Pulmonary Function Parameters in Workers of Woolen Industry.

There is an increase in proportion of workers suffering from occupational diseases. In occupational respiratory diseases, pulmonary function tests are the most important and widely used diagnostic tool. Limited studies have been conducted to evaluate the effect of wool dust on pulmonary function parameters. Hence, the present study was undertaken to evaluate the pulmonary function parameters in workers of woolen industry. This study was done on 150 subjects of either gender who were divided into two groups of 75 each. Group I comprised of healthy subjects who served as controls and group II included workers of woolen industry. The values of lung function parameters i.e. volumes and flow rates in these workers were found to be lower than the healthy controls. The significant reduction in percentage predicted values of FEV1 (82 vs 59), FVC (79 vs 63) and MVV (77 vs 64) in workers as compared to healthy controls indicates obstructive pattern of respiratory abnormality. In male workers, percentage predicted FEV1% was significantly lower. The values of all other parameters were lower in female workers. There was a significant decrease in FEV1 and FVC with increase in age in group I and this negative correlation was statistically significant. The decrease in respiratory volumes and flow rates was more with increase in duration of exposure to wool dust. It can be concluded that wool dust present in environment of woolen industry affected the pulmonary function parameters of the workers leading to obstructive pattern of respiratory changes.

Pulmonary Manifestations in HIV Seropositive Patients and Their Correlation with CD4 Counts in a Tertiary Care Centre of North India.

The prolonged course of human immunodeficiency virus (HIV) infection is marked by a decrease in the number of circulating CD4+ T helper cells and persistent viral replication, resulting in immunologic decline and death from opportunistic infections. The study was conducted in HIV Seropositive Patients admitted in our hospital. Demographic profile of the patient was recorded along with history, examination, investigations and evaluated for pulmonary manifestations and correlated with the CD4 counts. Age of HIV positive cases ranged from 21 to 74 years, male: female ratio was 3:1. Commonest mode of transmission was heterosexual sex (77%) followed by IV drug abusers (13.3%). Commonest X- ray finding was Infiltrates (33.3%) followed by pleural effusion (8%) and miliary mottling (5.3%). Commonest pulmonary diagnosis was pulmonary tuberculosis in 22.6% cases, followed by pyogenic pneumonia in 14.67% and pneumocystis carinii pneumonia (PCP) in 5.3% cases. Extrapulmonary tuberculosis was present in 16% of the cases. Pulmonary tuberculosis and pyogenic pneumonia was present in over wide range of CD4 count but their incidence has increased as the CD4 count declined. The knowledge of the CD4 count level in HIV patients is extremely useful in making differential diagnosis and suggesting a diagnostic and therapeutic plan.

Pulmonary Embolism in cases of Pulmonary Tuberculosis: A unique entity.

Pulmonary tuberculosis is very prevalent in developing countries but its thrombogenic potential is a new entity. There are reports stating the relation of Deep Vein Thrombosis (DVT) with severe forms of tuberculosis but no literature is available for correlation of pulmonary tuberculosis and pulmonary embolism. We are presenting series of five patients with different forms of tuberculosis presenting with pulmonary embolism having no risk factor for hypercoagulability. Also, serum protein C, protein S, antithrombin and factor V levels were normal in all. We are highlighting an unreported phenomenon so that high suspicion, adequate prophylaxis and prompt management of pulmonary embolism can play a vital role in the survival of this subset of patients.