Utilization of the pulmonary function test laboratory in the evaluation of respiratory disorders in the Al-Amiri Hospital: a secondary medical center

The aim of this study was to describe the current use of pulmonary function tests [PFT] and the degree of matching between the diagnoses at referral and after the test. Subjects and A pre-test questionnaire was administered to 464 [5-88 years] patients referred to the PFT laboratory followed by a complete PFT test. The results of the patients' tests were analyzed in terms of the diagnosis before the test, its relation to symptoms, and the rate of concordance between the diagnoses before and after the test. The most referrals were from the medical Outpatient Department; 61%] and the most frequent diagnosis before the test was asthma [31.8%]. Of the 464 patients, 34% were currently smoking cigarettes, and the most common symptoms were chronic dyspnea [30.2%] and chronic cough [19.6%]. The chronicity of symptoms showed some association with the diagnosis before PFT in the case of chronic obstructive pulmonary disease [COPD] showing the symptom of dyspnea [p = 0.05], and COPD and restrictive lung disease with cough [p < 0.05]. The overall rate of concordance in matching diagnoses before and after the test was 60.4% by consultant physicians and 51.9% by non-consultants, with an overall rate of 55% by all physicians. Our findings show that there should be better utilization of the PFT laboratory by physicians in all sub-specialities and there is a need to facilitate its use to make a better functional diagnosis

Comparison of lactose intolerance in healthy Kuwaiti and Asian volunteers

To study and compare the incidence of lactose intolerance among Kuwaiti and Asian healthy volunteers as measured by breath hydrogen level following challenge with lactose drink. Subjects and The study involved 70 Kuwaiti and 79 Asian healthy volunteers. The volunteers were physicians, medical students and other hospital workers. The study was carried out prospectively at Amiri Hospital, Kuwait. None of the volunteers was sick or had taken antibiotics or any other drug that could influence breath hydrogen level 2 weeks prior to the study. After an overnight fast 20-ml baseline samples of exhaled air were collected from each volunteer prior to oral administration of 40 g of lactose drink. Following this, the same amount of exhaled air was collected at 30-min intervals for 2 h. All samples were analyzed for hydrogen level using a Quintron microlyzer. Hydrogen level of 20 ppm more than baseline value was considered positive. The basal breath hydrogen levels were 12.49 ' 8.4 and 6.97 ' 6.9 for Kuwaitis and Asians, respectively. Thirty-three [47%] of the 70 Kuwaitis and 46 [58%] of the 79 Asians were positive for the breath hydrogen test. The clinical symptoms of flatulence, abdominal pain, and diarrhea were associated with high levels of breath hydrogen. The findings indicate that the Kuwaiti volunteers had higher breath hydrogen levels than Asians, but the incidence of lactose intolerance was similar in both groups

method to evaluate the effectiveness of treatment for tetanus with the application of life table approach

In the present study the life table approach is applied to evaluate the effectiveness of treatment for a disease of short duration namely, tetanus. Particulars of 729 tetanus neonatorum and 146 other cases of tetanus occurring in the post-neonatal phase among infants, available from hospital records were utilized for the purpose. It was observed that by the end of the 14 days of treatment, 16.6 per cent of cases would recover and 76.1 per cent would die out of the tetanus neonatorum patients who start treatment. It was observed that if the risk of death could be brought down to zero during the first two weeks, the gain in terms of number of lives saved by the end of the 14th day would be to the extent of 40 per cent. more. The direct relevance of the life table approach for the health care administrator is self evident as this helps to quantify the differential benefits occurring from patient care and that in terms of its impact on mortality and the resultant changes on survival rates