ABSTRACT
Background: Forced expiratory volume in 1 second (FEV1) to forced vital capacity ratio (FVC) is being used to diagnose the obstructive lung diseases. Forced manoeuvre (FVC) or relaxed/slow manoeuvre (SVC) can be used to determine vital capacity (VC). In healthy individuals the difference between SVC and FVC (SVC-FVC) is minimal whereas in the presence of airway obstruction this difference will become significant. The present study was done with the objective to detect and compare the airway obstruction by determining the FEV1/FVC and FEV1/ SVC ratios.Methods: This was a prospective cross-sectional study done at OPD, Government Thiruvoteeswarar hospital of thoracic medicine/Kilpauk medical college during the period from September 2016 to February 2017among the patients presenting with symptoms of obstructive airway disease. The sample comprised of 353 patients who underwent spirometry according to standard of ATS/ERS guidelines. As per the criteria, the patients are classified into four groups, by spirometry.Results: The analysis of FEV1/FVC revealed the presence of airway obstruction in 131 (37%) individuals compared to 165 (46%) individuals by the analysis of Fev1/SVC ratio. In the obstruction and mixed groups, the difference in vital capacity SVC – FVC is statistically superior (p<0.05) when compared to normal and restriction groups.Conclusions: The FEV1/SVC ratio detected the presence of airway obstruction in more individuals than did FEV1/FVC ratio and hence FEV1/SVC considered as more reliable factor in the detection of obstructive airway diseases.
ABSTRACT
Background: Cigarette smoking is a major public health problem and is the most important cause of chronic obstructive pulmonary disease (COPD). This study shows the importance of smoking cessation for improvement in respiratory function and quality of life and brings out the potential usage of pharmacological and behavioural therapy for the same.Methods: This prospective study was conducted on 50 male smokers at Kilpauk Medical College, Chennai. During the treatment only 43 patients were continued till the end of follow up. During the period, varenicline treatment was given for three months as per schedule, regular periodic counselling was given to these patients and followed up for a period of 1 year. Forced expiratory volume at one second (FEV1), COPD assessment test (CAT) scoring, 6 min walk test (6MWD), BODE index, was taken before starting therapy and on 3rd month and at the end of one year of follow-up. All the values obtained were analysed statistically.Results: The mean age of the 43 patients was 44.7±7.34, mean BMI was 22.27±4.24. The mean difference between pre and post treatment scores of CAT, 6MWD and BODE index were found to be statistically significant (p<0.0001).Conclusions: Combined behavioural counseling and pharmacotherapy with varenicline significantly improved the odds of achieving tobacco abstinence in the participants by the end of one year of treatment.
ABSTRACT
Background: Non-resolving pneumonia is a problem not only for the patient but also to the treating physician because establishing the cause for the non-resolution of pneumonia takes time and requires invasive investigations. The present study was done with the aim to evaluate the etiology and clinical outcome of non-resolving pneumonia by using fibre-optic bronchoscopy (FOB).Methods: This prospective study was done on 45 patients with symptoms and signs of non-resolving pneumonia attending the Govt. Thiruvotteeswarar Hospital of Thoracic Medicine, Otteri, Chennai, a tertiary care teaching centre, during the period January 2016 to December 2016. All the patients were investigated systematically to find out the etiological factors for non-resolution pneumoniaResults: Males preponderance was seen in the study (80%). Patients of age group 51-60 years are more affected (26.6%). Bacterial pneumonia not responding to empirical antibiotics (42.2%) was the most common cause followed by pulmonary tuberculosis (28.8%) and malignancy (24.4%). On FOB, inflammation with secretions was noticed in most of the patients (66.6%).Conclusion: The findings of the study concluded that apart from bacterial pneumonia not responding to empirical antibiotics, tuberculosis and malignancy were found to be the major causes of non-resolving pneumonia. Hence, it is necessary to observe every patients for the adequate response to treatment and to utilize other modalities of investigations like FOB,CT guided FNAC/biopsy whenever required to offer exact management to the patients.
ABSTRACT
Background: The study was conducted with the aim to evaluate the pre-treatment drug susceptibility profile and to assess the influence of drug resistance on treatment outcome among patients treated with category- II (cat- II) regimen under programme conditions.Methods: This study was conducted on 58 smear positive patients with history of previous anti-tuberculosis treatment for more than one month, comprising cases of ‘Failure’, ‘Treatment after Default’ (TAD) and ‘Relapse’. They received cat- II regimen in Chennai Corporation, RNTCP (revised National tuberculosis control programme) centers from July 2006 to September 2006 and they were monitored upto July 2007 as per RNTCP guidelines to assess the outcome of cat-II treatment by sputum smear status.Results: Male dominance (n=40) was seen in the study participants. Most common age group affected was 35-44 years (n=20). Out of 57 cases, 50.9% cases come under ‘Relapse’, 26.3% arises from ‘TAD’ and 22.8% cases were from ‘Failure’. After completion of treatment with cat-II regimen, out of 57 patients 33 patients were cured and 11 cases were into the category of failure, 10 patients were defaulted during treatment and 3 were died.Conclusions: Besides, the low treatment efficiency in MDR-TB cases, cat- II regimen was effective in sensitive and INH resistant cases.