Role of spacer device in improving FEV1 and PEFR in asthmatic patients

Objective: to study the role of spacer device in improving FEV1 and PEFR in asthmatic patients

Material and Methods: in this quasi experimental study, fifty asthmatics patients, already on inhaled therapy, visiting outpatient department of Jinnah Hospital Lahore were included

Results: while assessing the improvement, the mean FEV1 [mean+/-SD] was 1.46+/-0.42 litres, 1.97+/-0.76 litres, and 2.32+/-0.39 Litres at first, second and third visits respectively. The improvement in FEV1 was found to be significant after the use of spacer device [p < 0.001]. The mean PEFR [mean +/-SD] was 163.34+/-58.56 L/min, 271.68+/-69.12 L/min, and 346.66+/-64.15 L/min at first, second and third visits respectively. The improvement in PEFR at second and third visits as compared to first visit was statistically significant [p = 0.001]

Conclusion: FEV1 and PEFR significantly improve after the use of spacer device

Cervicofacial emphysema

The case describes a young girl developing cervicofacial emphysema after fall. She presented in emergency with gradually worsening upper body swelling without any sign of distress. Swelling was found on the right side of the face, all around the neck and right arm with crepitus in all these areas. CT scanning of head, neck and chest were performed and a small area of communication between nasopharynx and the trapped air of subcutaneous emphysema was seen. Video-endoscopy of the pharynx showed a tear in the nasopharyngeal mucosa acting as a one way valve leading to the development of cervicofacial emphysema

Pulmonary alveolar microlithiasis

This is a case report of 32 years old male, who presented in outdoor clinic of Pulmonology Department, Jinnah Hospital, Lahore, with progressively increasing shortness of breath over 2 years, multiple episodes of dry cough over 9 months, history of low-grade fever for 15 days and haemoptysis for the last one day. He was diagnosed as a case of miliary tuberculosis on the basis of his chest X-ray findings and was on anti-tuberculosis treatment by the GP of the locality. Diagnosis of pulmonary alveolar microlithiasis was made on the basis of clinical features and laboratory findings