Assessment of the correlates of respiratory morbidity related quality of life, using St George Respiratory Questionnaire (SGRQ) among male COPD patients

Background: COPD is ranked eighth among the top 20 conditions causing disability globally. Assessment in subjective areas such as dyspnea and HRQL provides complementary information to physiologic measurements. Lower Health-Related Quality of Life has been associated with mortality and morbidity in COPD.Methods: The study was conducted at the Department of Respiratory Medicine and at Vallabhbhai Patel Chest Institute and the associated, Vishwanathan Chest Hospital, University of Delhi. Between September 2012 to August 2013. We conducted present study on 40 male COPD subjects aged more than 45 years, divided into 4 groups based on CT phenotype as normal, Airway Dominant (AD), Emphysema Dominant (ED) and mixed types. We compared the St. George Respiratory Questionnaire scores, 6 Minutes’ walk Distance scores, Clinical parameters, Spirometry indices across these phenotypes. Results: The mean SGRQ score in present study was 54.07 ± 17.24 (Range :17.3 to 84.57). The Mean 6MWD in present study was 434.58 ± 125.47 metres. The significant parameters which had correlation with SGRQ total score were Age (r=0.343, p = 0.03), 6MWD (-0.397, p = 0.011), FEV1 /FVC (0.499, p< 0.001), DLCO (-0.601, p <0.001), Low attenuation areas in CT (0.606, p< 0.001). Conclusions: 6MWD, FEV1/FVC, age, Low attenuation areas in CT, DLCO had an influence on the quality of life as measured by SGRQ scores in present study. Therapeutic approaches to improve the quality of life in COPD should take these indices into consideration.

Interlobar hydropneumothorax.

We report a case of interlobar hydropneumothorax in a 42-year-old male with chronic obstructive pulmonary disease and a history of tuberculosis in the past. The diagnosis was suspected from chest roentgenograms that showed an incompletely circumscribed air containing space with a fluid level. The diagnosis was confirmed by computed tomography. This unusual presentation of hydropneumothorax with striking radiological features prompted us to report this case.

A rare cause of exertional dyspnoea and hemoptysis in a 30-year-old female.

A young female patient of 30 years of age previously asymptomatic presented with complaints of exertional dyspnoea and hemoptysis with a normal chest roentgenogram. She was eventually diagnosed to have lymphangioleiomyomatosis, a rare pulmonary disorder. In this patient it occurred without any history of current pregnancy or estrogen consumption, as a sporadic entity.

Rare case of pulmonary joint, cardiac and mediastinal involvement in rheumatoid arthritis with bronchial asthma and allergic rhinitis.

It is extremely uncommon to find a patient with rheumatoid arthritis with pulmonary and cardiac manifestations together with co-existent intrathoracic lymphadenopathy. We report the case of a 40-year-old female with rheumatoid arthritis with rheumatoid lung disease with severe aortic regurgitation, congestive heart failure, bronchial asthma and allergic rhinitis.