Department Of Pulmonary Medicine Research Articles

ICU Admission Rate Among Patients With Acute Exacerbation of COPD: What Are Predictors for Ventilator Support?

SESSION TITLE: Airways 5 SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM PURPOSE: To study the mean predictors of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) for hospitalization and intensive care unit (ICU) admission. METHODS: 139 patients with AECOPD had admidtted to the pulmonary medicine department of medical university hospital from November 2013 to December 2015.Depending on ICU admission all patients were divided into two groups:1)64 patients with AECOPD admidtted to ICU;2)75 patients with AECOPD with admidtted to pulmonary medicine department. RESULTS: Of 139 patients hospitalzed with AECOPD ,101 cases(64%) were radiologically -confirmed pneumonia,38cases(36%) were non-pneumonic AECOPD.ICU admission more frequently was noted among patients with pneumonic AECOPD(73.0% vs 27.0% in non-pneumonic group;p<0.001).Another mean predictor for ICU admission in patients with AECOPD was hypercapnic respiratory failure (p<0.0001).The older age of patients was one of most risk factors of ICU admission(74.9±5.3 vs 65.7±6.7; p<0.001).Rarely risk factor for ICU admission among patients with AECOPD was septic shock.There was no differenc in ICS use and hospital admission between pneumonia group amd non-pneumonia group and there is also was no difference in ICS use and ICU admission between pneumonia group and non-pneumonic group. CONCLUSIONS: The most frequent cause of hospitalization in patients was pneumonia.Altough the most common cause of ICU admission of AECOPD was pneumonia.It is difficult to separate exacerbation of bronchial inflammation by infection from concomitant pneumonia with COPD.Therefore,it is reasonable to regard pneumonia as one of condition of the COPD exacerbation.Hypercapnic repiratory failure and older age were another most common causes for ICU admission in hospitalized patients with AECOPD.Non-pneumonic exacerbation was observed frequently in non-emphysema type.Septic shock was rare risk factor ICU admission for patients with AECOPD. CLINICAL IMPLICATIONS: Critical and Intensive Care,Respiratory Therapist,Pulmonologists DISCLOSURE: The following authors have nothing to disclose: Alizamin Sadigov No Product/Research Disclosure Information

A cross sectional study to assess the nutritional status of Chronic Obstructive Pulmonary Disease Patients

Background: Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease, is a major public health concern. Therefore, the present study was conducted to assess the nutritional status in COPD patients by using anthropometric, biochemical and bioelectric impedance analysis. Methods: This cross-sectional study conducted in the Department of Pulmonary Medicine, Medical College, Thiruvananthapuram, India from March 2013 to November 2014. A pulmonary specialist diagnosed all subjects. Using revised GOLD 2011 criteria they were divided into four groups (A, B, C, D). Anthropometric and biochemical indices, body composition analyses by bioelectric impedance, spirometry test, and determination of disease severity were performed in all subjects. Results: A total of 435 COPD patients included 287 men (60.0%) and 148 women (34.0%), with a mean age of 60.2 (SD11.2) yr in disease stages A to D. Of all COPD patients, BMI was less than 18.5 kg/m2 for 37.9%. This Prevalence of under nutrition based on BMI was found to be statistically significant among study participants with p<0.001. Mean value of BMI, MAC, MAMC and TSF significantly lowered as the severity of COPD increased with p <0.001. Decreased mean values of FM, FMI, and FFM were significantly associated with increasing severity of COPD with p <0.001. Plasma albumin was less than 3.5 g/l among 72 (17%) patients. Total protein, less than 6 g/l was founded in 58 (13%) of patients. Plasma levels of albumin, total protein, urea, creatinine were lowered with the increase in the severity of disease. Conclusion: The study findings highlight the importance to consider body composition in addition to body mass index as the only criterion of malnutrition, because patients do show frequent alterations in body composition, affecting the muscle store, the fat and total body water as the disease became more severe.

A CASE REPORT ON PULMONARY ALVEOLAR MICROLITHIASIS.

31Aug 2016 A CASE REPORT ON PULMONARY ALVEOLAR MICROLITHIASIS. Suman Kumar Jagaty , Pravati Dutta , Rekha Manjhi and Sudarsan Pothal. Department of pulmonary medicine, VSS Medical College, Burla, Odisha, India.

Obstructive sleep apnea and excessive day time sleepiness as measured by epworth sleepiness scale

Introduction: Many patients search for medical care for symptom of a sleep disorder, obstructive sleep apnea hypopnea syndrome (OSAHS). Currently overnight polysomnography is the gold standard for diagnosis of OSAHS. However, the test is costly and time taking, accessible in big cities only and is not always well accepted by patients. Therefore approximately 95% of the patients with sleep disorders are not diagnosed. Although subjective, the Epworth Sleepiness Scale may contribute to analyze signs and symptoms. It is easy to be applied, fast and free of charge. The purpose of our study was to evaluate Epworth Sleepiness Scale Scores and AHI in obese patients and to compare these parameters. Methods: The present study is an observational study which was conducted in the Department of Pulmonary Medicine, People’s College of medical Science & Research Centre, Bhopal from Oct. 2013 to April 2015. Randomly selected 100 patients with BMI ≥23 fulfilling inclusion and exclusion criteria were assessed in the study. Result: In our study we took 100 patients, 5 of them have ESS score 9.In mild AHI group 2, patients were in ESS 9 group. In moderate AHI group 2 patients were in ESS score 9 group. In severe AHI group only 1 patient were in ESS 9 group. Conclusion: We concluded that ESS shows correlation with AHI for severe and normal levels, but not for mild and moderate levels.

Clinico Pathological Correlation of Chronic Obstructive Pulmonary Disease among Rural Population of North India

BACKGROUNDChronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality in rural population. COPD is characterized by chronic airflow limitation and a range of pathological changes in the lung, some significant extra-pulmonary effects, and important co morbidities which may contribute to the severity of the disease in individual patients.METHODSThis study was conducted in Department of Pulmonary Medicine and central laboratory from 1st January 2015 to 31st December 2015 in Rural Institute of Medical Science &amp; Research, Saifai, Etawah (U.P.), India on patients who presented with symptoms of COPD.RESULTSThe age group of the patient in the study, ranged from 35 to 85 years. The most common age group was 61-70 years (32.99%). Among these patients 92.95% were males and 7.04% were females. Dyspnoea (84.50%) was the common clinical manifestation. Out of 497 patients, 94.96% were smokers and 5.03% were non-smokers. Among these COPD patients 25.15% males and 4.82% females had normal hemoglobin. Similarly, normal total leukocyte count, differential leukocyte count was seen in 56.13% males and 3.82 % females. The gram negative isolates were 63.32% as compared to 36.82% of gram positive. On sputum cytology, bacteria were found in 64.18% and fungus in 35.81%. During sputum culture, Streptococcus (29.97%), was the commonest bacteria isolated followed by Moraxella (25.55%) and Pseudomonas (16.90%). Fungal isolates were Aspergillus (27.96%) and Candida spp. (7.84%).CONCLUSIONSCOPD was common in older age group, males, and smokers. Patients predominantly presented with dyspnea and chronic cough. Streptococcus was the most common organism isolated and fungus species were also isolated.

Bacterial etiology in acute hospitalized chronic obstructive pulmonary disease exacerbations

Introduction. The most common cause of acute COPD exacerbation (AECOPD) is the respiratory tract infections. We sought to determine the bacteriological etiology of hospitalized acute exacerbations of COPD requiring hospitalization in consecutive two years. Methods. We aimed to determine the bacteriological etiology underlying in patients whom admitted to Uludag University Faculty of Medicine, Department of Pulmonary Medicine and hospitalized with AECOPD in the last two years. Medical records of the study participants were screened retrospectively and sociodemographic characteristics, routine laboratory tests and sputum culture results were analyzed. Results. A total of 242 patients hospitalized for AECOPD were enrolled. Of these 86.4% (n=209) were male. The mean age of the group was 66.6±11 years old. Sputum cultures were available in the 45 % (n=109) of the study group. The most frequent bacteria isolated from the sputum cultures of the study group were Pseudomonas aeruginosa, Streptococcus pneumonia , Haemophilus influenzae and Acinetobacter baumanii . Length of stay was longer in patients with the A. baumanii isolate than the rest of the group ( p =0.024). Length of stay in hospital was independently associated with in-hospital mortality (OR: 1.37, 95% CI: 1.05–1.78). Isolation of A. baumanii and/or Staphylococcus aureus in sputum culture were identified as independent risk factors for prolonged length of stay in-hospital (b=0.26, p =0.008; b=15.40, p =0.003). Conclusion. Our study shows that P. aeruginosa, S. pneumonia , H. influenzae are common sputum isolates in AECOPD patients requiring hospitalization. Isolation of A. baumanii and/or S. aureus in sputum culture is associated with prolonged length of stay in hospital, which is an independent risk factor for in-hospital mortality.

Bronchial Artery Embolization for Moderate to Massive Hemoptysis

Purpose of study: Hemoptysis is a common emergency coming to the pulmonary medicine and general Medicine department. Massive hemoptysis has high mortality even after surgical treatment. Bronchial artery embolization is an effective alternative to surgery for controlling hemoptysis, with high success rate.

Case report of tracheobronchial squamous cell carcinoma treated with radiation therapy and concurrent chemotherapy

a Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Boston, Massachusetts b Harvard Medical School, Boston, Massachusetts c Department of Medical Oncology, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Boston, Massachusetts d Department of Pulmonary Medicine, Newton-Wellesley Hospital, Newton, Massachusetts e Division of Thoracic Surgery, Brigham and Women’s Hospital, Boston, Massachusetts

Frequency of adverse events observed with second-line drugs among patients treated for multidrug-resistant tuberculosis

BackgroundMultidrug-resistant tuberculosis (MDR-TB) is considered to be a worldwide problem with notoriously difficult and challenging treatment. Adverse events associated with second-line drugs (SLDs) can have severe impact on efficient management. ObjectiveTo know the frequency of adverse events due to SLDs in patients of MDR-TB. DesignA prospective cohort analysis of 98 MDR-TB patients enrolled between June 2009 to February 2010 was conducted in Department of Pulmonary Medicine, King George Medical University, Lucknow, India. All the patients were provided standardized regimen. Adverse events associated with treatment were recognized primarily by clinical evidence and/or laboratory investigations that were advised at baseline and whenever clinically indicated during course of treatment. Adverse events were considered major if required permanent discontinuation or substitution of drugs. Results119 adverse events were reported in 46 (46.9%) patients. The grouped adverse events were most commonly gastrointestinal that was observed with a frequency of 48 (40.3%) followed by ototoxicity in 28 (23.6%), and neurological in 21 (17.6%). 17 (17.4%) patients had major adverse events requiring permanent discontinuation or substitution of drugs that included deafness and tinnitus in 5 (5.1%) followed by psychosis in 4 (4.1%). None of the patients stopped complete regimen due to adverse events. The treatment success rate was observed to be 71 (72.4%). ConclusionsMDR-TB can be cured successfully with appropriate combination of drugs if adverse events associated with them can be managed aggressively and timely. Newer and less toxic drugs are urgently needed to treat MDR-TB patients.

A clinical review of 38 cases of cervical tuberculous lymphadenitis in Japan - The role of neck dissection.

After tuberculous pleurisy, lymphadenitis arising from cervical lesion is the second most common form of extrapulmonary tuberculosis. It is generally treated with antituberculosis agents, but some patients resist chemotherapy. In such cases, surgical resection is often considered as an alternative treatment. This study aims to evaluate the therapeutic outcome of cervical tuberculous lymphadenitis and the future course of treatment of this disease. We retrospectively reviewed the clinical charts of patients diagnosed at the Tokyo Metropolitan Tama Medical Center between 2009 and 2015 and identified 38 cases of cervical tuberculous lymphadenitis. Precisely 798 patients were registered for primary tuberculosis at our institution during the same period. Patient ages ranged from 21 to 85 years (average: 58.9 years), and the male-to-female ratio was 1:1.2. The range of tuberculosis progression was as follows: 30 (78.9%) in only the cervical lymph node, 3 in the other (axillary, mediastinal, and abdominal) lymph nodes, 1 in the lung and vertebrae lumbales, 2 in the lung, and 1 in the pleural membrane. All 38 patients were initially treated with antituberculous drugs at the Department of Pulmonary Medicine based on guidelines for tuberculosis cases in Japan. In seven cases, the antituberculous drugs were replaced due to side effects. Four cases involved a single drug-resistant strain, and one case involved a double drug-resistant strain. Thirty-three (86.8%) cases were cured by chemotherapy alone. The three patients resistant to chemotherapy were successfully treated through neck dissection. Thirty-six cases (94.7%) were cured by chemotherapy or chemotherapy and surgery. Local therapy could prove effective in cervical tuberculous lymphadenitis patients who exhibit an inadequate response to drugs. The role of neck dissection in cervical tuberculous lymphadenitis remains an important consideration.

Assessment of length of hospital stays of patients with acute exacerbations of chronic obstructive pulmonary disease

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is prone to acute exacerbations which may lead to enhanced morbidity and mortality. Information on the time course and recovery from COPD exacerbation is important in standardizing the length of treatment, in planning appropriate follow up and decreasing loss of working days of the patient. Material and Methods: It was a prospective study (observational) which included all patients with Acute Exacerbation of COPD (AECOPD) admitted to the Department of Pulmonary Medicine, People’s College of Medical Sciences & RC, Bhopal, over a period of 1 year 6 months. Results: In this study we observed the mean length of stay (LOS) of patients with AECOPD was 9.53±3.4 days. There was no significant difference in length of stay between patients in different age groups. The LOS varied significantly between different GOLD stages. The patient who had a history of admission for twice or more in the past 1 year had a greater mean LOS as compared to patient with just one or no hospitalisation in the past. Conclusion: The patient who had a history of admission for twice or more in the past 1 year had a greater mean LOS as compared to patient with just one or no hospitalisation in the past.

Effectiveness of clinical pharmacist intervention on health-related quality of life in chronic obstructive pulmonary disorder patients - a randomized controlled study.

Chronic obstructive pulmonary disease (COPD), a preventable and treatable disease, has been described as '10% medication and 90% education'. Extreme physician scarcity limits the implementation of quality healthcare delivery in India. We conducted this study to evaluate the effectiveness of clinical pharmacist intervention on health-related quality of life (HRQoL) in patients with COPD in an Indian tertiary care hospital. An open-labelled randomized controlled study was conducted over a 3-year period, at Kasturba Medical College Hospital, Manipal, India, after obtaining institutional ethics clearance (IEC 88/2012). The study was registered with the Indian clinical trial registry (CTRI/2014/08/004848). Patients were randomly assigned to two groups (intervention group [IG] and control group [CG]) by envelope method. St. George's Respiratory Questionnaire (SGRQ) was used to assess the HRQoL. The pharmacist intervention laid emphasis on (i) importance of medication compliance, (ii) need for smoking cessation, (iii) simple exercise, (iv) proper use of inhaler devices and (v) need for timely follow-up by pulmonary medicine department. SGRQ assessment was repeated at 6, 12, 18 and 24 months. Of 328 patients with COPD screened during the study period (March 2012 to June 2013), 260 (79%) were recruited. Of these, 202 (78%) patients completed follow-up (98 in CG and 104 in IG). Both groups were matched for baseline, sociodemographics and clinical characteristics. SGRQ scores and its subscales (symptoms, activity and impact) improved significantly after the pharmacist intervention in IG at follow-up (P < 0·001). Our randomized controlled study shows that pharmacist intervention improved the HRQoL of patients with COPD in India. The generalizability of our results requires exploration even within other settings in India. Nonetheless, our results provide support for a greater involvement of pharmacists in the care of patients with COPD.

Effect of vitamin A and zinc on circulating profile of IL-2, IL-12, and IFNγ cytokines in pulmonary tuberculosis patients

Background: Tuberculosis (TB) is a major public health problem throughout the world and one of the leading causes of mortality. Vitamin A and zinc deficiency is frequently observed in patients of pulmonary TB and thus, diminish the activity of their immune system. The aim of this study was to investigate the effect of vitamin A and zinc supplementation on sputum conversion time and immunological profile in pulmonary TB patients receiving antitubercular treatment. Materials and Methods: This was a double-blind, placebo-controlled study. The cases comprised those outpatients with active pulmonary TB (new sputum smear positive) who had attended the DOTS center in the Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India. Results: Total 260 patients were enrolled and randomly grouped into four categories of intervention. After completion of the follow-up, some patients dropped out from the study so that total 208 patients completed it. The level of interleukin-2 (IL-2), IL-12, and interferon gamma (IFNγ) was significantly (P = 0.001) changed and the sputum smear conversion was significantly early in the vitamin A and zinc supplemented group. Conclusion: We demonstrated that vitamin A and zinc may directly or indirectly influence the activation of cytokines. The circulating cytokines play an especially important role in the pathogenesis of active pulmonary TB.

Significance of Total Protein, Albumin, Globulin, Serum Effusion Albumin Gradient and LDH in the Differential Diagnosis of Pleural Effusion Secondary to Tuberculosis and Cancer

Lung cancer and Pulmonary tuberculosis are two major public health problems associated with significant morbidity and mortality worldwide particularly in low and middle income countries like India. Wrong diagnosis of lung cancer cases as pulmonary tuberculosis in primary health care system delays the onset of anti-cancer chemotherapy as well as initiation of DOTS thus increasing complication and mortality rate in malignancy patients. In this context easy, cost effective diagnostic tool at primary level must be the priority and need of hour. To study and evaluate any significance of biochemical parameters (total protein, albumin, globulin, serum effusion albumin gradient, LDH) in serum and pleural effusion secondary to tuberculosis and lung cancer. A case control study was carried out on patients attending OPD and IPD, Department of Pulmonary Medicine, RMCH. Hundred cases of Tuberculosis effusion, 50 cases of Malignant effusion and 100 age and sex matched apparently healthy controls were taken for correlation of biochemical parameters (total protein, albumin, globulin, serum effusion albumin gradient, LDH) and statistically evaluated to find any significance between tuberculosis, lung cancer and control group. Blood and pleural fluid samples were collected and then subjected to assessment of parameters (total protein, albumin, LDH) by using EM360 Autoanalyser and kits were supplied by Transasia diagnostics. Globulin and Serum Effusion Albumin Gradient (SEAG) was calculated mathematically. Data is presented as mean ± SD. Comparison of serum and pleural fluid levels (of taken parameters) were done in TB, Lung Cancer and Control groups by ANOVA and students t-test. The p-value <0.05 were considered as statistically significant. We found serum-total protein, albumin, globulin to be significantly higher in TB group than lung cancer group but serum LDH was higher in lung cancer group (in all parameters p=<0.0001). Pleural Fluid-total protein, albumin, globulin was again significantly higher in TB group than lung cancer group and LDH was higher in lung cancer group (p=<0.0001). SEAG is also significantly higher in TB group than lung cancer group (p=<0.002). The results suggests early quantization of these parameters can differentiate pulmonary tuberculosis from lung cancer and thus can decrease the mortality rate of lung cancer cases though more extensive study with increased sample size may provide more insights.

Study of 100 cases of pleural effusion with reference to diagnostic approach

Background: Collection of an abnormal quality and quantity of fluid in the pleural cavity is called pleural effusion. In this study an attempt has been made to arrive at the etiological diagnosis of pleural effusion by analysis of history, clinical presentation, biochemical, radiological, cytological and bacteriological methods. Methods: This study was carried out in the Department of Pulmonary Medicine, B.J. Medical College, Ahmedabad, Gujarat, India. In this study total 100 indoor patients of adult age and either sex were taken. Patients with pleural effusion as determined by clinical and or radiological means, thoracocentesis on who yield a minimum amount of fluid enough to carry out routine test were included in the study. Patients with pleural effusion with non aspirable fluid quantity decided clinically or radiologically, were excluded. Results: Most of the patients were between the age group of 31-40 years and males (68%). Most of the patients of tuberculous effusion were from younger age group between 21-50 years. Most common symptom was chest pain (72%) followed by fever (62%). Most of cases were tuberculous (62%) followed by malignant (18%). There were 15 patients with undiagnosed pleural effusion, in which, thoracoscopic pleural biopsy was done, among them 9 patients had malignancy and 5 patients had tuberculous pleural effusion. Conclusions: Most of etiologies for pleural effusion were tuberculosis among young’s and malignancy in older age. Right sided pleural effusion was more common in exudative effusion while bilateral pleural effusion was more common in patients with transudative. Thoracocentesis followed by pleural fluid analysis is the best method to diagnose the underlying etiology. Thoracoscopic pleural biopsy also has good role in undiagnosed pleural effusions.

Tuberculous lymphadenopathy: Experience from the referral center of Northern India.

Background:Lymphadenopathy is the common form of extrapulmonary tuberculosis (TB) in the developing country like India. The aim of the study was to assess the clinical and the pathological features of tuberculous peripheral lymphadenopathy along with the effect of the antitubercular drugs on its clinical course.Materials and Methods:A prospective study was carried out in the department of pulmonary medicine from July 2013 to June 2014. Clinico-demographical and pathological characteristics of the patients of tuberculous lymphadenopathy were studied.Results:Two and four cases, 84 (41.2%) male and 120 (58.8%) females were diagnosed as the cases of tuberculous lymphadenopathy. Mean age of the patients were 28.45 ± 12.83. Palpable mass (100%) was the most common presenting feature. Cervical lymphadenopathy (92.6%) was the most common presentation of peripheral tuberculous lymphadenopathy. Most common cytological pattern seen was epithelioid granuloma with caseous necrosis (32.84%) followed by epithelioid granuloma without caseous necrosis on fine needle aspiration cytology (FNAC). Directly observed treatment short course (DOTS) for TB was effective in treating tuberculous lymphadenopathy.Conclusion:Tuberculous lymphadenopathy affects female more often than males. FNAC is the effective mean in diagnosing tuberculous lymphadenopathy. DOTS is the effective mean for treating tuberculous lymphadenopathy.

Etiology of hemoptysis: A retrospective study from a tertiary care hospital from northern Madhya Pradesh, India

ObjectiveTo evaluate the various etiologies of hemoptysis and outcome in an Indian cohort. Material and methodsRetrospective analysis of patients admitted with complaints of hemoptysis in the department of Pulmonary Medicine between April 2010 and March 2013. We categorized the patients according to various etiologies and according to the grades of hemoptysis. ResultsThree hundred and forty-six patients were included in the study. Of these, 214 (67%) were men and 142 (33%) were women. Tuberculosis (79.2%) accounted for majority of cases of hemoptysis. Other causes of hemoptysis were lung cancer (7.2%), bronchitis (4.6%), and bronchiectasis (3.5%). Moderate grade (73.4%) of hemoptysis was the frequent mode of presentation. ConclusionHemoptysis is the most frequent presentation of tuberculosis in India. It may be the presentation of healed pulmonary tuberculosis. Moderate amount of hemoptysis is commonly seen in the general population.

Increasing incidence of adenocarcinoma lung in India: Following the global trend?

Lung cancer is one of the most common malignant neoplasms worldwide and accounts for more deaths than any other cancer. The clinicopathological profile of lung cancer has shown marked regional and geographical variation. We aimed to compare the demographic and pathological profile of lung cancer patients from North India with other Indian and International series. A retrospective study over a period of 5 years from January 2008 to May 2013 was conducted in the Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi. A total of 397 newly diagnosed patients with lung cancer from January 2008 to May 2013 were included in the study. The clinical, demographic, and pathological features were reviewed and compared with other major National and International reports. Data were entered and analyzed using SPSS software (SPSS Inc. Released 2009. PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc. A total of 397 patients (86% men, mean age 57.8 years) were studied. The ratio of men to women was 7.4. Majority of patients (78.3%) were current/previous smokers. Small cell carcinoma was diagnosed in 14.6% (58) of patients while 85.4% (339) had nonsmall cell lung carcinoma (NSCLC). Within NSCLC, the most common histology types were squamous cell carcinoma (30%), followed closely by adenocarcinoma (ADC) (28.3%) and large cell carcinoma (1.7%). Majority (87%) of the patient were staged III and IV. About 30.1% patients received anti-tubercular treatment during the current episode before a diagnosis of lung cancer was made. The clinicopathological profile of lung cancer has undergone noticeable changes over the last four decades, especially in the increase in ADC incidence and their frequent presence in smokers. Lung cancer is often mistreated as tuberculosis in the Indian subcontinent and hence continues to be diagnosed late.

The assessment of effects of yoga on pulmonary functions in asthmatic patients: A randomized controlled study

Background and Objective: Asthma is a serious health problem throughout the world, affecting people of all ages. It is a chronic inflammatory respiratory disorder. There are a few short-term studies with least number of the patients showing the impact of yoga on forced expiratory volume during the first second of the forced breath (FEV 1 ) and peak expiratory flow rate (PEFR). To assess the efficacy of yoga on pulmonary functions in asthma patients. Setting and Design: It was a randomized controlled trial, conducted at a tertiary-care teaching hospital in Lucknow, UP, India. Materials and Methods: The study was carried out in mild-to-moderate persistent asthma (FEV 1 > 60%) patients aged between 12 years and 60 years. The patients were recruited from the Department of Pulmonary Medicine and were randomly divided into two groups as follows: the case group and the control group. Their spirometric assessments were done at the baseline, third month, and sixth month. Statistical Analysis Used: The statistical analysis was done by using GraphPad inStat version 3.05 software Inc., year 2000 (Version. 3.05 GraphPad software, Inc., California, USA). Results and Conclusion: No significant changes were found in spirometric variables in the control group during the course of the study. In contrast, the yoga group got significantly better improvement in spirometric variables. The result shows that yoga can be an adjuvant therapy along with standard medical treatment for the better management of asthma.

Impact of Health Education in Perception of Patients regarding Storage of Health Records among Patients attending Tertiary Care Hospital, Bareilly District, Uttar Pradesh

ABSTRACT Objective To know the patients’ attitude regarding preserving records: pre- and postcounseling. Materials and methods A questionnaire was administered to all the subjects, and data were assessed by applying statistical test. The health education awareness is regularly carried out in outpatient department (OPD) and inpatient department (IPD) by various audiovisual aids. Setting A cross-sectional study was conducted among the patients from OPD and IPD of the Department of Pulmonary Medicine, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India. Results Out of 998 patients studied, 421 (42.2%) of them were preserving record and 577 (57.8%) did not. After counseling both groups who were preserving and not preserving the records, a remarkable change was observed, i.e., 800 (80.2%) patients from OPD and IPD started preserving their records in a positive way and were bringing at the time of consultation. Conclusion With the sustained and regular health education/motivation, the patients realized the importance of record keeping. How to cite this article Tiwari VK, Kumar A, Agarwal A, Joshi HS, Upadhyay D, Bansal P. Impact of Health Education in Perception of Patients regarding Storage of Health Records among Patients attending Tertiary Care Hospital, Bareilly District, Uttar Pradesh. Int J Adv Integ Med Sci 2016;1(4):151-157.