Peak Expiratory Flow Meter Research Articles

Cooking fuel use and respiratory health of women and children in rural Ballabgarh, Haryana.

Household air pollution arising from combustion of unclean fuels during cooking activities causes serious respiratory health effects. This study investigated patterns of household cooking fuel use and its effect on respiratory health status of women and children. A cross-sectional study was conducted in rural households of Ballabgarh, Haryana during December 2019 to January 2020 among 18-45 years old women and their children having age between 6 and 59 months. A total of 450 households were selected using simple random sampling. Cooking fuel use was categorised as unclean (Wood, dung cakes, crop residues) and clean (LPG and electricity). The classification of mixed fuel use (predominantly unclean or clean) was based upon duration of unclean fuel use ≥ 2.5h per day. The clinical history and physical examination was done using a semi-structured questionnaire. Assessment of respiratory health status of women participants was done using peak expiratory flow meter and presence of pneumonia in children was evaluated as per Integrated Management of Neonatal and Childhood Illnesses (IMNCI) guidelines. Overall use of unclean cooking fuels was predominant in 59.6% of households and 71.8% of households had mixed fuel use. Only clean fuel use was in 11.3% of households. Nasal stuffiness, breathing difficulty and cough were observed among 13.1%, 10.5% and 8.5% among women while the common respiratory symptoms in children were cough (27.8%) and runny nose (22.9%). As compared to clean fuels, women using unclean fuels were more likely to have any respiratory symptom (aOR 3.0, 95% CI: 1.5-6.0) and impaired pulmonary functions (adjusted OR 1.9, 95% CI: 1.2-2.9). Cooking fuel use was not associated with respiratory symptoms and presence of pneumonia in children living in the households. Cooking with unclean fuel continues to be prevalent in the households of rural Ballabgarh and adversely affects the respiratory health of women indicating strengthening of initiatives promoting clean fuel use.

Effect of Volatile Organic Compounds on Pulmonary Functions Among Paint Industry Workers of Unorganized Sectors.

Background Paint industry workers are constantly exposed to paints and organic solvents that contain a substantial quantity of volatile organic compounds (VOCs). Exposure to VOC emissions could result in pulmonary, neurobehavioral, and hematological consequences. Limited studies have been undertaken in India to assess the health consequences of VOCs among paint industry workers in unorganized sectors. Aim To assess the effects of VOCs on pulmonary function in paint industry workers of unorganized sectors. Methodology A hundred and twenty full-time male construction painters and small-scale paint manufacturing workers aged 25-60 were assessed for respiratory symptoms using a questionnaire, and pulmonary functions using Wright's Peak Expiratory Flow Meter (PEFR). Participants were randomly selected forVOC assessment andthe cumulative solvent exposure index was calculated. A pulmonary function test (PFT) was performed on a subset of construction painters (n=30) using a Koko spirometer. Results The concentration of VOCs such as benzene, ethylbenzene, toluene, and xylene (BETX) and dichloromethane levels exceeded American Conference of Governmental Industrial Hygienists (ACGIH)threshold limit values (TLVs) among the paint manufacturing workers. About 52% of paint workers reported respiratory symptoms. Around 22% of the participants showedreduced pulmonary function (PEFR<400 L/min). There was a significant weaknegativecorrelationbetween PEFR andwork experience (r = -0.2, p=0.03). PFT parameters among a subset of construction painters revealed a significant moderate negative correlation with work experience [forced expiratory volume at the onset of the first second (FEV1) (r = -0.6, p=0.001) and forced vital capacity (FVC) (r = -0.53, p=0.005)] and cumulative VOC exposure index [FEV1 (r = -0.53, p = 0.004) and FVC (r = -0.5, p = 0.008)]. Conclusion The concentration of VOCs was higher among paint industry workers of unorganized sectors and they reported respiratory symptoms and diminished pulmonary function. To reduce morbidity, it is critical to enhance awareness about occupational safety and services in these unorganized sectors.

Effect of Buteyko breathing technique on peak expiratory flow rate in patients undergone upper abdominal surgery

Upper abdominal surgery (UAS) alters postoperative pulmonary function, as observed by impairment of lung volumes such as total lung capacity, vital capacity. Impaired clearance of sputum results in a vicious cycle of colonization and infection of bronchi with pathogenic organisms, dilation of bronchi and further sputum production. Ten patients undergone UAS were assigned randomly in two groups equally; their ages ranged from 23 to 60 years. The group A received Buteyko breathing. The data were collected before and after the same treatment period for both groups. The evaluation procedure was carried out to measure peak expiratory flow meter. Post treatment evaluation showed a significant difference in peak expiratory flow meter in both groups but in the favor of group A. Post treatment result showed a significant difference within the group. The post treatment value of group A was 272 which was better than group B which was 172. Combination of Buteyko breathing with conventional physiotherapy were considered to be an effective exercise for postoperative pulmonary complications after upper abdominal surgeries.

Effects of Acapella versus Blow Bottle Positive Expiratory Pressure on Airway Clearance and Peak Expiratory Flow Rate in Post-Covid-19 Patients

Background: The COVID-19 pandemic has led to significant respiratory complications in affected individuals. Positive Expiratory Pressure (PEP) devices, specifically Acapella and blow bottle devices, have been widely used in respiratory rehabilitation, particularly in patients with pulmonary diseases and post-surgical respiratory complications. However, their efficacy in post COVID-19 patients has been less explored. Objective: This study aimed to compare the effectiveness of Acapella and blow bottle devices in improving oxygen saturation, peak expiratory flow rate, shortness of breath, and six-minute walk distance in post COVID-19 patients. Methods: This randomized clinical trial was conducted at Tehsil hospital Kot Addu over six months. Forty-eight post COVID-19 patients were divided equally into two groups: one group received treatment with the Acapella device, and the other with a blow bottle device. Baseline and post-treatment measurements of oxygen saturation, peak expiratory flow rate, and six-minute walk distance were recorded using a pulse oximeter, peak expiratory flow meter, and six-minute walk test, respectively. Results: On day 1, the Acapella group showed a mean oxygen saturation rank of 20.98 with a sum of ranks of 503.50 (p=0.79), while the Blow Bottle group had a mean rank of 28.02 and a sum of ranks of 672.50. By day 7, the Acapella group's mean rank was 17.31 (sum of ranks = 415.50, p=0.000) compared to the Blow Bottle group's 31.69 (sum of ranks = 760.50). For peak expiratory flow rate, no significant differences were found between the groups at day 1 (Acapella: mean rank = 28.06, sum of ranks = 673.50, p=0.078; Blow Bottle: mean rank = 20.94, sum of ranks = 502.50) and day 7 (Acapella: mean rank = 23.77, sum of ranks = 570.50, p=0.717; Blow Bottle: mean rank = 25.23, sum of ranks = 605.50). Similar trends were observed in the six-minute walk test results. Conclusion: The study found that both Acapella and blow bottle devices effectively improve oxygen saturation in post COVID-19 patients, but do not significantly affect peak expiratory flow rate, shortness of breath, and six-minute walk distance. These findings suggest that while these devices are beneficial for enhancing oxygenation, a more comprehensive respiratory rehabilitation approach is necessary for addressing the full spectrum of respiratory complications in post COVID-19 patients.

Wearable respiratory function detection system based on dynamic humidity sensing: Principle and experimental comparison of lung function detection

&lt;sec&gt;Traditional lung function detectors are based on measuring the changes in airflow and pressure during expiration and inspiration to evaluate the respiratory function of the subject. These techniques are mainly based on mechanical differential pressure sensors or turbine sensors which evaluate the lung function of the subject by measuring the ability of the subject to blow and inhale and determine their lung function parameters, including peak expiratory flow (PEF) and forced vital capacity (FVC). In this study, we present a wearable respiratory function testing system called the wearable respiratory spectrometer, which is developed based on dynamic humidity sensing technology. By exploring the principles and quantitative design of respiratory detection and conducting simulations of humidity sensors, we investigate the comprehensive characteristics of the system. According to Darcy’s law, the gas flow measured by the wearable respiratory spectrometer is directly proportional to the pressure difference inside and outside the device, showing that the system follows the differential pressure sensing principle. According to this basis and combining the structural characteristics of the system, we establish a quantitative relationship among PEF, FVC, and the changes in sensor electrical signals.&lt;/sec&gt;&lt;sec&gt;The experimental results validate a linear positive correlation between the maximum rate of relative humidity change inside the spectrometer and PEF. Additionally, the results of simulated moisture volume experiments of the spectrometer show that in the measurement range from 180 to 840 L/min, the indication error of PEF is less than 10%, the adjacent test error is less than 5%, and the frequency response test error is less than 12%, which meet the industry standards for peak expiratory flow meters. Moreover, we compare the spectrometer with traditional portable lung function testing devices in simulated moisture volume experiments at different PEFs (300 to 720 L/min) and FVCs (3 to 6 L) . The results demonstrate that the average indication error of measured PEF and FVC by the spectrometer are about 0.35% and 0.23%, respectively, both are much lower than those of the portable lung function testing devices, thus fully verifying the accuracy and reliability of this system for real-time lung function assessment. Importantly, under simulated free-breathing conditions (PEF from 12 to 24 L/min, FVC from 0.5 to 0.7 L), the changes in the electrical signals of the spectrometer maintain a linear relationship with the moisture volume. Therefore, the wearable respiratory spectrometer can provide the long-term, free, dynamic, and quantitative monitoring of natural and weak nasal breathing. The measured respiratory spectra of subjects have great potential in real-time monitoring of lung function and remote monitoring of respiratory system diseases.&lt;/sec&gt;

Lung Function Test of Smokers and Non-Smokers in Ubimini Community, Emohua Local Government Area of Rivers State

The Lung function test of smokers and non-smokers was carried out using spirometer and Peak Expiratory Flowmeter in 50 subjects in Ubimini Community of Rivers State. Their ages ranged from 19.0 to 40.0 years. Mean PEFR was 524.5±80/min in smokers and 418.4 ± 96/min in non-smokers. Smokers are insignificantly lower than non-smokers. Mean 'TV was 255.8+98 in smokers and 246.4±84 in non-smokers. These results obtained showed an exceptionally increase, instead of a decrease because of the passive smokers who were exposed to cigarettes smoke most of the time while in the midst of heavy smokers but do not smoke themselves. This agreed with the findings that cigarette particles inhaled by smokers and non-smokers settle on their airway epithclia and alveoli and can elicit allergic reactions. Mean 1RV was 401.2±110 in smokers and 402.7±126 in non-smokers. Mean ERV was 323.3±150 in smokers and 424±185 in non-smokers. Mean VC was 908.4±171 in smokers and 914.3±192 in non-smokers. This showed that a non-smoker is likely to have more respiratory volume than a smoker. Mean BM1 was 40.25± 8kg/m2 in smokers and 37.55 ± 5kgm2 in non-smokers. This fact also agreed with the findings that cigarette particles inhaled by smokers and non-smokers settle on their airway epithelia and alveoli thus, can elicit allergic reactions. In comparison, PEFR is lower in smokers than in non- smokers. Thus, smokers have low flow rate when compared with non-smokers. This means that, cigarette smoking has adverse effect on lung volumes.

Monitoring ambient air pollution and pulmonary function in asthmatic children by mobile applications in COVID-19 pandemic.

Several public health measures were implemented during the COVID-19 pandemic. However, little is known about the real-time assessment of environmental exposure on the pulmonary function of asthmatic children. Therefore, we developed a mobile phone application for capturing real-time day-to-day dynamic changes in ambient air pollution during the pandemic. We aim to explore the change in ambient air pollutants between pre-lockdown, lockdowns, and lockdowns and analyze the association between pollutants and PEF mediated by mite sensitization and seasonal change. A prospective cohort study was conducted among 511 asthmatic children from January 2016 to February 2022. Smartphone-app used to record daily ambient air pollution, particulate matter (PM2.5, PM10) Ozon (O3), nitrogen dioxide (NO2), Carbon Monoxide (CO), sulfur dioxide (SO2), average temperature, and relative humidity, which measured and connected from 77 nearby air monitoring stations by linking to Global Positioning System (GPS)-based software. The outcome of pollutants' effect on peak expiratory flow meter (PEF) and asthma is measured by a smart peak flow meter from each patient or caregiver's phone for real-time assessment. The lockdown (May 19th, 2021, to July 27th, 2021) was associated with decreased levels of all ambient air pollutants aside from SO2 after adjusting for 2021. NO2 and SO2 were constantly associated with decreased levels of PEF across lag 0 (same day when the PEF was measured), lag 1 (one day before PEF was measured), and lag 2 (two days prior when the PEF was measured. Concentrations of CO were associated with PEF only in children who were sensitized to mites in lag 0, lag 1, and lag 2 in the stratification analysis for a single air pollutant model. Based on the season, spring has a higher association with the decrease of PEF in all pollutant exposure than other seasons. Using our developed smartphone apps, we identified that NO2, CO, and PM10 were higher at the pre-and post-COVID-19 lockdowns than during the lockdown. Our smartphone apps may help collect personal air pollution data and lung function, especially for asthmatic patients, and may guide protection against asthma attacks. It provides a new model for individualized care in the COVID era and beyond.

Performance testing for different peak expiratory flow meters.

Peak expiratory flow meters (PEFMs) have emerged as primary tools used for diagnosing and monitoring a range of respiratory diseases including asthma and chronic obstructive pulmonary disease, and the performance of these meters will thus impact disease evaluation. The aim of this study was therefore to assess the technical performance of mechanical and electronic PEFMs commonly used in clinical practice. The accuracy, repeatability, airflow resistance, frequency response, and linearity of five electronic and seven mechanical PEFMs were measured using a standard flow/volume simulator in accordance with nine A-waveforms and three B-waveforms defined in ISO 23747:2015 issued by the International Standards Organization (ISO). The accuracy, repeatability, linearity, airflow resistance, and frequency response pass rates for these 12 different PEFM brands were 41.67%, 75.00%, 50.00%, 75.00%, and 25.00%, respectively. Just 16.67% (2/12) of the tested PEFMs met all evaluated criteria, whereas the remaining PEFMs partially met these criteria. There were no significant differences between the two tested PEFM types in the low flow rate waveform test (P> 0.05), although there were significant differences in the medium and high flow rate waveform test (P< 0.05). In addition, the overall PEFMs test had poor accuracy and good repeatability, although most of the repeatability errors occurred in the BTPS state. PEFMs commonly used in clinical settings exhibit variable technical performance, and relevant departments need to strengthen PEFM quality control and management in China.

Clinical applicability of peak expiratory flow measured with peak flow metre compared to spirometer in a resource-limited setting

Background: Peak Expiratory Flow (PEF) is the maximum flow produced during a forced expiration following a full inspiration. It is useful in the management of lung diseases especially the domiciliary assessment of disease control in patients with Asthma. PEF can be measured with either a peak flow meter or a spirometer. We aimed at comparing PEF measured using a Mini Wright peak flow meter with PEF measured using Spirolab III spirometer in order to assess its clinical applicability in resource-limited settings.Method: A method-comparison study with records of PEF values at the Niger-Delta University Teaching Hospital, Okolobiri. Hypotheses were formulated and tested after data was analyzed using the IBM SPSS version 25 software.Results: PEF readings of a total of 100 adults were analyzed. Mean age was 48.90 ± 19.77 years. Males (51%) were slightly more than females (49%). One- sample t-test showed no statistical difference in the mean PEF values measured with the two devices (p = 0.295). There was significant correlation between the PEF values measured with the two devices (p&lt;0.0001) with demonstration of agreement and absence of proportional bias in the PEF values measured by the two methods following linear regression analysis (p = 0.959).Conclusion: PEF values obtained from the Mini wright PEF meter and the Spirolab III spirometer are comparable. Therefore, the Mini Wright peakflow meter may be effectively used in the diagnosis and monitoring of Asthma and other lung diseases in resource-limited settings.

Analysis of Peak Expiratory Flow Rate and Spirometry in Obese and Nonobese Schoolchildren

Introduction: Obesity is a health condition of the collection of fat on the human body leading to increased body mass index and other health issues and has various impacts on the respiratory system, which reduces the functional capacity of the lung. It is also known that obesity in childhood is a serious health issue, leading to overweight for children. Pulmonary function test is an essential component for evaluating lung functions that shows valuable procedures for diagnosing and managing respiratory diseases. Materials and Methods: This study was conducted on school children in the age group of 11–17-year-old obese and nonobese students. Lung function was measured using the spirometry and mini-Wright's peak expiratory flow (PEF) meter to identify differences among children. Results: A total of 245 healthy boys and girls, ranging from 11 to 17 years of age, were recruited for the study. There is no statistical difference between mean spirometric values of forced vital capacity (FVC), forced expiratory volume in the first (FEV1), FEV1/FVC %, FEF 25%–75% and PEF rate for obese groups in comparison with the nonobese control group. Conclusion: The current study found that females have lower lung function than males, which is significant statistically (P < 0.03) and to overcome respiratory illness.

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.

Aerobic exercise capacity, cough strength, posture, and depression in primary ciliary dyskinesia.

Assessment of exercise capacity is important for information about lung function and prognosis in primary ciliary dyskinesia (PCD). In addition, deterioration in the pulmonary system may affect cough efficiency, posture, and thoracoabdominal mobility. In turn, this deterioration may also disturb the psychological function of patients with PCD. Therefore, this study aimed to compare exercise capacity, cough strength, thoracoabdominal mobility, posture, and depression in children with PCD and healthy peers. Twenty-seven patients with PCD and 28 healthy peers were included. Aerobic exercise capacity (3-minstep test), cough strength (peak expiratory flow meter), thoracoabdominal mobility (upper chest, lower chest, andabdomen), posture (Corbin postural assessment scale), and depression (Children's Depression Inventory) were evaluated. Patients' number of steps completed, cough strength, and thoracoabdominal mobility were significantly decreased; total posture and depression scores were higher compared with healthy controls (p< 0.05). There was a significant relationship between cough strength and maximal expiratory strength (r = 0.541, p= 0.004) and total number of steps (r = 0.509, p= 0.007) in the patients. Aerobic exercise capacity, cough strength, and thoracoabdominal mobility were impaired, posture was deteriorated, and depression perception elevated in children with PCD compared to healthy peers. Furthermore, aerobic exercise capacity and maximal expiratory strength are related to cough strength in these patients. Rehabilitation programs including aerobic and resistive exercise training, deep breathing and postural exercise, and nutrition counseling may improve these results and better be investigated.Trial registration: Clinicaltrials.gov: NCT03370029; December 12, 2017.

Respiratory morbidities among wood workers

Introduction: Data on morbidities among workers working in the informal sector are scares; the current study attempts to determine the respiratory morbidities among wood workers and its severity. Materials and Methods: The study was a cross-sectional study conducted in the field practice area of a medical college's urban health center in a metropolitan city. One hundred and five wood workers from the study area were recruited by complete enumeration method. Data were collected using one to one interview method. Peak expiratory flow rate (PEFR) of every worker was measured using a peak expiratory flow meter. The data were analyzed using SPSS version 22. Results: Respiratory morbidities such as cough (61%), chest tightness (15.2%), and breathlessness (18.98%) were found among the workers. Nearly 68.56% of wood workers had abnormal PEFR. Decreased PEFR was significantly associated with lack of ventilation at the workplace, increased duration of work, use of electricity driven tools and tenure of the worker's job. Using logistic regression, we devised a model that shows abnormal PEFR is significantly dependent on work duration, hours of work per day, category of job, use of protective devices, and electrical instruments. Conclusions: The study pointed at a high prevalence of respiratory morbidities among wood workers. It also pointed out that the problem is in implementing occupational health standards already laid by international labor organizations (ILO). The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and improvement, Systems-based practice.

Comparison between Effect of Balloon Blowing Exercise (BBE) in Semi-Fowler (45 Degree), Upright & 90/90 Bridge with Ball Position on Peak Expiratory Flow Rate in Healthy Individuals

Purpose: This study was conducted to investigate the Comparison between effects of balloon blowing exercise (BBE) in Semi Fowlers (45 degree), Upright &amp; 90/90 Bridge with ball position on Peak expiratory flow rate in healthy individuals. Participants &amp; Method: Participants were randomly assigned in respective groups to perform the balloon blowing activity. The exercise programs were conducted 30 minutes per day, 5 times a week for 4 weeks, Peak expiratory flow rate was measured with mechanical equipment called Peak Expiratory Flow Meter before and after the exercise program period. Results: Effectiveness of Semi fowlers position for Balloon blowing activity is significantly more than that of Upright and 90/90 Bridge Position with Ball on Peak expiratory flow rate pre and post values(p&lt;0.005). Conclusion: With accordance to objectives, Comparison of Peak expiratory flow rate values in pre &amp; post exercise in three positions shows that there is improvement of group A(Semi fowlers position)&gt; Group C(90/90 Bridge with ball position)&gt;Group B(Upright position) Keywords: Peak expiratory flow rate (PEFR), Balloon blowing exercise (BBE), Semi fowlers position, Upright position, 90/90 Bridge will ball position.

Effect of Adenotonsillectomy on Peak Expiratory Flow Rate Among Children.

Cross sectional, prospective, observational study. Department of otorhinolaryngology in tertiary care centre. Included 40 children aged between 5 and 15years, who had adenotonsillar hypertrophy and underwent adenotonsillectomy. Diagnostic nasal endoscopy and X-ray, nasopharynx, was done to assess the grade of adenoid hypertrophy endoscopically and radiologically respectively. Peak expiratory flow rate was assessed using Mini Wright peak expiratory flow meter pre-operatively and 1month post-operatively and both the readings were compared. Subjective improvement was also compared pre-operatively and post-operatively using visual analogue score. This study included 40 patients with male to female ratio of 1.6:1, 92.5% presented with mouth breathing. 92.5% presented with grade III tonsillar hypertrophy and 70% with grade III adenoid hypertrophy endoscopically. After adenotonsillectomy, improvement in Peak expiratory flow rate ranged from 16 to 25.3% which was statistically significant. Patients with grade III tonsillar and grade IV adenoid hypertrophy showed 25.3% improvement. Subjective improvement was 98.8% in the complaint of snoring. Adenotonsillectomy significantly improves pulmonary functions. This may help to improve physical and cognitive development in children and decrease chances of getting cardiopulmonary problems in later life.

Asthma monitoring and lung function in children with physician-diagnosed asthma

Background: Childhood asthma is the most common chronic lung disease of childhood that requires monitoring including lung function test. This study aimed to evaluate the lung function and the monitoring strategies of children with physician-diagnosed asthma. Methods: Children aged 6 to 18 years attending the respiratory clinic with physician-diagnosed asthma were studied. Clinical status and asthma monitoring strategies were obtained followed by spirometry. The tools used for monitoring asthma included symptom diary, peak expiratory flow meter, exacerbations, and use of rescue bronchodilator in the past 1 year. Results: There were 45 children aged between 6 and 18 years with 29 (64.4%) females and 16 (35.6%) males. There was no seasonal variation in the development of symptoms and most of the parents and siblings had no allergic conditions. Nearly all children did not use monitoring tools; none of them kept a symptom diary and only one (2.2%) and three (6.7%) had an action plan and peak flow meter, respectively. Only one (2.2%) had a history of being admitted to the intensive care unit (ICU). Thirty-three (73.3%) patients had identifiable triggers (single or multiple) with cold being the most common. Eleven (24.4%) patients had the need to use a rescue bronchodilator in the past 12 months. Thirteen (28.9%) patients had an abnormal spirometric pattern and the most common being the obstructive type. Conclusion: The majority of the children had no asthma monitoring tools and a third of them had an abnormal spirometric pattern with the obstructive type being the most common.

Peak Expiratory Flow Rate in Children with Multiple Neurological Disorder

A neurological disorder is a, structural, biochemical or electrical abnormalities in the brain or spinal cord and peripheral nerves. Neurological disorders include mental retardation, cerebralpalsy, autism and down’ syndrome. Children with neurological disorders have a high incidence of respiratory problems. Many children with cerebral palsy have scoliosis, an irregular curvature of spine that can interfere with lungs ability to expand. Genetic condition including cerebral palsy and muscular dystrophy can be associated with congenital airway abnormalities. The aim of the study is to find out peak expiratory flow rate in children with multiple neurological disorder. Study design non-experimental,15 subjects with age group of 7-17years was selected based on the inclusion and exclusion criteria.(subjects:3-cerebral palsy,3-down syndrome,2-autism,7-mental retardation) were selected Maithree special school, East Tambaram. An informed consent was obtained from the parents and children with detailed explanation of the procedure. First the participant was asked to breath in and breath out normally and then breath in deeply as much as possible followed by quick expiration to the maximum into the device. Three trials have been done and best of the three is adopted as PEFR. The value on the meter was monitored and recorded. The training was stopped whenever the subject feels dizziness. The data on height, age, sex, weight, were registered. The peak expiratory flow rate of normal children ranges from 182-565 l/min.The mean value of PEFR in children with multiple neurological disorder was found to be cerebral palsy-121 l/ min, Down’s syndrome-130 l/min, autism-77.5 l/min, mentally retarded-145 l/min. For the data, complete action of PEFR measurement were performed in children with multiple neurological disorder. The PEFR values clearly depicts that the children with multiple neurological disorder have decreased PEFR. Our findings confirm that the peak expiratory flow meter is a well functioning instrument for measuring PEFR in children, giving reliable results, and an inexpensive tool. The study conclude that there was a decreased PEFR in children with cerebral palsy, down’s syndrome, autism and mentally retarded. The study was made simple and this can be done by giving interventions like respiratory muscle training.

Efficacy of Balloon Blowing Exercise on Peak Expiratory Flow Rate in Young Adult Smokers.

BackgroundSmoking cigarettes which progressively impairs the lung functions is a leading risk factor for early death and disability worldwide. Alternate use of the tobacco products along with some exercise practicing behaviour help to prevent the impairment of lung function because most smokers fail to cease smoking. The objective of this research was to find out the effectiveness of the balloon blowing exercise among the young adult smokers using the peak expiratory flow meter.MethodsA quasi- experimental study in which 100 male participants were included according to inclusion and exclusion criteria. Pre-test and Post-test was taken using Peak expiratory flow meter, after intervention is provided.ResultsThe mean appraise of the Group A pre-test was 287.1 and the post-test was 283.2, and the mean appraise of the Group B pre-test was 279.7 and the post-test was 367.2. The significant appraise was .581 for Group A and .000 for the Group B since the p < 0.05. The study shows the significant result as the p appraise is less than 0.05.ConclusionThis study concludes that there was a significant increase in the peak expiratory flow rate in the post test of Group B.

Knowledge, attitude and practices among parents of asthmatic children in Rajasthan: a hospital based descriptive observational study

Background: Asthma is chronic inflammatory disorder associated with variable airflow obstruction and bronchial hyper responsiveness with different phenotypes. The objective of this study was to study the knowledge, attitude and practices among parents of Asthmatic children.Methods: It was a prospective observational study, conducted at Fortis Hospital Jaipur, from April 2016 to March 2018. All Asthmatic children fulfilling inclusion were included, 120 children were studied. A detailed interview of all the children/parents was conducted by pre-validated KAP questionnaire. Subjects were labelled as Bronchial Asthma in children above 5 years of age on the basis of symptoms and measurement of Peak Expiratory Flow (PEF) both baseline and post bronchodilator by PEF meter and in children less than 5 years of age by clinical symptoms, family history and response to bronchodilator according to GINA guidelines. Statistical analysis was done by one-way ANOVA test and Chi-square test.Results: In this study 26.4% parents were ignorant about etiology, 32% believed it to be allergy and 39.62% believed it to be hereditary. 1.9% had misconception of contagious. 68% parents know that their child have asthma while 32% parents did not know. Majority (52.1%) attributed it to cold air and rainy season followed by Dust mite and pollution in (42%).Conclusions: Knowledge about Asthma has improved over last few decades but still needs replenishment. Knowledge gap between recommended and actual practices, lack of adherence to aerosol therapy and fear of medication side-effects still persists. Parental education is important part of management of Asthma.

Prevalence and predictors of suboptimal peak inspiratory flow rate in COPD patients

The aim of this study was to determine prevalence and possible clinical predictors of suboptimal peak inspiratory flow rate (PIFR) with different dry powder inhalers.PIFR was measured across all resistance ranges of In-Check Dial® in 180 chronic obstructive pulmonary disease (COPD) subjects before hospital discharge. COPD subjects were defined as suboptimal if measured PIFR was suboptimal with any resistance representative of specific inhalers (R1-R5). Demographics and clinical data were collected, including COPD Assessment Test (CAT) and modified Medical Research Council (mMRC) scores, Global Initiative for Obstructive Lung Disease (GOLD) stage spirometry by Spirodoc® and peak flow meter measurements with portable peak inspiratory and expiratory flow meters. All were correlated with In-Check Dial PIFRs.Suboptimal PIFR was 44.44% prevalent in COPD subjects. 55% of the suboptimal cohort was female which represent 57.14% of the total female population in the study. The distribution of suboptimal PIFR included 43.75% with R1, 67.5% with R2, 100% with R3, 13.75% with R4, and 21.25% with R5. In the suboptimal cohort, CAT score was significantly higher and spirometry demonstrated significantly lower lung function results compared to the optimal cohort (p < 0.05). The only parameter to show strong and moderate correlation with In-Check Dial PIFRs was PIFR measured by peak flow meter (p < 0.001).Suboptimal PIFR is common among COPD subjects at hospital discharge. Female gender and peak flow meter PIFR was the only predictor of suboptimal PIFR. Inhaler therapy for COPD patients must be personalized based on simple routine measurement of In-Check Dial PIFRs or peak flow meter PIFR to optimize clinical benefits .