PEFR Values Research Articles

Regression equations for peak expiratory flow rate in children aged 5-10 years of Western Maharashtra, India: a cross-sectional study

Background: Incidence of pulmonary diseases in urban children is on the rise. Peak expiratory flow rate, a component of pulmonary function tests, is a useful measure for initial pulmonary assessment. It is easily implementable on large population due to its simplicity. Studies presenting such data for Indian children are severely lacking, as PEFR is anthropometric, population and region specific. The present study aimed to establish an equation for predicting PEFR in urban children in Pune city in western Maharashtra, India. Methods: The cross-sectional study was done in Pune, Maharashtra, India. Children from different schools were selected by cluster sampling. The number of participants screened was 2100 of which 1760 were selected. Best of three readings of PEFR was recorded for each child using an EU Scale Peak Flow meter (Breath-O meter, Cipla). Anthropometric data like height, weight, chest expansion, waist/hip ratio were measured and BMI was calculated along with PEFR of each child. Results: Out of the 1760 children included in the study 933 (53%) were boys and 827 (47%) were girls. The stepwise regression analyses were carried out using age, height, weight and waist/hip ratio as predictor variables. Conclusions: Final regression equation was derived using height. Approximately 80% of the data was used for prediction of regression equation and remaining 20% data was used as a control group to validate the derived equation. The regression equation formulated shall offer a predicted PEFR value as guideline for healthcare workers in Pune city, Maharashtra, India.

PEAK EXPIRATORY FLOW RATE DURING VARIOUS PHASES OF MENSTRUAL CYCLE IN ASTHMATICS PRESENTING TO A TERTIARY CARE CENTRE

Introduction: Asthma is a chronic inflammatory lung disease characterized by airway hyper responsiveness and reversible airway obstruction. Worsening of asthma symptoms and pulmonary functions in relation to menstruation has been documented by some authors. Objectives: To determine peak expiratory flow rate during various phases of menstrual cycle among adult asthmatic women. Methods: A Prospective studyof1 year duration (July 2020 to June2021) A consecutive series of 100 patients with asthma, attending the outpatient clinic of department of chest diseases, satisfying inclusion criteria were included in the study. The socio demographic details and the relevant clinical details was collected using the socio demographic Performa prepared specifically for the study, Patients asked to record asthma symptom scores, morning Peak Expiratory Flow Rate (m-PEFR) (best out of 3 readings taken) daily during the one month screening period to identify women with and without pre-menstrual asthma Results And Discussion: From our study we found highest mean PEFR value is during post ovulatory phase. Lowest during perimenstrual phase. Fall in PEFR seen mostly during perimenstrual phase (43%). Then during preovulatory phase (34%). No such fall seen during periovulatory and postovulatory phase. Severe symptoms were present during perimenstrual phase (19%) and preovulatory phase (14%) only. Similarly, moderate symptoms also during perimenstrual (22%) and preovulatory phase (21%). Both severe and moderate symptoms were not seen during periovulatory and postovulatory phase. Conclusion: Premenstrual exacerbation of asthma occurs in a significant proportion of female adult asthmatics. Thus proper history including menstrual variation of asthma of all these patients should be taken for effective management.

Effects of Exposure to Incense Smoke Associated with Impaired Lung Function and Respiratory Disease: A Systematic Review

The community uses incense (bakhour) through ceremonies, traditional health practices, and aromatherapy. Nevertheless, evidence from experiments and studies of populations suggests that a habit of burning incense makes the lungs work less well. The study investigated the relationship between exposure to incense smoke and impaired lung function and respiratory diseases. Data tracing was carried out systematically following PRISMA guidelines from January to April 2022 and registered in the PROSPERO database. The articles selected in this review were cross-sectional, cohort, observational, and experimental studies based on the criteria: (1) animals or humans exposed to incense smoke; (2) exposure to incense smoke which was carried out indoors or outdoors; (3) the selected articles which were included in the original type of article; (4) the publication year between 2016-2021 and the selected articles entered into reputable journals (Scopus and Web of Science). JBI guidelines and synthesis guidelines without meta-analysis (SWiM) to determine the level of evidence and minimize bias and interpretation of results. This study describes respiratory symptoms or diseases, home use of incense, and lung function measurement. Six articles were included; 6 (100%) reported using incense indoors, and 5 (83%) reported using incense outside the home. Respiratory symptoms and diseases caused by exposure to incense sticks are 5 (83%) shortness of breath, 6 (100%) wheezing, asthma, and inflammation of the lungs, 2 (33%) chronic obstructive pulmonary disease, and 4 (67%) allergic rhinitis. Incense smoke particles decrease lung function based on FVC, FEV, PEFR, and FEF values of 25-75%. The results indicate that smoking incense adversely affects lung function and leads to respiratory diseases. The community and related parties can minimize and conduct education and prevention related to simultaneous incense exposure in the community to reduce the burden of diseases and disorders due to respiratory incense smoke in areas that use it daily.

PEAK EXPIRATORY FLOW RATE (PEFR) VALUES OBTAINED WITH WRIGHT'S PEAK FLOW METER AND DIGITAL SPIROMETER IN OBSTRUCTIVE AIRWAY DISEASE (OAD) PATIENTS – A COMPARATIVE STUDY

Introduction: Peak expiratory ow rate (PEFR) is the highest ow achieved from a maximum forced expiratory maneuver and is a good modality in diagnosing and monitoring Br.asthma; in COPD it gives a rough estimate of the severity of obstruction.Normal values in males and females range between 320-550L/min. PEFR values can be obtained by a Peak Flow Meter or by standard Spirometer. To compare PEFR values obtained Aims And Objectives: by Wright's Peak Flow meter and those obtained by a Digital Spirometer and to understand Whether PEFR values are reliable in the diagnosis and monitoring of Obstructive Airway Disease. 75 Consecutive patients who pr Materials And Methods: esented with a history of COPD, Br.asthma or Bronchiectasis to the Respiratory Medicine OP, Govt General Hospital, Nellore, AP were recruited to the studyand PEFR values were recorded by both Peakowmeter and Spirometer. The rang Results: e of PEFR values obtained was between 120-480 L/min .and the difference was in the range of 9-164 L/min. In the present study the Conclusion: difference in values is not very signicant andhence PEFR can be used as a diagnostic & monitoring tool in OAD.

Variations In The PEFR With Various Factors With Respect To Age, Body Mass Index, Blood Pressure And Heart Rate Among Males And Females Patients

Introduction: PEFR is considered as the simplest index of pulmonary function. Ventilatory function tests like PEFR provide a better understanding of the changes in the lungs from a diagnostic viewpoint. It is effort dependent and reflects mainly the calibre of the bronchi and larger bronchioles, which are subjected to reflex bronchoconstriction. Objective: To study the variations in the PEFR with various factors with respect to age, body mass index, blood pressure and heart rate among males and females patients. Methods: This was a cross-sectional study conducted at Department of Medicine, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh from January to December 2020 among young male and female subjects. The subjects with no history of cardio, availability & capacity to cooperate adequately, non- smokers; and no history of any drug intake which could affect the lung functioning were included in the study. PEFR was measured with the subject comfortably seated during the same time of the day for all subjects. It was determined in litres/minute with the help of “The Peak”, Individualised Peak flow meter from Multispiro Inc. Results: Out of the total subjects 121 subjects, 45.4% were ≤18 years followed by 19-20 (42.1%) and >20 (12.3%). There were 37.1% males and 62.8% females. PEFR was found to be significantly (p=0.0001) higher among males compared to females in all the age groups. PEFR increased with increasing age in both male and female subjects. PEFR was found to be significantly (p<0.0) higher among males compared to females in the entire body mass index (BMI) category. PEFR increased with increasing BMI in both male and female subjects. Conclusion: PEFR is higher among male than female subject. Also, PEFR was higher in males than females in all the age groups and BMI status. The effects of various factors like age, height, weight, BSA and BMI on the PEFR values have also been discussed in this study. PEFR increases with increase in age and BMI in both male and female subjects.

Emerging Risk Factors for Impaired Lung Function in Chemical Industry Workers of Faisalabad

Objective: To determine the impact, obesity and age on the lung functions determined by PEFR of healthy workers of chemical industries.
 Methodology: This was a cross sectional study performed at private medical college of Faisalabad. Three days medical camp was arranged during 2nd to 4th September 2020 after taking approval from institutional ethical committee. All relevant information including age, residence and history about chemical exposure were recorded in a structured proforma. Obesity was determined on basis of BMI grading. BMI was calculated from estimated Height and weight PEFR of each participant was determined using Wright’s Peak flow meter. Data was analyzed by SPSS21.
 Results: Mean± SD age, height and weight of the studied population was 38.85 ± 12.1, 170.07 ±12.0 and 78.12 ±12.7. lowest PEFR value was found in subjects with age range 61 to 70 years as compred to youger subjects . The mean PEFR value were significantly different with respect to various age catagoeies with p value= 0.000 Highest mean PEFR values were found in taller subjects having height ≥ 180 cm and lowest values were found in subjects with height 150-159 cm, the difference in means was statisticaly significant with p value= 0.05.
 Morbid obese subjects showing comparatively lower PEFR values in morbid obese with significant p value =0.002.
 . PEFR was found to be negatively associated with age ( p- value= 0.000*) and BMI( p value =0.001*). Our results also showed weak positive association of PEFR with height, however this relation was not found to be statistically significant (p value= 0.081).
 Conclusion: Peak expiratory flow rate is negatively associated with increasing BMI and age, reflecting that elderly and obese subjects are more prone to have affected lung function due to exposure to chemicals

Consequences of COVID-19 in the Status of Physical Fitness in Post COVID Patients: A Cross Sectional Study.

Introduction- The COVID-19 pandemic caused by the highly infectious SARS-CoV-2 has affected over 15.9 million people across 200 countries and caused more than 643,000 deaths. The coronavirus is a highly infectious virus and spreads through droplets generated during coughing, sneezing, talking, and even breathing. .[1] As the main symptoms reported after COVID-19 are fatigue and dyspnoea, the need of the study is to find out consequences of COVID 19 in status of Physical Fitness with respect to Functional status, endurance and Lung capacity in Post COVID- 19 subjects Aim – To analyse the consequences of covid-19 in the status on physical fitness in post COVID patients. Objectives- 1. To find out effect of COVID on lung function capacity assessing PEFR in post COVID patients. To find out effect of COVID on functional status in post COVID patients. 3.To know the effect of COVID on endurance using Figure of 8 walk test in post COVID patients. Methods- The research was carried out in the Physiotherapy OPD at Vikhe Patil Memorial Hospital. A cross-sectional study was designed. Purposive sampling was used in the sampling process. The sample size for this study was 50. Consent form for a six-month study was made. Peak flow metre, Sterilium, Cotton wool, Weighing machine and Measuring tape, Post COVID-19 Functional status scale, 2 cones, stop watch, Pedometer, tape measure were among the materials utilised. Patients with COVID 19 infection who were recovered and willing to participate, both genders, ages 20 to 55, and able to walk without assistance met the inclusion criteria. Patients who were not cooperative or who had additional systemic illnesses, such as diabetes, were excluded. Result- A total of 50 patients entered the study who were in the age group of 20-55 yrs. We compare PEFR values among symptomatic and asymptomatic patients. The study shows that comparison of PEFR values between symptomatic and asymptomatic patients was not significant (p value 0.2265) and PEFR values of symptomatic patients were less than that of asymptomatic patients. The patients who were symptomatically ill were affected more and show symptom of pain, anxiety, depression rather than asymptomatic patients and there was no sign of functional limitation. There is no effect on endurance of the patients as such after recovery from COVID-19 infection. Conclusion- This study shows that there is effect of COVID on physical fitness of post COVID patients after recovery with respect to lung function capacity. Symptomatic patients were more affected than asymptomatic patients. The functional status of the post COVID patients is not affected, few of them suffered from pain, depression and anxiety after recovery. There is no effect on endurance in post COVID patients after recovery.

EFFECT OF YOGA BREATHING EXERCISE ON THE PULMONARY FUNCTION PARAMETER (PEAK EXPIRATORY FLOW RATE) AND SYMPTOM CONTROL OF CHILDREN WITH MODERATE PERSISTENT BRONCHIAL ASTHMA ATTENDING TERTIARY CARE CENTRE-A QUASI EXPERIMENTAL STUDY

Objectives: The study was undertaken with the objective of assessing the effect of breathing exercise ( Alternate Nostril Breathing Exercise with deep breathing and controlled relaxation, pranayama a form of yoga breathing technique) on the pulmonary function parameter as well as symptom control of children with moderate persistent bronchial asthma. Background: Childhood asthma is a chronic health condition that affects more than 1 million school-aged children and their families. Nonpharmacological therapy includes yoga breathing techniques such as Alternative Nostril Breathing techniques significantly reduces the stress and improves better asthma control in children with bronchial asthma. Design &Methods: Quasi-Experimental, two group pretest- post-test design were adopted. Sixty children with moderate persistent bronchial asthma attending asthma clinic of tertiary care hospital were selected for the study. Simple random sampling with a comparison group was used for selection of the sample. TREND checklist for quasi-experimental design used as guidelines for the current study. Results: Breathing exercise significantly changed the Peak Expiratory Flow Rate as evidenced by the significant change in the mean percentage of PEFR value from the predicted value in the experimental group. Comparison of mean percentage PEFR value from age wise predicted value in the experimental group showed that 69.5%/ 82.4% , t= 8.275, p= o.ooo (p< 0.05) and in the control group was 66.0%/ 66.2% , t= 1.326 , p = 0.195 ( p> 0.05). There was statistically significant change in asthma control parameters in the experimental group. Breathing exercise significantly improved the level of symptom control in the experimental group. No such significant improvement in Symptomcontrol was noted in the control group.(McNamer 0.000/ 0.063), (p< 0.05). Conclusion: Based on the above findings, the present study concluded that breathing exercise has an effect on improving the pulmonary functions and symptom control of children with bronchial asthma.Relevance to clinical practice:The practice of yogabreathing exercises improves asthma symptoms and helps children to achieve better control over asthma along with pharmacological management.

TO STUDY THE EFFECT OF BODY POSITIONS ON OXYGEN SATURATION AND PEFR IN POST CORONARY ARTERY BYPASS GRAFT PATIENTS

CABG is the most common type of heart surgery. Reduced pulmonary functions and oxygen saturation are common postoperative complications. Body positions tends to show effect on peak expiratory ow rate and oxygen saturation .so, in this study we have observed effects of different body positions in values of PEFR and oxygen saturation for better recovery from post-operative complications. Objective was to evaluate the differences in values of PEFR and oxygen saturation in different body positions (supine, erect sitting, three quarter sitting, standing). Method: the study design was observational cross-sectional study. 30 subjects of age group 40-70 years were selected through random sampling technique. PEFR and oxygen saturation values were checked on post-operative day 3.subjects were allocated each position for 15 min and then values were recorded. the study results Results: indicated that standing position shows highest PEFR value (340.67 liters/min) and best oxygen saturation (97.53), supine position shows lowest PEFR value (183.00 liters/min) and lowest oxygen saturation (93.43). Difference in between the body positions three quarter sitting, sitting and supine were signicant (p<0.005) when compared with standing. The study concluded that standing position leads to highest PEFR a Conclusion: nd oxygen saturation value and supine position leads to lowest value of PEFR and oxygen saturation. So standing should be considered as best therapeutic position.

Assessing the indoor air pollution level as per energy ladder and its effect on respiratory health

In rural areas of developing countries, where about 40 % of all people live, the household stove accounts for more of all national fuel combustion occur under cooking pots. The present study was undertaken in Hisar district of Haryana state to assess the indoor air pollution level as per the energy ladder and its effect on respiratory health. The study was conducted in the rural villages of Hisar district and rural women who were using traditional chullah were selected as the sample of the study. Results revealed that most of the women were using chullah for cooking their own food and hara for animal feed with fuel placed on the lower rung of energy ladder i.e. crop waste and dung cakes, wood, kerosene, and LPG. Major health problems faced by women were ‘headache’ and ‘irritation in eyes’ while using the traditional chullah and hara. The majority of them were also having respiratory problems like ‘phlegm’ (mean score-2.7) ‘shortness of breath’ (mean score-2.6), ‘cough’ (mean score-2.5), and ‘wheezing’ (attacks) with mean score of 2.0, respectively. Mean PEFR values for the traditional chullah and hara exposed women were significantly lower as compared with MDV chullah and improved hara. Therefore, it is recommended that the use of cheap improved chullah and hara are the best alternative, which is the permanent solution of smoke and also consumes less fuel than traditional chullah and hara.

Study of peak expiratory flow rate in young smokers in community

Background: Inhaling of cigarette smoke has sudden effect on airways which causes an inflammation in the peripheral airways. Pulmonary function testing (PFT) provides a quantitative and objective assessment of the physiological derangement associated with pulmonary diseases. A study of PEFR in smokers and non-smokers would provide the necessary data to correlate smoking and the effect on the pulmonary health of smokers. Objectives were to study the effect of smoking on lung functions in apparently healthy young smokers and to measure the PEFR and compare the values between young smokers and non-smokers in the villages surrounding Vadodara District, Gujarat.Methods: It was a cross-sectional comparative study. With convenient sampling of total 60 male subjects which are equally divided into smokers (group A) and non-smokers (group B) group between the ages 17-25 years. The PEFR was measured by Wright’s Mini PulmoPeak Flow Meter. Three readings were taken and best of three was documented. Comparison of PEFR values between smokers and non-smokers was done.Results: The mean PEFR between smokers and non-smokers was group A is 310.00 and group B was 440.00 litres/minute (p value <0.05) and the t value was 7.608 which shows that the PEFR of smokers is significantly lower than non-smokers.Conclusions: The values of PEFR are reduced in smokers compared to non-smokers in young individuals in community and all the values are more decreased with increase in number of cigarettes smoke per day.

Peak expiratory flow rate in children aged 6 to 14 years

Background: The objective of this study was to record the PEFR values in children aged between 6 to 14 years.Methods: A cross sectional study was conducted among 1205 children aged 6 to 14 years in department of paediatrics at a medical college hospital. In a pre-structured questionnaire, the age, sex and PEFR values were recorded. PEFR was considered as primary outcome variable. SPSS version 20 was used for data analysis.Results: Total of 1205 children, 51% were boys and 49% were girls. Ninety children of age 6 years ranged between 60 to 200 with 111.1±29.4 and 7 years ranging from 70 to 210 with 136.3±30.5. One hundred and five of age 8 years had 156.9±33.3 ranging from 90 to 230 and 126 of age 10 years with 195.7±38.8 ranging from 110 to 290. Mean PEFR for boys increased with their age and was greater than girls.Conclusions: The overall mean PEFR values for the age group 6 to 14 years was 225±90.07 l/min. Boys have higher PEFR value than girls of the same age group. Hence, PEFR values in this study can be used clinically as reference value for children aged 6 to 14 years.

Variation of Body Mass Index and Peak Expiratory Flow Rate among Medical Students of CMH Lahore Medical College

Objective: To find out the variation of body mass index and peak expiratory flow rate among medical students of Combined Military Hospital, Lahore Medical College, Lahore, Pakistan. Methods: A Cross-sectional study was conducted by undergraduate students of CMH, at CMH Lahore Medical College and Institute of Dentistry in September 2019 after Ethical approval from the Ethical Review Committee of the same institution. There were 138 1st year medical students. Demographic profiles of all the students were taken and height, weight, BMI, PEFR were measured. Participants were classified on the basis of their BMI values. Underweight (BMI<18.5), normal weight (18.5≤ BMI≤ 24.9), overweight (25≤ BM≤ 29.9), and obese (BMI≥ 30). Correlational tests were applied to find out any statistically significant correlations. A p value less than 0.05 was considered significant. Results: The mean BMI in females was 23.16±6.01 corresponding with that of mean PEFR value 325.23±62.30 whereas in males the mean BMI was 22.65±3.11 corresponding with that of mean PEFR value 433.97±101.84. There is a statistically significant variation in PEFR with gender (r=0.540, p=0.001) which can be explained on ethnic backgrounds. Males had a higher PEFR than females. However, there was no significant correlation between BMI and PEFR. Also, gender was not related to BMI. Conclusion: In our study, PEFR is not affected by variation in BMI. However, gender is associated with PEFR. Males have a higher PEFR than females. This can be explained on the basis of ethnicity. BMI is not associated with gender. A large sample size with more accurate calculation of PEFR is needed for better evaluation. Keywords: Obesity and lung function, PEFR and BMI, BMI and gender How to cite: Ijaz F, Hafeez F, Bashir I, Aftab RK, Malik SA.Variation of body mass index and peak expiratory flow rate among medical students of CMH Lahore medical college. J SIMS Esculapio.2021;17(1):100-103

Tobacco Smoking is a Risk Factor for Decline Peak Expiratory Flow Rate in Young Healthy Smokers

Objective: To compare peak expiratory flow rate among smokers and nonsmokers and to establish a relation between PEFR and smoking.Methodology: A cross-sectional study was conducted at Bahria Medical and Dental College, Karachi from August to October 2020. It was comprised of 151 male smokers and nonsmokers healthy subjects of 20 to 25 years age. After taking ethical approval (ERC 21/2020), hundred and fifty one subjects, who fulfill the inclusion criteria were enrolled in the study. PEFR values were estimated by Wright’s Peak flow meter. Data was analyzed by SPSS22. Mean PEFR was compared among smokers and nonsmokers. Association between PEFR and smoking was determined by regression analysis. p-value ?0.05 was considered significant.Results: This study was comprised of 151 male participants. Of total subjects, 49 (32.5%), 102(67.5%) were smokers and nonsmokers respectively. Mean±SD age of the study participant’s was 22.74±2.657 years. Smokers have lower PEFR values as compared to nonsmokers (323.94 versus 352.65L/min.), this difference was statistically significant (p-value 0.04). Regression analysis showed the negative association of PEFR with smoking, however, this association was not statistically significant (p-value 0.17). Conclusion: Peak expiratory rate was comparatively lower in smokers than nonsmokers healthy young subjects.

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.

Peak expiratory flow rate in normal school children (5-15 Years) of Vizianagaram district- A cross-sectional study

Introduction: PEFR is a simple bedside tool to assess the degree of airway obstruction in asthmatic children. As it is influenced by age, anthropometric data, racial and ethnic differences, region specific nomograms have been advocated for use. This study has been undertaken with a view to establish reference values for PEFR and develop nomograms in Vizianagaram district. Material and Methods: The present study was undertaken at MIMS medical college, Vizianagaram. The main aim of this school based, cross-sectional, descriptive study was to establish standard nomograms of PEFR for healthy school going children between 5-15 years age group. A total of 2684 students were included in the study after meeting the inclusion criteria. PEFR values were recorded with mini-Wright peak flow meter. Body surface area and body mass index were calculated from height and weight. Statistical analysis was carried out using R version 3.4.2. Results:PEFR showed high positive correlation with respect to Height, Weight, Age, Body Surface area and moderate positive correlation with BMI. Separate regression models were developed for boys and girls. Conclusions:PEFR had positive correlation with height, age, weight, BMI and BSA.PEFR values of children in Vizianagaram district were lesser than those of other south Indian, north Indian and western children. Keywords: PEFR, mini-Wright peak flow meter, linear regression equations, asthma morbidity, nomograms

Efficacy of relative bronchodilatation of salbutamol and ipratropium in smokers and non-smokers with asthma

Asthma is an age old disease with breathlessness and wheezing as a part of its clinical manifestations. Adrenergic drugs are also used as bronchodilators as they have a fast action. They are also useful in improving the mucilary transport and in the reduction in the release of inflammatory mediators. Sympathetic and parasympathetic mechanisms for airway calibre control were tested on 80 patients above the age of 18 years with bronchial asthma using salbutamol (beta 2 androgenic drug) and ipratropium bromide (anticholinergic drug). The base line values in our study, of the smokers and non-smokers on Day 1, where Salbutamol was given as the primary drug with Ipratropium as the second drug showed a significant difference in the FEV1, FVC and PEFR values, while there was no significant difference in the FEV1/FVC ratio. After giving salbutamol to the maximum effect, in comparison to the base line, there was a considerable improvement in all the values in both the smokers and non-smokers. But on giving Ipratropium, there was no further substantial improvement in the values in the non-smokers, but a significant improvement was seen among the smokers. On day two, there was a significant improvement in the FEV1, FVC, FEV1/FVC and PEFR values compared to the base line values, and on giving salbutamol, there was a substantial increase in the expiration volume in both smokers and non-smokers. In case of smoker asthmatics, a combination therapy of Salbutamol and Ipratropium is more useful.

The Effect of Pulmonary Rehabilitation on The Duration of Antibiotic Switches, IL-10 Levels and PEFR Values in Hospitalized Community Pneumonia Patients

Background: Pneumonia is an acute inflammation of the lung parenchyma and ranked third of 30 causes of death in the world. WHO estimates the death caused by pneumonia is 1.6 million per year. Long duration of antibiotic switches is associated with increased morbidity, nosocomial infections and costs of healthcare. This study aims to assess the effect of pulmonary rehabilitation with the duration of antibiotic switches and interleukin-10 (IL-10) levels of pneumonia patients in non-intensive care thus pulmonary rehabilitation can be routinely use as adjuvant therapy. Methods: The study was conducted in May-November 2019 at Saiful Anwar Hospital Malang, with 40 pneumonia patients in the non-intensive care and divided in two groups which contains of 20 patients. This study uses consecutive simple random sampling. In treatment group, pulmonary rehabilitation consists of breathing exercise, effective cough techniques, clapping, postural drainage and breathing muscle exercises with spirometry incentive tools. The pulmonary rehabilitation treatment was done by Medical Rehabilitation Department of Saiful Anwar Malang Hospital. IL-10 levels and PEFR values on the zero and fifth days of treatment were measured. Results: The duration of antibiotic switches received pulmonary rehabilitation was shorter 5.05 days (P<0.001). The IL-10 level of conventional therapy group before therapy was 20.76 pg/ml and after therapy was 18.33 pg/ml (P=0.852). The IL-10 level of the group that received both conventional therapy and pulmonary rehabilitation before treatment was 27.38 pg/ml and after treatment was 13.74 pg/ml (P=0.135). IL-10 level of fifth day between the two groups (P=0.779). The PEFR values of the conventional therapy group and conventional therapy with pulmonary rehabilitation showed a significant increase PEFR value (P <0.001) while the fifth day PEFR value between the two groups (P = 0.164). Conclusions: Pulmonary rehabilitation as adjuvant therapy could shorten the duration of antibiotic switches by 2.21 days. There is a reduction in IL-10 level on the fifth day compared to day zero in both groups but not significant. There is a significant increase PEFR level on the fifth day compared to zero day in both groups but not significant.

The Effect of Pulmonary Rehabilitation on The Duration of Antibiotic Switches, IL-10 Levels and PEFR Values in Hospitalized Community Pneumonia Patients

The Effect of Pulmonary Rehabilitation on The Duration of Antibiotic Switches, IL-10 Levels and PEFR Values in Hospitalized Community Pneumonia Patients

Effect of Yoga (Pranayama) in Improving Pulmonary Function Tests In Pediatric Age Group: a One Year Prospective Study

Aim: The aim of the study is to find out the effect of pranayama in improving the values of pulmonary function tests, in school going children (of adolescent age group between 12 years to 15 years) having mild to moderate asthma and also not being on any long term medication for the same.&#x0D; Method: After taking a written informed consent from the school teacher in charge, the parents and the children group from a government high school in Bengaluru, the screening of the children for asthma was done. Initial pulmonary function tests were done after inhaling a bronchodilator for the diagnosis of mild and moderate asthma. The diagnosed children were not put on any long term medication. They were educated about pranayama and were also taught the methodology of performing pranayama and other yoga asanas. They were made to perform pranayama every day for 20-30 minutes, for a period of 1 year (during June 2017 – June 2018) under the teacher’s guidance and during this period they were examined periodically(every 3 months) for the improvement in their pulmonary function tests.&#x0D; Results: FEV% deteriorated in 16 children in the second visit and 20 children in the last visit. This could be explained by the disproportionate increase of FVC compared to FEV1.FEV% improved better than FVC in 40% (20) of the children while the rest 60% (29) children’s improvement in FVC was better than FEV%. In the final visit around 11 children had no change in the PEFR values, which was significantly high when other lung functions were considered.&#x0D; Conclusion: FEV1 has increased from first visit to fourth visit, but at each visit the increase was not significant. This suggests the beneficial effect of pranayama in improving FEV1 when it is practised regularly for prolonged duration. Thus our prospective study confirms that Pranayama could be one of the better alternative therapies that should be considered in adolescent asthma.&#x0D;