ABSTRACT
Objective: To find the association of dyspnea and disease severity with anthropometric indicators of malnutrition among chronic obstructive pulmonary disease patients
Methods: The cross-sectional analytical study was carried out at Sir Ganga Ram Hospital, Lahore during October 2013 to December 2014. Total 138 adult patients with severe COPD were enrolled. The severity of disease was measured by global initiative for chronic obstructive lung disease criteria; and dyspnea was assessed by modified medical research council dyspnea scale. Anthropometric indicators of malnutrition such as body mass index [BMI] and mid upper arm circumference [MUAC] were measured to evaluate the nutritional status of COPD patients. Data was analyzed by using Statistical Package for Social Sciences version 20
Results: The mean age of 138 patients was 55±3 years. The frequency of male patients [76.8%] was threetimes higher than female patients [23.2%]. The overall frequency of underweight patients measured by BMI was 44%, which was increased to 92% undernourished patients by using MUAC. When compared with female patients, the male patients showed lower means of BMI, MUAC, FEV1% and FEV1/FVC ratio. The significant relationship of high grade dyspnea with BMI [p=0.001], and MUAC [p=<0.001] revealed that malnourished COPD patients had more shortness of breathing as compared to normal-weight patients. Similarly, the association of FEV1% with BMI [p=0.001], and MUAC [p=<0.001] showed that malnourished patients had very severe type of COPD than normal-weight patients
Conclusion: Dyspnea and severity of disease had significant association with BMI and MUAC among COPD patients. Thus, assessment of nutritional status by measuring BMI and MUAC should be considered to predict the severity of disease among adult COPD patients
ABSTRACT
To evaluate the Ankle Brachial Index [ABI] in the detection of peripheral arterial disease [PAD] among diabetic patients. Diabetic clinic of PMRC Research Centre, Fatima Jinnah Medical College, Lahore. Cross sectional descriptive. This pilot study included 95 diabetic patients with ages 40 years or above and duration of the disease was more than 5 years. Detailed history including treatment was documented. During examination systolic blood pressure in the right and left arms [Brachial Pressure] was measured and documented. Systolic Blood Pressure in both ankles was measured using ultrasound Doppler probe [Huntleigh Super Doppler - II]. Left and right ABI were obtained by dividing brachial systolic pressure with ankle systolic pressure. A ratio of 0.9 or above was taken as normal. The study included 95 patients [15 males and 80 females] with mean age 51.90 +/- 9.49 years and mean duration of diabetes 13.23 +/- 5.83 years. Smoking was observed in 53.30%, hypertension in 57.89% and 71.57% had dyslipidemia. ABI ratio was mildly abnormal in 52.68%, moderately abnormal in 7.38% while it was normal in 38.94% cases. Duration of thedisease was negatively correlated [r = - 0.650 and 0.937] with ABI and correlation was highly significant [p < 0.047 and 0.008]. Blood sugar and lipid levels were not significantly correlated with ABI. The results conclude the detection of high percentage [60.08] of abnormal ABI in this group of patients. Ankle brachial index, a non-invasive and simple technique, may be used to screen the detection of PAD and diabetic foot