Background: Treatment completed pulmonary tuberculosis (PTB) patients are often left with permanent pulmonary function impairment. Lag time remains a major factor in determining the severity of the ...sequelae.
Aims and Objectives: This study aims to assess the impact of lag time on PTB sequelae.
Materials and Methods: A cross-sectional study was conducted during July 2019–December 2020. A total of 85 patients presenting with clinicoradiological features of PTB sequelae were recruited for the study and spirometry and diffusion capacity of lungs (DLCO) were done. They were divided into study groups based on lag time. The lag time (in days) was considered as primary explanatory variable. One-way ANOVA and Chi-square tests were used. coGuide V.1.0 was used for statistical analysis.
Results: The mean lag time was 52.94 days in the study population. The mean duration of after treatment was 15.45 years in the study population. There was a statistically significant difference across study groups (classified based on the lag time) in lung function such as FVC%, FEV1, FEVI/FVC, MEF, DLCO, and duration of after treatment (P<0.05).
Conclusion: The lag time from the development of symptom to the diagnosis of the disease has a significant impact on lung function impairment in PTB sequelae patients since the increase in lag time increases the severity of lung function impairment. Early identification and treatment may help in reducing the progression of lung function impairment.
Background: Asthma is a heterogeneous disease presenting with various phenotypes usually characterized by chronic airway inflammation.
Aims and Objectives: The aim of the study was to identify ...epidemiology of bronchial asthma phenotypes in patients attending totertiary care center.
Materials and Methods: This was a descriptive cross-sectional study involving 69 patients who are suspected to have asthma according to the Global Initiative for Asthma guidelines. The data of each patient were collected on a proforma specially designed for this study on demographic data, socioeconomic status, body mass index, exposure to environmental factors, and other history-related questions. Sputum cytology and absolute eosinophil count were also examined using coGuide and P<0.05 was considered significant. Asthma phenotypes were the primary outcome and association of environmental factors with asthma phenotypes was the secondary outcome.
Results: Out of 69, majority 26 (37.7%) were aged 31–40 years; 35 (50.7%) males and 34 (49.3%) were females. Fifty-eight (84.1%) were illiterate and 46 (66.7%) belonged to low class. Sputum cytology report showed that majority of them, 66.7%, had eosinophilia. The majority, 48 (69.6%), of the participants were triggered by weather and 55.1% had a history of respiratory tract infections. Thirty-three (47.83%) participants had obesity associate asthma, 34 (49.28%) had allergic asthma, and 20 (28.99%) had smoking-related asthma phenotypes. The difference in the proportion of few environment factor was significant for allergic and smoking-related asthma (P>0.005).
Conclusion: The factors associated with the asthma phenotypes will help us further in anticipating the clinical course and better management of the specific phenotypes.
Chronic obstructive pulmonary disease (COPD) is a common disease causing significant socioeconomic burden. COPD patients, commonly smokers develop resistance to inhaled steroids attributed to ...deficiency of histone deacetylase 2 (HDAC2). The study of relationship between systemic inflammation and functional performance demonstrated that increased CRP level is inversely related to six minute walk distance (SMWD) and Forced Expired Volume in one second (FEV1). Theophylline restores HDAC2 activity thereby unlocking steroid resistance and potentiating inhaled corticosteroids (ICS) action culminating in reduced airway inflammation and mortality.
To study the effects of addition of Theophylline to the combination of Formoterol plus Budesonide on various objective and subjective parameters in moderate to severe COPD patients and to assess the safety profile of the combination. Setting and Study design: A single blinded, prospective, randomized, placebo controlled study at a tertiary care hospital in Jaipur, India.
Fifty eight patients diagnosed with moderate to severe COPD were randomized into two groups. Group A patients received Formoterol 24μg plus budesonide 800μg daily in divided doses along with Theophylline while group B patients received Formoterol 24μg plus budesonide 800μg daily in divided doses along with placebo tablets. Both groups were followed up on 15th, 30th &60th day. During every visit all patients were assessed subjectively (symptom scoring) and objectively (spirometry, CRP, SMWT) and adverse effects if any were recorded. The obtained data subject to statistical analysis using"Graph pad Instat3" software.
Statistically significant improvement with a decline in total symptom score (p < 0.0001) was found with respect to "Night symptoms"&"SOB on rising" in group A. Theophylline group showed significant improvement in SMWD and FEV1.Mean fall in CRP was greater in Group A (not statistically significant). No side effects requiring withdrawal of drug were noted with Theophylline.
Addition of Theophylline to Formoterol plus Budesonide reduces dyspnea, improves exercise performance and pulmonary functions in moderate to severe COPD. Further studies are required to explore if reduced dosage would have equal efficacy with better safety and tolerability profile.
Background:
Chronic obstructive pulmonary disease (COPD) is a common disease causing significant socioeconomic burden. COPD patients, commonly smokers develop resistance to inhaled steroids ...attributed to deficiency of histone deacetylase 2 (HDAC2). The study of relationship between systemic inflammation and functional performance demonstrated that increased CRP level is inversely related to six minute walk distance (SMWD) and Forced Expired Volume in one second (FEV1). Theophylline restores HDAC2 activity thereby unlocking steroid resistance and potentiating inhaled corticosteroids (ICS) action culminating in reduced airway inflammation and mortality.
Aim:
To study the effects of addition of Theophylline to the combination of Formoterol plus Budesonide on various objective and subjective parameters in moderate to severe COPD patients and to assess the safety profile of the combination.
Setting and Study design:
A single blinded, prospective, randomized, placebo controlled study at a tertiary care hospital in Jaipur, India.
Materials and Methods:
Fifty eight patients diagnosed with moderate to severe COPD were randomized into two groups. Group A patients received Formoterol 24μg plus budesonide 800μg daily in divided doses along with Theophylline while group B patients received Formoterol 24μg plus budesonide 800μg daily in divided doses along with placebo tablets. Both groups were followed up on 15th, 30th &60th day. During every visit all patients were assessed subjectively (symptom scoring) and objectively (spirometry, CRP, SMWT) and adverse effects if any were recorded. The obtained data subject to statistical analysis using“Graph pad Instat3” software.
Results:
Statistically significant improvement with a decline in total symptom score (p < 0.0001) was found with respect to “Night symptoms”&“SOB on rising” in group A. Theophylline group showed significant improvement in SMWD and FEV1.Mean fall in CRP was greater in Group A (not statistically significant). No side effects requiring withdrawal of drug were noted with Theophylline.
Conclusion:
Addition of Theophylline to Formoterol plus Budesonide reduces dyspnea, improves exercise performance and pulmonary functions in moderate to severe COPD. Further studies are required to explore if reduced dosage would have equal efficacy with better safety and tolerability profile.
Materials and methods:90 patients (73 males, 17 females) aged between 45 and 85 years were included in this cross sectional study. A detailed history was elicited and complete examination was done. ...The sputum specimen was collected using sterile sputum cups prior to emperical antibiotic administration and subjected to Gram’s stain, culture & sensitivity.Results:Our study shows .that Out of 90 cases 81% were males and 19% were females. The predominant clinical features observed in our study was cough with expectoration, exertional dyspnoea and production of mucopurulent sputum. Majority of the patients (95%) were smokers. The prevalence of Gram negative bacteria was 79% and Gram Positive bacteria was 21%. Pseudomonas aueroginosa was the commonest bacteria isolated (28%) followed by Klebsiella pneumoniae (16%). The drug sensitivity reveals that the bes t empirical antibiotic is Ciprofloxacin with gentamicin 79.55% followed by Cefotaxime with gentamycin. The best single antibiotic was piperacillin+tazobactam 68.18%. sensitivity to Amoxicillin +clavulanic acid was 54.55% .Interpretation and Conclusion:In a developing country like India AECOPD is more common in adult males more than 55 years of age due to smoking habit. As an empirical therapy in AECOPD patients the best antibiotic that can be started in our hospital for a better control would be Ciprofloxacin with gentamicin or cefotaxime with gentamicin. Amoxicillin with clavulanic acid was not effective. Other best antibiotic would be pipericillin+tazobactam.
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