ABSTRACT
Introduction: Obesity causes reduction of Lung compliance leading to decrease in lung volumes producing mostly a restrictive type of ventilatory defect. Compression of the thoracic cage by excessive fat and increased pooling of blood in pulmonary vasculature mainly contribute towards a reduction in respiratory compliance. Deposition of fat in diaphragm causes mechanical obstruction to the descent of diaphragm thereby causing increased work of breathing and metabolic demand thereby producing breathing difficulty. The aim of the study: To measure the association of body mass index (BMI) to lung volumes assessed by a digital spirometer. Materials and methods: Apparently healthy individuals above the age group of 15 years attending Master Health Check-up OP and attenders of in-patients of wards of general medicine department, Govt. Chengalpattu Medical College, Chengalpattu of either gender were recruited. Height and weight were measured and BMI was calculated as kg/m2 . Subjects were categorized as normal (BMI=18.5 to 24.9 kg/m2 ); overweight (BMI=25 to 29.9 kg/m2 ); obese Class 1 (BMI=30 to 34.9 kg/m2 ) and obese class 2 (BMI=35 to 39.9) on the basis of BMI. Lung volumes were measured by digital spirometer and were reported as a percentage of predicted values for forced vital capacity (FVC%), forced Vasanthakumar M, Gnanaprakasam J. A cross-sectional analytical study on the association of body mass index to dynamic lung volumes – assessed by digital spirometer in a tertiary care hospital in Chennai. IAIM, 2018; 5(5): 121-128. Page 122 expiratory volume in the first second (FEV1%) and the ratio of FEV1 to FVC (FEV1: FVC). Groups were compared using t-test and ANOVA, the correlation was assessed by Pearson's 'r'. Results: Significant differences in lung volumes were found in different BMI categories. Obese subjects had significantly lower FVC% and the significant difference calculated by using One Way ANOVA F = 11.9 with p = 0.0001. Similarly, obese participants have significantly lower values of FEV1% when compared to participants of normal BMI. The significant difference calculated by using One Way ANOVA F = 6.46 with p = 0.0001. Gender and age had no significant effect on mean values of PFTs. Conclusion: Obese individuals in this sample had a significant decline in lung volumes. The presence of nutritional abundance and a sedentary lifestyle, and importantly influenced by genetic endowment, this system increases adipose energy stores and obesity develops which produces adverse health consequences.
ABSTRACT
Introduction: Giving more fluid causes edema and less gives rise to hypoperfusion causing improper delivery of oxygen and substrate leads to cellular dysfunction and multiorgan dysfunction involving the brain, liver, kidneys, heart, lungs and causing death. Diffusion, filtration, osmosis and adequate reabsorption help in continuous exchange of water and solutes among compartment. Daily water intake from the food and water get equalized with losses in the kidneys as urine, from the gastrointestinal system as feces and evaporation of water through lung and skin. Various hormones like Angiotensin II, Aldosterone ADH, Atrial natriuretic peptide maintain sodium and water balance and hence volume status. To maintain normovolemia there is every need for meticulous evaluation for patient Volume status in each patient for adequate volume replacement. Aim of the study: Correlating the Clinical Assessment of Volume Status to the volume assessment By Echocardiography using Respiratory Variation in Inferior Vena Cava Diameter. Gnanaprakasam J, Vasantha Kumar M, Praveenkumar M, Lakshmi Priya R. Study on clinical assessment of volume status and correlation to the respiratory variation in inferior vena cava diameter by echocardiography, a non-invasive method of measuring volume status. IAIM, 2018; 5(5): 104-110. Page 105 Materials and methods: Study population consisted of 200 patient of medicine department both inpatient and outpatient of Chengalpattu Medical college. The patient was examined clinically, history suggestive of volume depletion and history suggestive of volume overload were noted, signs and symptoms of both hypovolemia and hypervolemia were noted. Echocardiography was used as a noninvasive method of measuring volume status. Results: Correlation of assessment of volume status by the clinical method and IVC method as low, normal and high was represented. Correlation – 0.797, P value < 0.001 which tell that there was a statistically significant correlation between your two variables. That means, increases or decreases in IVC do significantly relate to increase or decrease. Conclusion: The use of echocardiography as a non-invasive mode of volume assessment is helpful to empower the clinical assessment methods and hence improves diagnostic accuracy.