Correlation of Body Mass Index with Pulmonary Function Tests in North Indian Females

Introduction: Obesity is becoming one of the serious publichealth problems of modern world with rapidly changinglifestyles involving consumption of high calorie foods withdecreased physical activities. Spirometery is the initialscreening tool for pulmonary diseases. The aim of this studywas to evaluate the prevalence of deranged BMI, pulmonaryfunction tests and correlation between BMI and pulmonaryfunction test.Material and methods: This study was done on 300 femalesubjects in the age group of 18-25 years including 150 fromrural area and 150 from urban area of North Indian populations.Various anthropometric measurements (height, weight) weretaken. BMI was calculated. Parameters of pulmonary functiontests such as FVC, FEV1,FEV1/FVC,FEF25-75%,PEFR weremeasured by spirometer.Results: The mean value of BMI in rural and urban populationis (23.33±4.75) and (22.55±4.57) respectively. On comparingPulmonary function parameters of both the population, allthe parameters were significantly higher in urban populationexcept FEV1/FVC.Conclusion: Prevalence of deranged BMI was significantlyhigher in rural population. Negative correlation found betweenBMI with Pulmonary function tests in both population exceptFEV1 and FVC which showed positive correlation in urbanpopulation.

Pulmonary Function Impairment in Female Workers Exposed to Environments with Varied Ambient Air Pollution in the Central Business Area of Lusaka-Zambia.

Aims: To determine the lung function of cleaners exposed to particulate matter of aerodynamic diameter less than 2.5 micrometer (PM2.5) in the streets and offices in Lusaka, Zambia. Study Design: This was a cross sectional study between two groups. Place and Duration of Study: Lusaka city, central business area, between June and August 2014. Methodology: The study included women between 18-50 years of age who had been working as street or office cleaners for 6 months or more. Males and individuals in both groups who used to smoke or were currently smokers, as well as those with a history of respiratory related illnesses or had cardiopulmonary conditions were excluded from the study. The cleaners were interviewed to get information on socio-demographic characteristics and other information using a structured interview schedule. The participants’ lung volumes, forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and their ratio (FEV1/FVC) were measured using a MRI spirobank G spirometer. On the day of the interview, PM2.5 in their work environment was sampled using a personal aerosol monitor (SIDEPAK AM510). Results: Out of the 90 participants, 45 were street sweepers and 45 were office cleaners. More street sweepers had impaired lung function (FEV1/FVC) 15(75%) than office cleaners 5(25%) p=0.01. FEV1 was also significantly different among street sweepers 12(70.6%) and office cleaners 5(29.4%) p=0.05. PM2.5 measurements revealed significantly high levels of exposure among street sweepers (p=0.001). Participants with impaired lung function (p=.005) and those with reduced FEV1percent predicted were exposed to significantly high concentrations of PM2.5 (p=0.012). Conclusion: Exposure to high PM2.5 concentration is associated with pulmonary function impairment and reduced FEV1 % predicted among cleaners.

THE UNDERUSE OF SPIROMETERY IN ROUTINE MEDICAL PRACTICE FOR DIAGNOSIS AND MANAGEMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PATIENTS IN KARACHI, PAKISTAN

Introduction: Spirometry is important in the diagnosis and management of chronic obstructive pulmonary disease (COPD), yet it is a common clinical observation that it is underused though the extent is unclear. This survey aims to examine the use of spirometry in the diagnosis and management of COPD patients in districts of, Karachi. Material and Methods: It is a cross-sectional survey involving four clinic settings: hospital-based respiratory specialist clinic, hospital-based mixed medical specialist clinic, general outpatient clinic (primary care), and tuberculosis and chest clinic. Thirty physician-diagnosed COPD patients were randomly selected from each of the four clinic groups. All of them had a forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) ratio less than 0.70 and had been followed up at the participating clinic for at least 6 months for COPD treatment. Results: Of the 120 COPD patients, there were 111 males and mean post-bronchodilator FEV1 was 46.2% predicted. Only 22 patients (18.3%) had spirometry done during diagnostic workup, and 64 patients (53.3%) had spirometry done ever. Conclusion: We conclude that spirometry is underused in general but especially by non-respiratory physicians and family physicians in the management of COPD patients. More effort at educating the medical community is urgently needed.

Changes in pulmonary ventilatory function in patients with thyrotoxicosis / 대한내과학회지

OBJECTIVE: Dyspnea is a common symptom in patients with thyrotoxicosis, which may be caused by several mechanisms including pulmonary ventilatory dysfunction. There have been controversies among studies on changes in pulmonary ventilatory function in thyrotoxicosis. We were to evaluate the changes in pulmonary ventilatory function in patients with thyrotoxicosis. METHODS: We measured the pulmonary ventilatory function with spirometry in 32 thyrotoxic patients with Graves' disease and in 22 age, sex-matched euthyroid control subjects. The changes in ventilatory function after treatment were evaluated in 18 thyrotoxic patients who became euthyroid with antithyroid drug treatment. RESULTS: 1) Forced vital capacity(FVC) was significantly lower in thyrotoxic patients compared to control subjects(3.06+/-0.68 L and 3.35+/-0.55 L, respectively, p<0.05). Percent predicted values of FVC showed similar results; 82+/-16 % in patients and 95+/-11 % in control subjects(p<0.05).2) Forced expiratory volume for 1 sec.(FEV1.0), forced expiratory flow 25-75(FEF 25-75) and FEF 50 were not different between patients and control subjects. FEV1.0/ FVC ratio were higher in thyrotoxic patient than in control(88+/-7 % vs. 84+/-8 %, p<0.05). 3) Serum thyrotropin binding inhibitor immunoglobulin (TBII) activities were significantly correlated with pretreatment FVC values(R=-0.45, p<0.05) and with FEV1.0 values(R=-0.41, p<0.05) in thyrotoxic patients. However, serum thyroid hormone concentrations had no correlations with FVC or with FEV1.0 values. 4) FVC, FEV1.0 of thyrotoxic patients increased, and FEV1.0/FVC ratio decreased sifnificantly after treatment of thyrotoxicosis in patient group. Numbers of patients with normal, mild, moderate, severe restrictive disease were 10, 4, 3, 1, respectively before treatment, which became 14, 2, 2, 0 after treatment of thyrotoxicosis in patient group. CONCLUSION: Ventilatory disturbances of restrictive pattern were common in thyrotoxic patients that were partially reversible after treatment of thyrotoxicosis. Such changes may be one of mechanisms causing dyspnea in thyrotoxic patients. The fact that decrease in FVC were significantly associated with serum TBII activities (thyroid autoantibody), but not with degree of thyrotoxicosis suggests that autoimmune process itself is involved in the development of pulmonary function abnormalities observed in those patients.