Peak Expiratory Flow Rate Values Research Articles

The Effect of Diaphragmatic Breathing Exercises on Peak Expiratory Flow Rate in Bronchial Asthma Patients

Background: Asthma is a prevalent, chronic, and varied condition in which most people experience dyspnea, wheezing, chest tightness, and coughing due to reversible airway obstruction, airway inflammation, and bronchial hyperreactivity. cause the quality of life to diminish. The breathing method known as diaphragmatic breathing is tailored to the needs of asthmatics. During a deep inhale, a breathing method called diaphragmatic breathing relaxes the respiratory muscles. Objective: To determine the effect of diaphragmatic breathing exercises on peak expiratory flow rate (PEFR) patients with bronchial asthma. Method: This type of research is quasi-experimental with a one-group pre-test and post-test design. The sampling method used purposive sampling with 15 respondents. The PEFR measurement instrument uses a peak flow meter. Data were analyzed univariately and bivariately using the paired T-Test. Results: The average PEFR value before and after diaphragmatic breathing exercise therapy was 246.67 L/minute and 300 L/minute. There was a significant difference in PEFR before and after being given diaphragmatic breathing exercise therapy with an increase in PEFR value of 53.33 L/minute (p-value 0.00). Conclusion: Diaphragmatic breathing exercises have a significant influence on PEFR values in bronchial asthma patients

Peak Expiratory Flow Rate in Healthy Urban School Children (6 to 17 Years) and Its Correlation with Anthropometric Measurements

Background: The predictive normal value of peak expiratory flow rate (PEFR), in children, is correlated with height and other anthropometric measurements, however, it shows ethnic Differences. The present study was conducted to establish the normal value of PEFR in healthy school children and to know the effect of various anthropometric factors on PEFR.
 Methodology: This study was conducted among 2200 students to assess their Peak Expiratory Flow Rate (PEFR) using Mini-Wright peak flow meter. PEFR values correlated with age, gender and various anthropometric measurements.
 Results: Out of total 2200 students, 1122 were boys which accounted for 51%. Mean PEFR for boys was 282.53 L/min and for girls was 270/.79 L/min. In boys and girls PEFR value increase as the age advances.
 Multiple regression modeling with PEFR as dependent variable and MUAC, BMI, Age, CC, Height, Weight and BSA as independent variables shows that Height, Weight, BMI, BSA, Age and chest circumference are independently associated with PEFR value. However, MUAC is not independently associated with PEFR values.
 Conclusion: From this study we conclude that in children between 6 to 17 year of age group the PEFR value in higher in boys compared to girls at any age. Height has strongest association with PEFR then the other variables.

EFEKTIFITAS TEKNIK PERNAPASAN BUTEYKO UNTUK MENINGKATKAN PENGONTROLAN ASMA BRONKIAL DI PUSKESMAS KOTA PADANG

ABSTRACT
 Bronchial asthma is one of the chronic respiratory diseases caused by the narrowing of the airways due to hypersensitivity reactions in the bronchi, resulting in symptoms such as wheezing, coughing, and shortness of breath. When asthma patients experience breathlessness, there is an increase in respiratory frequency and a decrease in oxygen saturation. If not promptly treated, it can lead to oxygen deficiency (hypoxia), which can ultimately result in death. The management of bronchial asthma is typically done with pharmacological therapy aimed at achieving a normal lifestyle, avoiding attacks, and restoring optimal lung function. However, it has not shown significant improvement in preventing bronchial asthma. Non-pharmacological treatment methods, such as Buteyko breathing technique, are expected to complement pharmacological treatment in reducing the frequency of asthma attacks (exacerbations). The Buteyko breathing technique has shown an increase in peak expiratory flow rate (PEFR) values and a decrease in bronchial asthma score values. The objective of this study is to analyze the effectiveness of the Buteyko breathing technique in controlling bronchial asthma in the Padang Health Center area. Before the intervention, the average bronchial asthma control was 15.44, with a standard deviation of 2.279, and a minimum control of 11 and a maximum of 19. After the intervention, the average control increased to 21.69, with a standard deviation of 2.387, and a minimum control of 16 and a maximum of 25. Similarly, bronchial asthma control in the control group showed an increase from 16.19 to 15.38 after the intervention. Statistical tests using independent t-tests showed a significant influence of the Buteyko breathing technique on bronchial asthma control, with a p-value of 0.000 (p?0.05). This indicates that the Buteyko breathing technique has a significant impact on improving bronchial asthma control. Therefore, this research provides evidence that the Buteyko breathing technique can be a valuable addition to the treatment of bronchial asthma, helping patients achieve better control of their condition and reducing the risk of asthma attacks.
 Keywords: Buteyko breathing technique; Breathing patterns.

A Systematic Review of Peak Expiratory Flow Rate (PEFR) Values in Pre and Post Nebulization with Two Different Techniques in Adult Asthmatic Patients

A Systematic Review of Peak Expiratory Flow Rate (PEFR) Values in Pre and Post Nebulization with Two Different Techniques in Adult Asthmatic Patients

Study of peak expiratory flow rate in male and female young adults with respect to their weight status

Background: Young adults are more attracted toward fast food, alcohol, and sedentary lifestyles. Previous study shows that peak expiratory flow rate (PEFR) correlates better with height in males and weight in females. Body mass index (BMI) is one of the main factor that affect PEFR values. PEFR, a pulmonary function test is routinely used to confirm the diagnosis of the respiratory disease. Aim and Objectives: This study was conducted to evaluate PEFR values in male and female young adults in underweight, normal, overweight, and obese categories of weight status. Materials and Methods: The study was conducted in four groups. 40 participants in each group, includes males (20) and female (20) young adults. The groups were divided according to BMI values, underweight (<18.5), normal (18.5–24.9), overweight (25–29.9), and obese (>30). Data were taken and calculated 2 h post lunch after relaxing for 15 min in the afternoon. In the sitting position, at the same time of the day, PEFR values were measured using Wright’s Peak Flow Meter. Results: We found significantly high PEFR values in males as compare to females in the category of underweight (<0.01), normal (<0.05) and overweight (<0.05). The study also shows positive correlation between BMI and PEFR in underweight male and females, normal males, overweight females, and obese females, which is statistically non-significant, except in obese males. Conclusion: We concluded that male have high PEFR values than female as there are differences in their body build-up and low PEFR values in underweight and obese young adults as they have low body fat and reduced expansion of lungs, respectively.

A cross-sectional study of association between peak expiratory flow rate and anthropometric obesity parameters in young Indian adult males

Background: Obesity increases the risk of and modifies the severity of various pulmonary illnesses. There is a variation in the published literature regarding the association between peak expiratory flow rate (PEFR) and anthropometric obesity parameters, particularly in young adult males. Aim and Objectives: The aim and objectives of the study are to determine the impact of general obesity and abdominal obesity markers on PEFR in young adult males with and without obesity. Materials and Methods: A cross-sectional observational study was conducted on 140 healthy young Indian adult males in the age group of 18–25 years. Participants were divided into two groups: The study group (n = 70; BMI ≥ 25 kg/m2) and the control group (n = 70; BMI: 18.5–22.9 kg/m2), based on the Asia–Pacific body mass index (BMI) classification. Weight and BMI were considered measures of general (overall or relative) obesity. For abdominal (central) obesity, hip circumference (HC), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were calculated. PEFR was recorded with the Mini-Wright’s peak flow meter, and the best of three readings was considered. Statistical analysis was done with the Mann–Whitney U-test and Kendall’s tau correlation coefficient; P < 0.05 was considered statistically significant. Results: The PEFR value did not show any significant difference between the study groups, while a significant negative correlation was observed in the study (obese) group between BMI and PEFR. Conclusion: BMI can be a better obesity marker to evaluate pulmonary disorders with PEFR and should be included in prediction equations for PEFR in young Indian adult males.

Effects of Cement Dusts on Peak Expiratory Flow Rate (PEFR) in Female Cement Dust Exposed Construction Workers

Background: Occupational and environmental lung diseases are the major problems of clinical medicine. The cement dust workers are constantly exposed to high amounts of visible ambient air particulate matter, mostly without any respiratory protective device. Therefore, the inhalation of dust over periods of time leads to impaired lung functions. Objectives: To observe the effects of cement dust exposure on PEFR in female cement dust workers. Methods: This cross-sectional study was conducted in the Department of Physiology, Rangpur Medical College, Rangpur from July 2016 to June 2017. A total of 60 female subjects aged 20–50 years were selected for the study. Among them, 30 were apparently healthy workers exposed to cement dust, and 30 apparently healthy height, weight & BMI-matched subjects not exposed to cement dust were selected as control from the surrounding community. Their pulmonary functions were studied by measuring PEFR. For statistical analysis, an unpaired ‘t’-test was performed by computer-based software SPSS-17.0 version for Windows. Results: The mean measured and mean percentage of the predicted value of PEFR was significantly (p_0.001) lower in cement dust-exposed female workers (CD- EFW) than the non-exposed female workers (CD-NEFW). Conclusion: From the result of this study, it can be concluded that cement dust (CD) may have harmful effects on some pulmonary functions. J Rang Med Col. September 2023; Vol. 8, No. 2: 25-28

Correlation between Body Composition and Peak Expiratory Flow Rate in First-Year Medical Students of Diponegoro University

Background: Peak expiratory flow rate (PEFR) is one of the pulmonary ventilation parameters that affects quality of life. PEFR is known to be negatively affected by high body mass index (BMI) and waist circumference (WC). This study aimed to determine the correlation of BMI and WC with PEFR in first-year medical undergraduates at Diponegoro University.Methods: This was a cross-sectional study held from October 5th to October 8th, 2020, which measured the BMI, WC, and PEFR of 169 first-year medical students at Diponegoro University. The BMI, WC, and PEFR were assessed using a digital scale, measuring tape, and Mini-Wright peak flow meter (PFM), respectively. Spearman test was used for bivariate analysis, whereas the multiple regression method was used for multivariate analysis. The results are considered significant if P <0,05 for bivariate and F <0,05 for multivariate analysis. The IBM SPSS Statistics 26.0 Software was used for statistical analysis.Results: Most of the subjects had normal BMI, with a mean value of 23.38 (±0.36) kg/m2. As many as 71.6% of the subjects had normal WC. There was a correlation between BMI and PEFR (P = 0.001) with a weak strength (R = 0.260). As for BMI, WC also demonstrated a significant positive correlation (P <0.001) with a weak strength (R = 0.342) towards PEFR. Simultaneously, both BMI and WC had a significant positive correlation (F <0.001) with a weak strength (R = 0.361) towards PEFR.Conclusion: Higher BMI and WC values coincided with higher PEFR values.

Influence of indoor volatile organic compounds and its relative respiratory effects among children living in rural biomass cooking households of Tamil Nadu and Andhra Pradesh.

Exposures to volatile organic compounds (VOCs) cause respiratory symptoms among children, a known vulnerable group. Reports on exposures to VOCs and respiratory symptoms among South Indian children living in biomass-using households are not available thus far. A cross-sectional study was conducted among 313 rural children to assess the influence of emitted VOCs on their respiratory health. Standard analytical procedures for VOCs and Pulmonary Function Test (PFT), allied questionnaires, and all ethical considerations were fulfilled in the study. The increase in VOC concentrations was observed proportional to the amount of burnt biomass fuel in two selected sites in Tamil Nadu (TN) and Andhra Pradesh (AP). Houses cooked for more than 60min showed a remarkable increase in VOC concentrations and was observed as statistically significant (p < 0.01) in AP households. Among the younger children, the peak expiratory flow rate (PEFR) values were found significantly higher than comparatively older children in both the sites, TN and AP. However, the trend with respect to FEV1 is statistically significant (p < 0.01) among AP children. This study reports reduced lung function for a considerable proportion of the VOC-exposed selected children. Based on PFT, the children who were interpreted to be normal were found to be exposed to lesser indoor TVOC concentrations in comparison with the children of the households having restrictive or obstructive impairments. Diagnostic ratios with Benzene/Toluene (B/T) and Xylene/Ethyl benzene (X/E) confirmed the presence of VOCs-emissions from adjacent cooking fuels only. The observed results of this study recommends cleaner cooking fuel-use for better respiratory health among the citizens across the country, which in turn, in line with the Pradhan Mantri Ujjwala Yojana (PMUY), Government of India.

Diurnal variation of peak expiratory flow rate in adolescents

Lung functions exhibit a circadian rhythm. Peak Expiratory Flow Rate (PEFR) is an easily measured and reproducible parameter for measuring lung functions. Limited information is available on the circadian variations in lung functions in south Indian adolescents. Hence, this study was undertakento evaluate the diurnal variation of PEFR in adolescents.This longitudinal study was conducted among 30 adolescent girls in the age group of 18-19 years recruited from a hostel in Chirala, Andhra Pradesh. Smokers, pregnant women and subjects with history of tuberculosis were excluded from the study. PEFR was measured using the Mini — Wright s, peak flow meter, four times a day (5.30 – 6.00 am, 12.00-1.00 pm, 5.00-6.00 pm, 9-10.00pm) and the diurnal variation of lung function was calculated. The PEFR values at different time points were analyzed using analysis of variance. Statistical significance was taken at 5% level of significance. Amplitude % Mean and Standard deviation % Mean were used to estimate diurnal variation of PEFR. The mean PEFR recorded at 5.30 am, 12.00 noon, 5.00 pm and 9.00 pm were 340, 347, 349 and 348 respectively. The mean of amplitude % mean and standard deviation % mean obtained in this study were 8.42 ± 3.65and 3.87±1 respectively.C The results of this study indicate that PEFR in adolescents exhibits a definite circadian rhythm, it being lowest early in the morning, progressively rises till late afternoon following which there is a slight fall in the night.

EXPOSURE ASSESSMENT FOR PREVALENCE OF LUNG RELATED DISEASES IN COTTON OPERATIVES (GINNERS)

&#x0D; &#x0D; &#x0D; This study was conducted on exposure assessment for the prevalence of lung related diseases in cotton ginners. The study included 75 subjects in the age groups of 15–65 years from similar socio-economic status. Fifty subjects were exposed to cotton dust, while 25 were not exposed. The pulmonary function test, peak expiratory flow rate (PEFR) was performed to diagnose the presence of any lung related disorder. The decrease in PEFR showed an obstructive impairment. PEFR values of exposed subjects (M = 272.80 SD = 95.94) were compared with the unexposed subjects (M = 545.00 SD = 101.55). The difference between the two groups was significant, t(df) = -11.360, p = 0.000. The main results revealed that the subjects exposed to cotton dust had more respiratory disorders than unexposed subjects (p&lt;0.01). The prevalence of chronic bronchitis, occupational asthma, inhalation fever, chronic obstructive pulmonary diseases and cough were 42%, 18%, 34%, 6% and 80%, respectively among the exposed vs (0%) among unexposed. It was concluded that 52% cotton ginners had all types of byssinosis while no lung related diseases prevailed among the unexposed subjects.&#x0D; &#x0D; &#x0D;

Analysis of lung function and respiratory symptoms in brass/metal industrial workers of Moradabad, Uttar Pradesh, India.

The job demands of some of the industries have been reported to be hazardous to the health and safety of workers. Workplace environmental hazards or occupational hazards are a globally major cause of disability and mortality among the working population. The present study was done to analyze the effect of exposure to metal dust on pulmonary function and respiratory symptoms. The study population selected as cases were 200 male mill workers working for at least 1-year duration (direct exposure) in the age group of 20-50 years, and controls were 200 age- and gender-matched male participants without any history of occupational or environmental exposure. A complete history was taken. Spirometry was done. Spirometric parameters studied were forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), ratio of FEV1 and FVC, and peak expiratory flow rate (PEFR). The spirometry data and baseline characteristics of the participants were compared using unpaired t-test. The mean age of the participants of the study group and the control group was 42.3 years and 44.1 years, respectively. The majority of the study population belonged to the age group of 41-50 years. The mean FEV1 value among participants of the study group and control group was 2.69 and 2.13, respectively. The mean FVC value among participants of the study group and control group was 3.18 and 3.63, respectively. The mean FEV1/FVC value among participants of the study group and control group was 84.59% and 86.22%, respectively. The mean PEFR value among the study group and control group was 7.78 and 8.67, respectively. While analyzing statistically, mean lung functional tests were significantly lowered among the study group. About 69.5% of the participants of the study group thought it to be essential for making safety measures a necessity. The present study concluded that mean lung functional tests were significantly lowered among the study group. Despite the use of face mask, lung function abnormality was present in mill workers.

The Correlation of Peak Expiratory Flow Rate and Hand Dynamometry in Chronic Obstructive Pulmonary Disease Patients A Case Control study

Objectives: To determine the correlation of peak expiratory flow rate and hand dynamometry in patients with chronic obstructive pulmonary disease and to find out the differences between hand grip in cases and control group Methodology: This study was carried out in the Department of Physiology and Department of Chest Medicine, Liaquat National Hospital and Medical College between July 1st 2019 and June 30th 2020 after the approval of the research and ethical committee of the same hospital. We used purposive sampling technique. Total 100 consenting individuals were recruited that were equally divided into control group and chronic obstructive pulmonary disease group. Anthropometric measurements alongwith peak expiratory flow rate and hand dynamometry values were measured. Results: We found significant difference in hand grip strength and peak expiratory flow rate between the case and control groups, chronic obstructive pulmonary disease patients have decreased peak expiratory flow rate and handgrip strength. Weak correlation exists between peak expiratory flow rate and hand grip strength with significant p value. No relationship was found between waist hip ratio and hand grip. Also, body mass index showed a weak negative but statistically significant correlation with hand grip strength. Conclusion: In chronic obstructive pulmonary disease patients, hand grip strength is decreased and determining hand grip strength may ensures quick assessment of quality of life.

Study of The Pulmonary Function Test on Women, “The Domestic Biofuel (Wood) Users” in a Tribal Village of Paschim Medinipur, West Bengal, India

Air pollution is a widespread problem and its impact on the health of the human population is very high. This article provides an overview of the adverse effects of biofuel burning on women's health. The findings of this study were to determine the effect of the use of biofuel (mainly wood) in household works on lung function parameters of the exposed household workers (women). This study was conducted on 30 female subjects who use biofuel and collected the parameters height, weight, Body mass index (BMI), Saturation of peripheral oxygen (SpO2), Systolic and diastolic blood pressure, Peak expiratory flow rate (PEFR) was measured and was compared to the values of the different articles as reference values. Women, exposed to the biofuel smoke suffers from respiratory illness and have decreased PEFR values (l/min). To reduce pollutant exposures, we recommended the use of smokeless chullas as cleaner fuels such as kerosene, charcoal, remembering their poverty levels, as many studies show low pollution level from clean fuels. In the end, this study demonstrates the detrimental consequences of using biomass fuels, particularly wood, on the decline of pulmonary function.

EFFECT OF HIGH INTENSITY CIRCUIT TRAINING IN PEAK EXPIRATORY FLOW RATE VALUE AMONG MALE YOUNG ADULTS

Background: Lung function has mutual correlation with exercise. Abnormal lung function can affect physical ability to exercise. Otherwise, exercise can increase lung function. Peak expiratory flow rate (PEFR) is a parameter to observe the lung function. High Intensity Circuit Training (HICT) is a combination of aerobic and endurance exercise which has total duration only 7-minutes long. High Intensity Circuit Training can be a good choice for young adults because it does not need much time, easy to be practiced, and beneficial for physical health as well. Objective: To analyze a significant increase in PEFR value after High Intensity Circuit Training for 8 weeks. Methods: This study was a quasi-experimental study with pre-test and post-test comparison group method. Samples were taken purposively from medical student of Diponegoro University (n=56, age=18-21 years old), who were divided into two groups, the control and training group. Peak flow meter was used to measure PEFR value before and after intervention. The data were analysed using Paired T test and Independent T test. Results: A significant increase of PEFR value was found after High Intensity Circuit Training for 8 weeks (p=0.000). The mean difference between pre-test and post-test PEFR value was found increased significantly (p=0.001), that training group had higher score as compared to control group. Conclusion: Regular High Intensity Circuit Training can improve lung function particularly PEFR value in male young adults.

Evaluation of Peak Expiratory Flow Rates (Pefr) among Healthy Children of Khairpur Mir’s City of Pakistan: A Cross-Sectional Study

Aim:To assess the peak expiratory flow rates (PEFR) among healthy children aged 6 to 12 years Study design: A cross-sectional study Place and Duration: This Study was conducted at Gambat Medical College Khairpur Mir’s, Pakistan from April 2019 to March 2020. Methodology: A study using a random sampling technique was conducted in primary schools. Healthy school children of either gender ages 6 to 12 years were enrolled in the study. An EU scale peak flow meter measured PEFR (60-800 l/min). While standing, their PEFR was determined. A total of three readings were taken, with the highest value being recorded. SPSS version 21 was used for statistical analysis. Results: Boys made up 56.15 percent (n=278) of the 495 participants. PEFR was measured at a minimum of 6 years old and a maximum of 12 years old in both genders. Boys aged 6 to 12 years had a PEFR of 179.71 ± 30.67 (L/Min), whereas girls had a PEFR of 159.15 ± 25.77 (L/Min). There was no discernible difference between genders and age categories (t=0.912, P=0.189). Conclusion: Mean PEFR values may vary between gender and age. PEFR results from this study can be utilized as a clinical reference for children aged 6 to 12 years of age. Clinicians can use these PEFR values to measure lung function and airway obstruction in this population subset. Keywords: Age, Gender, Lung Function Test, Peak Expiratory Flow Rates

Efficacy evaluation of budesonide nebulizer as an adjunctive medication in post-rain asthma acute phase attack.

Bronchospasm attacks occur following syndromic rainfall and are increasing due to air pollution and need effective treatments. In this study, the effect of salbutamol nebulizer in comparison with salbutamol plus budesonide nebulizer in patients referred to the emergency department with dyspnea was investigated. The trial study was conducted on 228 patients with dyspnea after the first rainfall in Ahvaz. Two groups of 114 patients have been randomly allocated. On the course of treatment, the first group received salbutamol plus budesonide nebulizer and the second group received salbutamol alone. In the experimental group, budesonide 0.5 mg with salbutamol was nebulized three times for 20 minutes. In all patients, 20, 40, and 60 minutes after the start of the intervention, forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate (PEFR) and vital signs of size were recorded and analyzed by SPSS and t-test. Data revealed that there were significant differences between PEFR parameters of studied. Groups in minute 40 and 60 after intervention (p = 0.000001). There was better improvement.in PEFR values in minute 40 and 60 in budesonide plus salbutamol study group. There were no significant differences for FEV1 in minute 0, 20, 40, 60 between to studied group. Also there were no significant differences for borg dyspnea scale for minute 0 and 60 between two experimented group. Respiratory rates have significant differences in minutes 20, 40 after intervention and there was better improvement for salbutamol plus budesonide group rather than sulbutamol intervention group alone.(p = 0.001142). Experiment data revealed. that due to the significant difference between PEFR and increased FEV1 in the combination of the two drugs and due to the corticosteroid effects of budesonide in reducing and preventing inflammation and swelling of the lungs, nebulizer salbutamol + budesonide has better effects on moderate breath than in nebulizer salbutamol.

Utility of ultrasound-guided erector spinae plane block in patients presenting to the emergency department with rib fractures

Context: Alleviating significant pain and enhancing lung function in patients with multiple rib fractures presents a formidable challenge to all emergency physicians (EPs). Conventional pharmacological measures and traditional thoracic regional analgesia techniques are not always feasible or safe in the emergency department (ED). Therefore, an effective, feasible, and safe method for providing analgesia in such patients will be extremely advantageous to all patients and EPs alike. Here, we describe the utility of a regional block technique that can be applied in patients suffering from multiple rib fractures in the ED. Aims: The aims of this study were as follows: (1) to determine the effectiveness of an ultrasound-guided erector spinae plane block (ESPB) in ameliorating pain and improving lung function in patients presenting to the ED with multiple rib fractures and (2) to assess the safety and the feasibility of the ESPB in the ED. Setting and Design: This was a retrospective observational clinical study conducted in the ED of a tertiary care hospital over a period of 12 months. Subjects and Methods: Data regarding all patients with rib fractures who had undergone an ESPB in the ED were extracted from the ED procedure register, and the inpatient case sheets were obtained from the medical records department for review and analysis. The data included, but were not limited to, the Numerical Rating Scale (NRS) for pain and respiratory parameters, i.e., respiratory rate and peak expiratory flow rate (PEFR) at 30 min post procedure and subsequently after every top-up dose up to a period of 48 h. Statistical Analysis: Descriptive statistics such as mean, standard deviation, frequency, and percentage were used. Inferential statistics such as repeated-measures ANOVA were done using SPSS software version 22 (IBM). Results: The mean NRS was significantly reduced by >50% at 30 min and by 72% over a 48-h period (P < 0.001). Meaningful improvements in the respiratory parameters were also observed during the same period with significant increments in the PEFR values (49% increase [P < 0.001]) as well as a decrease of 36% in the respiratory rate (P < 0.001). The mean time for performing the procedure was 16.27 min, and no adverse events were observed as a consequence of the block. Conclusion: The study demonstrates the efficacy of USG-guided ESPB in ameliorating pain as well as improving lung function for multiple rib fracture patients. This procedure can be performed in a short time making it suitable for application in the ED. No adverse events as a consequence of the ESPB were noted.

Pulmonary function test: A critical domain in oral submucous fibrosis patients.

INTRODUCTION:The study aims to measure and compare pulmonary function tests (PFTs) in oral submucous fibrosis (OSMF) patients (smokers/nonsmokers) and normal individuals.MATERIALS AND METHODS:The study population included 150 participants that comprised 50 nonsmoker OSMF patients, 50 OSMF patients who smoke as well, and 50 patients with no deleterious habits. Spirometer was used to assess PFT.RESULTS:Results showed that a significant P value was obtained for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow rate (PEFR), and maximum voluntary ventilation (MVV) and also for the predicted values of FEV, FEV1, FEV1/FVC, PEFR, and MVV in OSMF (smokers/nonsmokers) study groups.CONCLUSION:Thus, the decrease in pulmonary function can be an alarming sign for restrictive type of pulmonary disease.

Dynamometer based hand grip strength as a clinical tool for objective assessment of post-operative residual muscle weakness.

Residual neuromuscular block continues to be a significant postoperative complication despite neuromuscular monitoring. This study aims to determine the applicability of a hand-held forced dynamometer for hand grip strength assessment as an objective measure of residual muscle weakness. The study included patients undergoing surgery under general anaesthesia. A demonstration was given to the patient on the usage of a dynamometer for handgrip strength and a peak expiratory flow meter for peak expiratory flow rate (PEFR) and baseline values were recorded. The parameters were monitored at 15 minutes post-extubation and again at intervals of 15 minutes until one hour, half-hourly until four hours, and hourly until six hours post-operatively. Paired t-test was used for comparison of baseline muscle strength and PEFR with the parameters at different time points. Association between muscle strength and PEFR was tested with the Pearson-correlation test. Muscle strength was 50 to 60%, 75% and 100% of baseline at 15, 45 and 210 minutes after extubation, respectively. PEFR was 50 to 60%, 75% and 100% of baseline at 15, 60 and 180 minutes after extubation. The Pearson-correlation test established a positive correlation between handgrip strength and PEFR (correlation-coefficient 0.86). A significant reduction in the postoperative muscle strength can be detected using an objective forced dynamometer to measure handgrip strength even when train of four count has returned to unity and even when there are no clinical signs of muscle weakness. The residual muscle weakness is significant enough to affect the PEFR in the postoperative period.