Early effects of vertical banded gastroplasty on pulmonary function tests

The aim of this study was to obtain a numerical assessment of the effect of vertical banded gastroplasty [VBG] on different pulmonary function tests [PFTs]. The study included 21 morbidly obese patients who had PFTs measured preoperatively and six months following VBG. Changes in the mean body mass index [BMI] and PFTs were analyzed using paired t test. Six months following VBG there was a significant BMI reduction from a mean of 49.64 +/- 8.44 kg/m2 to 38.01 +/- 6.46 kg/m2. There was a highly significant improvement in restrictive pulmonary dysfunction represented by changes of mean SVC from 3.13 +/- 10.47 L to 3.33 +/- 0.53 L and mean FVC from 3.07 +/- 0.5 L to 3.33 +/- 0.5 L. There was also a significant improvement in obstructive pulmonary dysfunction represented by changes of mean PEFR from 5.58 +/- 0.85 L/S to 6.12 +/- 0.94 L/S and mean FEVl from 2.54 +/- 0.42 L to 2.81 +/- 0.41 L. The FEF75% was significantly improved from 0.81 +/- 0.13 L/S to 0.94 +/- 0.18 L/S. Also, the peak inspiratory flow rate [PIFR] showed a significant improvement from 5.1 +/- 1.32 L/S to 6.01 +/- 1.03 L/S. The overall lung performance significantly improved as evidenced by elevation of ERV from 0.63 +/- 0.2 L to 0.93 +/- 0.24 L. MVV, which reflects work of breathing, also revealed significant improvement from 88.9 +/- 15.41 L/min. to 98.35 +/- 17.01 L/min. It was concluded that VBG produced highly significant improvement in both restrictive and obstructive PFTs as well as overall lung performance in a period of six months. Also it produced a significant improvement in the work of breathing

Effect of inhaled corticosteroids on intraocular pressure in COPD patients

The extent to which inhaled glucocorticoids increase the risk of intraocular pressure elevation has been controversial. To assess such risk attributable to fluticasone an inhaled glucocorticoide used in asthma and COPD therapy. COPD pts. with FEV1 < 50% on spirometry were identified as candidates for treatment with inhaled corticosteroids, according to GOLD criteria. Patients were divided into 2 groups: Group 1: Received a diskus device containing 50 micro grams of salmeterol [as xinafoate] and 250 micro gram of fluticasone propionate. Group 2: Received the same diskus device but containing 500 micro grams of fluticasone propionate [high dose inhaled corticosteroids]. Both groups received treatment. For 12 weeks and their intraocular pressure was measured using Applanation Tonometry before and after treatment. No fluticasone treatment effect on the intraocular pressure was evident in both groups. No association with an increased intraocular pressure was observed in COPD pts treated with fluticasone propionate at daily doses ranging from 500-1000 micro grams for duration of 12 weeks

use of fiberoptic bronchoscope in removal of inhaled turban pin

Straight pins are used extensively for securing facial scarves in women and girls in the islamic countries. Accidental aspiration often results in the pin lodging in the segmental bronchus with the sharp end pointing cephalad. The aim of this study is to find out the role of fiberoptic bronchoscope in the removal of inhaled pins. This study was carried out at the chest department, Kaser El-Aini Hospital and included 40 cases, all were females and their mean age was 16.4 +/- 2.98 years. 24 cases where referred after failure of removal of the pin by using the rigid bronchoscope and 16 cases where referred directly from the emergency hospital to the chest department without trial of rigid bronchoscopy. All cases were subjected to thorough history taking and clinical examination, chest X-ray postero-anterior view and fiberoptic bronchoscope for examination of the tracheo-hronchial tree and removal of the inhaled pin. The inhaled pin was removed, by the fiberoptic bronchoscope in all cases without any complications

Study of whole blood glutathione peroxidase enzyme activity and serum selenium level in bronchial asthma and COPD

This study was carried out in Kasr El-Aini Hospital and included 70 age and sex matched subjects who were divided into three groups. Group I included 25 patients with bronchial asthma, group II included 25 patients with COPD and group III included 20 healthy volunteers. The aim of this work was to study the relation between serum selenium level and whole blood GSH-Px activity and inflammation in bronchial asthma and COPD and if they have a correlation with the severity of the disease. All patients were subjected to history taking, clinical examination, ventilatory pulmonary function test and measurement of serum selenium level and whole blood GSH-Px activity. Serum selenium level and whole blood GSH-Px activity have a role in the pathogenesis of inflammation in bronchial asthma and COPD where they act against the oxidative stress. The reduction of serum selenium level and whole blood GSH-Px activity is correlated with the clinical and functional severity of the disease. Dietary supplementation with selenium and glutathione may have a role in the treatment of bronchial asthma and COPD