ABSTRACT
Background: Peak Expiratory Flow (PEF) is a value test for lung function and can be conveniently measured by using relatively inexpensive and portable Peak Flow Meter, identifying and assessing the degree of airflow limitation of individuals. While PEFR is obviously related to factors like age, weight, height, race, gender, it may also be additionally affected by seasons and climate. The purpose of study being to observe seasonal variation in PEFR amongst school going children and to observe peak expiratory flow rate in school going children in urban and rural areas.Methods: This prospective and comparative study was carried out on total 600 children; with 300 each from rural and urban schools, of age group 10-14 years, both sexes. Peak expiratory flow meter was used for the measurements in the seasons of summer (April to June) and winter (December to February) of the year. The results thus obtained were compiled and analysed.Results: The mean PEFR value (Litres/min) during summers in the rural children was 243.50(S.D.=16.050) while during winters was 253.63(S.D.=16.934), highly significant (p<0.001); mean PEFR summers in the urban children was 241.50(S.D.=20.530)and during winters was 249.93(S.D.=21.685), again highly significant (p<0.001).In both rural and urban groups PEFR values increased with increase in height and weight of the children which was found to be highly significant (p<0.001). Girls representation proportion in rural vs urban schools being 49% vs 45%; whereas boys being 51% vs 55% respectively.Conclusions: Peak expiratory flow rate decreased during summer season of the year in both rural and urban school attending children. In both the groups PEFR values had a direct correlation with height and weight of the children. Rural schools showed more girl student representation than their urban counterparts indicating more awareness for girl child education amongst rural population.
ABSTRACT
Background: Chronic respiratory diseases are among the leading causes of morbidity and mortality worldwide with chronic obstructive pulmonary disease (COPD) and asthma being the most common. There is under-utilization of the basic tools of inhalation therapy technique(s) in their management. Implementation of a personalized educational and demonstrational intervention by the attending physician during regular follow-up visits of these patients will substantially improve the treatment outcome.Methods: This prospective interventional study was conducted on 239 diagnosed cases of asthma and COPD. Inhaler technique was assessed in accordance to standard checklist and errors were corrected by a practical demonstration. A follow-up assessment was conducted for the same after 2 weeks. Data thus collected was evaluated.Results: Out of 239 patients, 47.6% (n=114) reported for follow-up assessment. Average reporting time for follow-up assessment was 27.4 days. Amongst them, an improvement of at least one step was found in 86.8% (n= 99) and about 28% (n=32) patients performed all steps correctly. Average number of steps improved was 2.1.Conclusions: Majority of the patients showed an improvement in the inhaler technique during follow-up assessment after an educational intervention and practical demonstration. Near perfection was achieved by about more than quarter of the patients. Regular practical demonstration of the inhalation technique during subsequent follow-up sessions unequivocally improves results.
ABSTRACT
Background: The dual epidemic of tuberculosis and HIV is a significant problem in the developed and developing countries. Tuberculosis is the most common human immunodeficiency virus related opportunistic infection in India and caring for patients with both diseases is a major public health challenge. Aim: The aim of the present study was to record the different clinical patterns of tuberculosis in HIV co-infected patients as a function of CD4+T cell count. Material and Methods: The study was a retrospective analysis of the HIV-TB co-infected patients admitted in the Chest and TB Hospital, Government Medical College, Amritsar (Punjab) during the calender year 2011. Results: Out of total 47 HIV sero-positive patients (n=47), 36 were males (76.59%) and 11 females (23.41%) of age group 14 to 51 years. Cough was the most common presenting symptom (72.34%).A large number of patients were diagnosed as having pulmonary tuberculosis (48.94%). The other diagnoses were tubercular meningitis (n=4), pleural effusion (n=4), tubercular lymphadenopathy (n=2), pneumothorax (n=2), hydropneumothorax (n=2) and abdominal tuberculosis (n=2). A total of 34 (72.34%) patients were having a CD4+T cell count of < 200. Conclusion: The manifestations of tuberculosis in HIV infected patients are quite varied and generally show a different pattern as a function of CD4+ T cell count. Co-infection with HIV infection leads to difficulties in both diagnosis and treatment of tuberculosis. High degree of suspicion of tuberculosis, with astute clinical and laboratory evaluation is the key for early diagnosis and management.