Pulmonary Manifestations in Patients of Rheumatoid Arthritis and its Correlation with Severity of Disease

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown etiology marked by symmetric, peripheral polyarthritis. RA has a prevalence of 1–2% in the general adult population. The mortality rate in patients with RA increases during the course of the disease, with a tendency to accelerate after 15 years. Aim: To study the pulmonary manifestations and their severity using [Disease Activity Score (DAS)—28 score] in patients of RA. Materials and methods: Present study was conducted in the Department of Medicine, Sardar Patel Medical College and Associated Group of Hospitals Bikaner, Bikaner, Rajasthan, India, on 100 patients. This study was a cross-sectional, observational study conducted over 1 year. Consecutive cases of RA patients attending the outpatient department or admitted to the medicine wards were selected according to the inclusion and exclusion criteria. Results: Pulmonary manifestation was present in a total of 38% of cases, while the remaining 62% of cases had no pulmonary manifestation. The presence of comorbidity and C-reactive protein (CRP) was significantly associated with pulmonary manifestation in RA patients. On high-resolution computed tomography (HRCT), the most common finding was interstitial lung disease (ILD) (60.5%), with usual interstitial pneumonia (UIP) as the most common pattern. On performing a pulmonary function test (PFT), 33 patients (86.84%) had an abnormal result, with restrictive as the most common pattern. Conclusion: The patients of RA, especially those with advanced age, long duration of disease, male sex, and associated comorbidity, should be screened for pulmonary complications of RA using X-ray chest and PFT, supplemented by HRCT chest wherever required.

Spectrum Of Dyspnea During Pregnancy A Tertiary Centre Based Study In North West Raasthan

Physiological changes during pregnancy influence maternal respiratory function and gas exchange, and may cause dyspnea in normal pregnancy. On the other hand, dyspnea can be caused by pregnancy complications, cardio vascular amd respiratory disorders.. In this review, the aim was to outline the mechanisms of change within the respiratory system during pregnancy, and thus to enable a differential diagnosis of dyspnea in normal pregnancy as opposed to pathological dyspnea.we found that out of 2400 females attending ANC clinic 70 was having pathological dyspnea among which 6 has involvement of cardio vascular system while remaining 64 was suffering from respiratory system involvement,hence we conclude that , a careful history, chest X-ray, pulmonary function test and arterial gas evaluation are warranted to diagnose pathological dyspnea in pregnancy and hence institution of proper therapy