ABSTRACT
Background: Pulmonary rehabilitation (PR) is known to be therapeutically useful for COPD patients. Objective: To evaluate the effects of combination of breathing exercises (pursed lip breathing and diaphragmatic breathing) and lower extremity endurance training (LEET) as part of PR program on six minute walk distance (6MWD), on oxygen saturation (SpO2%), on the level of dyspnea and fatigue in patients with moderate stable COPD. Methods: This prospective study was conducted in the Department of Physiology, BSMMU, Dhaka from July 2010 to June 2011 on 116 male stable moderate COPD patients aged 50 to 65 years. They were enrolled from the out patient department (OPD) of the Department of Medicine of BSMMU and NIDCH Dhaka. 56 patients without PR constituted control group and experimental group included 60 patients intervened with PR. The experimental patients were advised to perform the PR program for 30 minutes duration per session at home twice daily, for consecutive 60 days along with the standard drug treatment of COPD. The control patients were advised to continue their standard drug treatment alone for consecutive 60 days. For the assessment of exercise tolerance, 6MWD, SpO2%, the level of dyspnea and fatigue of all subjects were recorded on day 0 and day 60 for both the groups. SpO2% was recorded by portable Pulse Oximeter and the level of dyspnea as well as fatigue were recorded by Modified Borg Scale. Statistical analysis was done by independent sample ‘t’ test and paired sample ‘t’ test. Results: Significant improvement were observed in 6MWD, SpO2%, the level of dyspnea and fatigue in patients who performed PR program. In addition, significant improvement in these parameters were observed after completing PR program compared to the beginning of the intervention. Conclusion: The study concludes that regular exercise of all components of PR program significantly improve exercise tolerance in COPD patients.
ABSTRACT
Background: The importance of pulmonary rehabilitation (PR) as a therapeutic measure for COPD patients is well known. Objective: To evaluate the effects of PR program by pursed lip breathing (PLB) and diaphragmatic breathing (DB) on FVC, FEV1, FEV1/FVC ratio in male patients with moderate stable COPD. Methods: This prospective study was conducted in the Department of Physiology, BSMMU, Dhaka from July 2010 to June 2011 on 116 male stable moderate COPD patients aged 50 to 65 years. They were enrolled from the out patient department of the Department of Medicine of BSMMU and NIDCH Dhaka. They were grouped as control (56 patients without PR) and experimental (60 patients with PR). The experimental patients were advised to perform PR program for 30 minutes duration per session at home twice daily, for consecutive 60 days along with the standard drug treatment of COPD. On the contrary, the control patients were advised to continue their standard drug treatment alone for consecutive 60 days. For the assessment of spirometric lung function status, FVC, FEV1, FEV1/FVC ratio of all subjects were recorded on day 0 and day 60 for both the group by a portable digital MicroDL Spirometer and the statistical analysis was done by independent sample ‘t’ test and paired Student’s ‘t’ test. Results: FVC and FEV1 value were significantly increased in comparison to the control patients after 60 days of follow up. On the other hand, post exercise value of FEV1/FVC ratio was decreased but it was not statistically significant. Conclusion: The study reveals improvement of lung functions with this sort of combination of PR program in stable COPD patients.
ABSTRACT
Background: Essential hypertension is characterized by sympathovagal imbalance that is responsible for arrhythmias and sudden cardiac death. Antihypertensive drugs restores sympatho vagal balance. Losartan and amlodipine are common antihypertensive drugs. Objective: To compare the effect of losartan and amlodipine on heart rate variability (HRV) in hypertensive patients . Methods: This prospective analytical study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from July 2012 to June 2013. For this study, 120 newly diagnosed hypertensive patients without any treatment (group B, age 30-55 years) were selected from the Out Patients Department of cardiology, BSMMU, Dhaka on their first day of visit. 60 apparently healthy normotensive subjects were also studied as control (group A). HRV of the patients were measured both before and after they were treated with two different antihypertensive drugs (losartan and amlodipine) separately. According to the selection of drug these patients were divided into two groups. Group B1 included 60 patients received losartan 50 mg daily and group B2 included 60 patients treated by amlodipine 5 mg daily. They were observed once before the treatment (B1a&B2a) and after3 months medication(B1b & B2b ) and also after 6 months medication (B1c & B2c ). For assessing HRV, Mean heart rate (HR),Mean R-R interval, Max/Min R-R interval, SDNN, RMSSD were recorded by a polyrite. Data were compared among before treatment, after 3 months treatment and after 6 months treatment. For statistical analysis ANOVA, independent sample‘t’ test and paired sample ‘t’ were performed. Results: Mean resting pulse rate, mean heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP) were significantly higher(P<0.001) and mean R-R interval, SDNN, RMSSD were significantly lower(P<0.001) in patients before treatment compared to those of healthy normotensive subjects and to the values after treatment. In both drug groups, SDNN, RMSSD,mean R-R interval were found significantly higher after 6 months of treatment compared to their values after 3 months treatment and also close to the values in normotensive subjects. In losartan group RMSSD were found significantly higher (p<0.01) and mean R-R interval,SDNN were found though higher but not significant than the corresponding values in amlodipine treated patients after 6 months treatment. Conclusion: Vagal modulation is decreased in untreated hypertensive patients which is increased by treatment with both losartan and amlodipine but the effect is more pronounced in losartan. The decreased autonomic function was improved better with longer treatment duration.