Systolic blood pressure response to valsalva maneuver in cases of Chronic Obstructive Pulmonary disease

To observe the systolic blood pressure response to Valsalva maneuver in cases of chronic obstructive pulmonary disease [COPD]. To correlate the Valsalva responses with left ventricular ejection fraction [LVEF]. In all subjects the standard Valsalva maneuver was performed in the supine position and systolic blood pressure responses were characterized as a [a] Sinusoidal [Normal] [b] Absent over shoot and [c] Square wave [Abnormal]. LVEF was performed in all COPD subjects. Setting: Physiology Department BMSI, Medical Department, Chest Medicine Department J.P.M.C. and NICVD Karachi. A total of 95 male subjects were included, during the course of present study, out of which 30 subjects were healthy controls and 65 subjects were COPD with and without Cardiac failure. The Valsalva responses were strongly correlated with LVEF. Sinusoidal response was observed in all [100%] healthy control subjects, 21 [60%] of the 35 COPD subjects without cardiac failure and only 1 [3.33%] of 30 COPD subjects with cardiac failure, Absent overshoot was observed in 14 [40%] of the 35 COPD Subjects without Cardiac failure and 5 [16.67%] of the 30 COPD subjects with cardiac failure, square wave response was only observed in 24 [80%] of the 30 COPD subjects with cardiac failure. LVEF of 22 sinusoidal responses is 74.36 [ +/- 1.30], while 19 absent over shoot responses is 46.47 [ +/- 2.67] and 24 square wave responses is 29.67 [ +/- 1.69]. It is concluded that in the presence of physician systolic blood pressure response to Valsalva maneuver is a simple, safe and non-invasive technique than the more sophisticated test LVEF in early detection of cardiac failure

Smoking effect of passive on children's pulmonary function tests

Until recently, relatively few studies have focused on the health effects of passive or involuntary smokers. This study was planned to see the effects of passive smoking on pulmonary functions in children of both sexes. Pulmonary function tests of 100 children, 50 passive smokers [38 males and 12 females] and 50 non-passive smokers i.e. controls [36 males and 14 females] were performed on a computerized s-Model Vitalograph psirometer in Pakistan Medical Research Council, Research Centre, Jinnah Post-graduate Medical Centre, Karachi. Amongst male passive smokers, there was statistically significant reduction in FEV/FVC% FEF 25%-75% and PEF [P<0.001]. Also FEV/VC% and MVV were significantly low [P<0.01]. Amongst female passive smokers FEF 25-75% showed a highly significant decrease [P<0.001], whereas FEV/FVC% and PEF were low [P<0.01]. Both sexes i.e. male and female passive smokers consumed more time for forced expiratory flow 25-75% as compared to controls [P<0.001] and [P<0.01] respectively

Ventilatory lung functions and absolute eosinophil count in adult asthmatics

Ventilatory lung functions and peripheral blood eosinophil count have proved valuable screening guidelines both in diagnosis and prognosis of asthma. Furthermore, blood eosinophilia differentiates asthma from other inflammatory conditions of the airways. The present study was planned to ascertain the role of absolute eosinophil count in impairment of ventilatory lung functions of asthmatic subjects [both sexes, aged 15-45 years] attending out patients department of Thoracic Medicine at Jinnah Postgraduate Medical Centre in [JPMC] Karachi. 30 healthy controls and fifty asthmatics were investigated. Ventilatory lung functions were recorded by Autospiro [Model - AS500] Spirometer, whereas, peripheral blood eosinophil count was determined by direct method. The data revealed absolute eosinophil count/ul 137.13 ' 17.81 and 201.86' 28.64 [Mean ' S.E.M.] in male and female controls respectively. The eosinophil count/ul in asthmatic counterparts were found to be 442.0' 48.52 [Mean ' S.E. M.] which were statistically significant [P<0.001] as compared to controls. The asthmatics exhibited a trend of decline in forced vital capacity [FVC], forced expiratory volume in first second [FEV1], FIEF 25-75, and peak expiratory flow rate [PEF] in relation to increasing absolute eosinophil count. The present data suggest the reciprocal impairment of ventilatory functions in asthmatics with an increase in absolute eosinophil count. It reflects the critical role of eosinophils in the spasm and inflammation of the airways