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Background: Various studies have known abatements in lung function and several other health problems associated with longstanding air pollution exposure. One of the most cost-effective and environmental alternative of conventional fuels (petrol and diesel) is compressed natural gas (CNG). The increasing use of CNG as a fuel (as it is safe and cheap as compare to the conventional fuels) can add one more bug to the list of work-related disease. Aims and Objectives: This study is to evaluate the respiratory functions of CNG pump workers. Materials and Methods: The present study was held on 82 male subjects. The study group included of non-smoking healthy adult males, age group of 20–40 years working in different CNG stations in Surat city for >6 months and 8 h per day. The control group included of non-smoking healthy adult males, age group of 20–30 years working or studying in the Surat Municipal Institute of Medical Education and Research (SMIMER). Results: Out of 82 male subjects, 30 subjects were control and 52 subjects were CNG station workers. The study group comprised of 52 healthy non-smokers in the age group of 20–40 years working in different CNG station in Surat city for >6 months and 8 h/day. The control group comprised of 30 healthy non-smokers males between the age group of 20–30 years working or studying in the SMIMER. Conclusion: In this study, we have not found statistically significant deterioration in pulmonary functions of CNG pump workers when compared to controls.
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Background: Type-2 diabetes mellitus is related to decreased lung function. Prolonged inadequate control of glucose levels may alter regulation of inflammatory pathways that are implicated in pulmonary function complications. Aim and Objectives: The objjectives of the study were to assess the relationship of pulmonary function test (PFT) with factors influencing glycemic status in type 2 diabetes mellitus. Materials and Methods: A total of 110 diabetic cases with uncontrolled blood sugar levels and similar number age- and gender-matched control subjects above 30 years of age were recruited. Sociodemographic details were collected and participants underwent laboratory ad radiological investigations. PFTs including Forced vital capacity (FVC), peak expiratory flow rate (PEFR), forced expired volume in 1 s (FEV1), forced expiratory flow (FEF 25–75%), and FEV1/FVC ratio were assessed. Results: The comparison of PFTs with levels of HbA1c (<7 and >7) showed that the levels of FVC, PEFR, FEV1, and FEF 25–75% were higher in diabetics with HbA1c <7 and FEV1/FVC ratio was high in diabetic cases with HbA1c >7. The mean difference of PFT with HbA1c and body mass index (BMI) was statistically not significant in diabetics (P > 0.05). The person’s correlation analysis showed a negative correlation between FVC, FEV1 with HbA1c, and BMI in diabetics. Conclusion: Uncontrolled glycemic status and increased BMI were associated with functional impairment of lungs. Organized glycemic control and duly checking the PFTs may reduce the risk of onset of respiratory complications and lung function.
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Background: Increasing awareness to lifestyle disease has led to more participation of people in taking up various forms of exercise to avail more health benefits. The ability to perform physical exercise is related to cardiovascular systems capacity to supply oxygen to muscles and pulmonary systems ability to clear carbon di oxide from blood via lungs. Spirometry is a physiological test that measures the volume and flow of air that can be inhaled and exhaled. Aim and Objectives: The purpose of this study is not only to assess the beneficial effects of pranayama and aerobic exercises but to compare the improvements in the lung functions among these two modalities of exercises. Materials and Methods: It is a non-randomized cross-sectional comparative study. Total 150 participants of both sexes aged 30–50 years were selected and divided equally into three groups: Pranayama group, aerobic exercise group, and control group who were doing pranayama and aerobic exercise and no exercise respectively from the past 3 months were included in the study. The participants were assessed by their anthropometric parameters, pulse rate, respiratory rate, blood pressure, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, and peak expiratory flow rate (PEFR). Results: Among Pranayama groups, there was significantly higher level of FVC, FEV1, FEV1/FVC ratio, and PEFR as compared to aerobic exercise group and control group. Conclusion: Both pranayama and aerobic exercise play an important role in improving the pulmonary functions but effects were more pronounced with pranayama.
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Background and objective: Silicosis is one of the oldest occupational lung diseases. However, there are very few studies identifying the anthropometric variables associated with silicosis. The present study aimed at studying the association between body surface area (BSA), pulmonary function indices, and 6-minute walk distance (6MWD) in patients with silicosis. Materials and methods: The study was conducted on 102 male patients of silicosis. Height and weight were measured to calculate BSA. Spirometry and 6 minute-walk tests were performed. Data were analyzed using EPI info V 7 software. Student's t-test of significance (ANOVA) was applied to test the difference between means. Results: There are no significant changes found in the 6-minute walk distance with years of exposure and BSA. Statistically significant lower values of pulmonary function indices were observed in patients with BSA <1.6 sq m. Statistically significant higher values of forced expiratory volume in the first second and forced vital capacity were observed in patients with BSA >1.9 sq m in all categories of exposure. Conclusion: In conclusion, patients of silicosis with >1.9 sq m BSA had higher values of pulmonary function indices. Large body size may be of value in protection from developing occupational lung disease.
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Objective:To compare and analyze the effects of impulse oscillometry (IOS) and pulmonary function test (PFT) in the assessment of asthma control in children.Methods:A cross-sectional study of 323 children with bronchial asthma who visited the outpatient pediatric clinic of Shandong Provincial Hospital Affiliated to Shandong First Medical University from March to December 2020 was conducted.The patients were divided into the control group (123 cases) and the uncontrolled group (200 cases) according to the Childhood Asthma Control Test (C-ACT) score.In both groups, PFT and IOS were performed.The PFT test included the forced expiratory volume in one second (FEV 1), force expiratory volume in one second/forced vital capacity (FEV 1/FVC), peak expiratory flow (PEF), the instantaneous forced expiratory flow at 50% of forced vital capacity (FEF 50), the instantaneous forced expiratory flow at 75% of forced vital capacity (FEF 75), and maximum mid expiratory flow (MMEF). In the IOS test, the total respiratory impedance at 5 Hz (Z5), respiratory resistance at 5 Hz (R5), respiratory resistance at 20 Hz (R20), reactance at 5 Hz (X5), respiratory resistance at 5 Hz-respiratory resistance at 20 Hz (R5-R20), reactance area (AX), and resonance frequency (Fres) were measured.The data obtained were analyzed statistically using SPSS 25.0 software. ANOVA or Mann- Whitney U rank-sum test was used to compare data between groups.Receiver′s operating characteristic (ROC) curves were drawn to determine the predictive value of PFT and IOS parameters for uncontrolled asthma. Results:(1) According to the comparison results of PFT indexes between the two groups of children with asthma, the levels of FEV 1, FEV 1/FVC, PEF, FEF 50, FEF 75, MMEF in the control group were all higher than those in the uncontrolled group [(104.41±12.38)% vs.(98.89±16.61)%, 100.50 (94.40, 103.50)% vs.96.00 (89.83, 101.88)%, (100.29±15.31)% vs.(93.19±18.43)%, 85.60(70.60, 96.60)% vs.72.35 (57.08, 91.10)%, 67.20 (53.60, 81.70)% vs.56.80 (41.10, 74.73)%, 80.70 (66.80, 95.10)% vs.69.50 (54.03, 90.05)%] (all P<0.01). (2) According to the comparison results of IOS indices between the two groups, the levels of Z5, R5, R20, R5-R20, X5, AX and Fres in the control group were lower than those in the uncontrolled group {68.58 (63.29, 77.43)% vs.81.27(70.93, 91.96)%, 68.91(62.94, 77.60)% vs.80.61 (70.02, 89.29)%, 75.78 (67.50, 87.55)% vs.82.97 (71.50, 95.50)%, 0.51 (0.43, 0.59) [kPa/(L·S)] vs.0.62 (0.53, 0.74) [kPa/(L·S)], 69.31 (59.93, 79.14)% vs.86.48 (70.00, 102.48)%, 1.11 (0.76, 1.60) kPa/L vs.2.14 (1.42, 2.85) kPa/L, 18.21 (16.06, 19.56) Hz vs.20.56 (18.92, 22.81) Hz} (all P<0.01). (3) In the control group, 31 children (25.20%) had pulmonary dysfunction.(4) In the uncontrolled group, 95 children (47.50%) had pulmonary ventilation dysfunction.Only 20 children (10.00%) had a R5 larger than 120% of the predicted value and/or a R20 larger than 120% of the predicted value.(5) According to the ROC analysis results of the IOS indices for predicting asthma exacerbations, all of the areas under the ROC (AUC) of Z5, R5, R5-R20, X5, AX and Fres were greater than 0.7.AX had the highest value in predicting asthma exacerbations (AUC=0.785, 95% CI: 0.735-0.835), with sensitivity of 78.50% and specificity of 64.20%.All of the AUCs of PFT indices were smaller than 0.7.FEF 50 and MMEF had the largest AUC. Conclusions:PFT and IOS have good sensitivity in evaluating the level of asthma control in children, and IOS has good value in predicting asthma exacerbations.AX has the highest predictive value for asthma exacerbations.Asthma control levels of children should be evaluated using not only subjective (such as C-ACT score) but also objective (e.g.PFT, IOS) indices.
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ABSTRACT Introduction: The long-term consequences of COVID-19, especially pulmonary impairment, are frequent but not well understood. The knowledge about sequels or long COVID-19 are necessary, considering the high prevalence and need for specific public strategies. Method: The study was conducted to evaluate symptoms (standardized questionnaire), pulmonary function (spirometry), and exercise capacity (6-minute-walk-test) at 30 (D30), 90 (D90), and 180 (D180) days after hospital discharge of patients surviving to severe COVID-19. We excluded in this follow up patients with comorbidities before COVID infection. Results: 44 patients were included and 31 (26 men) completed the 6-month follow-up (age mean 53.6 ± 9.6 years). At D180, 28% presented still at least one symptom. The most common was dyspnea (17.2%), followed by cough (13.8%), and myalgia (10.3%). All spirometric parameters showed progressive improvement from D30 to D180. However, 16% maintained a restrictive pattern on spirometry test, 44% presented desaturation on the 6-minute walk-test, and 25% walked < 75% of the predicted value. Conclusion: 6-months after hospital discharge, reduced pulmonary function and reduced exercise capacity was founded frequently and more than a quarter remained symptomatic. The persistent symptoms and functional impairment suggest that sequels and development of Long COVID-19 are very common. The identification of these patients to provide the necessary health care is a challenging task, considering the large number of patients infected and surviving to COVID-19 disease.
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Bronchial asthma is a heterogeneous disease characterized by chronic airway inflammation. In recent years, the diagnosis and treatment of asthma tend to be precision medicine, and the individualized treatment of asthma is mainly based on individualized diagnosis. However, the pathogenesis of asthma is complex and the clinical phenotype is different, and its high heterogeneity also brings great challenges to realize individualized diagnosis and treatment, Diagnosis and evaluation based on multi-dimensional and multi-means is an important practical development direction.
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Background: Inflammation of gallbladder bed, CO2 pneumoperitoneum, and intraoperative patient posture all plays a role in the etiology of pulmonary dysfunction during laparoscopic cholecystectomy. Aims and Objectives: The goal of this study was to detect any changes in pulmonary function following laparoscopic cholecystectomy using a portable spirometry instrument, as well as to determine the degree of pulmonary function impairment and complications. Materials and Methods: The pre-operative and post-operative spirometry of 150 patients undergoing laparoscopic cholecystectomy under general anesthesia were compared in this prospective observational study conducted at JLN medical college and attached group of hospitals after obtaining due permission from the Institutional Ethics Committee. Spirometry was performed preoperatively to determine baseline values forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow rate (PEFR). Those who were unable to complete the required maneuvers were not included in the study. Pulmonary function testing was performed thrice after surgery, on days 1, 2, and 3 after surgery. To achieve a VAS score of <4, enough pain alleviation was provided. The paired t-test was used to compare spirometry values. Results: Between the preoperative and immediate post-operative periods, significant changes in FVC, FEV1, and PEFR were detected, indicating restrictive ventilator dysfunction. Conclusion: After laparoscopic cholecystectomy, light restrictive respiratory disturbances were noted with quick recovery of pulmonary function, potentially lowering post-operative pulmonary morbidity and mortality.
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Background: Pulmonary function test (PFT) is used to diagnose the underlying cause of respiratory symptoms in children and adolescents. It is also used to monitor the status of those with chronic lung diseases. In clinical practice, spirometry is the investigation of choice for the overall assessment of pulmonary function and is equated with the PFT in day to day practice the assessment of lung function. Aim and Objective: The aim of the study was to determine pulmonary function (as measured by FEV1 and FEV6) among school going children of age group 9� years and its variability with age, sex, height, and regional difference. Materials and Methods: This cross-sectional study was conducted among 703 normal healthy school children (335 boys and 368 girls) of Thiruvananthapuram city aged 9� years during 2015�16. The study group included both South Indian and North Indian children. Height, weight, and BMI were measured. All included children were tested in a sitting position with the head straight after taking written consent from parents. Spirometry was done using the instrument 揤italograph- COPD 6.� It displays FEV1 and FEV6. The FEV6 is used as a surrogate marker of FVC. Results: FEV1 and FEV6 were found to be statistically significant in the study group. Both FEV1 and FEV6 were higher in boys than girls. In both boys and girls, FEV1 and FEV6 values showed strong positive correlation with age, and height which was found to be statistically significant (P < 0.001). North Indian children have got higher FEV1 and FEV6 values than South Indian children. This was also found to be statistically significant (P < 0.001). Conclusion: Variables such as FEV1 and FEV6 values showed strong positive correlation with age and height in both sexes. By regression analysis, it was found that age, gender, and height were the significant predictors for both FEV1 and FEV6.
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Background: Gastroesophageal reflux disease (GERD) is a common condition that affects about 20- 30% of the adult population, presenting with a broad spectrum of symptoms and varying degrees of severity and frequency. Extra esophageal manifestations like respiratory symptoms are being increasingly recognized. There are only very few studies on the prevalence of pulmonary symptoms in patients with erosive gastroesophageal reflux disease. Aim: The objective of the study was to determine the frequency of pulmonary symptoms in patients with erosive gastroesophageal reflux disease, Materials and Methods: This was a cross-sectional study done on 100 patients diagnosed based on upper gastrointestinal endoscopy findings. Patients were first interviewed about GERD symptoms using the GERD Health-Related Quality of Life questionnaire. Then the respiratory symptoms are assessed. Demographic details are recorded in a proforma. Pulmonary function tests were done on all the patients. Upper GI endoscopic findings are graded according to Los Angeles (LA) grading from A to D Results: The prevalence of pulmonary symptoms was 60%. The most prevalent symptom was a cough, then followed by dyspnoea on exertion, chest pain, wheezing, and snoring. There was a significant association found between LA grading and pulmonary symptoms like wheezing, cough, chest pain, and hoarseness of voice. No significant association was found between GERD duration and pulmonary symptoms. There was a statistically significant association found between LA grading and pulmonary function test. No association was found between quality of life scoring and pulmonary symptoms. Conclusion: There was a high prevalence of pulmonary symptoms in patients with erosive gastroesophageal reflux disease. Erosive GERD can affect pulmonary function according to severity. There was no association between prolonged GERD and pulmonary symptoms.
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Background:Arterialhypoxaemiaisthecommonestcomplication,sincerespiratory depressantdrugsareusedforpremedication,andtheairwayisalsopartially occludedbythebronchoscope.Thestudyisthereforedesignedtofindoutthechangesinarterialoxygen tensionduring (FOB)alongwitheffectoncentral hemodynamics, pre andpost procedure ECGand PFT.Objectives were tofind out thechanges in arterial oxygentension during FOB, to study the effects of FOBon central hemodynamics, electrocardiographicallyand pulmonaryfunction tests.Methods:One hundred patients aged above 20 years undergoing FOB were evaluated for the arterial oxygen tension and cardiac rhythm changes at KNCH, Jodhpur during 12 months study period from 2019 to 2020.Results:All patients developed a fall in PaO2following FOB but hypoxaemia was noted only in 18 cases. Bronchial washing, punch biopsy and brush biopsy did contribute to hypoxaemia significantly. There was a uniform rise in heart rate in all the patients after FOB which was statistically significant. There was slight sinus tachycardia inmostofthecases although ECG indicated no major arrhythmias.ThepulmonaryfunctionswhichincludechangeinVC,FVC, FEV1andPEFR after FOB, on statisticallycomparisonnostatistical difference could be observed. Therewasnosignificantchangein PaCO2level and pH level.MeanofSBP andmeanofDBPwasstatistically significant.Conclusions:All patients showed a decline in arterial PaO2after FOB which was highly significant. There was slight sinus tachycardia in most of cases. FOB itself does not endanger the patients with any significant or serious complications.
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Objectives. Interstitial lung disease (ILD) with features of pulmonary fibrosis and honey-combing is a significant cause of morbidity and mortality in patients with systemic sclerosis (SSc). High resolution computed tomography (HRCT) is the established non-invasive gold standard technique for the diagnosis of SSc related ILD. The present study was designed to characterise HRCT features of ILD in SSc and to correlate pulmonary function test (PFT) parameters with HRCT semi-quantitative scores. Methods. This is an observational, cross-sectional study including 36 patients of SSc who underwent HRCT chest. All the patients were females. Severity and extent were assessed using four HRCT features: ground-glass opacity (GGO), mixed GGO and reticular opacity, reticular fibrosis and honey-combing. Thirty-three patients were able to perform PFT. Total HRCT score, inflammatory index and fibrosis index were correlated with PFT parameters. Results. Interstitial lung disease was found in 33 patients (91.6%), 24 patients (66.6%) had mixed GGO along with reticular inter-lobular septal thickening. Majority of the patients (64%) had non-specific interstitial pneumonia (NSIP) pattern. Usual interstitial pneumonia (UIP) pattern was seen in 25% of the cases. One patient had overlapping features of both UIP and organising pneumonia. There was predominant lower lobe involvement. Among the 33 patients who were able to perform PFT, 85% had abnormal results (predicted forced vital capacity [FVC]<80%). Total HRCT score showed significant negative correlation with PFT parameters 枛 FVC (r=�48, P=0.004) and forced expiratory volume in one second (FEV1) (r=�28, P=0.1), respectively. The ratio of FEV1 and FVC had significant positive correlation with total HRCT score (r=0.5, P=0.002). Inflammatory index and fibrosis index had significant negative correlation with predicted FVC% (P<0.05). Conclusions. Mixed pattern (GGO and reticular opacity) was the most common HRCT finding. HRCT semi-quantitative scoring system is sensitive in assessing the severity and extent of ILD qualitatively and quantitatively in SSc patients.
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Background:The increasing incidence of metabolic syndrome has been on the rise especially in urban population and leading to increased risk of cardiovascular disease (CVD) and diabetes mellitus. It has been associated with impairment of pulmonary functions. However, there is limited data regarding the association with individual components of metabolic syndrome and overall effect on components of pulmonary functions.Methods:This is a cross sectional study consisting of 50 subjects with metabolic syndrome. All the subjects underwent pulmonary function tests and the association between different components of metabolic syndrome and pulmonary function were examined using unpairedt-test and Pearson抯 partial correlation coefficient. This data was analysed by using statistical package for the social sciences (SPSS) version12.0.Results:In females, moderate negative significant correlation was seen between forced vital capacity (FVC)and systolic blood pressure (SBP), diastolic blood pressure (DBP),fasting blood sugar(FBS), triglyceride (TG), waist circumference (WC)and body mass index(BMI)whereas positive weak non-significant correlation was seen between FVC and high density lipoprotein cholesterol (HDLC), while no such relation was found with forced expiratory volumein one second (FEV1). In males, negative, moderate significant correlation was seen between FVC and FBS whereas strong, positive, significant correlation was seen between FVC and WC; between FVC and BMI. Negative, moderate, significant correlation was seen between FEV1 and WC; between FEV1 and BMI.Conclusions:Our study concluded that there was a significant impact of FBS and WCon decreasing FVC on both genders with minimally significant impact of other components of metabolic syndrome on FVC with no effect on FEV1 hence indicatinga restrictive pattern of pulmonary function derangement. Hence, further studies with larger sample size isneeded to confirm whether there are direct or indirect mechanisms through which insulin resistance could affect pulmonary function.
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Objective:To explore the predictive value of random forest regression model for pulmonary function test.Methods:From August 2018 to December 2019, 615 subjects who underwent screening for three major chest diseases in Shanghai Changzheng Hospital were analyzed retrospectively. According to the ratio of forced expiratory volume in the first second to forced vital capacity (FEV 1/FVC) and the percentage of forced expiratory volume in the first second to the predicted value (FEV 1%), the subjects were divided into normal group, high risk group and chronic obstructive pulmonary disease (COPD) group. The CT quantitative parameter of small airway was parameter response mapping (PRM) parameters, including lung volume, the volume of functional small airways disease (PRMV fSAD), the volume of emphysema (PRMV Emph), the volume of normal lung tissue (PRMV Normal), the volume of uncategorized lung tissue (PRMV Uncategorized) and the percentage of the latter four volumes to the whole lung (%). ANOVA or Kruskal Wallis H was used to test the differences of basic clinical characteristics (age, sex, height, body mass), pulmonary function parameters and small airway CT quantitative parameters among the three groups; Spearman test was used to evaluate the correlation between PRM parameters and pulmonary function parameters. Finally, a random forest regression model based on PRM combined with four basic clinical characteristics was constructed to predict lung function. Results:There were significant differences in the parameters of whole lung PRM among the three groups ( P<0.001). Quantitative CT parameters PRMV Emph, PRMV Emph%, and PRMV Normal% showed a moderate correlation with FEV 1/FVC ( P<0.001). Whole lung volume, PRMV Normal,PRMV Uncategorized and PRMV Uncategorized% were strongly or moderately positively correlated with FVC ( P<0.001), other PRM parameters were weakly or very weakly correlated with pulmonary function parameters. Based on the above parameters, a random forest model for predicting FEV 1/FVC and a random forest model for predicting FEV 1% were established. The random forest model for predicting FEV 1/FVC predicted FEV 1/FVC and actual value was R 2=0.864 in the training set and R 2=0.749 in the validation set. The random forest model for predicting FEV 1% predicted FEV 1% and the actual value in the training set was R 2=0.888, and the validation set was R 2=0.792. The sensitivity, specificity and accuracy of predicting FEV 1% random forest model for the classification of normal group from high-risk group were 0.85(34/40), 0.90(65/72) and 0.88(99/112), respectively; and the sensitivity, specificity and accuracy of predicting FEV 1/FVC random forest model for differentiating non COPD group from COPD group were 0.89(8/9), 1.00 (112/112) and 0.99(120/121), respectively. While the accuracy of two models combination for subclassification of COPD [global initiative for chronic obstructive lung disease (GOLD) Ⅰ, GOLDⅡ and GOLD Ⅲ+Ⅳ] was only 0.44. Conclusions:Small airway CT quantitative parameter PRM can distinguish the normal population, high-risk and COPD population. The comprehensive regression prediction model combined with clinical characteristics based on PRM parameter show good performance differentiating normal group from high risk group, and differentiating non-COPD group from COPD group. Therefore, one-stop CT scan can evaluate the functional small airway and PFT simultaneously.
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Objective:To explore the application value of CT pulmonary function imaging in patients with Coronavirus Disease 2019 (COVID-19) in the convalescent phase.Methods:The COVID-19 patients who were clinically cured and discharged from Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were prospectively collected from January to April 2020. Clinical pulmonary function tests (PFTs) and CT pulmonary function imaging were performed 3 months after discharge. The Philips IntelliSpace Portal image post-processing workstation was used to obtain the paired inspiratory-expiratory CT quantitative indexes of the whole lung, left lung, right lung and five lobes. The patients were divided into two groups according to whether residual lesions remain in inspiratory CT images: non-residual lesion group and residual lesion group. The chi-square test was used to compare the differences in the PFT results between groups; the Mann-Whitney U test was used to compare the differences in PFT indexes [forced expiratory volume in the first second as percentage of predicted value (FEV 1%), FEV 1/forced vital capacity (FEV 1/FVC), total lung capacity as percentage of predicted value (TLC%), FVC%] and the differences in quantitative CT indexes [lung volume (LV), mean lung density (MLD), volume change in inspiratory phase and expiratory phase (?LV)] between groups. Multiple linear regression was used to analyze the relationship between CT pulmonary function imaging and PFT indexes of convalescent COVID-19 patients. Results:Of the 90 patients with COVID-19, 35 were males and 55 were females; 45 were included in the non-residual lesion group and 45 were included in the residual lesion group. Fifty-three patients had clinical pulmonary dysfunction 3 months after discharge, including 22 patients in the non-residual lesion group and 31 patients in the residual lesion group. In patients with residual disease, left lower lobe and right lower lobe LV, left lower lobe and right lower lobe ?LV in the inspiratory and expiratory phase were smaller than those without residual disease; whole lung, left lung, right lung, left upper lobe, left lower lobe and right lower lobe MLD in the inspiratory phase and left lower lobe and right lower lobe MLD in the expiratory phase were greater than those without residual disease ( P<0.05). Since there was no significant difference in FEV 1/FVC and FVC% between residual and non-residual lesion groups ( P>0.05), FEV 1/FVC and FVC% of two groups were combined. Multiple linear regression analysis showed FEV 1/FVC=91.765-0.016×LV in-right middle lobe+0.014×MLD ex-left lower lobe ( R2=0.200, P<0.001), FVC%=-184.122-0.358×MLD in-right lung-0.024×?LV left upper lobe ( R2=0.261, P<0.001). There was significant difference in TLC% between residual and non-residual lesion groups ( P<0.05), so multiple linear regression analysis was performed both in the two groups. In the non-residual lesion group, TLC%=80.645+0.031×LV ex-right lower lobe ( R2=0.132, P<0.001); In the residual lesion group, TLC%=-110.237-0.163×MLD in-right upper lobe-0.098×MLD ex-left upper lobe -0.025×LV ex-right lower lobe ( R2=0.473, P<0.001). Conclusion:CT pulmonary function imaging can quantitatively analyze the whole lung, unilateral lung and lobulated lung, thus reflecting the regional pulmonary function, providing more valuable diagnostic information for the assessment of pulmonary function in convalescent patients with COVID-19.
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OBJECTIVES: Coronavirus disease 2019 (COVID-19) may be associated with prolonged symptoms and post-recovery health impairment. This study aimed to evaluate the persistence of symptoms, lung function, and pulmonary diffusion for carbon monoxide (DLCO) in patients between 15 and 30 days after hospital discharge after admission for severe COVID-19. METHODS: The evaluation consisted of 1) comparative analysis between the initial symptoms and symptoms still present at the post-discharge evaluation 2) analysis of the chest images obtained during hospitalization, and 3) conducting spirometry, plethysmography, and DLCO assessment. RESULTS: Forty-one patients who were hospitalized for 16±8 days with severe COVID-19 were included. Patients were predominantly men (73%) and had a mean age of 51±14 years. The most frequent comorbidities were arterial hypertension (51%) and diabetes mellitus (37%). Pulmonary evaluation was performed a mean of 36 days after the onset of symptoms, with the most frequent persistent symptoms being dyspnea (83%) and coughing (54%). Approximately 93% of patients still had at least one symptom, and 20% had more than five symptoms. Chest imaging revealed a typical pattern of COVID-19 on X-ray (93%) and computer tomography (95%). Lung function test results showed a restrictive pattern with a reduction in forced vital capacity (FVC) in 54% of individuals, with an average FVC of 78±14%. A reduction in DLCO was observed in 79% of patients. CONCLUSIONS: We observed a high prevalence of symptoms, in addition to a significant change in lung function and DLCO, in the post-discharge assessment of patients requiring hospitalization after admission for COVID-19.
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Humans , Male , Adult , Middle Aged , Aged , Patient Discharge , COVID-19 , Aftercare , SARS-CoV-2 , Hospitals , Lung/diagnostic imagingABSTRACT
COPD has considerable effects on cardiac functions. Most of the increased mortality and morbidity associated with COPD is due to cardiac involvement. We wanted to assess the electrocardiographic and echocardiographic findings in COPD, correlate these findings in assessing the severity and duration of the disease, analyse these findings in assessing right ventricular dysfunction and compare the results of clinical, electrocardiographic and echocardiographic findings in detecting right ventricular dysfunction in COPD. METHODS50 COPD patients fulfilling the inclusion criteria were recruited. They were staged by PFT and evaluated by ECG and echocardiography. Statistical analysis of correlation was done, and statistical significance was taken as p < 0.05. RESULTSAmong the total of 50 cases selected for study 80 % were males, 20 % were females. On the basis of GOLD guidelines there were 8 %, 44 %, 36 %, 12 % mild, moderate, severe and very severe COPD cases respectively. Symptoms at presentation were cough with sputum (92 %), breathlessness (96 %), swelling of feet (24 %), fever (16 %), and decreased urine output (4 %). Physical signs at presentation were tachypnoea (68 %), loud P2 (24 %), parasternal heave (20 %), raised JVP (24 %), pedal oedema (16 %) and ascites (4 %). ECG findings analysis were P-pulmonale (46 %), RAD (38 %), RVH (34 %), low voltage complexes (30 %), poor progression of r-wave (30 %) and incomplete RBBB (12 %). Correlation of all the above ECG findings showed statistical significance (p < 0.05) with disease severity and disease duration (p < 0.05). Echocardiographic findings were pulmonary hypertension (50 %), Cor pulmonale (44 %), RV dilatation (44 %), RA dilatation (32 %), RVH (24 %), interventricular septal motion abnormality (14 %), LVDD (16 %), LVSD (4 %) and RVSD (4 %). All the above echocardiographic findings of RV dysfunction i.e. PAH, Cor pulmonale, RA dilatation, RVD, RVH and RVSD were statistically significant with disease severity and duration (p < 0.05) along with LVDD, LVSD. CONCLUSIONSThis study emphasises on early cardiac screening of all COPD patients which will be helpful in the assessment of the prognosis and will further assist in identifying the individuals likely to suffer increased morbidity and mortality.
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Interstitial Lung Diseases (ILDs) also known as diffuse parenchymal lung disease, include a group of diffuse parenchymal infiltrative lung diseases. A restrictive defect is the most frequent pulmonary abnormality in patients with pulmonary fibrosis which is the usual consequence of many ILDs. Connective tissue disorders are usually rare, but are potentially life threatening conditions. The spectrum of ILD varies from mucocutaneous symptoms, arthralgia / arthritis to impairment of pulmonary and renal function. Systemic Lupus Erythematosus (SLE), Systemic Sclerosis (SSc), Sjogren’s Syndrome (SS), inflammatory muscle diseases and overlap-syndromes are grouped together as connective-tissue disorders. Involvement of lung and its function is the most common form of interstitial lung disease, leading to high morbidity and mortality among the group of connective tissue disorders. We wanted to correlate the 6-Min Walk Distance (6MWTD) with the Pulmonary Function Test values such as % FEV1, % FVC and FEV1 / FVC, among patients with connective tissue disorder associated Interstitial Lung Disease in SRM Medical College Hospital, a tertiary care hospital in Tamilnadu, South India. MethodsThis study was done as a cross sectional analytical study among 31 patients in the Department of Respiratory Medicine, Rheumatology and General Medicine in SRM medical college and hospital. Each patient was explained the purpose of the study and the need for complete co-operation. Those who satisfied the inclusion and exclusion criteria were included. Data was collected using a structured proforma. 6-minute walk test and pulmonary function tests were performed and correlated. ResultsThere appears to be a significant correlation between 6-minute walk test, % desaturation, 6 Minute Walk Test Distance, 6 Minute Walk Test Pre BDI and 6 Minute Walk Test Post BDI with spirometry values especially with the Spirometry FEV 1 %, Spirometry FVC % and % predicted DLCO. Conclusions6MWT can be used as a useful surrogate for pulmonary function tests especially among the population where spirometry is not possible. 6MWT has good reproducibility, is simple to perform and can be used as a screening tool for Interstitial Lung Disease in connective tissue disorder patients.
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Background: Asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome defined as a syndrome characterized by persistent airflow limitation with several features usually associated with asthma and several features usually associated with COPD. This overlap makes the difference between COPD and asthma with persistent airflow limitation difficult, especially in smokers and elderly people. Objective: The objective of the study was to study the clinical features, radiological and pulmonary function characteristics of patients having asthma-COPD overlap syndrome. Materials and Methods: A cross-sectional study carried out at the Department of Respiratory Medicine, Government Medical College, Baroda, attached to SSG Hospital, Vadodara. A total of 100 patients enrolled which were clinically diagnosed with chronic airway obstruction as defined in the GOLD/GINA asthma-COPD overlap syndrome (ACOS) guidelines. Results: In this study, a total of 100 patients were enrolled, out them 76 patients were male and 24 patients were female. Fifty-three patients were from urban area and 47 patients from rural area. Most patients belong to age ranging from 40 to 86. Ninety-nine patients had a breathlessness and it was the most common symptom followed by chronic cough in 93 patients, sputum production in 70 patients, wheezing in 70 patients, running nose in 65 patients, and chest tightness in 46 patients. In smoking history, 25 patients were current smoker, 49 patients were ex-smoker, and 26 patients had never smoked in their life. In pulmonary function test, 26 patients had a normal test, 13 patients had obstructive abnormality with no significant bronchodilator reversibility, 54 patients had a obstructive abnormality with significant bronchodilator reversibility, and 7 patients had a restrictive abnormality. Conclusion: Clinically diagnosed ACOS patients were mostly males, belong to middle age groups, had breathlessness, wheezing, chronic cough with sputum production, and rhinitis and sneezing as the major symptoms. The pulmonary function tests revealed majority of the patients having obstructive pattern in pulmonary function test (spirometry). Furthermore, a majority of these patients had significant positive bronchodilatory response.
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Background: To determine the association between the serum vitamin D levels with the control and severity of asthma.Methods: A total of 113 asthmatic children were enrolled in the study who were on regular follow-up and treatment for the past 6 or more months. The demographic details, presenting complaints, aggravating factors, allergic rhinitis, atopic dermatitis, hospital and ICU stay, duration of sunlight exposure, drug compliance and detailed clinical examination findings were noted in the predesigned proforma. Control of asthma was assessed based on GINA guidelines 2018 as well controlled, partly controlled and poorly controlled. The partly controlled and the poorly controlled group were further combined and labelled as not well controlled group. Severity of asthma was categorized into intermittent, mild persistent, moderate persistent and severe persistent. Serum 25 hydroxy vitamin D was assessed by solid phase ELISA. The well controlled and partly controlled group were compared for all studied parameters.Results: Asthma status of the subjects was categorized as well controlled (59%) as partly controlled (40%) and as poorly controlled (1%). Children with partly and poorly controlled asthma had significantly more vitamin D deficiency (10.9%) and insufficiency (32.6%) compared to well controlled group (4.5% and 4.5% respectively), with p value= 0.000. Low serum vitamin D levels are significantly associated with moderate and severe persistent asthma (p value= 0.009). Exercise significantly induced symptoms in 47.8% of not well controlled group and about 25.4% in well controlled group (p value= 0.014). Examination findings such as wheeze on auscultation was significantly more in not well controlled group.Conclusions: Low serum vitamin D levels are associated with poor control of asthma in children and the severity of asthma is inversely proportional to the serum vitamin D levels.