Today, Padiyath Medicity - Hopital Du Cinquantenaire Chest Clinic is committed to the integration of patient care, education, and scholarly research to provide state-of-the-art consultation and treatment for thousands of patients. In addition to our comprehensive general pulmonary practice, we offer specialty center programs in tuberculosis, adult cystic fibrosis, asthma, COPD, pulmonary vascular diseases, diseases, thoracic, lung cancer screening, sleep medicine, interventional pulmonary medicine, and occupational lung diseases. Padiyath Medicity - Hopital Du Cinquantenaire established with the intention of providing a state –of- the art investigative tools in the field of Chest Medicine. This perhaps is the only center, which provides such investigations under one roof.

The Clinic is well equipped and offers following Facilities:

• Basic Radiology Service
• Electrocardiography
• Fibre optic Video Bronchoscopy- Adult

• Rigid Bronchoscopy
• Clinical Pathology & Biochemistry

• Lung Function Assessment by Computerized Lab
• Fibre optic Video Bronchoscopy- Pediatric

Communicable disease refers to those diseases that can be passed or spread from person to person. As a public health agency, our primary goal is to assist the citizens of our communities in achieving their fullest health potential. Part of this goal is accomplished through the surveillance and investigation of communicable disease incidents reported to our department.

Padiyath Medicity - Hopital Du Cinquantenaire Communicable disease Clinic provides the following TB related services:

• Assessment and diagnosis for TB
• Health undertakings

• Education and counselling services
• Treatment and management

• BCG Vaccination

Diagnostic Services

• Pulmonary function testing
• Allergy testing
• Flexible video bronchoscopic investigation

• Endobronchial stenting
• Ventilation perfusion scans for pulmonary embolism and thoracoscopic procedures
• Exercise testing

• Diffusion studies
• BAL
• Spiral and higher resolution CT imaging guided biopsies

Pulmonary function testing

Pulmonary function tests are a group of tests that assess the functional status of the lungs and give us information about the likely cause of breathlessness. It measures how well we can inhale and exhale air and how well the gases such as oxygen move from the atmosphere into the body's circulation. PFT's are performed by our trained technician in the PFT lab.

Pulmonary function tests are done to:

• Diagnose diseases such as asthma, bronchitis, ILD and COPD
• Measure progress in disease treatment

• Measure whether exposure to chemicals at work affects lung function
• Find the cause of shortness of breath

• Check lung function before surgery
• Assess the effect of medication

Bronchoscopy is a technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. The bronchoscopeis inserted into the windpipe, usually through the nose or mouth, or occasionally through an endotracheal tube or tracheostomy. This allows the doctor to examine the patient's airways for abnormalities such as foreign bodies, bleeding, tumors, secretions, or inflammation as well as provides an opportunity to take diagnostic samples in the form of washings and lavage from the lung and biopsies of lung tissue for diagnosis of certain diseases.

Our Bronchoscopy Suite is equipped with state of the art technology inclusive of 2 ultra-modern video bronchoscopes, both Radial and Linear endobronchial ultrasound probe scopes,and facility for Endobronchial Stent placement, Electrocautery / Argon Plasma Coagulationwith related tools for tumor removal, foreign body removal tools, fluoroscopy guidance,endobronchial glue insertion and hot biopsy forceps.

Linear EBUS

Endo-Bronchial Ultrasound (EBUS) is one of the latest diagnostic tools in evaluating undiagnosed lung or mediastinal (the space between the two lungs where the heart and great vessels lie) masses and lymph nodes.

Indications

• Mediastinal lymph nodes – Tuberculosis, Sarcoidosis
• Suspected mediastinal cyst

• Peripheral intrapulmonary mass lesions
• To aid in certain therapeutic procedures

• Lung cancer
  –Mediastinal staging of lung cancer
  –Restaging after induction chemotherapy
  –Diagnosis of primary lung tumors
  –Assess the extent of airway invasion

Radial EBUS

Till date we are the only centre in the country with facilities for radial endobronchial ultrasound.Just as linear EBUS helps us to sample lesions which are juxta-bronchial, Radial EBUS aids in diagnosing diseased areas within the lung tissue which were traditionally accessible only surgically. This procedure thus has greatly reduced the cost and morbidity in diagnosis of these lesions which can range from benign lung tumors to lung cancers and infections like Tuberculosis and fungal.

Recent technological refinements of the electrodes and the use of high frequency current have made possible safe use of electrocautery through the bronchoscope. Various instruments like Hot Forceps, Snare, Knife powered by cautery can be used for diagnosing and treating endobronchial obstructive lesions like lung cancers, benign tumors, tracheo-bronchial stenosis, sub-glottic stenosis, relapsing polychondritis, amyloidosis, tracheobronchial papillomatosis and Wegener’s granulomatosis. Cautery coagulates the vessels thus reducing bleeding and making removal of vascular lesions possible. The procedure can even be done with a flexible therapeutic bronchoscope thus avoiding need for general anaeshesia or a more invasive surgical procedure. These procedures give patients an instant relief.

Indications:

• Lung cancer
• Oesophageal cancer
• Head and Neck tumours

• Vascular compression
• Benign tumors
• Thyroid cancer

• Tracheobronchial malacia
• Benign tracheal stenosis (Postintubation, Wegener’s ganulomatosis, Relapsing Polychondritis)

Medical Thoracoscopy is a procedure to examine the chest wall from the inside using an endoscope like device, called a thorascope, through a little hole (about 1-2 cm) in the chest. This also allows examiner to examine around the outside of the lungs apart from inside of the chest wall. During the procedure, samples are taken for establishing diagnosis of pleural disorders in the form of biopsies from the pleura (the covering of lungs and chest wall) and fluid. The procedure is done in our bronchoscopy suite under mild sedation (not general anaesthesia) and local anaesthesia. The total duration of the procedure is around 30-45min. The same sitting can also be used therapeutically for pleurodesis.

Indications:

• Undiagnosed pleural effusion

• To inspect the lung and chest wall pleura(covering of the lungs) and take biopsies for diagnosis

• To instill substances like talc to seal the pleural space and prevent recollection of fluid or air

We are equipped with all the necessary tools needed to remove any sort of foreign bodies accidentally finding their way into the respiratory tract and have removed foreign bodies including bone, dental file, needles, etc. from the airways.

This is a procedure wherein fluid accumulated outside the lungs in the chest cavity is taken out using a plastic cannula/needle for diagnosis of pleural diseases as well as therapeutic benefit when a large amount of fluid is causing respiratory embarrassment. This is an outpatient procedure requiring 15-20 minutes.

Various indications are:

• Tuberculosis
• Pneumonia

• Recent Surgery
• Cancer

• Congestive Heart Failure / Renal failure / Liver failure

Various diseases involving the pleura (covering of lungs) cause accumulation of fluid/ pus/ air in the chest cavity. This compresses the lungs and has to be drained. A thin tube needs to be put in the chest cavity to drain this collection. We perform this procedure under ultrasound guidance, to ensure safety on a routine basis. Also the cavity can be sealed after the collection is drained to prevent re-accumulation in case of air of rapidly collecting fluid in cases like malignancy, liver and kidney diseases.

Indications:

• Pneumothorax (air)
• Empyema (pus)
• Malignant effusion

• Postoperative: thoracotomy, oesophagectomy, cardiac surgery
• Pleural effusion

• Hemothorax (blood)
• Chylothorax (lymph)

Allergy testing

Allergy skin tests are tests used to find out which substances cause a person to have an allergic reaction in the form of asthma or allergic rhinitis. The skin prick test is routinely done by our department to find out the cause of allergic symptoms patients have and subsequent advice regarding avoiding some agents or specific therapy.

Spiral and High Resolution CT

Spiral and High Resolution CT Computed Tomography (CT) imaging. also known as 'CAT scanning’ (Computed Axial Tomography), provides high resolution imaging for cases of lung diseases, mediastinal diseases, and chest wall tumors. The software for spiral CT creates a CT endoscopy and a CT bronchoscopy, as well as a continuous helical acquisition which provides a 3-D volume scan allowing a radiologist to better localize very small tumor.

Scintigraphy Test

The Ventilation Perfusion Scan in Nuclear Medicine is extremely useful in the detection and localization of pulmonary thromboembolisms as well as primary and secondary tumors. The Gamma Camera is also used for pulmonary function testing.

Our Department of Pulmonology is dedicated towards providing excellent medical services for conditions like Asthma, Chronic obstructive pulmonary disease, Emphysema, Pulmonary Edema etc. Our Center provides cutting-edge, evidenced-based pulmonary care with superior patient outcomes and family satisfaction .