ABSTRACT
Chronic Obstructive Pulmonary Disease (COPD) is major cause of mortality & morbidity all over the world significantly affecting Quality of life of all the affected individuals and it also causes economic as well as social burden on society. COPD at present is the 4th leading cause of death worldwide, and is suspected to become 3rd leading cause of death worldwide by 2020. COPD diagnosis is confirmed by post bronchodilator FEV1 / FVC ratio < 0.70. In the present study, we wanted to examine the relationship between the history, clinical indices and spirometry in patients of COPD. Methods: Study was done in the department of pulmonary medicine on 50 patients of COPD, randomly selected after taking inclusion and exclusion criteria under consideration. Results: >80% of the patients were in age group of 40-70 years and mean age of presentation was 57.6 years. Smoking was present as risk factor in 62%. Most of the patients (42%) were under GOLD stage 3 followed by stage 4 (36%), stage 2 (22%) and no patients in stage 1. Duration of illness among patients ranged from 1 month to 40 years, with a mean of 7.4 years. As per new GOLD 2019 grouping criteria, maximum participants were in group B (78%), followed by group D (20%) and group A (2%). 24 out of 50 patients were in 19-25 BMI (normal) group, followed by 20 patients under <19 (low BMI) group and then 6 in >25 BMI group. We found statistically significant correlations between: FEV1/FVC ratio, MEF 25-75 and Age; between FVC and sexual difference;FEV1, FVC and MMRC Grading. Conclusion: PFT is an important tool for measuring degree of involvement of lung parenchyma in cases of COPD. It is affected by various factors, therefore a thorough history is important for assessment of level of involvement as well as for planning further management of patients.
ABSTRACT
Background: Successful treatment of TB confirming the bacteriological clearance from involved site or completion of chemotherapy does not assess structural and functional effects on the involved organ. This study has been conducted to assess the post tubercular sequelae in cured pulmonary tuberculosis patients. Methods: It was an observational hospital based study conducted on about 120 patients attending or being admitted in the department of Pulmonary Medicine after fulfilling the inclusion criteria India to assess the post tubercular sequelae by using spirometry. Results: Out of 120 patients, 20 patients were excluded from the study as they could not perform the test at all. Hence a total of 100 patients were finally enrolled in the study. The prevalence of pulmonary impairment was only 32% with predominant lung function abnormality being obstructive pattern. Conclusion: Out of 120 patients, 20 patients were excluded fromthe study as they could not perform the test at all. Hence a total of 100 patients were finally enrolled in the study. The prevalence of pulmonary impairment was only 32% with predominant lung function abnormality being obstructive pattern.
ABSTRACT
Background: Chronic obstructive pulmonary disease (COPD) is a common respiratory condition associated with high morbidity and mortality. A correct diagnosis of COPD can decrease symptoms, reduce frequency and severity of exacerbations, improve health status, improve exercise capacity, and prolong survival. Inhaler devices are mainstay in management of chronic obstructive pulmonary disease and their proper usage requires continuous training. A thorough literature search has shown limited data on the outcome of various techniques and devices used in COPD; hence this study is being done to study the outcome of use of inhalers in patients with COPD following training. Methods: This prospective, observational study was conducted on patients suffering from COPD as per Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The patients were given instructions and training correctly all patients were called after one month and spirometry parameters were assessed after one month. Spirometry and St. George Respiratory Questionnaire was administered to all participants. Results: A total of 60 patients were enrolled in study with the mean age of 49.37±17.65 years. 19 patient suffering from COPD also had concurrent diseases associated. Revolizer was used by 60% of patients. There was a significant (p<0.05) improvement in FEV1 and PEF after 1 month of proper use of inhalation technique. All patients showed a statistically significant (p<0.05) improvement in symptoms score in SGRQ. Conclusion: A significant improvement in FEV1, Ratio of FEV1/FVC and PEF was observed after 1 month, there was also improvement in Quality of life of patients.
ABSTRACT
Background: Tuberculosis (TB) is a communicable disease and it ranks second of all infectious agents due to co-infection with HIV . The causative agent of tuberculosis is a group of mycobacteria known as Mycobacterium tuberculosis complex. Mycobacterium tuberculosis complex consist of M. tuberculosis, M. bovis, M. africanum, M. microti, M. canetti. In PCR study, Most commonly sensitivity is higher in smear positive samples (95-100%) rather than smear negative specimens (46-63%). OBJECTIVE: To detection of Mycobacterium tuberculosis complex by Line Probe Assay. Methods: The study was done from non-interventional approaching study of 50 suspected patients of tuberculosis had visited the TB chest/ DOTS centre. Sputum sample collected early morning in a wide- mouth container from the patients having history of cough more than 2 weeks. Methodology used Z-N staining and for detection of MTB complex was done using MTBDR plus assay, multiplex PCR DNA strip assay (Hain Lifescience, Nehren, Gernamy) which is commercially available. M. tuberculosis secreted an important protein is MPT64, a 24-kDa protein. The major culture filtrate protein (24-kDa) is MPT64 encoded by the RD2 region genes and has been exposed to be an exact antigen that differentiates the M. tuberculosis complex from the mycobacteria other than tuberculosis (MOTT) Species. Results: In 50 samples, out of which 10 (20%) were smear positive & 40(80%) were smear negative. Out of 10 smear positive, 9 (90%) were MTB (Mycobacterium tuberculosis) & 01 (10%) was NTM (Non-tuberculous Mycobacteria) by PCR method. Out of 40 smear negative, 30 (75%) were positive by PCR method. Out of 30, 28(93%) were MTB & 02(7%) were NTM. Rests of the 10(25%) samples were found negative for M. tuberculosis complex. Conclusions: This study proved that PCR is a specific and sensitive method in comparison of sputum microscopy after staining with Z-N technique and it helpful the clinicians ability to diagnose and treat the patients on time. This will ensure early treat to patients and prevent further transmission of disease.
ABSTRACT
Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable condition characterized by persistent airflow obstruction that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Bronchodilators are mainstay of pharmacologic management of COPD and Inhaled corticosteroids (ICS) are the central of treatment of asthma but in management of COPD their role is controversial. Aim &Objectives: The sole aim and objective of this study is to evaluate the current prescription pattern of COPD management using data generated in a tertiary care hospital of UP India.. Methods: : In this prospective study, all patient data relevant to the study were obtained by examination of Case sheets of inpatients visiting the OPD of TB & Chest department. Results: In this prospective study, prescriptions of 74 patients were selected. Out of total patients, 60 (81.08%) were males and 14(18.9%) were females. Out of total 74 patients, 73 (98.64%) are smokers, in which 30 (40.54%) are currently smoking while 43(58.1%) are ex-smokers. Out of total patients 60(81.08%) have comorbidities. Hypertension is most common comorbidity having 36 (48.65%) of patients. Inhalational route was most common route of administration of drugs in the study. Oral route was second most common route; it was used for administration of 42.03% of drugs. Formoterol was maximum prescribed drug used in 60 (81.09%) of patients followed by Budesonide 57 (77.03%), Acebrophylline 48 (64.86%),followed by Levocetrizine 41 (51.41%), Salbutamol and Montelukast were used in equal no. of patients 40(54.06%) , followed by Ipratropium 39 (52.70%), Tiotropium which was used in 29 (39.19%) of patients, followed by Amoxicillin 16 (21.63%) followed by Theophylline and Azithromycin used in 8 (10.81%) patients ,followed by Doxophylline and Terbutaline which were also used in equal number and percent of patients that is 3 (4.05%). Conclusion: The prescribing trend observed in the study appears to be in concordance with the current GOLD guidelines for the management of COPD patients.