PEFR Values Research Articles

Gambaran Fungsi Paru Pada Penduduk yang Tinggal di Zona Erupsi Merapi, Dusun Meces, Sleman, DIY

Respiratory disease is the leading cause of mortality. One cause that affects lung damage is environmental factors. The International Agency for Research on Cancer states that the air has been contaminated with carcinogenic substances including volcanic ash that consequence the harmful effects. Mount Merapi is a high volcanic activity mountain located in the Special Region of Yogyakarta. Around Merapi, there are dense settlements so that volcanic particles will be inhaled and will cause respiratory problems. The study aims to determine the lung function in the population living in the Merapi zone. The study uses a quantitative method involving 32 respondents located at 15 Km from Merapi’s slope. Data collection was carried out for one week by the cross-sectional study. Descriptive data analysis on the short-term effects of volcanic ash exposure found that 50% of respondents experienced runny nose, 92.9% dry cough, 71.4% respiratory tract irritation at two weeks after exposure. Long-term effects found that 35.7% of respondents experienced cough with phlegm, 32.1% wheezing, 50% dyspnea, 50% shortness of breath gradation 5 according to MRC scale, and 82.1% experienced PEFR value decrease. Researchers suggest to routine health screening so that early detection of lung function can be reduced especially in the Merapi eruption zone.

Antichlamydia IgG Antibody in Adult Asthmatics in Al-Najaf

Infection is presumed to have a rule in the promotion of asthma exacerbations, and in deterioration of the course of the disease, Chlamydia pneumoniae (C. pneumoniae) is claimed to be a possible cause for these two issues. To assess the positivity and the titer of C. pneumoniae IgG antibodies in relation to the state of asthma and its severity. 61 asthmatic patients aged 15-85 years (mean of 47.10±14.887), and 29 apparently healthy, nonasthmatic age and gender-matched volunteers (control group) were assessed as at Asthma and Allergy Clinic in Al-Sader Medical City in AL-Najaf province, Chlamydia Pneumoniae IgG ELISA Kit was used for the detection of IgG antibody to C. Pneumoniae in human serum to detect chronic infection, and Spirometric test was done, and the best results for FEV1 and PEFR were taken. IgG antichlamydial antibodies were positive in 21 (34.4%) of patients compared to 4 (13.8%) of controls, and the difference was significant with OR=3.281, the seropositivity in acute exacerbation was more than in stable asthmatic, 43.8% vs. 24.1% (P=0.029), seropositivity was nonsignificantly more in moderate and severe asthma as compared with mild asthma, a significant inverse correlation between IgG titer and pulmonary function test parameters (FEV1, PEFR) was observed as the FEV1 & PEFR values decrease with increase IgG titer. Chronic C. pneumoniae infection is common in adult asthmatics and correlated with exacerbations & increased severity and disturbed lung function.

PEAK EXPIRATORY FLOW RATE IN SEDENTARY POPULATION: AN OBSERVATIONAL STUDY

Background- To date there are very few studies evaluating the relationship between sedentary behaviour and pulmonary function in a population who works for more than half a day i.e. 6-8hrs continuously in front of technologies (mainly desk jobs) with no sign of physical activities. Hence the aim of the study was to evaluate the effects of a sedentary lifestyle on peak expiratory flow rate. METHOD- The study was conducted on 75 desk job workers, males and females of age group 30-45 years working for 6-8 hours without physical activity. Analysis of their lung function capacity was done by PEFR. RESULT-It is seen that there is a significant difference in the predicted and obtained values of PEFR in both genders. The mean predicted value of PEFR in females is 416.04±25.72 and the mean obtained value of PEFR is 284.7±72.84. In males the mean predicted value of PEFR is 542.6±23.33 and the mean obtained value of PEFR is 396.2±80.6. It shows that the sedentary lifestyle with physical inactivity affects the PEFR values CONCLUSION-Regular exercise in terms of physical activity is essential for every individual with a sedentary lifestyle to overcome health problems and improve their pulmonary functions.

Evaluation of Lung Function in Automobile Diesel Mechanics in a Semi Urban Town of South India-Kumbakonam Urban Rural Epidemiological Study–KURES 6

Automobile mechanics are constantly exposed to dust from the exhausts of petrol and diesel. We recruited 50 petrol two wheeler mechanics and subjected them to lung function tests. All were non-smokers without any respiratory symptoms. All mechanics were regular workers with a minimum of three years and at least an exposure of 5 hours of more per day. They were explained about the methodology and asked to attempt three times and the best of three were selected. The incidence of obstructive lung disease (FEV1/FVC<70%) was only 2%. But the incidence of reduction of effort independent MEF 25-75 in a significant manner is around 38% which coincided with reduction in PEFR values. ⁅FEV1 = Forced expiratory volume in 1 second. PEFR = peak expiratory flow rate. MEF ( 25-75) = mean forced expiratory flow between the 25% and 75% of the FVC.] We did not find any correlation with body mass index. We did not resort to analyses of deterioration of lung function with differing exposure years with a low sample size. We suggest that a regular PEFR with practice of established preventive measures may prevent the progress from asymptomatic illness to a symptomatic stage in such health workers.

Comparative study of seasonal variability in peak expiratory flow rate amongst school children in rural and urban areas

Background: Peak Expiratory Flow (PEF) is a value test for lung function and can be conveniently measured by using relatively inexpensive and portable Peak Flow Meter, identifying and assessing the degree of airflow limitation of individuals. While PEFR is obviously related to factors like age, weight, height, race, gender, it may also be additionally affected by seasons and climate. The purpose of study being to observe seasonal variation in PEFR amongst school going children and to observe peak expiratory flow rate in school going children in urban and rural areas.Methods: This prospective and comparative study was carried out on total 600 children; with 300 each from rural and urban schools, of age group 10-14 years, both sexes. Peak expiratory flow meter was used for the measurements in the seasons of summer (April to June) and winter (December to February) of the year. The results thus obtained were compiled and analysed.Results: The mean PEFR value (Litres/min) during summers in the rural children was 243.50(S.D.=16.050) while during winters was 253.63(S.D.=16.934), highly significant (p<0.001); mean PEFR summers in the urban children was 241.50(S.D.=20.530)and during winters was 249.93(S.D.=21.685), again highly significant (p<0.001).In both rural and urban groups PEFR values increased with increase in height and weight of the children which was found to be highly significant (p<0.001). Girls representation proportion in rural vs urban schools being 49% vs 45%; whereas boys being 51% vs 55% respectively.Conclusions: Peak expiratory flow rate decreased during summer season of the year in both rural and urban school attending children. In both the groups PEFR values had a direct correlation with height and weight of the children. Rural schools showed more girl student representation than their urban counterparts indicating more awareness for girl child education amongst rural population.

Chronic Obstructive Pulmonary Disease (COPD) Screening is Still a Challenge in Pakistan

Background: Chronic obstructive lung disease (COPD) is a highly preventable disease with smoking as most recognizable risk factor globally. COPD remains undiagnosed worldwide due to unavailability of gold standard spirometry. Technical difficulties in this procedure, faced by patient result in over and under diagnosis of this prevalent disease. Objective of this study was to screen the undiagnosed air way obstruction which reflects the COPD among the smokers and nonsmokers. PEFR was used for assessment, as it is simple, reliable and easily available way at most of the health care centers.
 Methodology: A cross sectional study was conducted from May 2018 to Dec 2018 at private medical institute and private hospital in Faisalabad. It comprised of 200 males (smokers and nonsmokers) who had no previous history of diagnosis of COPD. Relevant information related to smoking including pack years and medical history specially related to COPD was inquired on structured questionnaire. Air way obstruction was assessed by PEFR using vitalograph compact. Data was analyzed by SPSS 21 version. Continuous variables are presented as mean and standard deviation (SD) and compared by Independent t-test among study groups. Categorical variables are expressed as proportions and compared by X2 test. P value ? 0.05 was considered significant.
 Results: Results are showing that 91.56% of the studied smokers have air way obstruction based on yellow and red zones of PEFR. Out of total COPD smokers 62.7% were in yellow zone and 28.9% were in red zone. Only 29.1% of nonsmokers have PEFR values within yellow. None of nonsmoker was in red zone (P value 0.001*). PEFR was significantly lower in smokers in comparison to nonsmokers (P value 0.003*). 95.5% of Subjects in red zone were symptomatic, while only 51.2% of subjects in yellow zone were symptomatic considering mild to severe air flow obstruction.
 Conclusion: Smokers and nonsmokers have undiagnosed airway obstruction with symptoms reflecting COPD but greater proportion of smoker were involved. PEFR was lower in smokers as compared to nonsmokers.

Effect of Air Pollutants on Peak Expiratory Flow Rate of Public Bus Drivers in Bhaktapur, Nepal

Background: Rapid increase in number of vehicles in Kathmandu valley over past decade and never ending road expansion projects has aggravated air pollution. People involved in transportation jobs for long duration like bus drivers, conductors are more vulnerable to ill effects of air pollutants. The purpose of the present study was to assess lung function of public bus drivers exposed to outdoor air pollution by means of PEFR.
 Methods: Fifty healthy, non smoking bus drivers were selected randomly from bus parks of Bhaktapur district. Anthropological records were taken. PEFR value was obtained by Mini Wright’s peak flow meter. Their mean PEFR was compared with 50, age matched control group involved in other office works.
 Results: The PEFR value was significantly lower among bus drivers than the control group (p<0.001). Mean PEFR decreased with increasing age and increased duration of bus driving.
 Conclusions: Our study concluded that PEFR value among bus drivers who are exposed to air pollutants for long period of time was significantly reduced.

An experimental study to check immediate effect of stacked breathing exercise on peak expiratory flow rate in cardiac surgery patient-pilot study

Aims and Objectives: To evaluate the immediate effect of Stacked Breathing Exercise (SBE) on Peak Expiratory Flow (PEFR) in cardiac surgery patient. Methodology: After obtaining an ethical committee clearance, a pilot study is carried out on 11 subjects with age 40- 70yrs planned for cardiac surgery through the mediastinal approach. After obtaining written consent and screening of patient for the inclusion, Patients were treated with a Stacked Breathing Exercise (SBE) on Post-Operative Day (POD) 1, 2 and 3 twice daily. Pre-exercise and post-exercise values for PEFR was collected in six treatment session as IA, IB, IIA, IIB, IIIA, IIIB (A=Morning session, B=Afternoon session and I, II, III was POD-1, 2 and 3 respectively). Result: Total of 11 patients followed by cardiac surgery are analyzed for outcome PEFR. Data was analyzed in term of the mean difference. There is a statistically significant change seen in PEFR value comparing IA vs. IIIA, IB vs. IIIB and IA vs. IIIB (mean difference -86.364, -73.636 and -106.36). There is net 29.77% improvement in PEFR value seen at the end of the sixth (IIB) treatment session over pre-exercise value at IA. Discussion: Statistically significant improvement seen in PEFR value when comparing pre-exercise value to postexercise with every session immediately after the intervention. Our result is best supported with research article carried out by, Luciana Chiavegato. He said, Breath Stacking as an intervention in non-cardiac thoracic surgery patients able to show significant improvement in the Peak Expiratory Flow (PEF). We conducted this study to have to check on, whether it is also effective in cardiac surgery patients? In our study, we found 27% gain over before exercise values of PEFR (in l/ min) after stacked breathing exercise in cardiac surgery patients. Conclusion: It is concluded that stacked breathing exercise is significantly effective in improving PEFR. Hence can be an effective tool to help in improving lung function.

Polysomnographic and pulmonary function changes in patients with sleep problems after septoplasty with turbinectomy.

To compare Polysomnography and Pulmonary function tests before and after Septoplasty with Turbinectomy in patients complaining of nasal obstruction and sleep problems due to deviated septum with hypertrophic inferior turbinate. 90 patients underwent Septoplasty with Turbinectomy due to nasal obstruction and sleep problems involved in this study, their sleep quality evaluated by polysomnography before and after the surgery, their pulmonary functions assessed by spirometry before and after the operation. The postoperative pulmonary function values; FVC, FEV1, PEFR and postoperative polysomonographic values; AHI, Snoring index/hour, SpaO2 were higher than the preoperative values, and the results were statistically significant (p-values <0.001). Septoplasty with partial inferior turbinectomy might be a useful operation in the management of nasal obstruction and sleep problems that caused by a deviated nasal septum and hypertrophied inferior turbinate.

Comparative study on differences in lung parameter between the obese and non obese collegiate sedentary students

Background: Obesity is a chronic and complex disorder which is characterized by an excessive accumulation of body fat that affects the normal healthy body. Obesity will influences functions of various systems in the body. Fat accumulation may influence lung function which might deteriorate respiratory well-being. Studies have identified those obese individuals prone to have respiratory symptoms like dyspnea when compared with non obese individuals.Method: So this study aims to find out the lung parameter differences between the obese and non obese collegiate students. Cross sectional study design which involves 80 collegiate students was selected for this study using non probability sampling method. Based on the BMI the students were classified as Obese and Non obese.Result: 40 students with obesity (Class I) and 40 students were non obese all students were ranged with the age group of 18—32 yrs. Once the consent was obtained from the participants all are asked to do the tasks which include six minute walk test and spirometry.Conclusion: The walking time and the FVC, FEV1/FVC &amp; PEFR values were identified. Inferential statistics were done between the groups and the study shows that there was significant differences exist in the walking time and the FVC, FEV1/FVC values between Obese and Non obese individuals.Bangladesh Journal of Medical Science Vol.17(3) 2018 p.351-354

Association between Food Intake, BMI and PEFR of School Children (10-14 years) in the Union Territory of Puducherry

Drastic transition in the dietary habits of children has resulted in an uprising trend in childhood respiratory morbidity. Diet being a modifiable risk factor for respiratory discomforts, the authors aimed to investigate the association between food intake, Body Mass Index and Peak Expiratory Flow Rate by examining cross-sectional data from 1926 school children (10-14 years) selected from the four regions of the Union Territory of Puducherry during 2015 to 2017. The results revealed that Chronic Energy Deficiency (CED) was prevalent and statistically significant among majority of the children in the Union Territory of Puducherry. The lowest minimum (228.2 L/min) and lowest maximum (330.9 L/min) PEFR values was noted among milk consumers while the highest maximum was seen among strawberry eaters (410 L/min). The minimum range of PEFR for fruit intake was found to be lowest for banana (235.8 L/min). Among the animal sources, fish eaters had the highest maximum PEFR (355.5 L/min). Those consuming fried foods had PEFR value of 353.8 L/min which was same as that of banana eaters. Of the 19 food items the highest difference in mean PEFR value within each food item was observed in strawberry (151.4 L/min) and the lowest in chicken (101.1 L/min). The implication of this study is that vegetarian diet consisting of more fresh fruits and vegetables have a stronger association with PEFR values when compared to non-vegetarian diet.

Effect of Inhaled Magnesium Sulphate on Bronchodilating Response, Levels of Substance P and Clinical Improvement of Acute Exacerbations COPD Patients

Background: Inhaled magnesium sulphate has a bronchodilator and antiinflammatory effect by block the calcium channels and inhibiting substance P. This study aimed to analyze the effect of magnesium sulfate inhalation on bronchodilator response, substance P levels, and clinical improvement on AECOPD patients.&#x0D; Methods: A quasi-experimental clinical trial, pre-test and post-test design with 34 acute exacerbation of COPD patients who are hospitalized in emergency room on Dr. Moewardi Hospital, Surakarta and Ario Wirawan Hospital, Salatiga on March-April 2017 used consecutive sampling. The independent variable is inhaled magnesium sulphate dose of 150 mg 3 times every 20 minutes when the patients was admitted in emergency room, while the dependent variables are peak expiratory flow rate, the plasma levels of substance P and CAT score acute exacerbation of COPD patients. &#x0D; Results: There was a significant difference (P=0.009) decrease of PEFR value of treatment group (111.76±12.37) compared to control group (141.18±24.21). There was a significant difference (P=0.0001) decrease in CAT score of treatment group (-14.88±1.75) compared to control group (-9.00±1.17). There was a significant difference (P=0.0001) treatment group (-1305.92±417.91) than control group (-355.95±206.25).&#x0D; Conclucions: The addition of MgSO4 inhalation of 150 mg during exacerbation increased PEFR, decreased the level of P substance, and decreased the CAT score with statistically significant results. (J Respir Indo 2018; 38(1): 16-23)

Efficacy Evaluation of Nebulized Magnesium, as an Additional Complementary Treatment, in Clinical and Peak Flow Metric Improvements of Acute Asthma Attack: A Randomized Double-Blinded Clinical Trial

Background: Exacerbation of acute asthma attacks is a medical challenging problem that affects health systems all around the world. According to the reports, acute asthma has allocated about 1 to 12% of adults’ referral to the emergency departments by itself. This study aimed to investigate the effect of additional nebulized magnesium sulfate, as an additional complementary treatment, on the management of acute asthma attack. Due to controversies and the fact that previous research has been unable to confirm the benefits of routine use of magnesium in the course of treatment of asthma acute phase, this trial was conducted. Methods: Patients with a possible clinically suggested acute asthma attack, aged 18 to 65, were divided into two groups of intervention and control. An initial peak flow meter evaluation at arrival identified the severity of patients’ asthma attack. 148 patients with moderate to severe attacks were included in the study in two groups. Patients of the control group received standard asthma treatment consisting of nebulized albuterol 2.5 mg and nebulized ipratropium bromide 0.5 mg, both in minutes 0, 20, and 40 after arrival and oral single-dose prednisolone 50 mg at arrival. Patients of the case group received additional doses of nebulized magnesium sulfate 0.3 g in minutes 0, 20, and 40 after arrival in addition to the standard treatment performed on the control group. The clinical setting of dyspnea Borg scale in both the case and control groups, as well as their PEFR and FEV1 values, were recorded during the trial in minutes 0, 20, 40, and 60 after arrival. Chi-square, T-test, and Mann Whitney test were applied for data analysis. Results: The study was conducted on 148 subjects who were divided into two groups of 75 and 73 as case and control groups, respectively. PEFR values in minutes 40 and 60 after arrival were 295.04 and 336.2 in the case group and 249.64 and 282.86 in the control group, and there was a significant difference in the PEFR improvements between the case and control groups (P < 0.001). In addition, FEV1 in minutes 40 and 60 after arrival was respectively 2.26 and 2.66 in the case group and 1.88 and 2.23 in the control group. There were significant differences in FEV1 improvements between the case and control groups (P < 0.001). Conclusions: According to the results of this study, it can be concluded that administration of nebulized magnesium sulfate as an adjunctive medication to the standard treatment is beneficial in the management of moderate to severe acute asthma attacks and significantly leads to better control of acute attack in short term.

Bronchodilator activity of Ocimum sanctum Linn. (tulsi) in mild and moderate asthmatic patients in comparison with salbutamol: a single-blind cross-over study

Background: Bronchial asthma is one of the commonest chronic inflammatory diseases. The drugs available to treat bronchial asthma such as, beta-2 agonists, though very effective are associated with adverse effects. Therefore, the Ocimum sanctum (Tulsi) which was shown to have antiasthmatic activity in Ayurveda, is evaluated in this study.Objectives: To evaluate the bronchodilator activity of Ocimum sanctum Linn. in mild and moderate asthma and compare its efficacy with the standard bronchodilator drug, Salbutamol.Methods: This is a single-blind cross-over study. Capsules of Ocimum sanctum Linn. (200 mg, twice daily) and Salbutamol sulphate (2 mg, twice daily) were administered in 41 patients. Each drug was administered for a period of one week with a washout period of one week between the two drug schedules. FEV1 and PEFR were recorded in these patients to assess the bronchodilator activity before the drug administration, on 4th and on 7th day of administration of Ocimum sanctum and the parameters obtained were compared with that of the standard drug, Salbutamol.Results: Ocimum sanctum 200mg twice daily produced significant improvement in both FEV1 and PEFR values, on 4th and 7th day and also produced improvement in symptoms of asthma. On comparing the results with that of Salbutamol 2mg twice daily, the bronchodilator activity of Ocimum sanctum was found to be less efficacious, where Salbutamol produced very highly significant improvement in FEV1 and PEFR values on both 4th and 7th day.Conclusions: Our results suggest that Ocimum sanctum Linn. possesses significant bronchodilator activity in mild and moderate bronchial asthma.

PIKO-1, an effective, handy device for the patient’s personal PEFR and FEV1 electronic long-term monitoring

Subjects with airway obstruction are strongly recommended to monitor their lung function, which is particularly variable in asthma. Unlike PEFR, other personal measurements (such as FEV1) are still difficult to perform. PIKO-1 is the first electronic device for both PEFR and FEV1 personal check, but its precision has not yet been assessed. The aim of this study was to compare PEFR and FEV1 values from PIKO-1 and from a conventional spirometer in subjects with airway obstruction. In total, 352 subjects (217 men; 47.6 +/- 19.0 years; 72.6 +/- 15.0 kg; 168.1 +/- 11.9 cm) performed sequential measurements using a PIKO-1 device and a spirometer. Wilcoxon signed-rank test and sign test were used as statistical tests. Mean FEV1 values from the spirometer and PIKO-1, respectively, were 2.9 L +/- 1.1 and 3.0 L +/- 1.1, and mean PEFR values were 466.1 L/min +/- 164.5 SD and 426.3 L/min +/- 151.6 SD. PIKO-1 proved to overestimate FEV1 values by 4% (p<0.0001) and to underestimate PEFR values by 8% (p<0.000) systematically. The precision of both PIKO-1 measurements (such as FEV1 and PEFR) have been assessed. PEFR and FEV1 measures should be reset by two different constants. Nevertheless, PIKO-1 is a suitable and reliable device for the personal monitoring of obstructive patients in real life.

Serial Peak Expiratory Flow Rates in Patients Undergoing Upper Abdominal Surgeries Under General Anaesthesia and Thoracic Epidural Analgesia.

Anaesthesia and upper abdominal surgeries alter lung compliance and functional residual capacity resulting from atelectasis. Upper abdominal surgeries also cause a decrease in peak expiratory flow rates, cough reflex due to pain limited inspiration. This study aimed to study the effect of thoracic epidural analgesia (TEA) on the peak expiratory flow rates in patients undergoing upper abdominal surgeries. A total of 44 patients posted for elective surgery were enrolled. Group 1 patients received GA + 0.125% bupivacaine infusion TEA and Group 2 received GA + Inj. Diclofenac sodium 50 mg slow i.v. TID for Postoperative analgesia. Haemodynamics, VAS pain score, PEFR measurements were done at 60 minutes, 24 hours, 48 hours and 4 days after surgery in both groups. ABG analysis was taken pre operatively and 24 hours after surgery. The SBP and DBP values obtained at 60 minutes (p<0.016) 24 and 48 hours (p<0.001) and day 4 (p<0.02) postoperative showed highly significant difference between the two groups which indicate better haemodynamic parameters in patients receiving epidural analgesia. Postoperatively the difference in PEFR values at 60 minutes, 24 hour, 48 hour and day 4 were very highly significant. (p<0.001). Group1 had a 10.739% deficit on day 4 from its pre operative baseline value while group 2 showed a 34.825 % deficit which was very highly significant (p<0.001). The difference in VAS scores recorded at 60 minutes, 24 hours, 48 hours and day 4 post op were very highly statistically significant (p < 0.001). The ABG taken at 24 hours shows statistically significant difference with patients in group 2 showing decreased values in pCO2 and pO2 reflecting poorer ventilation and oxygenation. Thoracic epidural analgesia provides superior analgesia, better cough reflex as seen by better PEFR values, were haemodynamically more stable and their ABG values were better than the NSAID group.

Comparative Evaluation of Peak Expiratory Flow Rate between Computerized Spirometry and Peak Flow Meter

ABSTRACT Peak expiratory flow rate (PEFR) is a simple, reliable, and easily reproducible and measurable lung function test. It has not been formally assessed whether the PEFR values measured with peak flow meter are in close correlation with the values measured by digital spirometer. The present study is carried out to determine whether there is a significant difference between the PEFR values derived from digital spirometer and peak flow meter in patients with respiratory symptoms. How to cite this article Tiwari VK, Bansal S, Sood S, Kumar A, Shukla R. Comparative Evaluation of Peak Expiratory Flow Rate between Computerized Spirometry and Peak Flow Meter. Int J Adv Integ Med Sci 2016;1(3):93-94.

Salmeterol/fluticasone through breath-actuated inhaler versus pMDI: a randomized, double-blind, 12 weeks study

Objective: Salmeterol/fluticasone combination (SFC) formulated in a breath-actuated inhaler (BAI) overcomes the co-ordination problem associated with the pressurized-metered dose inhaler (pMDIs). Our aim was to compare the efficacy and the safety of SFC given through the BAI versus the conventional pMDI in moderate-to-severe asthmatics. Methods: In this randomized, double-blind, double-dummy, prospective, active-controlled, parallel group, multicenter, 12 weeks study, 150 asthmatics were randomized to receive SFC (25/125 mcg) through either BAI or pMDI. The primary efficacy endpoint was mean change in pre-dose morning PEFR value at 12 weeks and the secondary efficacy endpoints included, mean change in FEV1, pre-bronchodilator FVC, pre-dose morning and evening PEFR, symptom scores at 2, 4, 8, and 12 weeks. Patient preferences for device and safety were also assessed. Results: At 12 weeks, the mean change in pre-dose morning PEFR in BAI and pMDI groups was 50.72 L/min and 48.82 L/min, respectively (p < 0.0001; both groups) and the difference between the two groups was not significant. Both the treatment groups showed a statistically significant improvement in secondary endpoints at all-time points compared with baseline. The usability questionnaire assessment results showed that the BAI device was preferred by 75% of patients as compared with 25% preferring pMDI. SFC in both BAI and pMDI devices was found to be safe and well tolerated. Conclusion: This is the first study to demonstrate that SFC given through the BAI produces comparable efficacy and safety endpoints as pMDI. Additionally, BAI was the preferred inhaler by patients compared to conventional pMDI.

Prevalence of musculoskeletal disorders and occupational health problems among groundnut farmers of West Bengal, India.

The main aim of the study was to determine the nature and extent of work-related musculoskeletal disorders and physiological and thermal working stress among the groundnut farmers. In the present investigation, eighty-five groundnut farmers were recruited from the villages of Tarakeswar of West Bengal, India. Eighty-five control office workers were also selected as a control group. The modified Nordic questionnaire and a posture analysis using the OWAS method were applied in the case of groundnut farmers. The working environment and physiological stress of the groundnut cultivators were also assessed. The analysis of working posture indicated that most of the groundnut cultivation activities needed corrective measures as soon as possible. Most of the groundnut farmers suffered from discomfort at different parts of the body, especially at the lower back (99%), knee (92%), ankle (66%), shoulder (61%) and hand (60%) regions. This study also showed that groundnut farmers suffered from excessive thermal (33.4 degrees C) and physiological stress (heart rate rose up to 121.5 beats/min, systolic and diastolic blood pressure up to 132 and 80 mm/Hg, respectively, PEFR values are 403 lit/min) which affects their health. From the observation and analysis of the results, it was concluded that the health of the groundnut farmers was highly affected by improper body postures and work-load. Twisting, bending, and awkward postures during work could lead to musculoskeletal disorders among them.

Alterations in Lung Functions Based on BMI and Body Fat % Among Obese Indian Population at National Capital Region.

In India, non-asthmatic hospital admission case study has been conducted to find out the relationship between obesity and lung functions. The main objective of the present study was to find out the alterations in lung functions due to obesity among Indian population living at National Capital Region (NCR). We examined 609 non obese and 211 obese subjects in a cross sectional study from National Capital Region, India with age group ranges between 18-70 years. BMI and body fat % was determined using body fat analyzer. Obese and non-obese subjects were classified based on criteria for BMI and Body fat %. Lung function test viz., FEV1 and PEFR were conducted using portable spirometer (PIKO-1). A significant correlation (p<0.05) was observed between BMI and PEFR among non-obese male and female subjects. Decline in PEFR and FEV1 values for corresponding increase in body fat % was observed among study subjects. A significant (p<0.01) decline in mean FEV1 and PEFR was observed among non-obese and obese subjects, compared to their Indian reference standards for lung functions. A significant negative correlation (p<0.01) was observed between body fat % and lung functions (FEV1, PEFR). It is concluded that obese subjects are at a risk of lung function impairment, based on the criteria followed for BMI and body fat %. The study also demonstrate that body fat% classification as a better index for determination of obese subjects compared to BMI classification, with respect to lung function impairments.