@article{Jindal_2023,

title = {Scoring system for the use of nebulizers in the primary care settings: an expert consensus statement},

author = {Surinder K. Jindal and Shrikant Pawar and Ashfaq Hasan and Aloke Ghoshal and Raja Dhar and Subodh K. Katiyar and K. S. Satish and Deepak Talwar and Sundeep Salvi},

url = {https://pubmed.ncbi.nlm.nih.gov/37355847/},

doi = {10.5005/japi-11001-0273 },

issn = {0004-5772},

year  = {2023},

date = {2023-06-30},

urldate = {2023-06-30},

journal = {Journal of the Association of Physicians of India},

volume = {71},

issue = {6},

pages = {11-12},

abstract = {Background: The use of nebulizers is an important and useful method for delivering drugs to the lungs in patients with various airway and lung parenchymal disorders. They are primarily used in patients with acute symptoms and in a selected group of patients for maintenance treatment.Its use has increased, especially during the coronavirus disease 2019 (COVID-19) pandemic. To ensure the appropriate use of nebulizers by primary care physicians and to guide them, we aimed to develop a simple nebulizer use score.Methods: An expert working group (EWG) of pulmonologists were formed who using a semi-Delphi method, developed a list of variables and a cut-off score to decide when to use nebulizers. We started with a total of 55 variables that were developed through an exhaustive review of the literature. These were further reduced to smaller numbers that had the maximum score as well as concordance with the EWG. The scores ranged from 1 to 10 (completely disagree to completely agree), and only those above 7.5 were selected.Results: A total of 8 variables with the highest scores were selected (Table 1), which had a total maximum score of 40. A score of <15 was suggested to indicate no use of nebulizer and >20 to suggest definite use of nebulizer. A score between 15 and 20 was suggested for physician judgment.A separate table of 12 conditions was made where the use of nebulizers was mandatory.Conclusion: This first-of-its-kind nebulizer score can be used by primary care physicians to decide which patients should be put on nebulizer treatment.},

key = {pmid37355847},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Dhar_2022,

title = {Clinical outcomes of bronchiectasis in India: data from the EMBARC/Respiratory Research Network of India registry},

author = {Raja Dhar and Sheetu Singh and Deepak Talwar and B. V. Murali Mohan and Surya Kant Tripathi and Rajesh Swarnakar and Sonali Trivedi and Srinivas Rajagopala and George D'Souza and Arjun Padmanabhan and B. Archana and P. A. Mahesh and Babaji Ghewade and Girija Nair and Aditya Jindal and Gayathri Devi H. Jayadevappa and Honney Sawhney and Kripesh Ranjan Sarmah and Kaushik Saha and Suresh Anantharaj and Arjun Khanna and Samir Gami and Arti Shah and Arpan Shah and Naveen Dutt and Himanshu Garg and Sunil Vyas and Kummannoor Venugopal and Rajendra Prasad and M. Aleemuddin Naveed and Saurabh Karmakar and Virendra Singh and S. K. Jindal and Shubham Sharma and Deepak Prajapat and Sagar Chandrashekar and Michael Loebinger and Aditi Mishra and Francesco Blasi and Ramanathan Palaniappan Ramanathan and Pieter C. Goeminne and Preethi Vasudev and Amelia Shoemark and B. S. Jayaraj and Rahul Kungwani and Akanksha Das and Mehneet Sawhney and Eva Polverino and Tobias Welte and Nayan Sri Gulecha and Michal Shteinberg and Anshul Mangala and Palak Shah and Nishant Kumar Chauhan and Nikita Jajodia and Ashutosh Singhal and Sakshi Batra and Ashfaq Hasan and Stefano Aliberti and Megan L. Crichton and Sneha Limaye and Sundeep Salvi and James D. Chalmers},

url = {https://erj.ersjournals.com/content/erj/61/1/2200611.full.pdf},

doi = {10.1183/13993003.00611-2022},

issn = {0903-1936},

year  = {2022},

date = {2022-10-01},

urldate = {2022-10-01},

journal = {European Respiratory Journal},

volume = {61},

issue = {1},

pages = {2200611},

publisher = {European Respiratory Society (ERS)},

abstract = {Background Identifying risk factors for poor outcomes can help with risk stratification and targeting of treatment. Risk factors for mortality and exacerbations have been identified in bronchiectasis but have been almost exclusively studied in European and North American populations. This study investigated the risk factors for poor outcome in a large population of bronchiectasis patients enrolled in India.

Methods The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India (EMBARC-India) registry is a prospective observational study of adults with computed tomography-confirmed bronchiectasis enrolled at 31 sites across India. Baseline characteristics of patients were used to investigate associations with key clinical outcomes: mortality, severe exacerbations requiring hospital admission, overall exacerbation frequency and decline in forced expiratory volume in 1 s.

Results 1018 patients with at least 12-month follow-up data were enrolled in the follow-up study. Frequent exacerbations (≥3 per year) at baseline were associated with an increased risk of mortality (hazard ratio (HR) 3.23, 95% CI 1.39–7.50), severe exacerbations (HR 2.71, 95% CI 1.92–3.83), future exacerbations (incidence rate ratio (IRR) 3.08, 95% CI 2.36–4.01) and lung function decline. Coexisting COPD, dyspnoea and current cigarette smoking were similarly associated with a worse outcome across all end-points studied. Additional predictors of mortality and severe exacerbations were increasing age and cardiovascular comorbidity. Infection with Gram-negative pathogens (predominantly Klebsiella pneumoniae) was independently associated with increased mortality (HR 3.13, 95% CI 1.62–6.06), while Pseudomonas aeruginosa infection was associated with severe exacerbations (HR 1.41, 95% CI 1.01–1.97) and overall exacerbation rate (IRR 1.47, 95% CI 1.13–1.91).

Conclusions This study identifies risk factors for morbidity and mortality among bronchiectasis patients in India. Identification of these risk factors may support treatment approaches optimised to an Asian setting.},

key = {pmid36229049},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Ali_2022c,

title = {Role of circulatory miRNA-21 and associated signaling pathways in the pathogenesis of pulmonary fibrosis among individuals recovered after COVID-19 infection},

author = {Mohammad Ali and Fahad Abdullah Bin Breik and M. Aleemuddin Naveed and Syed Mahmood Ahmed and Aleem Ahmed Khan and Ashfaq Hasan},

url = {https://pdf.sciencedirectassets.com/781323/1-s2.0-S2773044122X00041/1-s2.0-S2773044122000675/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEGEaCXVzLWVhc3QtMSJGMEQCIE0LJ%2BCvVLB86Touyqcy2AguFweYOYjtUTEMTkViqBbbAiAI%2BAvwB315j9dC9Se4lbm9nDydykFzM1oYJsMEVqzKmCqyBQhaEAUaDDA1OTAwMzU0Njg2NSIMq8cixabBNQ%2FFlP7RKo8F4tHFQ2XCEX%2BnNUv%2Fo5kJzDriDFR%2B4esGfpxvWYZe2iJLDcqko4%2FKj6UJNujCCeczxRju1D5fVB%2BeBslzhdQvE7hnh%2F%2FnzV7nqibmZXBDBzsscCcFaUKkvp6kTveTxyA2rUH4diDkXnrrhgfmOX2eisr7Qhmd%2F0AcaREv%2BO%2FmbdqUbKMsbAkTgrzYw8Yx9qK%2BgJYzk19T300hlFdoGGGafOWk8DK9wuY5JSMb96a1S%2Bm1kTBHrmHg7dvRgmq2I1GbV2y10AY3eLayG%2FhLZNqxy%2FswXa16YVvtYJ6UG8o998uMZe7Zxu%2FLw73%2Fnjd7E0un%2FhMbpOan6kbXc9KEG%2BqVvtXV2NXKxAZBhIwHXMsDyyt16dwdwcE5f9pLP7vBhiEuK4SbFC0Xo1t4sc2wKNY3uCh0GPpTDa%2FTLWgyY0sPMImc%2FyZ8RjKKL4hrQkmVoNqFqLgdsOPVsqoMxmYbErD0EbMwwVf%2FRBQwSeRKi0Y3CfzAMqOnGUzrghoR9Yha2MG4CpBAHpTaFLIeiuETnxdr7GWzvsEOCqDwtMmoYPKXIEe0aKp%2Fk96I5JniIHBdwlx4OwzzPORgC6qdJ195O9b%2FFvA9zGGsLaNfVhKe3oHRDYapPDQBSvrsgZ7dLldkHOhE0yGQm573V51HZu1i4XdNOLoUje5EzAtEmJe3ALac9yxDO2yu1gI5ygLizO7QtWowln2DDIEwZgfsJguAfo6%2B5YPvapbKcKLXEcCWPik3KBMgkNKvboCwdXor52nrYcUmbVLGGyqbzIMTvWglr5840F4sxHkWbJv%2FBWjbAwTfUtiRfJBEW76e4GNtFK%2FbS7ttN5oHd2D4a%2FjewMBmD5Zb38tmdBC4yNt%2FcndcejUPzTDjk8WoBjqyAdtvZMDfupHhuUIvK8v%2BtQIPbtzLcwwqA8TyxzrCBPad5FAsv%2F3jjLRZkjVmqHwehp4d8QPgKrJYWEfRm8E8Vnuv2c7WxFhoBtYlIoy6CaA3lgtqtbI6j%2F%2FLQ1TZqhk2g5HhF3CyYAU%2FVADQIEPLQ1M6S%2FHxWtEMDZFbrx17lQO1IkEiGEH3k9wxJ11A4Diy3Ny8U3Cvjz1nYvoebZtaoSg%2BCgQtb5jjGEjMJAf7iA5s0MI%3D&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20230925T094841Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTYTGSOBQO3%2F20230925%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=aa7b878d5e9909131750691259b7560c6773fade490297b8b03355bffa840587&hash=ec409bf344f4e3f2a9188514ea2f0cce6751ec7906e16403ebe1144637fa97b4&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S2773044122000675&tid=spdf-d9142a09-f0a7-44e7-aade-22a3c5a32970&sid=7685485b9275d2467038aec-c7fdaf004220gxrqb&type=client&tsoh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&ua=0f0d5750005550025154&rr=80c25a55481a2e84&cc=in},

doi = {10.1016/j.humgen.2022.201093},

issn = {2773-0441},

year  = {2022},

date = {2022-07-28},

urldate = {2022-07-28},

journal = {Human Gene},

volume = {34},

pages = {201093},

publisher = {Elsevier BV},

abstract = {Introduction: Currently pulmonary fibrosis in post-COVID individuals represents a crucial milieu of investigation due to long-term associated complications and worse clinical outcome. Lack of studies in Indian population confers a crucial need for elucidating possible targets and mechanisms to explore better management and outcome. Hence, this study aimed to explore the role of circulating miRNA-21 in patients from South India after COVID-19 recovery, while targeting TGF-β signaling pathway involved in the development of pulmonary fibrosis. Methods: This prospective, single centre, hospital-based study enrolled a total of 50 participants in the age group of 50 to 60 years including 25 non-infected controls and 25 patients who were recovered after 3–6 months of COVID-19 infection and presented radiological pulmonary abnormalities. Quantification of miRNA-21 and selected gene transcripts (TGF-β, Col1A2, Col3A1, and α-SMA) was performed in plasma samples of both patients and controls. Results: Significantly increased expression levels of miRNA-21 was observed in patient samples compared to controls (4.50 ± 1.03 vs 12.60 ± 3.52, p < 0.0001) with 72.10% sensitivity and 80.10% specificity. Further, significantly increased levels of central fibrosis regulatory gene transcript TGF-β (0.56 ± 0.27 vs 1.83 ± 0.98), two crucial collagen transcripts Col1A2 (0.62 ± 0.19 vs 1.56 ± 1.00) and Col3A1 (0.61 ± 0.27 vs 1.54 ± 0.89), and α-SMA (0.46 ± 0.17 vs 1.20 ± 0.78) was observed in patients compared to controls. Western-blot analysis also showed almost similar observations at proteins levels. Conclusion: Circulating miRNA-21 may provide crucial insights for elucidating TGF-β mediated pulmonary remodeling involved in the fibrosis development and achieve better clinical outcome for post-COVID patients after recovery, in real-time with high diagnostic accuracy.},

key = {pmid37521444},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Ali_2022d,

title = {Psychometric analysis of clinical chronic obstructive pulmonary disease questionnaire and chronic obstructive pulmonary disease assessment test and its correlation with St. George respiratory questionnaire in chronic obstructive pulmonary disease patients},

author = {Syed Aamir Ali and Hajera Saniya and Khaja Naseeruddin and Sabiha Naaz Sana and Talath Fatima and Syed Mahmood Ahmed and M. Aleemuddin Naveed and Ashfaq Hasan and Fahad Abdullah Bin Breik},

url = {https://www.ijrc.in/doi/pdf/10.4103/ijrc.ijrc_12_22},

doi = {10.4103/ijrc.ijrc_12_22},

issn = {2321-4899},

year  = {2022},

date = {2022-07-28},

urldate = {2022-07-28},

journal = {Indian Journal of Respiratory Care},

volume = {11},

issue = {3},

pages = {224-229},

publisher = {Jaypee Brothers Medical Publishing},

abstract = {Introduction: Chronic obstructive pulmonary disease (COPD) is a disease of respiratory airflow obstruction. There are > 80 tools to measure various aspects of COPD patients well.being. This study aimed to evaluate the reliability and consistency of CAT and clinical COPD questionnaire (CCQ) and their correlation with St. George respiratory questionnaire (SGRQ). Methods: A prospective observational comparative study was conducted for 6 months in the pulmonology department of a tertiary care hospital. The following questionnaires were employed to evaluate the state of health of COPD patients: modified Medical Research Council (mMRC), COPD assessment test (CAT), CCQ, and SGRQ. Consistency and inter.rater reliability of CAT and CCQ scales was performed by taking into account the scores of four assessors. Results: Of the 52 patients included, 96% were male, and 4% were female. Cronbach's alpha was 0.620 (CAT score) and 0.861 (CCQ score). The percentage of patients with an mMRC scale of grade 0, 1, 2, 3, and 4 was 4%, 23%, 38%, 8%, and 27%, respectively. SGRQ showed a moderate correlation with CCQ (0.621) and CAT (0.652) scores. Conclusion: The psychometric properties of CAT and CCQ were consistent and satisfactory. Reliability and internal consistency of CAT and CCQ were good and can be employed easily for examining the health state of COPD patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Abdullah_2021,

title = {Prevalence of airway reversibility in connective tissue disease-interstitial lung disease (CTD-ILD)},

author = {Fahad Abdullah Bin Breik and Ashfaq Hasan and Moid Mir Siddiq Ali and Rahmath Fida and Sufia Iram Irshad},

url = {https://sciencescholar.us/journal/index.php/ijhs/article/view/13347/10539},

doi = {10.53730/ijhs.v6ns8.13347},

issn = {2550-696X},

year  = {2021},

date = {2021-12-01},

urldate = {2021-12-01},

journal = {International Journal of Health Sciences},

volume = {6},

issue = {S8},

pages = {4989-4994},

publisher = {Universidad Tecnica de Manabi},

abstract = {Background: Spirometry is the most reproducible and objective measurement of airflow limitation. Improvement in FEV1 and/or FVC by 12% or 200ml after using bronchodilator is definitive of reversible airway disease.[1] Several conditions like sarcoidosis predominantly involve the interstitium have nevertheless been associated with reversible airways obstruction. Connective tissue diseases (CTDs) form another important subgroup of interstitial lung disease(ILD). CTDs usually produce a restrictive pattern of lung involvement on spirometry, but might have unrecognized additional reversible airway obstruction. Seeking out and treating the latter components of disease may be crucial in optimizing lung function and alleviating the breathlessness that is common to the problem. Aim: The aim of this study is therefore to determine the post bronchodilator response in patients with connective tissue disease related interstitial lung disease (CTD-ILD) and thus potentially help improve quality of life by addressing the latter component by inhaled bronchodilator-steroid therapy. Methods: Consecutive patients with a confirmed diagnosis of CTD-ILD were identified in the out-patient clinics of our institute. CTD was diagnosed by a combination of clinical and serological parameters. ILD was confirmed by high resolution computed tomography (HRCT) images.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hasan_2021,

title = {Small airways, big problem: extrafine beclomethasone/formoterol in asthma and chronic obstructive pulmonary disease- a systematic review},

author = {Ashfaq Hasan and Priyanka Mukherjee and Sushmeeta Chhowala and Meena Lopez and Prashant N. Chhajed},

url = {https://journals.lww.com/lungindia/Fulltext/2021/08000/Small_Airways,_Big_Problem__Extrafine.9.aspx},

doi = {10.4103/lungindia.lungindia_394_20},

issn = {0970-2113},

year  = {2021},

date = {2021-08-01},

urldate = {2021-08-01},

journal = {Lung India},

volume = {38},

issue = {4},

pages = {350-358},

abstract = {Asthma and chronic obstructive pulmonary disease (COPD) are common chronic respiratory diseases characterized by an inflammatory process that extends from the central to peripheral airways. Conventional pressurized metered-dose inhalers and most dry-powder inhalers emit drug particles too large to target the small airways effectively. Advancements in drug formulation have given rise to a new generation of inhalers that can generate aerosols with extrafine drug particles that leads to more effective aerosol penetration into the lung periphery. An extrafine formulation of inhaled beclomethasone/formoterol (BDP-FF) with enhanced lung deposition is now available. This document reviews the various real-world and controlled studies that have evaluated the efficacy of extrafine BDP-FF in asthma and COPD.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Afreen_2020b,

title = {Single nucleotide polymorphism in the promoter region of interleukin-4 and risk of asthma: TT homozygotes may have high propensity of developing chronic airway remodeling},

author = {Arshiya Afreen and S. Farhana F. A. and Sumaya Fatima and T. K. M. Rayees and Nida Makeen and Nusrath Fathima and Ashfaq Hasan and M. Aleemuddin Naveed and Fahad Abdullah Bin Breik and Mohd. Mohiuddin and Mohammed Ishaq},

url = {https://www.ijrrjournal.com/IJRR_Vol.7_Issue.9_Sep2020/IJRR0014.pdf},

issn = {2349-9788},

year  = {2020},

date = {2020-09-01},

urldate = {2020-09-01},

journal = {International Journal of Research and Review},

volume = {7},

issue = {9},

pages = {104-110},

abstract = {Background: In view of a key role played by Interleukin-4 (IL-4) in the molecular mechanisms leading to the development of asthma and its complications like chronic airway remodeling, a few reports have attempted to investigate a possible role of SNP’s in the promoter region to predict genetic risk. As it is associated with quantitative variations in IL-4 gene expression and may serve as an important candidate gene for asthma risk prediction. Objective: To investigate the polymorphic variations, at -590 (C/T) in the promoter region of IL-4 gene. Methods: 50 consecutively selected cases of asthma (36 females and 14 males) were recruited and genotyping for SNP at -590 C/T was done by PCR-RFLP method on the genomic DNA extracted from blood samples. Blood samples from 50 randomly selected healthy subjects served as controls. Mean values of Absolute Eosinophil Count and total serum IgE between the genotypes were compared by student’s unpaired t test. Odds-ratio analysis was carried out to determine risk of developing asthma. Results: Odds ratio (OR) analysis revealed two-and-a-half folds increased risk of asthma for individuals with TT genotype compared to those with CC genotype. A decreased frequency of CC genotype in patients (28%) compared to controls (58%) is indicative of protective nature of CC genotype. AEC counts and total serum IgE levels were significantly higher in TT compared to CC and CT genotypes. Conclusion: It is concluded that individuals with TT and CT genotypes (overproducers of IL-4) have high risk of developing asthma and high vulnerability to develop chronic airway remodeling.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kerstgens_2020,

title = {IRIDIUM Trial. Once-daily, single-inhaler mometasone-indacaterol-glycopyrronium versus mometasone-indacaterol or twice-daily fluticasone-salmeterol in patients with inadequately controlled asthma (IRIDIUM): a randomised, double-blind, controlled phase 3 study},

author = {A. M. Kerstgens and Jorge Maspero and Kenneth R. Chapman and Richard N. van Zyl-Smit and Ashfaq Hasan and Syed Mahmood Ahmed and Fahad Abdullah Bin Breik},

url = {https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30190-9/fulltext},

doi = {10.1016/S2213-2600(20)30190-9},

issn = {2213-2600},

year  = {2020},

date = {2020-07-09},

urldate = {2020-07-09},

journal = {Lancet Respiratory Medicine},

volume = {8},

issue = {10},

pages = {1000-1012},

abstract = {Background: Patients with asthma who are inadequately controlled on inhaled corticosteroid–long-acting β2-adrenoceptor agonist (ICS–LABA) combinations might benefit from the addition of a long-acting muscarinic receptor antagonist. The aim of the IRIDIUM study was to assess the efficacy and safety of a once-daily, single-inhaler combination of mometasone furoate, indacaterol acetate, and glycopyrronium bromide (MF–IND–GLY) versus ICS–LABA in patients with inadequately controlled asthma. Methods: In this 52-week, double-blind, double-dummy, parallel-group, active-controlled phase 3 study, patients were recruited from 415 sites across 41 countries. Patients aged 18 to 75 years with symptomatic asthma despite treatment with medium-dose or high-dose ICS–LABA, at least one exacerbation in the previous year, and a percentage of predicted FEV1 of less than 80% were included. Enrolled patients were randomly assigned (1:1:1:1:1) via interactive response technology to receive medium-dose or high-dose MF–IND–GLY (80 μg, 150 μg, 50 μg; 160 μg, 150 μg, 50 μg) or MF–IND (160 μg, 150 μg; 320 μg, 150 μg) once daily via Breezhaler, or high-dose fluticasone–salmeterol (FLU–SAL; 500 μg, 50 μg) twice daily via Diskus. The primary outcome was change from baseline in trough FEV1 with MF–IND–GLY versus MF–IND at week 26 in patients in the full analysis set, analysed by means of a mixed model for repeated measures. Safety was assessed in all patients who received at least one dose of study drug. This study is registered with ClinicalTrials.gov, NCT02571777, and is completed. Findings: Between Dec 8, 2015, and Jun 14, 2019, 3092 of 4851 patients screened were randomly assigned (medium-dose MF–IND–GLY, n=620; high-dose MF–IND–GLY, n=619; medium-dose MF–IND, n=617; high-dose MF–IND, n=618; high-dose FLU–SAL, n=618). 2747 (88·8%) patients completed the 52-week treatment and 321 (10·4%) started but discontinued study treatment prematurely. Medium-dose MF–IND–GLY (treatment difference [Δ] 76 mL [95% CI 41–111]; p<0·001) and high-dose MF–IND–GLY (Δ 65 mL [31–99]; p<0·001) showed superior improvement in trough FEV1 versus corresponding doses of MF–IND at week 26. Improvements in trough FEV1 were greater for both medium-dose MF–IND–GLY (99 mL [64–133]; p<0·001) and high-dose MF–IND–GLY (119 mL [85–154]; p<0·001) than for high-dose FLU–SAL at week 26. Overall, the incidence of adverse events was balanced across the treatment groups. Seven deaths were reported (one with medium-dose MF–IND–GLY, two with high-dose MF–IND–GLY, and four with high-dose MF–IND) during the study; none of these deaths was considered by the investigators to be caused by study drugs or other study-related factors. Interpretation: Once-daily, single-inhaler MF–IND–GLY improved lung function versus ICS–LABA combinations (MF–IND and FLU–SAL) in patients with inadequately controlled asthma. The safety profile was similar across treatment groups. MF–IND–GLY therefore constitutes a good treatment option in these patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Nayar_2019,

title = {Management of community‐acquired bacterial pneumonia in adults: limitations of current antibiotics and future therapies},

author = {Sandeep Nayar and Ashfaq Hasan and Pradyut Waghray and Srinivasan Ramananthan and Jaishid Ahdal and Rishi Jain},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852216/pdf/LI-36-525.pdf},

doi = {10.4103/lungindia.lungindia_38_19},

issn = {0970-2113},

year  = {2019},

date = {2019-12-01},

urldate = {2019-12-01},

journal = {Lung India},

volume = {36},

issue = {6},

pages = {525-533},

abstract = {Community‑acquired bacterial pneumonia (CABP) is one of the leading causes of morbidity and mortality in India and worldwide. Evidence indicates that Gram‑positive, Gram‑negative, and atypical bacteria are encountered with near‑equal frequency. Despite guideline recommendations and antibiotic options for the management of CABP, burden of morbidity and mortality is high, which is attributable to a variety of factors. Failure of empirical therapy, probably because of insufficient microbial coverage, increasing bacterial resistance, and adverse effects of existing treatments, underlies the unsuccessful treatment of CABP, especially in India. Multiple novel therapies that have entered clinical development phases have potential to address some of these issues. This article discusses the current treatment guidelines in CABP, management limitations, and emerging potential treatment options in the management of CABP.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Dhar_2019,

title = {Bronchiectasis in India: results from the European multicentre bronchiectasis audit and research collaboration (EMBARC) and respiratory research network of India registry},

author = {Raja Dhar and Sheetu Singh and Deepak Talwar and Murali Mohan and Surya Kant Tripathi and M. Aleemuddin Naveed and Ashfaq Hasan},

url = {https://www.thelancet.com/action/showPdf?pii=S2214-109X%2819%2930327-4},

issn = {2214-109X},

year  = {2019},

date = {2019-09-01},

urldate = {2019-09-01},

journal = {Lancet Global Health},

volume = {7},

pages = {e1269-e1279},

abstract = {Background: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India. Methods The Indian bronchiectasis registry is a multicentre, prospective, observational cohort study. Adult patients (≥18 years) with CT-confirmed bronchiectasis were enrolled from 31 centres across India. Patients with bronchiectasis due to cystic fibrosis or traction bronchiectasis associated with another respiratory disorder were excluded. Data were collected at baseline (recruitment) with follow-up visits taking place once per year. Comprehensive clinical data were collected through the European Multicentre Bronchiectasis Audit and Research Collaboration registry platform. Underlying aetiology of bronchiectasis, as well as treatment and risk factors for bronchiectasis were analysed in the Indian bronchiectasis registry. Comparisons of demographics were made with published European and US registries, and quality of care was benchmarked against the 2017 European Respiratory Society guidelines. Findings: From June 1, 2015, to Sept 1, 2017, 2195 patients were enrolled. Marked differences were observed between

India, Europe, and the USA. Patients in India were younger (median age 56 years [IQR 41–66] vs the European and

US registries; p<0∙0001]) and more likely to be men (1249 [56∙9%] of 2195). Previous tuberculosis (780 [35∙5%] of

2195) was the most frequent underlying cause of bronchiectasis and Pseudomonas aeruginosa was the most common

organism in sputum culture (301 [13∙7%]) in India. Risk factors for exacerbations included being of the male sex

(adjusted incidence rate ratio 1∙17, 95% CI 1∙03–1∙32; p=0∙015), P aeruginosa infection (1∙29, 1∙10–1∙50; p=0∙001), a

history of pulmonary tuberculosis (1∙20, 1∙07–1∙34; p=0∙002), modified Medical Research Council Dyspnoea score

(1∙32, 1∙25–1∙39; p<0∙0001), daily sputum production (1∙16, 1∙03–1∙30; p=0∙013), and radiological severity of disease

(1∙03, 1∙01–1∙04; p<0∙0001). Low adherence to guideline-recommended care was observed; only 388 patients were

tested for allergic bronchopulmonary aspergillosis and 82 patients had been tested for immunoglobulins.

Interpretation Patients with bronchiectasis in India have more severe disease and have distinct characteristics from

those reported in other countries. This study provides a benchmark to improve quality of care for patients with

bronchiectasis in India.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Uzma_2019,

title = {Assessment of neurocognitive impairment in obstructive sleep apnea},

author = {Nazia Uzma and Juhi Fatima Sultan and Nooruddin Owaisi and Mariya Syed and Abid Ali Khan and Ashfaq Hasan},

url = {https://ijop.net/index.php/ijop/article/view/217},

doi = {10.37506/ijop.v7i2.217},

issn = {2320-6039},

year  = {2019},

date = {2019-07-20},

urldate = {2019-07-01},

journal = {International Journal of Physiology},

volume = {7},

issue = {2},

pages = {126-130},

abstract = {Sleep apnea is usually reported in south Indian population. The indications of obstructive sleep apnea (OSA) comprise of breathing difficulties particularly owing to obstruction in the upper airway tract. The present study investigated the effect of the syndrome, the patients documented with OSA, by categorizing the patients into mild, moderate and severe OSA groups depending on apnea-hyponea index (AHI), derived from sleep study (polysomnographic findings). The comparative evaluation of various outcomes considered in this study included healthy individuals (control group, AHI < 5), mild OSA (AHI 5–15), moderate (OSA 15–30) and severe (AHI > 30). Investigations were conducted on the subjects which evaluated baseline characteristics, polysomnographic data and neuro-cognitive performances by Mini-Mental State Examination (MMSE). The results revealed significantly higher body mass index (BMI), snoring and decresed sleep efficiency in patients with sleep apnea syndrome when compared with control group. OSA patients further exhibited compromised neuro-cognitive. The intensity of the impairments and difficulties increased with upsurge in severity of the syndrome among all patients. The findings of this work strongly indicated that impaired executive functioning; neuro-cognitive abnormalities exit in a heightened state among OSA patients, than in the normal healthy individuals, the control group. These findings in aggregate would help clinicians in diagnosis and in understanding the disease prognosis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kilaru_2019,

title = {Active pulmonary tuberculosis presenting with acute respiratory failure},

author = {Satish Chandra Kilaru and Sudhir Prasad and Hemanth Kilaru and Raghavender Reddy Anneela and Ashfaq Hasan and Eshwar Chandra Nandury},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635142/pdf/RCR2-7-e00460.pdf},

doi = {10.1002/rcr2.460},

issn = {2051-3380},

year  = {2019},

date = {2019-07-16},

urldate = {2019-07-16},

journal = {Respiratory Case Reports},

volume = {7},

issue = {7},

pages = {1-5},

abstract = {Four patients with active pulmonary tuberculosis (PTB) presenting with respiratory failure are reported here. Bronchogenic PTB, simulating an acute febrile illness or diffuse interstitial lung disease with short duration of

symptoms, as a cause of acute respiratory failure is less recognized. If diagnosed and treated early, it has good prognosis. Three of the four patients presented here had an acute presentation with fever, dyspnoea, and hypoxemia with diffuse infiltrative lesions on radiography, and the other younger patient presented predominantly with lobar consolidation. These patients presenting with respiratory failure required intensive care management, and a diagnosis was made with bronchoalveolar lavage fluid and transbronchial lung biopsy. All four patients promptly received antitubercular therapy, showed clinicoradiological improvement, and were stable at 1 year follow up. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Tirunagari_2018,

title = { Koch’s with Kikuchi together in a young male},

author = {L. N. Swamy Tirunagari and Ashfaq Hasan},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6120309/pdf/LI-35-443.pdf},

doi = {10.4103/lungindia.lungindia_422_17},

issn = {0970-2113},

year  = {2018},

date = {2018-10-01},

urldate = {2018-10-01},

journal = {Lung India},

volume = {35},

issue = {5},

pages = {443-444},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Naveed_2018,

title = {N-acetylcysteine in a treatment of COPD},

author = {M. Aleemuddin Naveed and Raheem Fatima and Mohammed Mohsin and Ashfaq Hasan},

url = {https://www.ijirm.org/journal-article-file/7457},

doi = {10.18231/2581-4222.2018.0035},

issn = {2581-4214},

year  = {2018},

date = {2018-09-01},

urldate = {2018-09-01},

journal = {IP Indian Journal of Immunology and Respiratory Medicine},

volume = {3},

issue = {3},

pages = {137-146},

abstract = {Introduction: In COPD excess expectoration secondary to tracheobronchial secretions contributes to symptoms, airflow obstruction and is diagnostic criterion. It also causes increased mortality, risk of hospitalizations and accelerated decline in FEV1. N-acetylcysteine (NAC) helps in liquefying mucus and DNA (via disruption of disulfide bonds) and has antioxidant effects. Aims: Evaluate add-on effect of NAC on clinical-physiological parameters in COPD patients treated according to GOLD guidelines. Material and Methods: Single labeled, randomized, parallel group prospective Observational study. In 120 stable COPD patients Modified medical research council (MMRC) dyspnoea score, COPD Assessment test (CAT score), number of exacerbations and hospitalizations in the last year were recorded and were randomized into 2 groups of 60 each. Group A

received NAC 600mg twice daily along with standard treatment. Group B received standard treatment only. Mean and Standard Deviation was compared between groups using unpaired t-test. After 1 year, changes in above parameters were reassessed. Statistical Analysis: Unpaired t-test and chi square test were used. Statistical significance was set at <0.05 level. Results: MMRC score reduced from 3.37 study group) to 2.91, difference being -0.46, and in control from 3.37 to 1.18, difference of -0.22 and p value of p<.05. CAT score reduced more in test group (-4.4) than control group (-3.1), p=.02. Out of 40 exacerbations, 14 (35%) occurred in test and 26 (65%) in control group, reduction of 30% and p=0.01. Out of 28 hospitalizations 10 (36%) test group 18 (64%) control group. i.e. a reduction of 28% and p=0.06. Conclusions: Use of N-Acetyl Cysteine, 600mg twice daily along with standard treatment can bring clinically significant change in CAT Score and frequency of exacerbations but not in MMRC score and hospitalizations. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Breik_2017,

title = {Carina at the carina: spirometry leading to the diagnosis of an unusual foreign body within the tracheobronchial tree},

author = {Fahad Abdullah Bin Breik and Ghouse Ahmed Khan and Sandeep Saboo and Raheem Hussain and Ashfaq Hasan},

url = {https://www.respircase.com/jvi.aspx?un=RCR-61587&volume=6&issue=1},

doi = {10.5505/respircase.2017.61587},

issn = {2051-3380},

year  = {2017},

date = {2017-02-28},

journal = {Respiratory Case Reports},

volume = {6},

issue = {1},

pages = {1-4},

abstract = {Foreign bodies in the lung can be difficult to diagnose. They may result in unusual symptoms leading to confusion about the diagnosis. Spirometry can sometimes provide a clue to a mainstem obstruction, although it may be compromised by artifacts. Herein, we present a case of an unusual foreign body within the tracheobronchial tree, for which spirometry provided the indication for bronchoscopy.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hasan_2017b,

title = {Noughts and crosses: the uncertain future of TB control in India},

author = {Ashfaq Hasan},

url = {https://jmas.in/fulltext/154-1485322681.pdf?1676958653},

doi = {10.5455/jmas.256739 },

issn = {2231-1696},

year  = {2017},

date = {2017-01-31},

urldate = {2017-01-31},

journal = {Journal of Medical and Allied Sciences},

volume = {7},

issue = {1},

pages = {1-2},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hasan_2017,

title = {Is obstructive sleep apnea more prevalent than central sleep apnea in patients with systolic heart failure? A retrospective study},

author = {Ashfaq Hasan and Nazia Uzma and Fahad Abdullah Bin Breik and Mohammed Abdul Hannan Hazari and C. Narasimhan and L. Rao},

url = {https://www.hilarispublisher.com/archive/jcrdc-volume-3-issue-1-year-2017.html},

doi = {10.4172/2472-1247.1000126},

year  = {2017},

date = {2017-01-01},

urldate = {2017-01-01},

journal = {Journal of Clinical Respiratory Diseases and Care},

volume = {03},

issue = {01},

pages = {126},

publisher = {OMICS Publishing Group},

abstract = {Central sleep apnea (CSA) rather than obstructive sleep apnea (OSA) is widely believed to be the dominant form of sleep apnea (SA) in patients with heart failure (HF). Hitherto, no study has characterized sleep disordered breathing (SDB) in Indian subjects with heart failure and evaluated its impact on severity of HF, which this study attempts to do. A retrospective data-analysis was done in 65 consecutive patients with stable mild-to-moderate HF referred for evaluation on the basis of fatigue and excessive daytime somnolence (EDS) regarded by the institute’s cardiologists. Patients with ejection fraction (EF) <55% or LV fractional shortening of 28% were included in the study. PSG was scored according to current AASM recommendations. Based on the Apnea-Hypopnea Index (AHI), OSA was classified as mild (AHI:5-15), moderate (AHI: 15-30) and severe (AHI: >30). HF was arbitrarily classified as mild (EF:<35%) moderate (EF:35-45%) and severe (EF:45-55%). OSA emerged as the exclusive form of SA (95.4%; n=65) and was more severe in males. Patients with more severe HF tended to be less obese, and interestingly to have less severe OSA. In contrast to Western literature, OSA seems to be by far the most prevalent form of sleep apnea in Indian subjects with HF. HF mortality is known to be high in underweight individuals yet, persons with severe HF are often less obese and partly by reason of a lower BMI, appear to be relatively protected against severe OSA and severe nocturnal hypoxemia. This study thus raises important and intriguing questions which merit further enquiry.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Uzma_2016,

title = {Effect of henna (mehndi) on pulse oximetry reading},

author = {Nazia Uzma and Juveria Sultana and Abid Ali Khan and Usama Syed and Ashfaq Hasan},

url = {https://www.ijcap.org/article-details/2998},

doi = {10.5958/2394-2126.2016.00127.4},

issn = {2394-2118},

year  = {2016},

date = {2016-12-31},

urldate = {2016-01-01},

journal = {Indian Journal of Clinical Anatomy and Physiology},

volume = {3},

issue = {4},

pages = {556-559},

publisher = {IP Innovative Publication Pvt. Ltd.},

abstract = {Introduction: Pulse oximetry is a frequently used and a non-invasive method for monitoring oxygen saturation in blood. It estimates arterial hemoglobin saturation by measuring the light absorbance of pulsating vascular tissue at two wavelengths which can be altered by various factors. Numerous factors could lead to inaccuracy or ambiguous information about oxygen saturation and might result in unwanted procedures. In many cultures, women decorate their fingernails and feet with henna. The purpose of this study was to determine the effect of henna on the measurement of oxygen saturation.

Methods: 100 healthy females with a mean age of 19±1.0 years with normal oxygen saturation at room air were included into the study. Individuals with cardiovascular disorders like congenital heart disease, heart failure, any respiratory diseases were excluded from the study. Henna was applied to all the participants on the distal phalanx of left index finger (test) of the individuals and kept for 2 hours whereas right index finger was left empty as control. After 2 hours of application, henna was scrapped off from left finger. Oxygen saturation in addition to radial pulse was determined on both tested and control finger. Similarly, oxygen saturation and radial pulse was again determined on 2nd day as well as on the 7th day of application of henna on both tested and control finger and were statistically compared.

Results: Our results revealed no alteration in radial pulse after henna application even after 07th day (p value more than 0.05 in all the cases). However, a change in oxygen saturation was observed after 2 hours of application of henna till 07th day. Nonetheless, it must be emphasized that an increase of saturation of this minor magnitude (average 0.67%) does not translate into a clinically important change.

Conclusion: Application of natural henna does not cause any major error in measurement of oxygen saturation in young healthy individuals.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}