ABSTRACT
Background: The inherited disorders of haemoglobin are the commonest single gene disorder of the world population. Sickle cell anaemia being the most widespread and numerically the most important haemoglobinopathy in the world today. The major features of sickle cell disease (SCD) in most patients are life-long anaemia and the consequences of recurrent vaso-occlusion. Many complications of SCD involve anaemia, vasoocclusion etc. Impairment of pulmonary function is a common complication of SCD. The patients suffering from this disease frequently present with complaints referable to the pulmonary system although other systems are also involved. Hence present study was carried out to determine the difference in the pulmonary function tests between male and female sickle cell disease patients ( HbSS ),sickle cell trait patients(HbAS)and compare with normal controls ( HbAA) non-sicklers. Aim and Objectives: 1) To study the pulmonary alterations in cases of homozygous SS & heterozygous AS Sickle Cell Disorder subjects.2) To compare the parameters with normal healthy controls of both sexes & assess the importance of PFT in "Steady State"(free from complications or crisis)as an objective evidence to predict the risk of "Sickle Cell Chronic Lung Disease'' in future. Method:Across sectional study was done in 50 cases of SCD (22HbSS& 28HbAS) and age and sex matched normal 50 HbAAcontrols. From the various measured pulmonary function test( PFT )parameters Forced Vital Capacity( FVC),Forced Expiratory Volume in 1 sec(FEV1) Peak Expiratory Flow Rate(PEFR)in both sexes were selected for the study. The data collected was subjected to statistical analysis involving computation of Mean, Standard deviation, Independent Ttest. Result: Mean value of FVC, FEV1 and PEFR were found to be significantly lower than normal controls, but the difference in FVC between HbAS and HbSS turned out to be statistically non-significant whereas the difference in FEV1, PEFR between HbAS and HbSS was statistically significant.The lung function indices were lower in females than males of the sickle cell patients. Conclusion: There were significant reductions in pulmonary function test parameters in sickle cell anaemia patients as compared to normal controls of a similar age and gender.It is indicative of mixed pattern (both restrictive and obstructive) lung impairment in sickle cell anaemia.
ABSTRACT
Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death and disability worldwide. Its prevalence is increasing globally, especially in countries with high frequencies of smoking combined with signifi cant environmental exposures to pollutants and biomass smoke. Currently COPD is the third leading cause of death worldwide, after ischemic heart disease and stroke. Efforts have been made to design a standard protocol for treatment of the disease, and these efforts are still in the process. Methods: The study was done on 100 subjects to assess whether steroid (inhaled or oral) actually have any role in decreasing the decline in forced expiratory volume in 1 sec and to compare the effect of both to fi nd out which one is superior. Patients were divided into two arms, inhaled steroids group (according to GOLD guidelines), and the other group was oral prednisolone 10 mg in addition to standard treatment except inhaled steroid. The effects were studied with appropriate statistical tests. Results: Our study data showed that oral steroids are more effective on symptom control as compared to inhaled steroids. Symptoms such as cough (64% vs. 82%) and breathlessness (76% vs. 94%) signifi cantly improved in the oral corticosteroids group. The rate of exacerbation also improved (22% vs. 12%) in the test group. Conclusion: The use of steroids has ever been a subject of divergence of views ever since its role in the treatment of COPD was fi rst described. Although, overall steroid in any form is benefi cial in symptomatic/subjective and objective improvements in COPD, oral steroids stand a better chance as compared to inhaled steroids.