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Background: Flexible bronchoscopy is an essential tool in diagnosing and managing pulmonary diseases. However, there is limited capacity for bronchoscopy in low and middle income countries (LMICs). In 2019, a pilot program for flexible bronchoscopy training was launched for local physicians in Kampala, Uganda. We then conducted a follow up multimodal bronchoscopy course after 2 years.
Objective: The aim of this study is to assess a longitudinal multimodal bronchoscopy training in an LMIC setting.
Methods: A multimodal follow up curriculum was developed with pulmonologists from Uganda and the United States. The training was delivered to Ugandan providers who attended previous bronchoscopy training and new participants. The training included a prepared curriculum consisting of lectures, simulations, and deliberate practice-based proctoring. A 12-question multiple-choice exam was administered at the beginning and end of the course, assessing knowledge. Procedural competency was measured using a validated assessment tool called the BSTAT (Bronchoscopic Skills and Tasks Assessment Tool). Results were analyzed to evaluate the retention of knowledge among those who took part in previous training and the efficacy of the follow-up curriculum for participants without previous training.
Results: Among the participants who attended didactic training in 2022 (11), mean exam scores were improved after training, from 43.9 (standard deviation [SD], 11.3) to 59.8 (SD, 16.1) (mean difference [MD], +15.9; SD, 13.9; = 0.008), but were lower compared with post didactic scores in 2019: 90.8 (SD, 6.1; MD, -31; < 0.0001). Participants who completed BSTAT assessments (8) had mean scores similar in 2019 and 2022, at 72.1 and 75.2, respectively (MD, 3.1; = 0.38).
Conclusion: This study provides an example of how a longitudinal multimodal bronchoscopy curriculum can improve competency and proficiency for local physicians in an LMIC.
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http://dx.doi.org/10.34197/ats-scholar.2022-0080OC | DOI Listing |
Cureus
August 2025
Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Esophageal-respiratory fistulae are abnormal communications between the esophagus and the respiratory tract, most commonly appearing as tracheoesophageal or bronchoesophageal fistulas. Esophago-pulmonary fistulas represent a rare subtype, typically associated with malignancy, and may lead to severe complications such as lung abscesses. We report a case of a 58-year-old male patient who presented with a two-week history of fever, foul-smelling mucoid sputum, dyspnea, dysphagia, and weight loss.
View Article and Find Full Text PDFBMJ Open
September 2025
San Donato Hospital, Arezzo, Italy.
Introduction: Flexible bronchoscopy (FB) is widely used for diagnostic and therapeutic procedures in pulmonary medicine. However, FB can cause respiratory and haemodynamic complications, especially in patients with pre-existing lung and/or cardiovascular comorbidities. Despite the range of oxygenation and ventilatory approaches available to prevent these risks, evidence regarding their real-world application and clinical impact is limited.
View Article and Find Full Text PDFLung India
September 2025
Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Introduction: The increased risk of tuberculosis associated with inhalation corticosteroids has been demonstrated in various studies. However, the specific risk factors for developing tuberculosis in this context are less studied. So, this study was planned.
View Article and Find Full Text PDFLung India
September 2025
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Background And Objective: Oxygen desaturation events occur commonly during Endobronchial endobronchial ultrasound (EBUS) guided-transbronchial needle aspiration (TBNA) performed under conscious sedation. We hypothesized that high-flow nasal cannula (HFNC) would be superior to conventional nasal cannula (NC) in preventing these hypoxemic episodes.
Methods: We randomized consecutive subjects ≥18 years undergoing EBUS-TBNA to receive oxygen with HFNC or NC.
Int J Pediatr Otorhinolaryngol
August 2025
Department of Otolaryngology - Head and Neck Surgery, Western University, Canada. Electronic address:
Objectives: The primary objective of this study was to evaluate international practice patterns related to environmental sustainability in pediatric otolaryngology ORs, with a focus on the use of single-use versus reusable supplies.
Methods: An electronic survey was distributed using REDCap to members of an international pediatric otolaryngology WhatsApp group (n = 324). The survey included multiple-choice, Likert-scale, and open-ended questions regarding drape, gown, and glove usage for adenotonsillectomy, ear tube insertion, and laryngoscopy/bronchoscopy procedures, and broader sustainability practices including barriers and enablers.