ABSTRACT
Objective: The objective of this study was to evaluate the presence of interstitial lung disease (ILD) in rheumatoid arthritis (RA) and to determine the role of clinical, spirometry, and high-resolution computed tomography (HRCT) findings to facilitate early detection of ILD in RA. Materials and methods: This is a prospective study at a tertiary care hospital from February 2016 to June 2019. All patients satisfying the American College of Rheumatology (ACR) criteria for RA and having respiratory symptoms or signs were included. All patients had detailed history, clinical examination, laboratory evaluation, spirometry, and HRCT chest. Results: A total of 280 patients of RA with respiratory symptoms were evaluated, out of which 82 (29.29%) had pulmonary involvement. There were 70 women and 12 men. Rheumatoid factor was positive in 90.2% of patients while anti-CCP antibody was positive in 43.9%. Chest X-ray (CXR) showed bilateral haziness in 36.9%. HRCT findings revealed a usual interstitial pneumonia (UIP) pattern in 73.2% patients and 24% had an nonspecific interstitial pneumonia (NSIP) pattern. Spirometric evidence of lung involvement was present in 84.2% of these cases. 2D Echo showed pulmonary hypertension (PH) in 46.3% of patients. Conclusion: Screening for respiratory symptoms and signs is essential in the clinical evaluation of RA. CXR, HCRT chest, and spirometry can be used effectively to diagnose RA-ILD early.
ABSTRACT
Background:Chronic obstructive pulmonary disease / COPD is a multifactorial disease involving various electrolyte abnormalities. This study aimed at evaluating serum electrolyte levels in patients with acute exacerbation of COPD. Material And Methods:This study aimed at evaluating serum electrolyte levels in patients with acute exacerbation of COPD. This study included 100 cases & 100 controls with acute exacerbation of COPD admitted in intensive care unit. All the patients from the cases group were screened for Ca+2 & Mg+2 abnormalities during their intensive care unit stay. In group 1 (cases) correction for abnormal electrolytes were given on the day of admission. Treatment, antibiotics selection, metabolic parameters correction & acid base correction were considered equally in both the groups as per GOLD (Global initiative for chronic obstructive lung disease) guidelines. Symptomatic patients after 48 hours of intensive care unit admission were screened for calcium & magnesium levels & prevalence of hypocalcemia & hypomagnesemia was calculated.Result:It was found out that average duration of intensive care unit stay was reduced significantly in group 1 (cases) in whom the correction of electrolyte imbalance was considered at the time of admission. Also, in the control group, who were still symptomatic after 48 hours of intensive care unit treatment, a significant proportion was found to have hypocalcaemia and hypomagnesaemia (Electrolytes measured after 48 hours).Conclusion:In stable COPD patients there are abnormal serum electrolytes that may get further deranged during acute exacerbations. Thus serum electrolytes level should be monitored routinely in these patients & an attempt should be made to correct them at the earliest to avoid poor outcomes.