[Comparison of pulmonary function in diabetic patients with and without retinopathy compared with control group]

All pulmonary complications of diabetes have not yet been identified completely and results of limited studies available show controversial results. This study aims to determine lung involvement in diabetic patients with and without retinopathy and compare them with healthy subjects. This cross-sectional study was conducted on three groups, 33 diabetic patients with, and 33 patients without retinopathy and 33 healthy subjects as the control group. Diabetic patients were matched with the control group in terms of weight, height, age and sex. Spirometry was performed using a portable spirometer and the results compared with the appropriate statistical software. Diabetic patients did not show significant reduction in FEV1 and FVC compared to the control group [p>0.05] but PEFR showed significant reduction [p<0.001]. Mean PEFR values were lower in patients with retinopathy compared to subjects without retinopathy, difference not statistically significant [p >0.05]. FEV1/FVC was significantly higher in diabetics than nondiabetics, and also in patients with retinopathy in comparison to patients without retinopathy [p<0.001]. PEFR and FEV1/FVC values, in regard to duration of diabetes [>/= 10 Yrs], had significantly reduced and increased respectively [p=0.039, p = 0.049]. Type of diabetes control [Insulin Vs Oral agents] did not show significant changes in spirometeric parameters between patients with and without diabetes [p >0. 05]. This study showed that the pulmonary function is impaired in diabetes mellitus. Increased FEV1/FVC and decreased PEFR present a restrictive pattern in diabetic patient. And the severity of pulmonary complications seems to be correlated with other complication of diabetes [retinopathy]. Duration of diabetes has a significant association with pulmonary complications, whereas the type of treatment has no effect on pulmonary function. To design screening tests for lung involvement in diabetic patients, we need more precise and extensive studies

[ value of clinical presentation in diagnosis of reflux in noncardiac chest pain patients]

Non-cardiac chest pain [NCCP] presents as a frequent diagnostic challenge, with patients tending to use a disproportionate level of health care resources. Gastroesophageal reflux disease [GERD] is the most frequent cause of NCCP. Thus the typical symptoms of reflux like Heartburn and regurgitation, when present as predominant symptoms are quite specific for diagnosing GERD patients but in patients with NCCP the clinical diagnos of reflux is difficult and need to utilize invasive methods or omeprazol [PPI] test for its detection. The aim of the study was to evaluate the role of clinical presentation in diagnosing GERD in NCCP patients. NCCP patients underwent upper endoscoy, Bernstein test and short course of omeprazol test. the patients were divided in two groups based on the GER or non-GER related chest pain. In the end, clinical presentation of the patients was compared in two groups. GERD was considered positive as evidences of mucosal injury on upper endoscopy and or Bernstein and PPI tests had been positive together. From 78 NCCP patients [41 male; mean age 50.4 +/- 2.3], the chest pain in 35 patients [44.8%] were related to GERD. Two groups were the same based on sex and age. The chest pain; severity, site, radiation and relation to food, exercise, and sleep were the same in two groups, except two symptoms; the pain that was relived by anti-acid [p<0.031] and presence of classical reflux symptoms [p<0.009] were seen in GERD patients. It was interest that in the history of the patients, heart burn [p<0.036] and regurgitation [p<0.002] were seen in patients with GERD-related chest pain. Clinical examination is important in diagnosing GERD in NCCP. Although the chest pain is the same in reflux and non reflux related NCCP, but the symptoms of heartburn or regurgitation in present or recent past history of patients are diagnostic for GERD-related chest pain

[ value of clinical presentation in diagnosis of reflux in noncardiac chest pain patients]

Non-cardiac chest pain [NCCP] presents as a frequent diagnostic challenge, with patients tending to use a disproportionate level of health care resources. Gastroesophageal reflux disease [GERD] is the most frequent cause of NCCP. Thus the typical symptoms of reflux like Heartburn and regurgitation, when present as predominant symptoms are quite specific for diagnosing GERD patients but in patients with NCCP the clinical diagnos of reflux is difficult and need to utilize invasive methods or omeprazol [PPI] test for its detection. The aim of the study was to evaluate the role of clinical presentation in diagnosing GERD in NCCP patients. NCCP patients underwent upper endoscoy, Bernstein test and short course of omeprazol test. the patients were divided in two groups based on the GER or non-GER related chest pain. In the end, clinical presentation of the patients was compared in two groups. GERD was considered positive as evidences of mucosal injury on upper endoscopy and or Bernstein and PPI tests had been positive together. From 78 NCCP patients [41 male; mean age 50.4 +/- 2.3], the chest pain in 35 patients [44.8%] were related to GERD. Two groups were the same based on sex and age. The chest pain; severity, site, radiation and relation to food, exercise, and sleep were the same in two groups, except two symptoms; the pain that was relived by anti-acid [p<0.031] and presence of classical reflux symptoms [p<0.009] were seen in GERD patients. It was interest that in the history of the patients, heart burn [p<0.036] and regurgitation [p<0.002] were seen in patients with GERD-related chest pain. Clinical examination is important in diagnosing GERD in NCCP. Although the chest pain is the same in reflux and non refluxrelated NCCP, but the symptoms of heartburn or regurgitation in present or recent past history of patients are diagnostic for GERD-related chest pain