value of pulmonary function tests before and after different thoracic and abdominal operations

This study included seventy-one patients classified according to the type of surgery into two groups. Thoracic group including thirty-nine patients subjected to thoracic surgery, their age ranged from 9 to 60 years with the mean of 37.31 +/- 15.29. Abdominal group including thirty-two patients subjected to upper abdominal operation, their age ranged from 17 to 70 years with the mean age of 49.4 +/- 17.95. Full clinical and radiological assessment and also changes in pulmonary function tests [PFTs] and arterial blood gases were done for all the patients pre and postoperatively. The results revealed an acute restrictive pattern, following thoracic and upper abdominal surgery persisting for two weeks and was being more in the first days with gradual improvement in the following days. This reduction in PFTs was marked among patients with preexisting pulmonary disease [COPD], heavy smokers and who underwent resectional thoracic surgery. A significant hypoxemia was observed in the first two days following thoracic and abdominal operation. The incidence of postoperative complications increased in patients with previous lung disease and increased also with abnormal preoperative pulmonary function < 60% for VC, FVC, FEV1, PEFR, MVV and < 75% for FEV1/FVC%. Resectional thoracic operations were followed by a higher incidence of postoperative pulmonary complication than non- resectional surgery

Diagnostic value of chest ultrasonography in different broncho-pulmonary and mediastinal diseases

This study included 113 patients. They were classified into 2 groups including those with bronchopulmonary diseases [89 patients] and mediastinal lesions [24 patients]. The positivity yield of sonography for patients with bronchopulmonary diseases was collectively 31.5%. The highest yield was recorded among patients with bronchial tumours and lung abscess [60% each] while sonography was absolutely valueless in cases with chronic obstructive airway diseases, bronchiectasis and interstitial pulmonary fibrosis. However, the results proved that sonographic success was achieved in 100% of bronchial tumours abut to the chest wall. Ultrasonography was successful in the diagnosis of the mediastinal lesions collectively. The yield of sonography was positive in all the cases presented with pericardial effusion and aortic aneurysm while the positivity yield was only 72.7% for the mediastinal masses. The experience in sonographic evaluation of the mediastinal lesions clarified that the ventral approach is the most suitable one for the diagnosis of these cases. The results have referred to the equal positivity yield [60%] of ultrasonography and fluoroscopy as guided tools for percutaneous needle lung biopsy

Comparison between the effect of nebivolol and other B-blockers on ventilatory lung functions

Bronchial B2 adrenoreceptor blockade was assessed in six normal subjects which were found eligible among 17 normal subjects in whom the bronchodilator response to increasing cumulative doses of inhaled salbutamol was studied. The degree of the bronchial B2 adrenoreceptor blockade was assessed after single oral doses of nebivolol 5mg, atenolol 100mg and propranolol 40mg. The study has a randomized, double blind, crossover, placebo controlled design. There was no significant decrease in post-drug FEV1, PEFR or specific airway conductance [sGaw] after any of the B-adrenoreceptor antagonists. The percentage increase in sGaw after each salbutamol dose did not differ between nebivolol and placebo. The response after atenolol was significantly lower than that after placebo for some salbutamol doses and the response with propranolol was significantly lower than that after placebo, nebivolol and atenolol for all salbutamol doses. The mean dose ratio was 2.5 for nebivolol, 6.3 for atenolol and 31.7 for propranolol. The dose ratio for nebivolol was not significantly different from placebo in contrast to that for atenolol. The dose ratios for nebivolol and atenolol did not differ significantly from each other and both were significantly less than that for propranolol. The response of FEV1 and PEFR to salbutamol was completely blocked after propranolol, but it was insignificantly altered after nebivolol and atenolol. Nebivolol significant blocked cardiac B-adrenoceptors as judged by inhibition of exercise-induced tachycardia. Meanwhile, it did not block cardiac B2-adrenoreceptors as judged by absence of inhibition of salbutamol-induced tachycardia. In conclusion, nebivolol, at the 5mg dose proposed for use in clinical practice, is a selective B2-adrenoceptor antagonist which produces insignificant bronchial B2-adrenoceptors blockade. Its bronchial B2-adrenoceptor blockade is significantly much less than that of the nonselective beta blocker, propranolol and is not grater than that of the selective B- 2-adrenoceptor antagonist, atenolol

role of serology in the diagnosis of extrapulmonary tuberculosis

This study deals with assessment of the diagnostic yield of ELISA, Agglutination and indirect immunofluorscent antibody tests among thirty patients with different types of extrapulmonary tuberculosis in addition to thirty-two healthy subjects as a control group. The overall positivity yield of ELISA at both dilutions of 1/10, 1/100 were 93.3% and 86.7% respectively for the whole group of patients with extrapulmonary tuberculosis in comparison to a positivity yield of 83.3% and 96.7% for agglutination and indirect immunofluorescent antibody tests respectively. On the other hand, the study recorded a specificity of 75%, 84.4%, 81.3% and 90.6% for ELISA 1/10, 1/100, agglutination and indirect immunofluorescent antibody tests respectively as regards their validity in the diagnosis of extrapulmonary tuberculosis. Moreover, the three serological tests proved in this work to be 100% diagnostic for tuberculous pleural effusion and tuberculous lymphadenitis while all the tests had a relatively lower diagnostic yield in cases with tuberculous peritonitis

Effect of a controlled release salbutamol on patients with non-reversible chronic airflow obstruction

Thirty six patients with at least moderate severity CAO [18 in each treatment group] were enrolled in a randomized, double blind, placebo-controlled, parallel group study. Patients received either 8 mg controlled release salbutamol [SCR] or matching placebo tablets twice daily for 6 weeks. Twenty eight patients [14 in each treatment group] completed the study on whom efficacy analysis was performed. Outcome measure included measurements at clinic visits as well as those recorded at home inpatient's daily record cards. Clinic-visit variables were FEV, FVC, PEFR, 6-minute walking distance, oxygen cost diagram score, dyspnoea Borg scale score, and patient's assessment of efficacy. Daily record card variables included morning and evening PEFR, and day-time symptom score of breathlessness. The efficacy of SCR was assessed by comparing it to placebo regarding the absolute change from baseline of the various outcome variables after 3 and 8 weeks of treatment. The absolute magnitude of SCR or placebo-induced changes for all the test parameters were small, as might have been predicated from the characteristics of our study population. Three and six-week treatment resulted in a tendency towards greater improvement with SCR compared to placebo in most of the variables tested. However, SCR did not differ significantly from placebo in any of these outcome variables. Tremors was the most frequently reported side effect among 22% of patients receiving SCR. In conclusion, SCR has no significant beneficial effects in patients with predominantly non-reversible CAO of at least moderate severity and the benefits gained from its use in those patients, may not outweigh the potential risks and expense, and do not justify routine long-term prescription