ABSTRACT
BACKGROUND: Endotracheal intubation and mechanical ventilation in individuals experiencing acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with several complications. Therefore, utilizing noninvasive positive pressure ventilation (NIPPV) is the suggested initial management for these individuals. The current study was done to assess and compare the clinical and physiological parameters before and after the application of NIPPV and also to evaluate the outcomes of NIPPV. METHODOLOGY: A prospective observational study was conducted on 50 patients with COPD experiencing acute exacerbations. These patients were treated with NIPPV. Measurements of blood pressure, respiratory rate (RR), heart rate (HR), dyspnea using the modified Borg scale, and arterial blood gas (ABG) parameters (pH, PaCO2, and PaO2) were recorded at baseline, one hour, six hours, 24 hours, and daily until discharge. The study's outcomes included the subjects who successfully underwent NIPPV and failed during NIPPV. RESULTS: NIPPV effectively reduced the dyspnea score from 7.24 ± 1.58 at baseline to 5.53 ± 1.82 at one hour, 4.11 ± 1.75 at six hours, 2.60 ± 1.03 at 24 hours, and 1.26 ± 0.44 at the time of discharge. Significant improvements were also observed in HR and RR (P < 0.001). When compared to the baseline, the pH level was significantly maintained, PaCO2 was decreased, and PaO2 was increased at various times. Mortality was observed in four patients. CONCLUSIONS: NIPPV was successful in 42 (84%) patients, with improvements in ABG and pH for early recovery and reduced hospital stay.
ABSTRACT
Background Schoolbags or backpacks have been an essential part of the education system for a long time. However, a hefty backpack causes the child to arch the back excessively or bend their head and trunk forward to withstand the weight of the schoolbag. If the student carries the backpack on one shoulder, he/she bends to the opposite side to compensate for the extra weight, which may damage the shoulders and spine. Considering these factors, the main aim of this study was to investigate the percentage of backpack weight in proportion to the student's body weight regarding the new guidelines among urban and rural schoolchildren aged 12 to 15 years in Bangalore, Karnataka. Methodology In southern India, over a year, a cross-sectional study was conducted with 500 students who voluntarily participated after providing written consent. They completed a questionnaire, underwent vital and anthropometric measurements, and had their weights measured, including the weights of their backpacks. Sample bags were inspected to determine contributing weight factors and evaluate adherence to timetables. Results The average weight carried by children of all ages was 6.53 kg, averaging 13.53% of their body weight. Among males, the percentage carrying backpacks weighing over 10% of their body weight was 80.9%, while among females, it was 85.7%. Of all the males carrying bags weighing more than 10% of their body weight, 67.7% attended government schools, while 32.3% attended private schools. Among females studying in government schools, 63.6% carried backpacks weighing more than 10% of their body weight, while among those in private schools, 36.4% carried bags exceeding that weight. Conclusions The study concluded that despite regulations being implemented on backpack weight for children, a significant number still carry bags exceeding 10% of their body weight among both urban and rural school children. This could elevate pressure on neck and back muscles, leading to excessive fatigue and potential damage to the skeletal system, ultimately contributing to spinal deformities.
