Effects of opium inhalation on pulmonary volumes in smoking patients

Historically, opium was used as a potent analgesic and to treat dyspnea and cough. It is documented that opium can increase exercise tolerance and relieve breathlessness. However, its overdose can suppress respiratory centers. The purpose of this study was to evaluate effects of opium on spirometric lung volumes. The study was done on two groups of patients referred to the lung clinic of Labbafi Nejad hospital. Group A was composed of 84 patients who were smokers and group B was made up of 40 patients who were smokers and opium addicts. Patients underwent spirometry and demographic questionnaires were collected. Significant differences were noted on lung volumes between two groups. Forced Vital Capacity [FVC] was 56 +/- 4.6 % in Group A and 72 +/- 4.7 % in Group B [P < 0.001]. Difference on Forced Expiratory Volume in one second [FEV1] was also statistically significant, 53 +/- 6.6 % in Group A versus 69 +/- 4.4 % in Group B [P < 0.001]. In this study, lung volumes were considerably larger in patients who were opium addicts and smokers compared to patients who were only smokers. Further studies are warranted to confirm these results, and such confirmation may lead to better understanding about role of opioids in respiratory diseases

Effect of pulmonary rehabilitation program on patients admitted to ICU: a comparative cross sectional study

Generally ICU patients are in critical status and need long stay in ICU. Pulmonary rehabilitation program [PRP] is considered as an important tool to improve outcome and shorten the length of stay in ICU. The aim of this study was to investigate whether PRP can affect outcome and duration of hospitalization in ICU patients. This study was performed in medical ICU of Labafi Nejad hospital, Tehran, Iran during 2012 and 2013. All of patients who had more than one day stay in ICU were included in the study. They underwent PRP. We compared length of stay, mortality rate and number of hospitalized patients within 2 years in patients with PRP and patients without PRP. In 2012, 155 patients and in 2013, 173 patients were admitted in ICU. Admission period was 15 +/- 2.7 and 11 +/- 2.1 days, respectively [p< 0.001]. Pulmonary physiotherapy showed no effect on patients' outcome in which during 2012, 94 patients were discharged and 61 patients were died and in 2013, 98 patients were discharged and 64 patients were died [p=0.9]. Our study shows that PRP can shorten hospitalization time which can indirectly decrease hospitalization costs but there is no effect on overall survival

Assessment of rapid shallow breathing index as a predictor for weaning in respiratory care unit

At present, air way support plays pivotal role in management of patients in the ICU [Intensive Care Unit] and also RCU [Respiratory Care Unit]. Ventilator weaning is an important step in the care of ICU and RCU patients. It is the gradual removal of mechanical ventilatory support. Different predictors are used for initiation of weaning. This study was designed to investigate the rapid shallow breathing index [RSBI] as a predictor for successful weaning. This cross-sectional study was conducted on 70 patients who had mechanical ventilation for more than 48 hours in a respiratory care unit in Tehran Labbafi Nejad Hospital. They were clinically stable and had the criteria for weaning from the ventilator. We measured RSBI, and then evaluated the value of RSBI for successful extubation. RSBI was calculated when patients were on spontaneous breathing mode with PSV=0 and PEEP=0 for one minute. A total of 70 patients were included in this study; 63[90%] patients had RSBI

Comparison between induced-sputum and bronchoalveolar lavage fluid in diagnosis of pulmonary tuberculosis

Diagnosis of pulmonary tuberculosis in patients with negative smear result or sputum culture and patients who are unable to produce sputum requires other though techniques. This study compares the smear and culture results obtained by induced-sputum as a non invasive method with samples taken by bronchoalveolar lavage [BAL]. A total of 82 patients subjected for bronchoscopy were enrolled. They had 3 negative sputum samples, or were unable to produce sputum. Induced-sputum specimens were taken from all patients before performing bronchoscopy. A total of 18 BAL culture samples were positive, among whom 16 had positive culture in induced-sputum sampling [kappa test: 0.92, p=0.0001]. There was a significant relation between radiologic findings and smear and culture results. Induced-sputum is a non-invasive method when compared with BAL. It is a reassuring alternative of BAL which is a semi-invasive and expensive approach. If the radiologic findings are compatible with pulmonary TB, possibility of positive induced-sputum samples can be increased

Serum troponin levels, APACHE II score and mortality rate for non-cardiac reasons in RCU patients

Estimating the severity of disease and prognosis for patients hospitalized in intensive care units may be important in selection of diagnostic procedures and treatment regimens. For this purpose, various ranking methods have been used in these units which have their benefits and shortcomings. n this study, all patients admitted to the respiratory intensive care unit [RCU] of Labbafi Nejad Hospital during the year 2005 with no signs of cardiac disease or history of cardiopulmonary resuscitation were evaluated. All patients had their serum troponin level checked in the first hour of hospitalization in the unit and upon first medical examination acute physiologic and chronic health evaluation [APACHE] II scores were determined for them. In total, 87 patients were eligible for entering the study. There were significant correlations between serum troponin levels and APACHE II score [p=0.0001]. There was also a significant correlation between elevated troponin levels and mortality rate. Multivariate statistical analysis showed that APACHE II scores and serum troponin levels each are independent variables affecting prognosis among hospitalized patients in the respiratory intensive care unit. Determination of serum troponin levels in non-cardiac patients admitted to respiratory intensive care unit can be a helpful prognostic factor

Intrathoracic kidney presented with chest pain

Intrathoracic kidney is a rare congenital anomaly, with only about 50 cases reported in the literature to date. It comprises less than 5% of all ectopic kidney disorders. However, it should be included in the differential diagnosis of posterior mediastinal masses as confirmation of the diagnosis obviates the need for further clinical studies, further treatment, or unnecessary surgical operation. Chest computed tomography is an important and efficient tool in confirming the diagnosis. We report a case of a 72-year-old woman who suffered from nonspecific chest pain for 3 years. Chest radiography revealed a left posterior mediastinal mass which was later confirmed by chest computed tomography to be a congenital intrathoracic kidney