Of cial quarterly Communication from Indian Chest Society

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Of cial quarterly Communication from Indian Chest Society
Ofcial quarterly Communication from Indian Chest Society
Of cial quarterly Communication from Indian Chest Society
Of cial quarterly Communication from Indian Chest Society
Of cial quarterly Communication from Indian Chest Society
Of cial quarterly Communication from Indian Chest Society
A
                                         Note From

                                         The President’s Desk..
 Dr. S. K. Luhadia

  Dear Colleagues,

  Indian Chest Society is growing very fast in terms of Academic & Research activities. Young
  chest physicians are showing a great interest in becoming its members. This year we have
  further strengthened our democratic character as democracy is backbone of any society.

  We have started e -voting and more than 1200 members have used their voting right,
  which is more than twice as compared to previous years. There was neck to neck contest
  for almost every post. I congratulate our dynamic secretary Dr. Rajesh Swarnkar and our
  past President & returning election officer Dr. Suryakant Tripathy for completing successful
  electoral process & e -voting.

  I am also thankful to our esteemed members for participating in huge numbers in the
  election and hope that voting percentage will further rise in future.

  The society will further achieve great heights under the leadership of Dr. Sudhir Choudhary
  & Dr. D. J Christopher, our future president & president elect respectively.

  The forthcoming NAPCON - 2018 at Ahmedabad is again going to be a mega event under
  the able leadership of Dr. Rajesh Solanki. The academic programme prepared by Dr. S. K
  Katiyar along with Dr. Nikhil Sarangdhar will be excellent in terms of academics. I appeal all
  the members of ICS to kindly attend and participate in this conference with full enthusiasm
  & interest.

  Long live Indian Chest Society and NAPCON!!!

  With Regards
  Dr. S. K. Luhadia

Secretariat Address: Dr. Rajesh Swarnakar, Secretary, Indian Chest Society, ICS Secretariat office, IMA Annexe
         IMA House, North Ambazari Road, Nagpur -440010, Email: icsofficeexecutive@gmail.com

                                                                                                                 1
Of cial quarterly Communication from Indian Chest Society
A
                                             Note From

                                             The Secretary’s Desk..
      Dr. Rajesh Swarnakar
      Secretary, Indian Chest Society

    Hello Members !!!

    They say there is no shortcut to success and this has proved true when all the efforts of ICS
    team proved successful in bringing you to vote in such huge numbers. Let me start by
    thanking each one of you for voting for the 2018 GB Elections and making a grand success
    whopping 1117 votes were registered by us which are more than two times our usual
    ballot. The learnings are pretty clear that ICS going digital has helped all its members with
    the ease and convenience of choosing their members at the touch of their mobiles in
    minutes. I would sincerely appreciate the efforts of all our GB Members, Dr. SuryaKant,
    Election Officer for e-voting, Dr. Jyoti Bajpai for her continuous efforts and last but not the
    least Mrs. Sakshi Deshmukh for helping me bring this remarkable possibility in our society.
    A more detailed experience is shared by in her article on “Every Vote does Count Indeed !!!
    ICS e-voting journey from Traditional to Digital...
    We at ICS are keen to bring, HERMES Europe Adult Respiratory exam will now be held in
    India and this is the first time anywhere out of Europe. Also, we have strengthened our
    international ties by collaborating with Lung Health Joint Fellowships with the ERS is also a
    great venture of ICS which our young members can avail benefits of. I am thankful to Dr.
    Raja Dhar for constantly putting in efforts for all these tie-ups.

    RESPIRE has been loved by all our members and we wish you would help us with your
    feedback and suggestions for our constant improvement. Do write to us at
    icsofficeexecutive@gmail.com for your queries, suggestions and feedbacks.
    I also hope you follow us digitally on our Facebook and Twitter Handles for all the latest at
    ICS.

    We have a great new team on board, after elections and I wish all of them a great tenure
    ahead. They have been introduced to you inside the newsletter.
    Happy Reading!!!

    Secretariat Address: Dr. Rajesh Swarnakar, Secretary, Indian Chest Society, ICS Secretariat office, IMA Annexe
             IMA House, North Ambazari Road, Nagpur -440010, Email: icsofficeexecutive@gmail.com

2
Of cial quarterly Communication from Indian Chest Society
THE COVER STORY
Dr. Ashok Mahashur, Past President & Founder Joint Secretary Of ICS
              Talks To Dr Amita Nene, Member ICS

    Dr. Ashok Mahashur was born in Khamgaon,             his training and get his MD in TB & Chest Diseases
    near Akola, Maharashtra in December 1948. He         in 1976 from the Bombay University.
    did his basic education in Khamgaon, nurturing a
    keen desire to become a doctor since a very          He then immediately joined the Dept. of Chest
    young age. Worked hard and was academically          Medicine at Seth GS Medical College and KEM
    inclined - doing well through his early years, and   Hospital - which was probably the only Non-TB
    then, with the grace of God, procured an MBBS        respiratory disease Dept at that time. DR. S. R.
    seat at the Govt. Medical College in Nagpur in       Kamat, a no-nonsense man, was the HOD who
    1966. Working hard through all those years, he       played a major role in his development,
    completed his MBBS in 1971.                          cultivating Respiratory diseases as a Speciality.
                                                         These formative years formed the base of his
    Due to family compulsions, he had to come to         career till he retired as a Professor and Head
    Mumbai. Having done his MBBS in Nagpur, he           from KEM Hospital, his parent institute.
    had to struggle a lot to get a PG seat in Mumbai
    but finally got his PG seat in Chest Medicine in     Dr. Amita Nene - Dear Sir, We all know that you
    1973 at the Grant Medical College, Mumbai.           were one of the key persons responsible for
    It was a memorable moment for him to complete        conceptualizing and creating the Indian Chest

                                                                                                              3
Of cial quarterly Communication from Indian Chest Society
Society. This was truly a great step forward for       one of the first papers on non TB pulmonology
    our field of Pulmonology and we all                    and brought into light that we also diagnosed
    pulmonologists will always remain grateful to          and treated diseases other than TB.
    you and to the other founder members of the
    Indian Chest Society for your great vision and all     Dr. Amita Nene - That's truly commendable Sir !!
    your extraordinary efforts.                            What inspired the birth of ICS? Was there any
                                                           stimulating factor?
    Our Pulmonology community is extremely
    interested in knowing how you did this all and         Dr. Mahashur – After my paper presentation at
    the tremendous efforts that you and other              the conference, I was surprised that very few
    founder members put in creating the Indian             physicians were aware of the condition ILD. This
    Chest Society and bringing it to its current, highly   motivated me to think that in our speciality,
    respectable position.                                  significant progress and research was being done
                                                           with respect to TB, but there was very little
    Can you pls tell us what was the status of chest       awareness and few efforts were being made to
    medicine prior to the formation of the ICS?            promote education in non-tuberculous
                                                           respiratory medicine. It highlighted the need to
    Dr. Mahashur - In the 1970s chest medicine was         work simultaneously to improve awareness,
    only tuberculosis. I passed my MD Chest and TB         knowledge and research in non-TB respiratory
    in 1976. That was the nomenclature used for our        diseases amongst clinicians by getting maximum
    degree at that time. Before 1973, it was called        chest physicians together for this purpose and I
    MD TB. Everyone referred to us as TB specialists       was occupied with this thought.
    and there was very little awareness about non-
    tubercular chest diseases.                             Incidentally, on the same evening in this Nagpur
                                                           1979 API meeting, was the general body meeting
    Dr. Amita Nene- That's very interesting… Pls, tell     of the chest group where Dr. S R. Kamat
    us about your non-TB work in those days !!             proposed that a new democratic nationwide
                                                           Pulmonology society is created which would
    Dr. Mahashur - Immediately after completing my         have true national representation with a
    MD, I joined Chest Medicine Dept at Seth GS            transparent election process.
    Medical College and KEM Hospital with Dr S R
    Kamat. This dept was entirely dealing with non-        This did not meet with an easy approval and so
    tuberculous respiratory diseases. After working        he came to me and said that we must take lead in
    for a few years, I realized that our PG training and   creating such a new National Chest Association
    clinical approach is TB centric. There were a lot of   w h i c h i s t ra n s p a r e n t , i n c l u s i v e a n d
    non-tuberculous diseases which were on a rise          representative of the entire country - with the
    and needed special attention.                          whole and sole intention of spreading
                                                           knowledge. This very important day of 1979 API
    The opportunity came in 1979, while I was a            Meeting in Nagpur led to the conception of
    lecturer in this department and was involved in        Indian Chest Society
    the research in ILD in India. My paper on ILD was
    accepted for verbal presentation and discussion        Dr. Amita Nene - Sounds really exciting Sir !! So
    in the API conference at Nagpur in January 1979.       how was ICS finally formed?
    In those days, the number of chest physicians
    was small and National College of Chest                Dr. Mahashur - Within 4 days of coming to
    Physicians (NCCP) was holding its annual chest         Mumbai, I called the meeting of important chest
    conference under the banner of API.                    physicians in the seminar hall of KEM hospital
                                                           Mumbai. It was attended by Dr S R Kamat, Dr. P.
    My paper in the API meeting in 1979 on ILD was         G. Kamath, Dr. A. P. Rao, Dr. Sundari Mirchandani

4
Of cial quarterly Communication from Indian Chest Society
and by me - Dr. A. A Mahashur.                       etc was the real task and I still have fond
                                                     memories of the entire process.
All of us agreed to the idea of starting a society
which would encourage research in all types of       We all five founder members sitting in one fiat
respiratory diseases and spread of knowledge         car, literally went around to Pharma companies
and would function democratically by strictly        one-on-one requesting for their support and
adhering to the constitution formed on               eventually managed to raise as much as four
democratic principles. After a lot of                lakh rupees – a very good amount in those
deliberation, the society was named INDIAN           times.
CHEST SOCIETY. Dr P G Kamath wrote the
original constitution of ICS. A new society was      Our first meeting was held at the Hotel
born in May 1979. Dr. P. G Kamath was the            President in South Bombay and was very very
unanimous choice for secretary's post, Dr. M P.      successful
Mehrotra, a senior physician from Agra was
elected as President, Dr. A. P. Rao as Vice          We spent about two lakh rupees for organizing
President and me, Dr. Mahashur as joint              this first annual meeting of Indian Chest
secretary.                                           Society and we put the remaining two lakh
                                                     rupees in the association kitty.
Dr. Amita Nene– That's Fantastic !! Can you pls
tell us something about the early years of the       This first meeting marked the rise of our Indian
ICS. Did the society prosper immediately or          Chest Society which soon grew nationwide.
was there an inertia time for people to accept
the ICS?                                             Over time the pre-existing Association of Chest
                                                     physicians of India asked to join hands with us
Dr. Mahashur - The philosophy of the Indian          and combine our annual meeting and we
Chest Society was to have membership and             readily agreed as we wanted single and true
representation across the country with elected       national pulmonology representation
office bearers on an annual basis.
                                                     Dr. Amita Nene – Truly incredible Sir !! Can you
The membership drive yielded quick results           pls tell us about your involvement in the day to
from East, South and Central zones. The              day functioning of the ICS in these early years
response was growing and to reach to larger          since its inception?
physicians and chest physicians it was decided
to start a national journal in 1980. The first       Dr. Mahashur - With Dr. P. G. Kamath being the
journal of ICS named LUNG INDIA was                  ICS secretary since inception through the late
published under the editorship of Dr C V             80s, my involvement with the association as
Ramakrishnan. It continues to be published           the joint secretary was complete and right
uninterrupted from 1980 till date.                   from the start. I was entrusted with handling all
                                                     matters of the secretary's office including
We proudly watched our ICS grow in numbers           correspondence, memberships, and planning
to soon become the most influential academic         meetings.
Society for pulmonology
                                                     I continued to work for ICS in all capacities
Dr. Amita Nene – That's wonderful… So when           without a break and with the meticulous
was the first ICS national meeting held? Can         nature of Dr. P. G Kamath and constant pushing
you tell us something about this meeting?            from Dr. S. R Kamat, it was indeed difficult to
                                                     balance both the hospital and ICS work.
Dr. Mahashur - We finally decided to have our        Honestly, this was the most hectic period of my
first annual meeting of ICS in 1981.                 career. I wish to mention and give full credit to
                                                     my wife Mukul and my son Nikhil who allowed
Planning the meeting, the venue, the budget          me to pursue my passion without complaining

                                                                                                         5
Of cial quarterly Communication from Indian Chest Society
and were always supportive and made it possible         active working of ICS but continue to take
    for me to be what I am today. I owe a lot to them.      interest in all activities of the society. The society
                                                            has given me access to national exposure and
    Dr. Amita Nene – Hats off to you and your lovely        gain in-depth knowledge from all respiratory
    family !! How do you think has the ICS grown in         physicians in the country, interact and exchange
    the recent past? Are you happy with the growth          academic thoughts, and encouraged me to get
    of ICS?                                                 involved in research, education and patient care.
                                                            I could train a large no of PGs between 1977 till
    Dr. Mahashur - As I look back, I feel very very         date and am enjoying it still. My work has been
    proud and as a dream come true. Respiratory             recognized by ICS, International Academy of
    medicine has grown into an important and much           Allergy and Immunology, and Maharashtra
    sought-after speciality. All respiratory physicians     University of Health Sciences.
    are at same wavelength because of a large
    number of frequent interactive sessions, CMEs,          Dr. Amita Nene - Dear Sir, the entire Indian
    exposure to international conferences with the          Pulmonology family is extremely grateful to you
    opportunity to shine not only at home but also          and the other 4 founder members of the ICS. Pls
    internationally - given awards as appreciation for      let us know what your vision for ICS from hereon
    their work. Every year ICS is coming up with            is. How would you want us to continue with the
    newer incentives to encourage young scientists          ICS legacy??
    to excel in their favourite area. The journal has
    achieved an international standard under able           Dr. Mahashur - With the way the ICS is growing I
    editorship.                                             predict it to be the topmost organization in
                                                            respiratory medicine that is dedicated to the
    I congratulate and offer my sincere thanks to all       welfare of each and every respiratory physician
    members of ICS and all the governing body               and helping their growth. I visualize ICS as a body
    members from the inception of ICS till date for         that would dictate health policies for respiratory
    their contribution, dedication and hard work to         diseases to the Government and would help in
    make ICS an internationally recognized body.            implementing effective policies for TB control
    Each of You have made us - all founder members          and awareness.
    happy and proud by helping their dream come
    true. I bless you all for your and Indian Chest         I am highly proud of the talent and foresight of
    Society's continued success and academic                young members of the governing body of ICS.
    prosperity.
                                                            In the end, I earnestly request to all members to
    Dr. Amita Nene – Thank you very much, Sir, for          continue to stick to the drafted constitution and
    your blessings and kind words !! Can you please         stick to it in difficult situations so that no decision
    tell us what ICS has given back to you?                 would sound difficult to take. I bless the society
                                                            for a bright future and pray for its success in all its
    Dr. Mahashur - I have now retired from the              future ventures.

                    Your feedback and suggestions are welcomed @ icsofficeexecutive@gmail.com or
                                     visit our website www.indianchestsociety.com

6
RECENT UPDATES

                           EBUS: The journey so far and beyond…

Dr. Prashant N. Chhajed

 Dr. Prashant N. Chhajed is a Governing Council         Dr. Yasufuku and Dr. Chhajed developed the EBUS
 Member of the Indian Chest Society (2017 –             TBNA in Chiba, Japan and presented the first
 2019). He has been Chair, West Zone, Indian            paper on EBUS TBNA at ATS International
 Chest Society (2014 – 2107). Dr. Chhajed               Conference in 2003 and published the Original
 habilitated as Privat Dozent at University of Basel,   Paper, as first large series on EBUS TBNA in Journal
 Switzerland (2007). He is the current Chair,           CHEST in 2004. His research has received several
 Interventional Pulmonology Group at the                awards at ERS, Swiss TB Award, Swiss Society of
 European Respiratory Society (2018 – 2021). Dr.        Pulmonology, Charak Award, St Vincent's
 Chhajed has also held the following positions in       Hospital, Garvan Institute, etc. He has conducted
 International Societies: Secretary, Interventional     many workshops and lectures nationally and
 Pulmonology, ERS (2015 – 2018); Member of              internationally on Interventional Pulmonology
 Program Committee, American Thoracic Society           and EBUS TBNA over the last 15 years. He has
 (2005 – 2015); Member of Planning Committee,           been on Editorial Board of CHEST (2005 – 2010)
 ATS (2006 -2009); Secretary, European                  and continues to be on Editorial Board of
 Association of Bronchology & Interventional            RESPIRATION, Journal of Bronchology &
 Pulmonology (2006 – 2010); Vice President,             Interventional Pulmonology, Lung India, JCRT, etc.
 EABIP (2005 –2006).                                    Dr. Chhajed has 125 peer-reviewed publications
                                                        on PubMed

 The utility of endobronchial ultrasound guided         and hilar lymphnodes on a day. care setting
 transbronchial needle aspiration (EBUS-TBNA)           under moderate sedation with high diagnostic
 was first reported in 2004. (1) The new ebus           accuracy. Enlarged mediastinal and hilar
 bronchoscope with a linear probe at its tip allows     lymphnodes as well as subcentimeter sized
 real time visualisation and sampling of                lymph nodes can be sampled using EBUS-TBNA.
 paratracheal and peribronchial lymphnodes.             It is performed using a 21 or 22 gauge dedicated
 The ability to sample mediastinal and hilar            TBNA needle. The anaesthesia for this procedure
 lymphnode stations 10, 11 and 12 with EBUS-            varies from conscious sedation to general
 TBNA, which were not accessible with                   anaesthesia based on the patient comfort and
 mediastinoscopy, has led to a paradigm shift in        safety. Three to five passes per lymphnode are
 diagnostic pulmonology and lung cancer staging.        obtained for cytology by cellblock and aspirates
 The availability and usage of EBUS-TBNA has            for microbiological analysis. Core biopsies can
 grown exponentially over the last decade, both         also be obtained and have been reported to
 clinically and geographically. The technique           increase the diagnostic yield in both benign and
 allows safe, real time sampling of mediastinal         malignant pathologies.(2) The training in
                                                                                                               7
technique of EBUS-TBNA has been incorporated           Lung cancer is the leading cause of mortality due
    in academic curriculum of several institutions         to cancer worldwide. While the incidence has
    worldwide.                                             been increasing, only around 15% of lung
                                                           cancers are diagnosed at an early stage. The
    EBUS-TBNA has been reported to be non-inferior         molecular profiling of lung cancer has become an
    and safe compared to other modalities for tissue       important step in deciding therapy for a patient
    acquisition.(3) It adds to the diagnosis and           with an advanced stage disease. This implies that
    prevents more invasive procedures in a patient         the pathological subtype, stage of disease and
    with an inconclusive CT guided biopsy.                 molecular profile together constitutes the
    Conventional TBNA using flexible bronchoscope          complete diagnosis of lung cancer to plan
    can be used for sampling mediastinal lymph             appropriate therapy for a patient. Accurate
    nodes. However, there is no real time guidance         mediastinal staging is required in a patient
    for this technique and it requires the operator to     where obvious distant metastases is ruled out
    make a mind map of the mediastinum based on            with the help of positron emission tomography
    the available imaging. EBUS-TBNA provides real         (PET-CT) or computed tomography (CT). PET-CT
    time visualization of the lymph node, its size and     can yield false positive results in case of
    the adjoining blood vessels in the Doppler mode.       inflammatory or co-existent infective conditions
    This increases the diagnostic accuracy and             along with malignancy.(3) Hence, all PET positive
    safety.(4) Also, core biopsies can be obtained         mediastinal lymph nodes should be sampled for
    using EBUS-TBNA which significantly increases          accurate staging with no obvious evidence
    the diagnostic yield.(2) Endoscopic ultrasound         extrathoracic metastases. This can help in down
    guided fine needle aspiration (EUS-FNA) can be         staging of PET-CT and help in identifying
    used to sample paraesophageal and lower                candidates for surgery. EBUS-TBNA has the
    medistinal lymph nodes (stations 8 and 9) and          advantage of diagnosing, staging and acquiring
    also detect liver and adrenal metastases. It can       samples for molecular profiling of lung cancer in
    co m p l e m e nt E B U S - T B N A i n co m p l ete   the same setting. Also, endobronchial staging
    mediastinal staging of lung cancer. The EBUS           can be done during EBUS bronchoscopy. It can
    bronchoscope can be passed through the                 also diagnose PET positive lymph node with high
    esophagus by pulmonologists and used to                accuracy. Intrapulmonary lesions adjacent to the
    sample station 8 and 9. However, the knowledge         trachea or bronchi can also be sampled using
    of mediastinal anatomy on transesophageal              EBUS-TBNA. It yields the highest tumor RNA
    ultrasound is necessary for the operating              material when compared to CT guided core
    pulmonologist. Mediastinoscopy has been                biopsy and bronchoscopic forceps biopsy. EBUS-
    considered the gold standard in staging                TBNA can accurately diagnose metastatic
    mediastinum. However, it is a surgical procedure       mediastinal and hilar lymphnodes in a
    done under general anesthesia requiring                radiologically normal mediastinum.(5) The
    hospitalization. Moreover, it can sample               reported diagnostic yield of EBUS-TBNA in
    paratracheal and subcarinal lymph nodes. EBUS-         malignancy is close to 90%. Moreover, it helps in
    TBNA can sample N1 and N2 lymphnodes with              restaging of lung cancer after surgery or
    high accuracy. EBUS-TBNA is now the initial            chemotherapy. It is the only modality which can
    choice of modality in mediastinal staging and          help in restaging mediastinum after lobectomy
    may render mediastinoscopy unnecessary in              or pneumonectomy despite distortion of normal
    most number of cases. However, negative results        mediastinal anatomy. EBUS-TBNA can accurately
    on EBUS-TBNA with high suspicion of                    diagnose and stage small cell lung cancer as well.
    malignancy or disease may need to be confirmed         Now, with the approved CT screening for lung
    on mediastinoscopy .                                   cancer in smokers, accurate mediastinal staging

8
will be the need of the hour. The utility of EBUS-   processed for cartridge based nucleic acid
TBNA in these situations will expand further. Oral   amplification test (Genexpert for MTB/Rif) and
tyrosine kinase inhibitors individualised for        liquid based TB cultures. (7) It can help in
treating advanced lung cancers with particular       detection of MDR and XDR TB in patients with
genetic mutations has helped in improving the        mediastinal tuberculous lymphadenitis. A case
quality of life and survival. The commonest          highlighting role of EBUS-TBNA in diagnosis of
mutations in non-small cell lung cancer are          MDR-TB in patients with meningitis is reported
epidermal growth factor receptor (EGFR),             in the literature. Sarcoidosis poses a diagnostic
anaplastic lymphoma kinase (ALK) and Kirsten         dilemma in patients with mediastinal
rat sarcoma (Kras). The success rate of multiple     lymphadenopathy in a TB endemic region. EBUS-
genome analysing techniques for the above            TBNA diagnosis sarcoidosis with high accuracy
mutations on samples acquired by EBUS-TBNA is        and the accuracy increases when it is clubbed
reported to be over 90%. EBUS-TBNA samples           with transbronchial lung biopsy in the same
when made into cell blocks returned an               setting.(8) The characteristics of lymph nodes on
adequacy rate of around 97% when processed           endobronchial ultrasound may help in
for various immunohistochemical stains.(3)           differentiating the causative pathologies.
EBUS-TBNA has a place in tissue acquisition for      Heterogeneous echotexture of the lymph node
research settings as well due to the high quality    and coagulation necrosis sign on EBUS are more
genetic material obtained in malignancy.             specific for a diagnosis of TB.(9)

Mediastinal lymphadenopathy in patients with         EBUS-TBNA has a complication rate of 1%.(10) It
malignancy can be due to metastasis, infection       can be safely performed in patients who are
or a sarcoid reaction to malignancy. These need      elderly, with superior vena cava syndrome or a
to be subtyped accurately even in the                space occupying lesion in the brain. However,
management of extra-thoracic malignancy. It          infective and fatal complications like massive
can help in down staging PET-CT and also             bleeding, bacterial pericarditis and mediastinitis
accurately diagnose granulomatous or                 have been reported. The role of EBUS-TBNA in
metastatic mediastinal lymph nodes during            patients receiving clopidogrel is still
post-therapy PET-CT. EBUS-TBNA can thus              controversial. Transvascular EBUS-TBNA through
impact management even in extra thoracic             the aorta and pulmonary artery have been
malignancies. It can yield estrogen receptor and     reported by expert operators. Endobronchial
progesterone receptor status in patients with        ultrasound with elastography is an emerging and
mediastinal lymphadenopathy with carcinoma           promising tool to differentiate benign versus
of breast.(6) The role of EBUS-TBNA in               malignant lymph nodes. Recently, EBUS-TBNA
diagnosing lymphomas is emerging.                    has been reported to provide diagnosis in people
                                                     living with HIV and mediastinal lympha-
In tuberculosis endemic region, mediastinal          denopathy. (11) The ability of EBUS-TBNA to
lymphadenopathy and fever often pose a               provide diagnosis in a low lymphocytic situation
diagnostic challenge to the clinicians. The          is promising. EBUS-TBNA has certainly
emergence of multidrug resistant (MDR) and           penetrated and established itself as the standard
extensively drug resistant (XDR) tuberculosis        of care in diagnostic pulmonology. The past
(TB) has led to acquiring the microbiological        fifteen years definitely set the path for the rise
                                                     and rise of EBUS-TBNA in the clinical applications
evidence necessary during diagnosis. Accurate
                                                     of the technique for maximum patient benefit!
drug susceptibility pattern can prevent a delay in
                                                     References:
appropriate therapy and improve outcomes. The
                                                     1. Yasufuku K, Chiyo M, Sekine Y, Chhajed PN, Shibuya K,
samples acquired by EBUS-TBNA can be                 Iizasa T, et al. Real-time endobronchial ultrasound-guided

                                                                                                                  9
transbronchial needle aspiration of mediastinal and hilar        2018;29(1):35-40.
     lymph nodes. Chest. 2004;126(1):122-8.                           7. Dhasmana DJ, Ross C, Bradley CJ, Connell DW, George PM,
     2. Vaidya PJ, Saha A, Kate AH, Pandey K, Chavhan VB, Leuppi      Singanayagam A, et al. Performance of Xpert MTB/RIF in the
     JD, et al. Diagnostic value of core biopsy histology and         diagnosis of tuberculous mediastinal lymphadenopathy by
     cytology sampling of mediastinal lymph nodes using 21-           endobronchial ultrasound. Annals of the American Thoracic
     gauge EBUS-TBNA needle. Journal of cancer research and           Society. 2014;11(3):392-6.
     therapeutics. 2016;12(3):1172-7.                                 8. Gupta D, Dadhwal DS, Agarwal R, Gupta N, Bal A,
     3. Vaidya PJ, Kate AH, Yasufuku K, Chhajed PN.                   Aggarwal AN. Endobronchial ultrasound-guided
     Endobronchial ultrasound-guided transbronchial needle            transbronchial needle aspiration vs conventional
     aspiration in lung cancer diagnosis and staging. Expert          transbronchial needle aspiration in the diagnosis of
     review of respiratory medicine. 2015;9(1):45-53.                 sarcoidosis. Chest. 2014;146(3):547-56.
     4. Chhajed PN, Odermatt R, von Garnier C, Chaudhari P,           9. Dhooria S, Agarwal R, Aggarwal AN, Bal A, Gupta N, Gupta
     Leuppi JD, Stolz D, et al. Endobronchial ultrasound in hilar     D. Differentiating tuberculosis from sarcoidosis by
     and conventional TBNA-negative/inconclusive mediastinal          sonographic characteristics of lymph nodes on
     lymphadenopathy. Journal of cancer research and                  endobronchial ultrasonography: a study of 165 patients.
     therapeutics. 2011;7(2):148-51.                                  The Journal of thoracic and cardiovascular surgery.
     5. Herth FJ, Eberhardt R, Krasnik M, Ernst A. Endobronchial      2014;148(2):662-7.
     ultrasound-guided transbronchial needle aspiration of            10. Vaidya PJ, Munavvar M, Leuppi JD, Mehta AC, Chhajed
     lymph nodes in the radiologically and positron emission          PN. Endobronchial ultrasound-guided transbronchial
     tomography-normal mediastinum in patients with lung              needle aspiration: Safe as it sounds. Respirology.
     cancer. Chest. 2008;133(4):887-91.                               2017;22(6):1093-101.
     6. Serra P, Sanz-Santos J, Castella E, Cirauqui B, Andreo        11. Prasad KT, Muthu V, Sehgal IS, Dhooria S, Sharma A,
     F, Llatjos M, et al. Identification of oestrogen, progesterone   Gupta N, et al. Utility of endobronchial ultrasound-guided
     receptor and human epidermal growth factor receptor 2            transbronchial needle aspiration in HIV-infected patients
     expression in mediastinal metastases of breast cancer            with undiagnosed intrathoracic lymphadenopathy. Lung
     obtained by endobronchial ultrasound-guided                      India :official organ of Indian Chest Society. 2018;35(5):379-
     transbronchial needle aspiration. Cytopathology : official       83.
     journal of the British Society for Clinical Cytology.

                        Your feedback and suggestions are welcomed @ icsofficeexecutive@gmail.com or
                                         visit our website www.indianchestsociety.com

10
ICS - ATS Travel Grant Reciepient Interview
                               Dr. Deepak Muthreja

          Dr. Mark Weir, (MD) from Chicago Reviewing The Poster Of Dr. Deepak Muthreja

Q1. Please tell ICS Members about your background and how did you come to know about the
travel grant?

I am Dr. Deepak Muthreja (L-1827) an Interventional Pulmonologist based in Nagpur. I did my MD
Chest Diseases from Government Medical College, Rajkot and currently pursuing European
Respiratory Society's EBUS course having passed Part II assessment. I have also passed HERMES Adult
Respiratory Examination held in paris 2018. Our abstract titled “Removal of Endobronchial
Endodontic Equipments with help of Flexible Video bronchoscope: Single centre experience” was
accepted for presentation at ATS International conference 2018. I became an ICS member in 2015 and
was aware of the travel grant through letters and continuous emails from ICS office.
Their frequency is very appropriate and also the apt timings which young members especially new
ones to get every information required.

Q2. What was the process and how were you selected?

The procedure for applying for a grant is pretty simple. I sent my abstract and the acceptance of it
which I received from ATS to the ICS team via email; I received the approval of my grant once all my
documents were thoroughly verified by ICS Office and the reviewing committee.

Q3. How did the travel grant help you and was there competition for it at ICS?

The travel grant immensely helped me in easing out my financial crunch as travelling to the USA is very
expensive. Although, I did have a hard time competing with other eligible Doctors who had also
applied for the grant. ICS thoroughly verifies all the documents and provides the grant to the most
deserving one with a scrutinising committee overlooking the selection in the most transparent way.
So my advice to all my fellow ICS Members applying for grants would be to make your paper or poster
very sound in all matters and submit required documents correctly and on time.

                                                                                                          11
Q4. How was experience and what would you say to other young doctors of ICS?

     I think ICS is providing a very good opportunity for young doctors to grow by supporting doctors who
     require financial assistance. Early career members seldom get the opportunity to attend such
     conferences. These kinds of travel grants help them not only for attending the conference but also to
     present their work at an international platform. I suggest all young ICS Members to regularly visit the
     ICS Website, follow them on social media platforms like their facebook and twitter handles and read all
     ICS emails sent to them to know about various travel grants available time to time from various
     international societies with which ICS forges tie-ups.

     Q5. After your return, how many days did it take to get the grant and what is the process?

     The travel grant is issued after submitting the proof of travel along with a certificate of attendance and
     presentation. You also need to submit all original bills paid by you like your travel tickets. These are all
     verified at the Treasurer's office. Treasurer's office took around two to four weeks for the release of
     funds.

     Q6. How do you feel as a receipt on the grant and on being an ICS Member?

     This grant has helped me to a large extent to make ends meet and given me an opportunity to present
     my work at an International forum. I am very thankful to ICS for giving me this opportunity. I would
     encourage the young members of ICS to participate and make the most of the opportunities provided
     by ICS. I would request Leadership of ICS to further increase the grant in view of depreciating rupee.

                     Your feedback and suggestions are welcomed at icsofficeexecutive@gmail.com or
                                     visit our website www.indianchestsociety.com

12
ERS Paris Report 2018

Conference of ERS is an important venue for ICS leadership to have meetings with international
societies. This meeting helped ICS to forge new relationships and bring various benefits in terms of
international grants, academic activities, Joint membership plans etc. This time too ICS had its stall at
the ERS Congress, Paris 2018 held from 15-19th September. ICS leadership was represented by Dr.
Rajesh Swarnakar, Hon Secretary, Dr. Raja Dhar, National Representative of ICS for ERS, Dr. Prashant
Chhajed, Member GB, Prof Surya Kant, Ex-President of ICS and Dr.Sundeep Salvi.

Meetings were held with office bearers of ERS, Lung Health Workshop and American College of Chest
Physicians ACCP-Chest to explore possibilities of new ventures with them. ICS in association with ERS
is keen to bring HERMES European Adult Respiratory Examination in India from next year along with
its preparatory course. This will be the first time this exam will be held outside Europe. Another
possibility being actively pursued is Joint Membership with ACCP, discussions on which are underway.

ICS has collaborated with Lung Health in its conference is at NICE from 17th-19th January 2019 giving
three travel grants for accepted abstracts of ICS Members & also the opportunity of being a “Rising
Star”.Keep visiting our website www.indianchestsociety.com for recent updates and detail
information, also follow us on social media platforms like Facebook, Twitter and Youtube for all latest
at ICS.

                         ICS Lung Health Meeting at ERS Congress Paris 2018

                         ICS - ERS Meeting at the ERS Congress at Paris 201

                                                                                                            13
ICS-ACCP meeting at the ERS Congress at Paris 2018

         Dr. Raja Dhar, interacting with ICS members at ERS Congress Paris 2018

     Dr Rajesh Swarnakar interacting with ICS members at ERS Congress Paris 2018

     Dr. Surya Kant Tripathi interacting with ICS members at ERS Congress Paris 2018
           Your feedback and suggestions are welcomed at icsofficeexecutive@gmail.com or
                           visit our website www.indianchestsociety.com

14
ICS e-voting journey from
                                    Traditional to Digital...

Mrs.Sakshi Deshmukh,
B.E,M.B.A (Mktg),
Office Executive ,Indian Chest Society,
Nagpur

 Dear Friends,                                        An active member of the college committee since
                                                      her early college days she has won several awards
 Let me introduce you all to our ICS Executive who    for her communications and management skills.
 must have interacted with you all through her        Organizing guest lectures, taking part in various
 local mailers, phone, SMS etc from our ICS office.   competitions and workshops include her interest
 A firm Believer of “Attitude is Everything”...Mrs.   while dancing and yoga being her hobbies. With
 Sakshi Deshmukh has been working with the            her husband Ajinkya Deshmukh, Captain in the
 Indian Chest Society as an Office Executive at the   Indian Army attending the call of National Duty
 Secretary office in Nagpur for 1.5 years. Post       posted remotely Sakshi chose to quit her lucrative
 completing her MBA from the ICFAI University
                                                      job to look after her widowed mother in law in
 (IBS Hyderabad) in Marketing and Operations,
                                                      Nagpur and agreed to work in Nagpur ICS office.
 Mrs. Sakshi Deshmukh was working as a Business
 Analyst with Genpact India, a subsidiary of G.E      She was the backbone of our maiden ICS e-voting
 (USA) in Bengaluru. She has also worked with an      endeavour and pens her thought about her
 e-commerce firm for almost 2 years, post             experience during e-voting in this article.
 completing her Engineering in Electronics and
 Telecommunication.                                   Dr. Rajesh Swarnakar, Secretary, ICS

  It all began with a thought of making the           He was surprised to know that without involving
  elections at Indian Chest Society more              Human Interference at all this process was now
  transparent and simultaneously increasing the       possible. Without wasting time I contacted some
  participation of voters that e-Voting as a          vendors and I kept the final list in front of Dr.
  resolution was passed in Annual General             Swarnakar, the same was discussed in the GB
  Meeting of ICS Members at Kolkata NAPCON            meeting and CDSL was the clear winner. CDSL e-
  2017. Our mandate was to hold ICS Election this     Voting System was approved by the Ministry of
  year by only electronic voting. Dr. Rajesh          Corporate Affairs (MCA) vide its circular no.
  Swarnakar, Hon. Secretary of the Indian Chest       21/2011 dated 2nd May 2011. The
  Society generally asked me about the e-voting       Standardization Testing and Quality Certification
  process, how is it conducted and what would be      (STQC) has also been taken for the e-Voting
  the expenses etc. I am an engineering graduate      website. Additionally, the e-Voting system is also
  in electronics and telecommunication although       ISO 9001:2015 certified. After a detailed
  we engineers do not have every answer at our        presentation and exhaustive discussion with
  tips, I explained some technical aspects about it   Governing Body of Indian Chest Society in its
  to Dr. Swarnakar.                                   meeting, CDSL was finalized.

                                                                                                           15
The next big challenge was to have as much               made the officer in charge of this election who
     correct email ID as possible; this would help us         himself received.
     involve most of our Life Members. As it was the          One to one training in e-voting process in an
     first time, Governing Body of ICS instructed             exclusive exhaustive session with CDSL trainers.
                                                              Two months in advance Email reminders,
     CDSL to send postal information of their user ID
                                                              Facebook posts, videos and SMS were used to
     & e-voting password to all members without
                                                              spread awareness before the e-voting actually
     emails registered with us. But it was decided that
                                                              began. This helped us spread the word and
     once they received these instructions by post            helped us gain the maximum votes possible.
     they will also have to go online and vote on the
     CDSL E-VOTING PORTAL. I made a state-wise list           From day one I could feel tremendous
     of missing email ID and it was worked upon until         enthusiasm not only in the nominees but also in
     we had retrieved many emails and mobile                  life members. We were overwhelmed to receive
     numbers from fellow members, pharma help                 hundreds of emails and phone calls every day at
     etc. These were then cross-checked, verified and         our secretary office. The same was the case with
     then included in the final list of 1917 emails in all.   the election office at Lucknow of Dr. Suryakant
                                                              sir. All these revelations made me understand
     I personally made almost 200-250 phone calls
                                                              that doctors were a little less tech-savvy as
     just to ensure we had the correct email ID on a
                                                              presumed earlier or/ and indeed very busy in life
     regular basis. Some marketing applications like
                                                              to have time to read through our instructive
     MailChimp helped me to understand the bounce             emails and fish out the CDSL email from their
     emails and cleaned them as well. This exercise           respective registered accounts with I C S.
     also helped us clean our data and make it                Members most common complaint was they had
     accurate. I really thank all our GB members for          not received the user id and password required
     their kind support during the retrieval exercise of      to perform e-voting. Actually, our emails privacy
     emails.                                                  and server settings are the players here and a lot
                                                              depended on them. The CDSL emails would end
     A trial e-voting was also conducted a month              up in spam, junk or any other section which was
     prior with all GB Members to accrue faith in the         not visible immediately and needed to be dug
     system. The motive here was to understand the            out among so many other emails received on a
     system well so that there were no glitches during        daily basis which led to panic in some members.
     the actual process. Feedbacks and suggestions
     from the esteemed GB members were noted                  The whole process was just three simple steps:
     and implemented in the final e-voting                    1.Click on Shareholders/Members on the
     accordingly.                                             www.evotingindia.in
                                                              2.Enter Userid and Password along with captcha
     The final e-voting was held from 1st Aug 12 am to        code whenever required
     20th Aug 11.59 pm. There were in all 21 nominees         3.Choose among the nominees , Vote and submit
     fighting for the Post of President, Vice-President
     and Member, GB. To help members know the                 But this sadly seemed to be very confusing
     nominees well and to make them take an                   initially with members copy pasting their
     informed decision we had a one-pager designed            credentials and putting passwords in the place of
     for all nominees which would be displayed on             Captcha codes. The captcha basically checks if
     the website along with their names. The data             the person using the system is a robot/malware
     was given to the CDSL team with Dr. Suryakant,           thereby ensuring that the whole e-voting
     Election officer and Past President of ICS being         process is safe, secured not succumbing to any

16
deceptive intent. And hence system does not            laws of ICS can't vote. Many of them then
take copy paste of user IDs and password.              promptly sent their degrees that they had
                                                       forgotten to submit to let their associate
Based on queries and difficulties the voters faced     membership be converted to life membership.
we promptly compiled a FAQs (Frequently Asked          ICS Membership almost doubled of average per
Questions) and mailed them to all our members.         month with 46 new life members in the month of
The frequency of doubts reduced after that but         A u g u st a n d t h ey a l l wa nte d to e -vo te
until the end, we continued to help the e-             immediately since life-members only till 30th
voters..! Also, our nominees who were also very        June were allowed to vote we had to ask our
actively campaigning themselves as allowed in          members to wait for the next year elections ….!
democratic election process cleared many               Correct Address, emails phone numbers and
doubts of members and really helped us majorly         new life members were all a result of the
during the election process in getting huge            enthusiasm that ensued during e-voting.
numbers in e-voting. We sincerely acknowledge
nominees & voter's cooperation, patience and           Out of all the successful emails delivered and
enthusiasm but at the same time seek                   seen by the Life Members, we were happy that
forgiveness if they had to face some                   94% people voted while the overall voting was
inconveniences.                                        62%. On an average 54-56 people voted daily
                                                       which was not a bad number for the first time e-
Some members who were really understanding             voters of ICS. We are also happy that 1117 votes
and were tech-savvy could finish the process in        were registered in all which were more than two
one go. All in all, since this was the first time we   times of what we recorded earlier the previous
at the Election Office expected some problems          high through ballot paper election voting being
and were ready always to help the members in           only 526.
casting their e-votes. I am happy to share that we
could successfully resolve 98% queries coming          Just to make ICS Members more tech savvy I
through all modes in our offices very promptly         have some information on email use and
although we could not help some of them who            technology,
had not even updated their old postal addresses
leave alone email and mobile numbers. But the
                                                       1. Always log out from your email account when
e-voting prompted them to at least contact us
and let us correct their contacts. The                 you have finished your emails, as open emails
combination of Emails, SMS and Voice Prompts           can be hacked easily.
helped us to a great extent in reminding the busy      2. Never copy-paste any user id and password for
doctors about ICS Elections throughout the             logging in.
process. A special contest to promote and              3. Keep all your junk and spam folders clean.
motivate voters to e-vote was thought of SELFIE        4. Check emails in all the sections of your email
with the device used for e-voting was conducted        account.
as well and our ICS Facebook page filled with          5. Keep updating your passwords regularly as
members selfies pouring in. So much was the            they also carry important information like bank
enthusiasm that enquiries came from Associate
                                                       account details.
Members to enable them to vote which as per By

                                                                                                            17
Kindly see that you always update your email and          Dr. Jyoti working hard in the election back office at
     mobile numbers whenever you change them and               Lucknow for her prompt actions and all GB
     prompt others including your colleagues to do so.         members for trusting me motivating me
     Re s o l v e t o e n c o u ra g e m o r e a n d m o r e   throughout the election journey. I humbly
     Pulmonologists to become members of Indian                apologize for any mistakes that inadvertently
     Chest Society. And yes just one day before the e-         might have happened.
     voting had begun I met with an accident and had           Concluding I congratulate all the winners and also
     compound fractures in my left toes, but since we          the nominees for participating in this historic e-
     were striving hard to make this maiden e-voting           elections of ICS.
     effort a resounding success I could not rest at all       They say all's well that ends well and this was
                                                               hence proved true...
     and my enthusiasm which was matched in equal
     amount by our revered members made me forget
                                                               Best Regards,
     my pain. I am sincerely thankful to Dr. Rajesh            By Mrs. Sakshi Deshmukh, B.E,M.B.A (Mktg),
     Swarnakar for his vision, Dr. Suryakant for his           Office Executive, Indian Chest Society, Nagpur
     supervisory skills,

                       Your feedback and suggestions are welcomed @ icsofficeexecutive@gmail.com or
                                        visit our website www.indianchestsociety.com

18
Congratulations To The Winners Of
             ICS GB Elections 2018.
  On behalf of the Indian Chest Society, we welcome all our newly elected
   GB members and wish them all the best for their tenure. Here is their
                       introduction and vision for ICS

Dr. D. J. Christopher,
President-Elect
MBBS, CMC (Vellore), PG MMC(Chennai),
advanced training UK and Australia

 Past Professional Experiences:

 Fellow of ICS, Royal college(UK), ACCP, Asia Pacific Society
 Research awards Grand challenges, RePORT India(TB)- NIH & DBT & others. Coveted Ida-Scudder
 research chair(CMC, Vellore)
 130 publications, 12 chapters, 200 invited lectures
 HOD CMC, Vellore- ranked 3rd Nationally - the Week Neilson survey. Set up MD, Postdoc fellowships
 in Pulmonology & Allergy and BSc (respiratory therapy).
 Annual workshops in Allergy, bronchoscopy, thoracoscopy and ultrasonography
 Admin Experience: Deputy MS & Assoc Director
 2 terms ICS South zonal chair – Several workshops, new initiatives & state societies
 Founder- former president Indian association of respiratory care (IARC)

 Vision For ICS :

 ICS a vibrant organization will be made stronger and richer. Reciprocal membership with ERS be
 extended to APSR, ACCP etc. and efforts to elevate ICS to their status. ICS resources will be used
 wisely to further its objectives - Educational activities and filling the National need of quality
 research. A scientific committee will scrutinize appropriate research projects for funding.

 Advocacy role of ICS with the government and the civil society will increase. Focus on young
 trainees and fresh postgraduates, the future of ICS - offer academic input in Napcon, workshops,
 CME & conferences regionally.

                                                                                                      19
Dr. Sundeep Salvi,
     Vice President
     MD, DTCD, DNB, PhD(UK), FCCP(USA),
     FICS, Hon FRCP (Lon)

       Past Professional Experience

       Director, Chest Research Foundation
       Lecturer, BJ Medical College Pune and Sassoon General Hospitals, Pune (1991 – 1994)
       Clinical Research Fellow, Asthma Research Unit, University of Southampton, UK (1994 – 2002)
       Director, Chest Research Foundation, Pune (2002 onwards)
       Elected Member of the Governing Council of Indian Chest Society for 2 terms, with one term serving
       as Chairman, West Zone Chapter
       Member, Board of Directors, GOLD (Global Initiative for Chronic Obstructive Lung Disease)
       Member, Advisory Board, Air Pollution and Health, Ministry of Health and Family Welfare
       International Advisory Board Member, Lancet Respiratory Medicin
       Chairman, Chronic Respiratory Disease Group, Global Burden of Disease, India
       Editorial Board of several national and international journals
       Highly cited Clinician Scientist, more than 250 published papers (Google Scholar Total Citation: 6287,
       H-index 33)

       Vision for ICS:

     1. To build Indian Chest Society as a valuable knowledge generating society through promoting
        research in the field of respiratory medicine by developing research networks, research capacity and
        addressing simple, yet highly applicable and relevant research questions that will improve clinical
        practice.
     2. To develop Indian Chest Society as the prime driver of advocacy for Respiratory
        Medicine in India by working with the State and Central Governments to facilitate
        preventative and disease control healthcare policies.
     3. To develop Indian Chest Society as a premier knowledge dissemination society
        for Respiratory Medicine, through the conduct of educational activities for
        postgraduate students of Respiratory Medicine and clinicians to upgrade their
        knowledge and skills in order to relieve the suffering or people with respiratory
        diseases.

20
Dr. Raja Dhar,
ICS Governing Body Member
MD (Respiratory Medicine),
MRCP (UK) CCST (UK), FCCP (USA)

Past Professional Experiences

Working in Fortis Kolkata as the Director of Pulmonology. I set up the Department of Pulmonology
here and it has been acclaimed as a Center of Excellence in Pulmonology amongst all Fortis hospitals
in India. We have a robust academic structure with our DNB and Fellowship Programs. I completed my
MD in Respiratory Medicine in the year 2000 and thereafter went for further training to the UK.
Completed MRCP (UK) and then their structured training Program in Respiratory Medicine and
Intensive Care. I also completed an MSc in Evidence-Based Medicine from Teeside University which
has facilitated my Clinical Research work in India. I then worked as a Respiratory Consultant at St
James' Hospital in Leeds. I came back to India in 2009 and started working as a Respiratory Consultant
in Apollo before taking on my current mantle.

Vision for ICS:

I envision the Indian Chest Society leading the Academics and Research in India We have taken giant
strides in building bridges with other International Society (like ERS) but there is much more to
achieve. These bridges should facilitate training of the bright young brigade in the best of centres in
the world. I also want to build up robust training, fellowship and preceptorship programs in the
country to train Pulmonologists in Centers of Excellence. We have made some progress in furthering
collaborative Research under the umbrella of the ICS but this needs to be greatly enhanced to include
Pulmonologists from Tier 2 and 3 cities. I want to promote the concept of Electronic record keeping in
every Pulmonologists OPD so that building up robust Disease Registries becomes feasible. The ICS has
to become the mouthpiece for every Pulmonologist in the country.

                                                                                                          21
Dr. Deepak Talwar
     ICS Governing Body Member,
     DM (Respiratory & Critical Care)

        Past Professional Experiences

     1. V. P. Chest Institute Delhi worked as Resident medical officer w.e.f. July 1983 till March 1986. This was
        a three-year residency in Respiratory Diseases while doing Diploma and MD post-graduation.
     2. R. M. L. Hospital Delhi worked ad Medical officer Incharge Respiratory Labs and Senior Resident
        Medicine for three years W. e. f. April 1986 till June 1989.
     3. PGI Chandigarh worked as Post Doctoral Fellow in Pulmonary & Critical Care Medicine for two years
        w. e. f. July 1989 till June 1991.
     4. L. N. J. P. N. Hospital Delhi worked as Senior Medical officer cum Incharge Respiratory Division for one
        year w. e. f. July 1991 till April 1992.
     5. Assir Central Hospital KSA, worked as Consultant Pulmonologist for six years w. e. f. June 1992 till July
        1998.
     6. Metro Group of Hospital, worked as Director & Chair Metro Centre for Respiratory Disease w. e. f.
        August 1998 till date.

        I am working in Metro group of Hospitals for last 20 years as Director & Chair of Pulmonary & Critical
        care, which is the academic centre and has DNB training program in Pulmonary Medicine since 2008
        with 3+3 PG seats every year. We run Fellowship programs in Interventional Pulmonology, Critical
        Care, Sleep Medicine and Allergy & Immunology. We run one of the best Pulmonary Rehabilitation
        Program in the country. I have a deep interest in research and teaching activities in which I'm engaged
        for last 30 years ever since doing my Post Doctoral Fellowship in Pulmonary Medicine from PGIMER
        Chandigarh in 1991. I intend to work for better training and providing research opportunities to our
        young and fresh colleagues in all aspects of Pulmonology so that they are future ready in this ever
        expanding and developing the field.

        Vision for ICS:

        I would work for bringing new research projects under ICS banner, which would fill the gaps in the
        existing knowledge of Pulmonary Diseases in India e.g. Sarcoidosis, Exposure-related diseases and
        phenotyping of Pulmonary Hypertension and Severe airway diseases. I would also work to create
        newer opportunities to learn new and innovative interventions for our younger colleagues e.g. in
        interventions and in critical care.

22
Dr. Shubhankar Kandi,
ICS Governing Body Member
MD, FAGE, FICS FCCP (USA)

Past Professional Experiences

Chair International Council of Global Governors & Board of Regent - American College of Chest
Physicians (CHEST)
Membership Committee-CHEST
Member – Community service awards- Chest Foundation
Zonal Task Force Chairman RNTCP- SouthZone-1
Central Council Member IMA
Member – Technical Committee of TB Association of Andhra Pradesh.

  Air Born Infection Control Committee
  Technical Committee for guidelines on first line Anti-TB drugs (Daily regimen)
  Technical Committee- Indian standards of TB care.
  National Operational Research committee- RNTCPA vision for this ICS post

State Coordinator for Swine flu - Andhra Pradesh
President IMA - Hyderabad North-2013-2014
State Task force Chairman RNTCP Andhra Pradesh-2006-2010
Honorary Secretary IMA -Hyderabad North2006-2010
Treasurer AP Government Doctors Osmania Unit II - 2005
President AP Junior doctors Association-1985

Vision this ICS:

tion to the cause of Indian Chest Society. I wish to retain and further strengthen the role of ICS as a
premier organization representing professionals who promote pulmonary health throughout India.
I desire to build and strengthen the membership with innovative leadership and unflagging energy.
My vision is to involve ICS in identifying the current and future educational needs of the doctors
practising pulmonary medicine and provide quality CME initiatives towards changing clinical practice,
thus making it a vibrant organization.
I will explore the opportunities to conduct multicentric research projects under ICS banner.

                                                                                                          23
Dr. Indranil Halder,
     Zonal-Chairperson East
     MBBS, DCH, MD, FCCP, FICP

     Past Professional Experiences

     Served as a specialist medical officer in ESI Hospital of West Bengal since 1997. Conducted various
     works in occupational health under the ESI. Joined medical education as Assistant Professor in
     College of Medicine and JNM Hospital, Kalyani, under the West Bengal University of Health Sciences.
     Conducted various research works in Asthma, Allergic Rhinitis, COPD and Tuberculosis. Conducted
     various scientific seminar in District, State and National level.

     Vision for ICS:

     I will work with commitment and dedication to the cuse of Indian Chest Society. I do solemnly affirm
     that I would do the best of my ability to preserve, protect and defend the integrity of ICS and carry
     forward the untiring efforts of the previous chairpersons to uphold the responsibility of the ICS. My
     focus of action would be to conduct training programmes both for the postgraduates and regular
     updating programmes for practising pulmonologists, in newer aspects of research methodology,
     FOB, Critical Care, Thoracic Imaging, Sleep Medicine and its application in broader aspects for the
     benefit of our society at large. It is a heavy responsibility and if elected I would do my best to
     discharge my duties faithfully in the best interest of ICS.

24
Dr. Rakesh Chawla,
Zonal-Chairperson North
MBBS, MD, FCCP (USA)

Past Professional Experiences

Sr. Consultant, Respiratory Medicine, Critical Care and Sleep Disorders Delhi. He is one of the
topmost Interventional Pulmonologist with 30 + years of experience. He is a pioneer in the
endobronchial placement of glue in cases of hemoptysis. He has been conferred with appreciation
award by Honorary Dr. A. P. J. Abdul Kalam (Honourable former President of India). He was chair
(head) of the rare lung, airway and pleura disorder (USA), WABIP. He is the recipient of prestigious OA
Sarma Oration of ICS at NAPCON 2015. He is member Governing Council ICS. I am an Interventional
Pulmonologist in Delhi. I have invested my 2 years working as member governing council and is trying
to take ICS forward. During my tenure, I have done basic bronchoscopy workshops for budding chest
physician at Delhi, Dehradun, Bhiwani and Guwahati. I have done CME under the aegis of ICS with our
annual conference of Replicon India.

Vision for ICS:

My all efforts are to have academic excellence and spread education through ICS. You can have faith in
me and write me what more should be done, I should try to have those changes.

                                                                                                          25
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