vishwanath, additional, Savio, Jayanthi, additional, Madan, Surabhi, additional, Hallur, Vinaykumar, additional, Maturu, Venkata Nagarjuna, additional, Srinivasan, Arjun, additional, Sethuraman, Nandini, additional, Singh Sibia, Raminder Pal, additional, Pujari, Sanjay, additional, Mehta, Ravindra, additional, Singhal, Tanu, additional, Saxena, Puneet, additional, Gupta, Varsha, additional, Nagvekar, Vasant, additional, Prayag, Parikshit, additional, Patel, Dharmesh, additional, Xess, Immaculata, additional, Savaj, Pratik, additional, Sehgal, Inderpaul Singh, additional, Panda, Naresh, additional, Rajagopal, Gayathri Devi, additional, Parwani, Riya Sandeep, additional, Patel, Kamlesh, additional, Deshmukh, Anuradha, additional, Vyas, Aruna, additional, Gandra, Raghava Rao, additional, Sistla, Srinivas Kishore, additional, Padaki, Priyadarshini A., additional, Ramar, Dharshni, additional, Sarkar, Saurav, additional, Rachagulla, Bharani, additional, Vallandaramam, Pattabhiraman, additional, Premachandran, Krishna Prabha, additional, Pawar, Sunil, additional, Gugale, Piyush, additional, Hosamani, Pradeep, additional, Dutt, Sunil Narayan, additional, Nair, Satish, additional, Kalpakkam, Hariprasad, additional, Badhwar, Sanjiv, additional, Kompella, Kiran Kumar, additional, Singla, Nidhi, additional, Navlakhe, Milind, additional, Prayag, Amrita, additional, Singh, Gagandeep, additional, Dhakecha, Poorvesh, additional, and Chakrabarti, Arunaloke, additional

Published
2023
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46. Innate and adaptive immune responses in subjects with CPA secondary to post‐pulmonary tuberculosis lung abnormalities.

Author

Chirumamilla, Naresh Kumar, Arora, Kanika, Kaur, Mandeep, Agarwal, Ritesh, Muthu, Valliappan, Rawat, Amit, Dhooria, Sahajal, Prasad, Kuruswamy Thurai, Aggarwal, Ashutosh Nath, Rudramurthy, Shivaprakash M., Chakrabarti, Arunaloke, Choudhary, Hansraj, Pal, Arnab, and Sehgal, Inderpaul Singh

Subjects
IMMUNE response, LYMPHOCYTE subsets, PULMONARY aspergillosis, T cells, B cells, TUBERCULOSIS, LUNGS, IMMUNOGLOBULIN M
Abstract

Background: Post‐tuberculosis lung abnormality (PTLA) is the most common risk factor for chronic pulmonary aspergillosis (CPA), and 14%–25% of the subjects with PTLA develop CPA. The pathogenesis and the host immune response in subjects with PTLA who develop CPA need to be better understood. Methods: We prospectively compared the innate and adaptive immune responses mounted by patients of PTLA with or without CPA (controls). We studied the neutrophil oxidative burst (by dihydrorhodamine 123 test), classic (serum C3 and C4 levels) and alternative (mannose‐binding lectin [MBL] protein levels) complement pathway, serum immunoglobulins (IgG, IgM and IgA), B and T lymphocytes and their subsets in subjects with PTLA with or without CPA. Results: We included 111 subjects (58 CPA and 53 controls) in the current study. The mean ± SD age of the study population was 42.6 ± 15.7 years. The cases and controls were matched for age, gender distribution and body weight. Subjects with CPA had impaired neutrophil oxidative burst, lower memory T lymphocytes and impaired Th‐1 immune response (lower Th‐1 lymphocytes) than controls. We found no significant difference between the two groups in the serum complement levels, MBL levels, B‐cell subsets and other T lymphocyte subsets. Conclusion: Subjects with CPA secondary to PTLA have impaired neutrophil oxidative burst and a lower Th‐1 response than controls. [ABSTRACT FROM AUTHOR]

Published
2024
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