Assessment of pulmonary functions FVC, FEV1, and FEV1/FVC ratio among athletes and non-athletes

Background: Pulmonary function will improve by regular and intense physical activity. There will be difference in degree of improvement or increase in pulmonary functions in different types of athletic activities. Recent studies have stated forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC ratio to be higher in athletes than in the normal sedentary control individuals. Few studies have found lower values of dynamic pulmonary function while few other studies have found higher values of dynamic pulmonary function tests. We undertook this study to know the pulmonary function in athletes of Bengaluru and compare it with controls. Aim and Objective: This study aims to record dynamic pulmonary function tests (FVC, FEV1 and FEV1/FVC) using COSMED computerized spirometer in athletes and to compare with non-athletes. Materials and Methods: This is a case朿ontrol study which included 50 non-smoking athletes of 18� years age group from Shree Kanteerava Stadium, Bengaluru, and 50 non-athletes as control group after considering inclusion and exclusion criteria. Subjects were age and gender matched. FVC, FEV1, and FEV1/FVC were recorded using COSMED computerized spirometer. For statistical analysis, independent Student抯 t-test was used. Results: FVC, FEV1, and FEV1/FVC (P < 0.001) were significantly increased in athletes than non-athletes. Conclusion: Regular exercise and athletic training will improve the lung function tests.

Pulmonary function tests in workers of medical college

Background: Pulmonary function tests (PFTs) include a group of tests that measure breathing and functionality of lungs. PFT variables are affected by height, weight age, gender, environmental factors, and smoking. Aims and Objectives: The aim of the study is to measure the respiratory fitness of medical college workers and to evaluate effect of gender, basal surface area (BSA), body mass index (BMI), and smoking on lung functions in workers of medical college. Materials and Methods: A cross-sectional study was conducted on total 50 (29 males and 221 females) subjects in the age group of 18–40 years of medical college workers in Ahmedabad. The subjects were selected randomly for this study. Dynamic lung functions such as forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, forced expiratory flow (25–75%), and maximum voluntary ventilation were measured by Computerized spirometer (Spiro excel 1.1, Medcaid, India). The data were analyzed by the help of statistical software medical and computer software. Results: Out of 50 subjects 29 (58%) were males and 21 (42%) were females. Mean age of study subject was 26.34 ± 7.31, mean height of study subject was 161.44 ± 9.48, and mean weight of study subject was 59.52 ± 12.62. Mean BSA was 162.16 ± 0.19 and mean BMI was 22.74 ± 4.19. Out of total 50 subjects, 76% subjects were non-smokers and not having habit of tobacco chewing while 8% were smokers and 14% of study subjects having habit of tobacco chewing. Our results showed lower values of PFT parameters than standard inbuilt predicted values of inbuilt software (KAMAT formula). The values of PFT parameters were higher in males compared to females. In smokers value of FEV1/FVC was less than non-smokers. All the PFT parameters showed positive correlation with BSA. BMI shows negative correlation with PFTs. Conclusion: The respiratory strength of male workers was higher than female workers as their volume of lungs and body circumference is more than females. The respiratory muscle endurance and pulmonary compliance is also more in males than females.

Pharyngeal reperforation following incentive spirometry: A case report

Despite its widespread use, complication of incentive spirometry has been rarely reported. We report a case of pharyngeal reperforation following incentive spirometry. A 75-year-old female, had a history of long-term steroid use, entered the intensive care unit for maintenance of mechanical ventilation following surgical repair of a pharyngeal perforation. After ventilator weaning, incentive spirometry was implemented on postoperative day 4. Immediately after incentive spirometry use, patient's neck began to swell, and subcutaneous emphysema was palpated. Pharyngeal reperforation was suspected on neck computed tomography, and emergency surgery was performed. Surgery revealed a 3-cm long rupture from the hypopharynx to the esophagus. The causes were thought to be delayed wound healing due to long-term steroid use and a sudden increase in pharyngeal pressure due to incentive spirometry. In conclusion, particular attention should be paid when using incentive spirometry after head and neck surgery in patients with a history of long-term steroid use.

Evaluation of nutritional status in patients with chronic obstructive pulmonary disease in Government Dharmapuri Medical College, Dharmapuri

Background: The link between varicocele and infertility was first reported by cessius in 1st century AD but it was not widely acknowledged until TULLOCH and colleagues reported the improvement of sperm parameters in 26 of 30 patients undergoing varicocelectomy. Varicocele is defined as excessive dilatation of pampiniform venous plexus of spermatic cord. varicocele is an important cause infertility which can be corrected by surgery. Several methods have been used for its treatment including open surgical ligation of spermatic veins as well as laparoscopic varicocelectomy. Open varicocelectomy has more risk of recurrence and complications whereas laparoscopic varicocelectomy is simple, has less risk of recurrence and complication in expert hands. Objectives: To compare Laparoscopic varicocelectomy with open varicocelectomy, in terms of postoperative pain, recurrence rate, hospital stay, cost, cosmetic and complication. To prove hospital stay was more in open group than laparoscopic group and also patient of laparoscopic group return to normal activities earlier than open group. To standardize the laparoscopic varicocelectomy procedure for varicocele. Materials and methods: It was a randomized clinical trial done in Department of General Surgery, Vinayaka Mission Medical College, Karaikal. Study was carried out from 1 st March, 2015 to 1st R. Bharathidasan, Reny Jayaprakash, Subith P. Bhaskar, G. Ambujam. Laparoscopic varicocelectomy now the gold standard procedure for varicocele - A comparative study with open technique based on our experience. IAIM, 2017; 4(7): 218-221. Page 219 March, 2016. A total 70 patients was taken in our study of its 36 patient undergone open varicocelectomy and 34 patient undergone laparoscopic varicocelectomy. Results: Recurrence rate 0% in Laparoscopic Varicocelectomy and 5.6% in open varicocelectomy. Wound complication was 0% in Laparoscopic varicocelectomy and 2.5% in open varicocelectomy. Post-operative pain was more in open group as compared to laparoscopic varicocelectomy. Laparoscopic varicocelectomy has less post-operative morbidity and early return to normal activity. Also there was improvement in seminal analysis in both groups. Conclusion: We would like to standardize laparoscopic varicocoelectomy and make it as a gold standard for Varicocele by replacing open technique provided there is good experienced surgical team and good instrumentation. Cost of the procedure is comparatively high.

Change in Pulmonary Function after Incentive Spirometer Exercise in Children with Spastic Cerebral Palsy: A Randomized Controlled Study

PURPOSE: The aim of this study was to investigate the effect of incentive spirometer exercise (ISE) on pulmonary function and maximal phonation time (MPT) in children with spastic cerebral palsy (CP). MATERIALS AND METHODS: Fifty children with CP were randomly assigned to two groups: the experimental group and the control group. Both groups underwent comprehensive rehabilitation therapy. The experimental group underwent additional ISE. The forced vital capacity (FVC), forced expiratory volume at one second (FEV1), FEV1/FVC ratio, peak expiratory flow (PEF), and MPT were assessed as outcome measures before and after 4 weeks of training. RESULTS: There were significant improvements in FVC, FEV1, PEF, and MPT in the experimental group, but not in the control group. In addition, the improvements in FVC, FEV1, and MPT were significantly greater in the experimental group than in the control group. CONCLUSION: The results of this randomized controlled study support the use of ISE for enhancing pulmonary function and breath control for speech production in children with CP.

Efeitos do treinamento com espirômetros de incentivo a fluxo e a volume em indivíduos saudáveis / Effects of training using volume and flow-oriented incentive spirometry in healthy subjects

São escassos os relatos encontrados na literatura que fazem comparações entre diferentes espirômetros de incentivo (EI) e há diferenças nos métodos adotados. Assim, os objetivos do estudo foram comparar o efeito dos EI a fluxo Cliniflo® com fluxo pré-determinado e a volume Voldyne® na função pulmonar, mobilidade tóraco-abdominal e força muscular respiratória, assim como analisar as características dos protocolos de treinamento baseado na sobrecarga gerada por cada um desses EI em indivíduos saudáveis sedentários. Foram avaliados 20 indivíduos saudáveis sedentários de 18 a 30 anos, de ambos os sexos, distribuídos randomicamente entre dois grupos: grupo Cliniflo® (GC) e grupo Voldyne® (GV) e reavaliados após cinco semanas, por meio da espirometria, manovacuometria e cirtometria dinâmica, e foi calculado o índice de amplitude tóraco-abdominal (IA). Os indivíduos realizaram duas sessões semanais de treinamento muscular respiratório (TMR) durante cinco semanas, totalizando 10 sessões. Na análise intragrupos, no GC verificou-se aumento estatisticamente significativo da capacidade vital e do pico de fluxo expiratório (PFE), e no GV observou-se aumento significativo dos valores de capacidade vital forçada, do PFE e da ventilação voluntária máxima, obtidos pela espirometria. Quanto às pressões inspiratória e expiratória máximas e os IA axilar, xifoidiano e abdominal não foram observadas diferenças significativas em nenhum dos grupos. Quanto à análise intergrupos, também não foi observada diferença significativa entre eles. Conclui-se que o treinamento com EI a fluxo Cliniflo® e a volume Voldyne® proporcionaram melhora das capacidades pulmonares, pico de fluxo e, somente no a volume, na endurance muscular respiratória na amostra estudada. E quanto as características do treinamento, ambos geraram baixa sobrecarga e dessa forma, não caracterizaram-se como treinamentos de força muscular respiratória.(AU)

There are few reports in the literature to make comparisons between differente respiratory spirometer and there are differences in the adopted methods. The objectives of the study were to compare the effect of flow-oriented spirometer Cliniflo® with pre-determined flow and volume-oriented spirometer Voldyne® on the pulmonary function, thoracoabdominal mobility and muscle strength volume, as well as analyze the characteristics of training protocols based the overhead generated by each EI in sedentary healthy individuals. Twenty healthy sedentary individuals were assessed, aged from 18 to 30 years, of both sex, randomly assigned in two groups: Cliniflo® group (CG) and Voldyne® group (VG) and revalued after five weeks, by spirometry, manometer and cirtometry dynamics and was calculated the amplitude thoracoabdominal index (TAI). Subjects performed two weekly sessions of respiratory muscle training (RMT) for five weeks, totaling 10 sessions. . In the intragroup analysis, the CG was found statistically significant increase of vital capacity and peak expiratory flow (PEF), and VG showed a significant increase in the values of forced vital capacity, PEF, and maximal voluntary ventilation, obtained by spirometry. As for the maximal inspiratory and expiratory pressures and TAI axillary, xiphoid and abdominal found no significant differences in either group. As for inter-group analysis, was not significantly different between them. In conclusion, training with the flow-oriented spirometer Cliniflo® and volume-oriented spirometer Voldyne® provided improves lung capacity, peak flow, and only on the volume in respiratory muscle endurance in the study sample. And the training characteristics, generated both low overhead and thus not characterized as respiratory muscle strength training.(AU)

Ventilatory Function of Jute Mill Workers in Border Areas of Bihar.

Aim: To study the effect of jute-dust and further impact of smoking on pulmonary function test parameters in jute mill-workers. Method and Result: With the help of computerized multifunctional spirometer 91 male workers were compared with 90 controls for their PFT-parameters. The study indicated an overall reduction in FVC, FEV1, PEFR, FEF (25-75) % and MVV. FEV1/FVC was within normal range. Further division of workers into smoker and nonsmokers there was a more decline in FEV1 along with FEV1/ FVC in smokers. Conclusion: Exposure of jute-dust lead to combined type of restrictive/obstructive lung diseases.

Consumo máximo de oxigênio em surfistas brasileiros profissionais / Peak oxygen uptake of brazilian professional surfers

O Surfe é um esporte muito popular em todo o mundo, mas há falta de informação dos efeitos fisiológicos induzidos pelo treinamento. Em geral, surfistas têm de remar para alcançar e pegar as ondas, essa fase pode durar de minutos há horas e provavelmente, a capacidade aeróbia dos músculos superiores do corpo pode ser alterada. O objetivo deste estudo foi medir o pico de VO2 de surfistas brasileiros profissionais. Para tal avaliação utilizou-se um ergômetro de alavanca de braço, com intuito de comparar a medida dos valores do pico de VO2 com os valores do VO2max próprios preditos para exercícios de membros inferiores calculados pela equação de Wasserman’s e verificar se o pico de VO2 nos braços pode ser afetado pelo treinamento. Foram estudados oito surfistas do sexo masculino (idade: 26 ± 6 anos, estatura: 175 ± 8 cm, peso corporal: 74 ± 9 kg). O pico de VO2 foi o maior VO2 obtido por um espirômetro de circuito aberto usando uma medição metabólica (V-max Series 229/Sensor Medics, USA) em um teste máximo. Valores medidos de pico de VO2 e preditos de VO2max de surfistas para membros inferiores foram de 3.42 ± 0.46 L.min-1 e 2.87 ± 0.22 L.min-1, respectivamente. Medidas dos valores do pico de VO2em exercício de braço foram significantemente melhores que os valores de VO2max preditos para exercício de perna (120%). Concluí-se que a prática do surfe pode ter um importante efeito induzido pelo treinamento na capacidade aeróbica dos músculos superiores do corpo de surfistas brasileiros profissionais.

Surfing is very popular sport all over the world. But there is lack of data of the physiological training-induced effects of surfing practice. In general, surfers must paddle to reach and catch the waves. And the paddling phase can last from several minutes to few hours. Probably, the aerobic capacity of the upper body muscles could be affected by the surfing practice. Our goals were to measure Brazilian professional surfer`s VO2peak. In an arm cranking ergometer, compare these measured VO2peak values to their own predicted VO2max values for legs exercise calculated by Wasserman`s equation and verify if the arms` VO2peak could be affected by the surfing training. We studied eight Brazilian professional male surfers (age: 26 ± 6 years, height: 175 ± 8 cm, weight: 73 ± 9 kg) that used to train only surfing at least 10 hours per week longer than 10 years. VO2peak was the highest VO2 obtained by an open circuit spirometer using a metabolic measurement cart (V-max Series 229/Sensor Medics, USA) in a maximal incremental test. Surfers` measured VO2peak and predicted VO2max for legs values were 3.42 ± 0.46 L.min-1 and 2.87 ± 0.22 L.min-1, respectively. Measured VO2peak values in arm exercise were significantly greater than predicted VO2max values for leg exercise (120%). We concluded that surfing practice could have an important training-induced effect on the aerobic capacity if the upper body muscles of Brazilian professional surfers.

Clinical Value of a Desktop Spirometer (HI-801) for Spirometry Screening / 결핵및호흡기질환

BACKGROUND: A national health care initiative recommends routine spirometry screening of all smokers over age 45 or patients with respiratory symptoms. In response to the recommendation, new, simple, and inexpensive desktop spirometers for the purpose of promoting widespread spirometric screening were marketed. The performance of these spirometers was evaluated in vivo testing with healthy subjects. However, the clinical setting allows spirometric assessment of various pathologic combinations of flow and volume. OBJECTIVE: The aim of this study was to compare the accuracy of a desktop spirometer to a standard laboratory spirometer, in a clinical setting with?pathologic pulmonary function. METHOD: In a health check-up center, where screening pulmonary funct test was performed using the HI-801 spirometer. Subjects who revealed the ventilation defect in screening spirometry, performed the spirometry again using the?standard Vmax spectra 22d spirometer in a tertiary care hospital pulmonary function laboratory. Pulmonary function test with both spirometer was performed according to the guidelines of the American Thoracic Society. RESULTS: 109 patients were enrolled. Pulmonary function measurements (FVC, FEV1, PEFR, FEF25%-75%) from the HI-801 correlated closely (r=0.94, 0.93, 0.81, 0.84, respectively) with those performed with the Vmax spectra 22d?and showed the good limits of agreement and differences between the 2 devices; FVC +0.35 L, FEV1 +0.16 L, PEFR +1.85 L/s, FEF25%-75% -0.13 L/s. With the exception of FEV1, FEF25%-75%, these differences were significant(p<0.05) but small. Conclusion: The HI-801 spirometer is comparable to the standard laboratory spirometer, Vmax spectra 22d, with high accurary for FEV1 and FVC and?acceptable differences for clinical use.

Comparison of Mini-Wright Peak Flow Meter and Microplus Pocket Spirometer in Measuring Peak Expiratory Flow Rate / 소아알레르기및호흡기학회지

PURPOSE: Peak expiratory flow rate (PEFR) monitoring plays an important role in the diagnosis of airway obstruction and management of patients with bronchial asthma. This study compared the PEFR taken by a Microplus pocket spirometer and mini-Wright peak flow meter by assessing the extent of agreement between the instruments and the repeatability of measurements with each instrument. METHODS: Eighty healthy children (age 11-12 years, 43 females, 37 males) performed three PEFR maneuvers on the Microplus pocket spirometer and on the mini-Wright peak flow meter in a random order. Agreement and reproducibility between the two instruments were assessed by the statistical methods proposed by Bland and Altman. RESULTS: Seventy six (95%) of the PEFR taken by the mini-Wright peak flow meter were higher than that of Microplus pocket spirometer. The 95% limits of agreements (mean difference+/-2SD) between each instrument were very wide (2.7 to 144.3 L/min). The repeatability coefficient for the mini-Wright peak flow meter was 27 L/min and for the Microplus pocket spirometer was 33.5 L/min. Analysis by sex and order of usage did not show any significant differences. CONCLUSION: The limit of agreement between the Microplus pocket spirometers and the mini-Wright peak flow meter was too wide to use interchangeably.