Sputum Production Research Articles

Effect of TB Treatment on Neutrophil-Derived Soluble Inflammatory Mediators in TB Patients with and without HIV Coinfection.

The mycobacteriological analysis of sputum samples is the gold standard for tuberculosis diagnosis and treatment monitoring. However, sputum production can be challenging after the initiation of TB treatment. As a possible alternative, we therefore investigated the dynamics of neutrophil-derived soluble inflammatory mediators during TB treatment in relation to HIV ART status and the severity of lung impairment. Plasma samples of TB patients with (N = 47) and without HIV (N = 21) were analyzed at baseline, month 2, month 6 (end of TB treatment) and month 12. Plasma levels of MMP-1, MMP-8, MPO and S100A8 markedly decreased over the course of TB treatment and remained at similar levels thereafter. Post-TB treatment initiation, significantly elevated plasma levels of MMP-8 were detected in TB patients living with HIV, especially if they were not receiving ART treatment at baseline. Our data confirm that the plasma levels of neutrophil-based biomarkers can be used as candidate surrogate markers for TB treatment outcome and HIV-infection influenced MMP-8 and S100A8 levels. Future studies to validate our results and to understand the dynamics of neutrophils-based biomarkers post-TB treatment are needed.

SYSTEMATIC LONG COVID SYMPTOMS ASSESSMENT IN HYPERTENSIVE AND NON-HYPERTENSIVE INDIVIDUALS DURING THE 12-MONTHS FOLLOW-UP AFTER HOSPITAL DISCHARGE

Objective: To study the impact of hypertension on the dynamics of physical, emotional and cognitive symptoms during the 12-months follow-up after hospitalization for COVID-19. Design and method: 212 patients hospitalized for COVID-19 (50% hypertensive, 53% female, mean age 53,4±13,6 years) underwent comprehensive questionnaire survey evaluating physical (CAT, CCQ and mMRC dyspnea scales for respiratory and EFTER-COVID for other related symptoms), emotional (HADS) and cognitive well-being (Memory, Thinking and Communication subscale of SBQ-LC questionnaire, MTC-SBQ-LC) that was performed pre-discharge and repeated after 1, 3, and 12 months. Results: Despite being older (57,8±11,8 vs 50,7±13,9, p<0,001) and having higher BMI (31,7±5,3 vs 27,4±4,4 kg/m2, p<0,001), hypertensive patrticipants had similar baseline summary scores of symptoms severity but slightly higher mMRC dyspnea score (2,7±1,1 vs 2,3±1,1, p = 0,023), and no significant difference in trends of summary scores have been detected by ANOVA (see graphic abstract). Non-hypertensive subjects had worse baseline limitation of everyday activity, cough and sputum production by respective CAT and CCQ sections that were characterized by better dynamics during follow-up. The residual level of respiratory-related symptoms at 12 months was higher in hypertensive cohort (CAT score 8,1±5,1 vs 5,8±5,0, p = 0,003, CCQ score 7,5±6,1 vs 4,5±5,1, p<0,001, mMRC dyspnea score 1,57±0,63 vs 1,27±0,54, p<0,001), most likely due to more frequent concomitant obesity and diastolic dysfunction. The most striking data was obtained in the MTC-SBQ-LC: yonger and healthier non-hypertensive participants displayed similar trends of most cognitive symptoms to the hypertensive cohort, but had persistently worse brain fog, difficulties in understanding others’ speech, planning, concentrating, and word-finding, that resulted in significantly higher summary score at 12 months after discharge (1,71±2,36 vs 0,96±1,30, p = 0,010). No differences were detected in anxiety and depression levels as assessed by HADS. Conclusions: Hypertensive patients that had been hospitalized for COVID-19 displayed similar trends of resolving physical, emotional and cognitive symptoms throughout the 12-month follow-up but had higher levels of residual respiratory-related symptoms and dyspnoea compared to the non-hypertensive participants, whereas the latter were characterized by significantly higher level of cognitive dysfunction as assessed by the dedicated SBQ-LC subscale.

Awareness of chronic obstructive pulmonary disease (COPD) among the general population in Aseer Region, Kingdom of Saudi Arabia (KSA).

Chronic obstructive pulmonary disease (COPD) is a common but preventable disease and has a prevalence of 5%-14% in the general population. It is characterized by airflow limitation and persistent respiratory symptoms. In this survey, we aimed to assess the awareness of COPD among the general population in the Aseer Region of the Kingdom of Saudi Arabia (KSA). This was an observational, cross-sectional study in which predesigned electronic questionnaires were distributed to 504 randomly selected community personnel utilizing phone services. The collected data were analyzed using the IBM SPSS Statistics software, version 24 for Windows (IBM Corp., Armonk, NY). Participants were asked 11 questions with yes-or-no answers based on awareness and symptoms of COPD: 35.5% of participants had heard about the COPD as a term and 72% had no detailed information about COPD. Only 3.5% of participants had relatives with COPD. During the survey on COPD symptoms, 31% of participants chose shortness of breath and the rest chose cough (20%), sputum production (15%), wheezing (14%), and chest pain (19%). Almost two-third of the participants had no idea about COPD symptoms. For the most disease knowledge, majority of the study participants had very poor knowledge about the disease that was evident in the 22 questions intended to assess this domain. Social media sites ranked as the most popular source of information on COPD among the study participants. Awareness about COPD among the general population in the Aseer Region in KSA is poor. It is advisable to carry out programs to increase their level of awareness.

WS18.01 Impact of elexacaftor/tezacaftor/ivacaftor therapy on sputum metabolomics in adult cystic fibrosis

Background: Adults with cystic fibrosis (CF) suffer from chronic inflammation, infection, and airway obstruction, and often have enhanced sputum production. Although CF transmembrane conductance regulator modulator therapies such as elexacaftor-tezacaftor-ivacaftor (ETI) confer lung function gains in patients with CF, their impact on inflammation and infection is not fully understood. CF sputum contains metabolites and proteins that reflect inflammation. We hypothesized the impact of ETI therapy on CF airway inflammation would be mirrored by changes in the sputum metabolome.

36-Year-Old Man With Shortness of Breath, Difficulty Swallowing, and Productive Cough

A 36-year-old man from Minnesota presented to the emergency department with a constellation of symptoms that included progressive nausea, difficulty swallowing, shortness of breath, and productive cough with brown sputum. He had a history of alcohol use disorder complicated by malnutrition and protein S deficiency leading to recurrent deep vein thromboses and was on lifelong anticoagulation. Since stopping alcohol 2 months earlier, he developed intermittent episodes of productive cough and malaise. He also developed painless dysphagia and globus sensation, leading to frequent nausea/vomiting, gastrointestinal pain, and unintentional weight loss of 30 pounds. Before presentation, he had worsening shortness of breath in conjunction with a significant increase in brown, nonbloody sputum production. He denied fevers, chills, odynophagia, skin lesions, diarrhea, or myalgias. He reported no travel outside of the state and had no known tuberculosis (TB) exposures but had a history of incarceration. The patient is a heavy cigarette smoker in addition to using smoked cannabis. He did not have significant environmental exposure from his employment. It is unknown if he had any pets. On presentation, the patient’s medications included ascorbic acid 500 mg twice daily, divalproex 250 mg daily at bedtime, enoxaparin 80 mg subcutaneous injections twice daily, and gabapentin 600 mg three times daily. CORRECT ANSWERS: 1. d. 2. b. 3. d. 4. d. 5. c.

Genome-wide association study of chronic sputum production implicates loci involved in mucus production and infection.

Chronic sputum production impacts on quality of life and is a feature of many respiratory diseases. Identification of the genetic variants associated with chronic sputum production in a disease agnostic sample could improve understanding of its causes and identify new molecular targets for treatment. We conducted a genome-wide association study (GWAS) of chronic sputum production in UK Biobank. Signals meeting genome-wide significance (p<5×10-8) were investigated in additional independent studies, were fine-mapped and putative causal genes identified by gene expression analysis. GWASs of respiratory traits were interrogated to identify whether the signals were driven by existing respiratory disease among the cases and variants were further investigated for wider pleiotropic effects using phenome-wide association studies (PheWASs). From a GWAS of 9714 cases and 48 471 controls, we identified six novel genome-wide significant signals for chronic sputum production including signals in the human leukocyte antigen (HLA) locus, chromosome 11 mucin locus (containing MUC2, MUC5AC and MUC5B) and FUT2 locus. The four common variant associations were supported by independent studies with a combined sample size of up to 2203 cases and 17 627 controls. The mucin locus signal had previously been reported for association with moderate-to-severe asthma. The HLA signal was fine-mapped to an amino acid change of threonine to arginine (frequency 36.8%) in HLA-DRB1 (HLA-DRB1*03:147). The signal near FUT2 was associated with expression of several genes including FUT2, for which the direction of effect was tissue dependent. Our PheWAS identified a wide range of associations including blood cell traits, liver biomarkers, infections, gastrointestinal and thyroid-associated diseases, and respiratory disease. Novel signals at the FUT2 and mucin loci suggest that mucin fucosylation may be a driver of chronic sputum production even in the absence of diagnosed respiratory disease and provide genetic support for this pathway as a target for therapeutic intervention.

P199 Non-invasive monitoring of cystic fibrosis lung disease in a new era: the TERRIFIC-MILE study

Cystic Fibrosis (CF) lung disease is characterized by respiratory infections and chronic inflammation. Monitoring of these parameters and timely interventions are important to prevent structural lung damage. Elexacaftor/tezacaftor/ivacaftor (ETI) markedly improves lung function and decreases pulmonary exacerbations. However, inflammation does not seem to resolve totally. Also, detecting infections has become more difficult, due to lack of sputum production. There is a need for new tools to monitor CF lung disease in the era of ETI.

Deterioration of lung function and its association with eosinophil count.

Exposure to lethal dust particles has a negative impact on human's health. This work investigated the association between respiratory symptoms and eosinophil levels between quarry workers and the controls. A total of 75 workers exposed to quarry dust and 45 age, sex, body mass index-matched unexposed controls participated in this study. Results of this study indicated that the quarry dust particles produced inflammatory responses, increasing the mean eosinophil level (7.56 ± 2.94), causing allergic respiratory symptoms such as rhinitis , chest tightness, wheeze, sputum production thus impairing the lung function with decline in FEV1(80.84 ±108.8) level in workers exposed to quarry dust compared to controls (P≤0.00**) Conclusion: The presence of increased levels of respiratory irritants in quarry sites may explain the higher prevalence of respiratory infections and exacerbated inflammatory reactions found to ascertain the link between increased eosinophil count and the lung impairment in quarry workers.

The Effect of Physical Activity on Patients with Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is characterized by narrowing of the respiratory tract. Deterioration of pulmonary ventilation occurs, as a result of which tissues and organs are insufficiently supplied with oxygen.&#x0D; The aim. To review scientific literature sources and provide data on the impact of physical activity on patients with chronic obstructive pulmonary disease (COPD).&#x0D; The research method. The review covered scientific literature sources from the period between 2009 and 2021. Electronic scientific literature search was carried out on PubMed, Google Scholar, Cochrane Database Syst. Rev., using keywords and their combinations. Full-text and freely accessible English-language articles were included. A total of 18 literature sources were considered appropriate.&#x0D; The results and conclusions. COPD is characterized by coughing, shortness of breath, sputum production, and changes in blood gases. The effect of gas (stimulus) damages lung tissue. Low tolerance to physical exertion significantly complicates respiratory function. COPD is a progressive disease. One of the main COPD stimuli is shortness of breath, which restricts daily physical activity and may have a decisive impact on disability development. Age, behavioural risk factors, emphysema, chronic obstructive bronchitis, and metabolic syndromes are predisposing risk factors for COPD. As the disease progresses, physical activity decreases. Passive physical activity manifests itself in symptoms of shortness of breath and fatigue.

Respiratory Care Management of COPD Exacerbations.

A COPD exacerbation is characterized by an increase in symptoms such as dyspnea, cough, and sputum production that worsens over a period of 2 weeks. Exacerbations are common. Respiratory therapists and physicians in an acute care setting often treat these patients. Targeted O2 therapy improves outcomes and should be titrated to an SpO2 of 88-92%. Arterial blood gases remain the standard approach to assessing gas exchange in patients with COPD exacerbation. The limitations of arterial blood gas surrogates (pulse oximetry, capnography, transcutaneous monitoring, peripheral venous blood gases) should be appreciated so that they can be used wisely. Inhaled short-acting bronchodilators can be provided by nebulizer (jet or mesh), pressurized metered-dose inhaler (pMDI), pMDI with spacer or valved holding chamber, soft mist inhaler, or dry powder inhaler. The available evidence for the use of heliox for COPD exacerbation is weak. Noninvasive ventilation (NIV) is standard therapy for patients who present with COPD exacerbation and is supported by clinical practice guidelines. Robust high-level evidence with patient important outcomes is lacking for the use of high-flow nasal cannula in patients with COPD exacerbation. Management of auto-PEEP is the priority in mechanically ventilated patients with COPD. This is achieved by reducing airway resistance and decreasing minute ventilation. Trigger asynchrony and cycle asynchrony are addressed to improve patient-ventilator interaction. Patients with COPD should be extubated to NIV. Additional high-level evidence is needed before widespread use of extracorporeal CO2 removal. Care coordination can improve the effectiveness of care for patients with COPD exacerbation. Evidence-based practices improve outcomes in patients with COPD exacerbation.

Characteristics of idiopathic pulmonary fibrosis -associated cough. a case-control study

BackgroundMost patients with idiopathic pulmonary fibrosis (IPF) complain of cough. IPF-associated cough is widely characterized as dry or non-productive. The aim of this study was to compare chronic cough in early stage IPF patients to cough in subjects with chronic cough from a community-based sample and, especially, to investigate whether cough in IPF is less productive than chronic cough in a community-based sample.MethodsThe IPF cough population consisted of 46 biopsy-confirmed patients who complained of chronic cough. Control population consisted of subjects with chronic cough, gathered by a community-based email survey sent to public service employees and the Finnish Pensioners’ Federation. A case-control setting was applied by having four age, gender, and smoking-status matched subjects from the community sample for each IPF cough patient. A cough specific quality of life questionnaire (Leicester Cough Questionnaire (LCQ)) was filled in by all subjects. The LCQ questionnaire contains 19 questions, each question is scored from 1 to 7 and total score from 3 to 21 with a smaller value indicating more severe impairment.ResultsThe sputum production frequency, as assessed by LCQ question 2, was 5.0 (3.0-6.0) in the IPF chronic cough population and 5.0 (3.0–6.0) in the community-based chronic cough population (median and interquartile range p= 0.72). The LCQ total score was 14.8 (11.5-18.1) in the IPF chronic cough population and 15.4 (13.0–17.5) in the community-based chronic cough population (p=0.76). The domain impact scores were physical, 4.9 (3.9–6.1) vs. 5.1 (4.5–5.6) (p=0.80); psychological, 4.6 (3.7–5.9) vs. 4.7 (3.9–5.7) (p=0.90); and social, 5.5 (3.7–6.5) vs. 5.5 (4.5–6.3) (p=0.84), respectively. Furthermore, cough response to paint or fumes, cough disturbing sleep, and cough frequency per day did not differ between the groups.ConclusionCough in early stage IPF patients was not distinguishable from chronic cough in the community-based population by LCQ. Especially, there was no difference in the self-reported frequency of cough-associated sputum production.

Usefulness of gastric aspirates for diagnosing nontuberculous mycobacteriosis

Distinguishing between nontuberculous mycobacterial pulmonary disease (NTM-PD) and pulmonary tuberculosis (TB) is difficult. We aimed to evaluate the usefulness of gastric aspirate examination for NTM-PD diagnosis and for differentiating NTM-PD from other diseases, including pulmonary TB. We retrospectively collected data for 491 patients with negative sputum smears or a lack of sputum production at Fukujuji Hospital. We compared 31 patients with NTM-PD to 218 patients with other diseases (excluding 203 with pulmonary TB). Additionally, we compared 81 patients with NTM cultured from at least one sputum or bronchoscopy sample to the other 410 patients. Gastric aspirate examination for NTM-PD diagnosis showed 74.2% sensitivity and 99.0% specificity for culture positivity. There was no significant difference between the nodular bronchiectatic disease and cavitary disease types for culture positivity (p = 0.515). The significance of NTM isolation from gastric aspirate showed 64.2% sensitivity and 99.8% specificity for culture positivity. Gastric aspirate examination revealed NTM in one TB patient, allowing TB to be ruled out in 98.1% of patients with NTM cultured from gastric aspirates. Gastric aspirate examination is helpful for early-stage NTM diagnosis and ruling out pulmonary TB. This could lead to more accurate and timely treatment.

Bottlenecks and recent advancements in detecting Mycobacterium tuberculosis in patients with HIV

AbstractTuberculosis (TB) remains a leading cause of deaths among patients with acquired immunodeficiency syndrome patients. Early diagnosis of TB is essential for administering timely anti‐TB therapy and improving health outcomes, particularly in the people living with HIV. However, conventional techniques used to detect Mycobacterium tuberculosis have significant drawbacks: for example, sputum smear microscopy has low sensitivity, and liquid culture is time‐consuming in patients with HIV‐TB co‐infection due to low sputum production. In addition, while immunological‐based methods involving tuberculin skin testing and interferon gamma release assays are commonly used for auxiliary TB diagnosis, they are often inaccurate in immunodeficient patients. Molecular techniques such as line probe assays, Xpert MTB, and lipoarabinomannan assay are recommended for early diagnosis by World Health Organization. However, no single technique is sufficicent for diagnosing HIV/TB co‐infection, suggesting that multiple diagnostic tests should be used to detect TB. Here, we summarize the drawbacks and advantages of existing TB‐diagnostic methods, as well as their applications to diagnosing HIV/TB co‐infection. We describe newly emerging technologies such as whole genome sequencing and mass spectrometry, with the aim of providing updated guidelines and alternative strategies for TB diagnosis, and particularly HIV/TB diagnosis.

Vogesella urethralis-induced aspiration pneumonia and bacteremia in an elderly man: a first case report and literature review

BackgroundVogesella species are common aquatic Gram-negative rods that were first reported in 1997. Vogesella urethralis bacterium was first isolated from human urine in 2020. Only two cases of disease caused by Vogesella species have been reported with no case of Vogesella urethralis-caused disease being reported as yet. Herein, we report a case of aspiration pneumonia and bacteremia caused by Vogesella urethralis.Case presentationAn 82-year-old male patient was admitted with dyspnea, increased sputum production, and hypoxia. Gram-negative rods were isolated from the blood and sputum cultures of the patient. He was diagnosed with aspiration pneumonia and bacteremia. Initially, Vogesella urethralis was wrongly identified as Comamonas testosteroni based on fully automated susceptibility testing; however, additional 16S rRNA gene sequencing identified the causative as Vogesella urethralis. The patient was treated with piperacillin and tazobactam. Unfortunately, he developed aspiration pneumonia again and died during hospitalization.ConclusionsSince no database exists for rare bacteria in traditional clinical microbiology laboratories, 16S rRNA gene sequence analysis is useful. We report the first case of Vogesella urethralis-induced aspiration pneumonia and bacteremia.

Analysis Descriptive of Anosmia and Dysgeusia in SARS CoV-2 Patients: Overview of Epidemiology, Pathogenesis, Prognosis, and Treatment Options

Introduction: SARS CoV-2 (COVID-19) is a respiratory infectious disease whose cause has been identified as the seventh type of the coronavirus family that attacks humans. Common symptoms among patients with COVID-19 include fever, dry cough, shortness of breath (dyspnea), muscle aches (myalgia), confusion, headache, sore throat, rhinorrhea, chest pain, diarrhea, nausea / vomiting, conjunctival congestion, nose. congestion, sputum production, fatigue (malaise), hemoptysis, and shivering. However, the spread of COVID-19 infection has shown new symptoms of the disease: patients with dysfunction of smell, taste and indigestion. Methods: Literature review by taking libraries from 34 journals and 2 textbook. The journal obtained from the Google, NCBI and Pubmed search engine, as well as processing research materials into new information related to the research objectives. Results: One hypothesis currently developing is that SARS-CoV-2 will cause olfactory changes through direct access and damage to the CNS through its penetration by the cribriform plate. Another hypothesis that is also developing suggests direct viral damage to olfactory cells and taste receptors. Glial cells, neurons, and the oral cavity present the ACE-2 receptor which appears to be a mechanism of cell invasion by viruses. Conclusion: People who have lost their smell or taste are six times more likely to become positive for COVID-19. Likewise, people who have anosmia have a 10-fold higher chance of being diagnosed with COVID-19. Taste and smell disorders with ageusia have a 10 times higher chance of catching COVID-19.

Latihan batuk efektif terhadap keefektifan jalan napas pada pasien tuberkulosis paru

Introduction : Pulmonary tuberculosis is a disease caused by the bacteria Mycobacterium tuberculosis which is also known as acid-fast bacillus (BTA). The entry of tuberculosis bacteria will infect the respiratory tract, reduce the work function of the cilia and will result in the accumulation of secretions in the airways and will cause ineffective airway clearance nursing problems. . Effective cough is a cough method where the client can expend energy and expel phlegm maximally. Objective: To obtain an overview related to the application of effective coughing in pulmonary tuberculosis patients in meeting oxygenation needs. Methods: This study used a quasi-experimental pre and post test design method with data collection methods using observation sheets and interviews. Results: After giving effective coughing exercises, it showed that there was a difference in results from before and after giving effective coughing exercises characterized by reduced coughing, sputum production from 2 cc to 1.1 cc, breath frequency from 28×/mnt to 24×/mnt, No crackles were found, regular breathing rhythm, the type of sputum that changed color, viscosity and the patient was able to produce sputum. Conclusion: There is an effect of giving effective coughing exercises on airway clearance in pulmonary tuberculosis patients. Recommendation: The application of effective coughing exercises can be used as one of the nursing interventions in treating patients with a diagnosis of airway clearance in pulmonary tuberculosis patients who have impaired oxygenation.

Sublethal Effects of Neonicotinoid Insecticides on the Development, Body Weight and Economic Characteristics of Silkworm.

Silkworm Bombyx mori (L.) (Lepidoptera: Bombycidae) is a critical insect for silk producers, but the inappropriate application of insecticides negatively affects the physiology and behavior of silkworms. This study found that the effects of neonicotinoid insecticides applied using two spraying methods on the growth and development of silkworms were different: the median lethal concentration (LC50) values of two pesticides applied using the leaf-dipping method were 0.33 and 0.83 mg L-1 and those of two pesticides applied using the quantitative spraying method were 0.91 and 1.23 mg kg-1. The concentration of pesticides on the mulberry leaves did not decrease after their application using the quantitative spraying method, and a uniform spraying density was observed after the mulberry leaves were air-dried (no liquid) under realistic conditions. We then treated silkworms with the quantitative spraying method and leaf-dipping method. The treatment of silkworm larvae with imidacloprid and thiamethoxam at sublethal concentrations significantly prolonged the development time and significantly decreased the weight and pupation rate, as well as economic indicators of enamel layers and sputum production. Thiamethoxam treatment significantly increased the activities of carboxylesterase (CarE) and glutathione-S-transferase (GST). The activity of CarE and GST increased, decreased, and then increased, and the highest activity was detected on the 10th and 12th days. Thiamethoxam exposure significantly elevated the transcription levels of CarE-11, GSTe3 and GSTz2 and induced DNA damage in hemocytes. This study confirmed that the quantitative spray method is more stable than the leaf-dipping method. Moreover, imidacloprid and thiamethoxam treatment affected the economy and indexes of silkworms and induced changes in detoxification enzymes and DNA damage in silkworms. These results provide a basis for understanding the mechanism of the sublethal effects of insecticides on silkworms.

ROLE OF LOW-DOSE AZITHROMYCIN IN THE MANAGEMENT OF CYSTIC BRONCHIECTASIS: A CASE SERIES

Bronchiectasis is an abnormal chronic and persistent dilatation of the bronchi that is accompanied by destruction of the bronchial walls due to congenital or acquired disorders such as chronic respiratory tract infections. Recurrent respiratory tract infections are characteristic of bronchiectasis. Radiological examination plays a role in diagnosis, a thin section CT to confirm a diagnosis of bronchiectasis when clinically suspected, and provides clearer information on lung morphology. The goals of treating bronchiectasis are to prevent exacerbations, reduce complaints, improve the patient's quality of life, and stop the disease from worsening. Therapy is expected to address the proven underlying cause, cutting off the vicious cycle of bronchiectasis Long-term antibiotics are considered in patients with bronchiectasis with frequent exacerbations three or more times per year to relieve symptoms and reduce the frequency of exacerbations. Macrolides are a plausible alternative antibiotic and anti-inflammatory agent with a lower burden of treatment for bronchiectasis patients. We present three cases of Bronchiectasis that were admitted to Mataram University Hospital. The three cases were given Long-term antibiotics with low-dose Azithromycin for 2 and 3 months. This report demonstrates clinical improvement in a reduction of exacerbation frequency, improvement in quality of life, decreased sputum production, and increased ability to carry out activities in patients treated with low-dose azithromycin. The most common side effect that appears in three cases is gastrointestinal disturbances.

Clinical features and 1-year outcomes of chronic bronchitis in participants with normal spirometry: results from the ECOPD study in China

BackgroundEvidence regarding clinical features and outcomes of individuals with non-obstructive chronic bronchitis (NOCB) remains scarce, especially in never-smokers. We aimed to investigate the clinical features and 1-year outcomes of individuals...

Persistence and Prevalence of Clinical Symptoms in SARS-CoV-2 infected patients

Coronavirus disease 2019 (COVID19) is the recently reported disease caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID19 spreads among population through the close/direct contact and nasal droplets when an infected person sneezes, coughs, talks or breaths. On an average, COVID19 infected patient develops clinical symptoms 5-6 days after the infection and some develops symptoms even after 14 days of infection. Detailed study on the symptoms shown by COVID19 patients can help in identifying individuals so that proper identification and isolation of patients can be done and transmission of virus can be reduced significantly. In this study, a total of 99 (66 males and 33 female) COVID19 infected symptomatic patients without any comorbidities were included. Nasopharyngeal and oropharyngeal swabs were used for the collection of samples from the suspected patients to extract total RNA and perform real time PCR for the detection of genetic material for SARS-CoV-2. Samples with Ct value ≤ 36 in case of Orf1ab gene and E gene with good sigmoidal curve were reported as positive for novel SARS-CoV-2. Fever, shortness of breath, dry cough and cough with sputum production persisted for longer timer and were more common symptoms reported by the COVID19 infected patients. In conclusion, understanding of the clinical symptoms shown by COVID19 infected patients can help in identification and isolation of patients so that transmission of virus can be reduced significantly.