Online ISSN: 2515-8260

Keywords : COPD


CLINICAL STUDY OF PULMONARY FUNCTION TESTS IN PATIENTS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Vivek Bapurao Chavan, Shweta Shirish Deshmukh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 2047-2054

Background: The hallmark of COPD is airflow obstruction which is typically described by spirometry. Spirometry is a cost efficient method of ordering pulmonary function tests is to start with spirometry and then order further tests in a stepwise fashion to refine the diagnosis.Present study was aimed to study pulmonary function tests in patients of chronic obstructive pulmonary disease.
Material and Methods: Present study was Cross-sectional Observational Study, conducted in patients clinically diagnosed as COPD in OPD or admitted to our wards and having symptoms of COPD (dyspnea, chronic cough or sputum production).
Results: 100 COPD patients were studied, majority were from age group 50 to 59 years (41%) & age group 60 to 69 years (30%). The male to female ratio was 5.67:1. Mean post-bronchodilator FEV1 % predicted of males in the group was 53.81 ± 19.29) whereas mean FEV1 % predicted of females in the group was 51.26 ± 15.96.  Mean post-bronchodilator FEV1/FVC ratio of males in the group was 0.433 ± 0.156 whereas mean FEV1/FVC ratio of females in the group was 0.411 ± 0.128. 15 patients were in GOLD Stage I (FEV1 ≥ 80% predicted) ,34 patients were in Stage II (50% ≤ FEV1 < 80 % predicted),36 patients were in stage III (30% ≤ FEV1 < 50 % predicted) whereas 15 patients were in stage IV( FEV1 < 30%). The difference between mean post-bronchodilator reversibility in FEV1 (in percentage) in patients in GOLD stage 1 vs stage 2 vs stage 3 vs stage 4 (applying ANOVA) was not found to be statistically significant (P=.869>0.05).
Conclusion: Spirometry is important tool in confirming and assessing severity of airway obstruction in COPD patients. Majority of COPD patients were in stage 2 & 3 (GOLD) of airway obstruction confirmed by spirometry.

To assess the function of CRP as a biomarker in COPD acute exacerbation

Dr. Shikhar Tripathi, Dr. Rohit Pathak, Dr. Vipin Chaudhary

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11726-11731

Aim: The purpose of this research is to assess the function of CRP as a biomarker in COPD acute exacerbation.
Methods: The Department of Respiratory Medicineconducted this cross-sectional research. After washing their mouths twice with plain water, all patients were advised to collect deep coughed up phlegm into a sterile wide mouth container with a screw cover. The samples were promptly sent to the microbiology laboratory and processed within 30 minutes of being collected. Gram staining was performed on a sputum sample and results were reported using Bartlett's grading method. A appropriate sample was defined as one with a score of 1 or above. Mac Conkey's agar, chocolate agar, and blood agar plates were inoculated with appropriate sputum samples. Standard microbiological procedures established by the American Society for Microbiology were used to identify the isolated organisms. Sputum samples cultured for pathogenic bacteria were classed as Bacterial exacerbations, whereas samples with no pathogenic bacteria or oral commensals were classified as Non bacterial exacerbations.
Results: Among the 100 patients, 65 had bacterial growth on culture and were classed as Bacterial COPD exacerbation. The other 35 instances in which no bacterial growth or oral commensals were found were classed as Non Bacterial COPD exacerbation. Using the crude odds ratio, it was determined that the chances of Bacterial Exacerbation for patients with COPD "≥5 years" are 2.87 (95 percent CI: [1.26,6.88]) times greater than persons with COPD "<5 years." Furthermore, smokers had a 3.77(95 percent CI[1.50,10.28]) greater risk of bacterial exacerbation than nonsmokers. In our investigation, the optimal CRP cut-off point for separating Bacterial COPD patients with Bacterial Exacerbation from those without Bacterial Exacerbation was 8.77 mg/L (sensitivity:97%; specificity:40%; PPV:75%; NPV:87%, AUC:0.77).
Conclusion: Higher CRP levels are related with individuals experiencing Bacterial COPD exacerbations rather than Non Bacterial COPD exacerbations. CRP levels might therefore be utilised to anticipate Bacterial exacerbations and also to recommend antibiotic treatment.

To Study Association Between the Levels of Oxidative Stress Markers and Pulmonary Hypertension in Patients with Chronic Obstructive Pulmonary Disease at a Tertiary Care Hospital

Shinde Shivprasad, Karpe Sonal Prabhakar, Meshram Priti, Pundpal Gurudas Sadanand

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5782-5788

Introduction: Chronic obstructive pulmonary disease (COPD) is a disease state
characterized by airflow limitation that is not fully reversible. An increased
inflammatory response in the lungs plays a central role in the pathogenesis of COPD.
Oxidative stress and systemic inflammation are co-dependent processes. Pulmonary
hypertension is a common complication of chronic obstructive pulmonary disease
(COPD). The present study is an attempt to study the various markers of oxidative
stress in COPD and their co relation with pulmonary hypertensionusing 2D ECHO
findings.
Materials and Methods: The present study enrolled 100 participants, 50 of them
diagnosed cases of COPD and the remaining 50 as control. Apart from the chest X ray,
routine blood investigations, sputum AFB examination and PFT, 6-minute walk test
(6MWT), 2D Echo and levels of above mentioned oxidative and inflammatory markers
were done of the patients. Pulmonary hypertension diagnosed based on the
Transthoracic 2D – ECHO by TR jet method – presence of mPAP more than 25 mmHg
considered as the criteria for defining pulmonary hypertension. As far as the
quantitative data was concerned, comparison between the 2 groups was done using
unpaired t test, and for the qualitative data appropriate data was used.

Study to evaluate the effect of vitamin C supplement on pulmonary function test in COPDpatients.

Dr SatyendraPrajapati,Dr ArpitVerma, Dr BalajiGhugare, Dr Nikita Toshi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10715-10721

Introduction: A substantial body of evidence indicates that nutrition influences respiratory
health. Much of the nutrition research has focused on the intake of fruits, vegetables, and
antioxidant micronutrients, because lungs are subject to a wide range of oxidant induced insults
and because antioxidant defenses play an important role in protecting the lungs from damage.
Materials and methods: Seventy five patients with COPD were included in the study. In their
baseline clinical examination, malondialdehyde (MDA); red blood cell superoxide dismutase
(SOD) and erythrocyte glutathione peroxides (GPx) levels were measured. All the above
parameters were repeated after 12 weeks of supplementation with 1000 mg vitamin C daily.
Result: Serum MDA levels were significantly lowered, erythrocyte SOD and Gap activity were
significantly higher after supplementation of vitamin C. No significant improvement in FEV1
and FEV1/FVC was observed after 12 weeks of vitamin C supplementation.
Conclusion: The present study shows that the plasma lipid peroxide (MDA) levels were
decreased and antioxidants levels (GPx and SOD) increased after 12 weeks supplementation of
vitamin C in patients with COPD. Exogenous supplementation with vitamin C does not have any
significant effect on the spirometric measurements though it brings down the levels of MDA
showing attenuation of further damage.

A study on clinical profile of patients with acute exacerbation of COPD

Dr. Ch Sandeep

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 942-945

In 2002 COPD was the fifth leading cause of death. Total deaths from COPD are projected to
increase by more than 30% in the next 10 years unless urgent action is taken to reduce the
underlying risk factors, especially tobacco use. Estimates show that COPD becomes in 2030
the third leading cause of death worldwide. Sputum cultureand sensitivity was done
collecting sputum in sterile containers and were incubated on sheep blood agar, chocolate
agar and Mac conkey agar. IgG antibodies against viruses and atypical organisms is done by
indirect immunofluorescent assay(IFA) kit.Sensitivityis 94.6% to 100%and specificity is 90%
to 100%based on micro-organism.Most of them have smoking history with 82% of Exsmokers
and 6% of smokers.Only 12% were non-smokers. Renal failure was seen in 42% of
patients. Chest x-ray showed opacities in only 24% of patients.

Clinical profile of COPD patients at a tertiary care hospital

Dr.Raghu BP, Dr.Raghavendra MK, Dr.Aravindh Ram VR,Dr.Deepak UG, Dr.Yunus Sheriff

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 478-481

COPD currently is considered the 11th leading cause of disability worldwide. Current projectionssuggest that by the year 2020, COPD will be the 5th leading cause of disability worldwide, behind only ischemic heart disease, major depression, traffic accidents, and cerebrovascular disease. The research students will attend ward rounds on a daily basis and collect cases which are under inclusion criteria. The patients will be randomly divided into intervention and control group. The intervention group of patients will be analysed. Majority of the patients came with complaints of dry cough, wheezing and breathlessness, and a very few patients had complained of fever. Most of the patients were admitted for exacerbation of COPD. It was observed that the patients with exacerbation of COPD were more in number in intervention group.

Identification of infectious etiological agents in acute exacerbation of COPD

Dr. Ch Sandeep

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 936-941

Introduction-Chronic obstructive pulmonary disease (COPD) is a common respiratory
condition involving the airways and characterized by airflow limitation.
According to the Global Burden of Disease Study 2010, COPD is the fourth leading cause
of death in the world and is projected to be third leading cause by 2020. The chronic course of
this disease is frequently accompanied by acute exacerbations, usuallydue to infections.
Materials and methods- A total of 50 patients were included in the study.The data was
collected using structured proforma including demographic data, clinical history and lab
investigations. Descriptive statistical analysis (such as mean, median, standard deviation and
percentage) has been carried out in the present study.
Results-In the present study of 50 study subjects comprised of 46 males and 4 females with
mean age of 70.5 years. In 38% of the patients, bacteria were determined to be the cause of
AECOPD. [ Klebsiella pneumoniae (52.63%), Escherichia coli ( 31.57%) and Streptococcus
pneumoniae (15.78%)]. Among viral etiology, parainfluenza(44.4%), influenza(27.8%) and
Respiratory syncytial virus(22.2%). Among Atypical organisms Mycoplasma, Chlamydiae and
Legionella accounted for 38.46%, 30.77% and 30.77% of the cases, respectively.
Conclusion-
Present study indicates that gram-negative bacteria play a major role in exacerbation of COPD
in our population .Among bacterial infections, Klebsiella was most common organism.
Para influenza followed by influenza and RSV are common viral etiological agents in
exacerbations.
Present study indicates that a good proportion of COPD exacerbations were caused by atypical
bacteria. Mycoplasma was the most commonly isolated organism followed by Chlamydia
pneumophila and Legionella species.

A study on sleep related breathing disorders among COPD patients

Dr.Basavaraj Sangolli, Dr.SSVB Murali Krishna, Dr.Manjunath M

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1059-1064

COPD is a growing global epidemic and it is estimated to kill around 3 million people every
year. It is currently the 4th largest killer disease in the world and expected to climb to 3rd
position by the year 2030. WHO has estimated that 600 million people worldwide have
COPD. It affects around 5-10% of population over the age of 40 years but still there is wide
variations in the prevalence between countries. Patients underwent Spirometric analysis and
those with post bronchodilator FEV1 < 40% are asked for willingness to participate in the
study. Those who are willing to participate are screened for inclusion into the study. Informed
Consent was obtained from all the patients. GOLD criteria revealed that majority of the
patients in our study i.e.27(45%) were of Grade 1 followed by 22(36.7%) were from Grade 2,
10(16.7%) from Grade 3 and 1(1.7%) were of Grade 4.

THE EFFECTS OF COMBINATION ORTHOPNEIC POSITION AND PURSED LIPS BREATHING ON RESPIRATORY STATUS OF COPD PATIENTS

Maya Ardilla Siregar, Amira P. Tarigan, Yesi Ariani

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4106-4111

Chronic obstructive pulmonary disease is a disease condition characterized by a progressive
and not reversible airflow previously associated with an abnormal inflammatory response in the
lungs to harmful substances. This can overcome the nursing problem in the form of gas transfer
problems. As a nurse, the thing that can be done is to do an independent intervention consisting of
orthopneic position and to try to improve breathing status based on the results of the classification
of nursing results, namely breathing frequency, oxygen saturation, and chest wall retraction. The
study aimed to investigate the combination of orthopneic position and breathing lips on the
respiratory status of COPD patients. The study was quantitative with the quasi-experimental
approach. Seventy-two were sample divide into two groups, namely, 36 control and 36 intervention
group using purposive sampling. Data were analyzed using Wilcoxon signed-rank test and Mann
Whitney Test. The results found significant differences between before and after the intervention
with values for respiratory frequency 0,001, oxygen saturation 0,001, and chest wall retraction
0,005, then found differences between the control group and comparison of respiratory frequencies
and oxygen saturation <0.005. The Intervention of combination orthopneic position and pursedlips
breathing can improve the respiratory status of COPD patients, namely: respiratory frequency,
oxygen saturation, and chest wall retraction.

The Effect of the Combination of Chest Physiotherapy and Active Cycle Breathing Technique on Respiratory Rate and Ability to Expend Sputum in Chronic Exacerbation Obstructive Lung Disease Patients at Haji Adam Malik Hospital Medan

RotuaElvina Pakpahan; Amira Permatasari Tarigan; NurAsnahSitohang .

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 616-623

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the world but is projected to be the third leading cause of death in 2020. This study aimed to examine the effect of combined chest physiotherapy and Active Cycle Breathing Technique (ACBT) on oxygen saturation and respiratory rate. The research method used was a quasiexperimental approach with pre -test and post-test control group design. The sampling technique used by the researcher was purposive sampling with 60 responde nts, divided into 30 intervention groups and 30 control groups. The results obtained were there were significant differences in the respiratory rate in the control group and the intervention group after being treated with a value of p=0.001 (p <0.05). The difference in the proportion of the ability to excrete sputum in the intervention group was 7 times more productive than the control group. It is hoped that nursing practice and nursing education will increase knowledge and skills in providing chest physiotherapy and ACBT so that they can apply these actions to patients who have sputum retention problems in the airway, especially COPD patients.

Acomparative analysis of neutrophil to lymphocyte ratio in chronic obstructive pulmonary disease patients and healthy individuals

Dr. Dipti mohapatra; Dr. Manasi behera; Dr.tapaswini mishra

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 6, Pages 824-831

Background/aims: COPD is among the significant health complications in entire world; studies have shown that there is systemic inflammation with pulmonary inflammation in case of COPD. To detect the systemic inflammatory response, neutrophil lymphocyte ratio (NLR) in peripheral blood which is important biomarker. NLR hasn’t been studied in patients having chronic obstructive pulmonary disease (COPD). Current study was targeted to determine the importance of NLR as inflammatory marker in patients with COPD.
Methods: The neutrophil and lymphocyte count in the peripheral blood was found out from blood count (CBC) reports. The NLR was determined by dividing neutrophil count from lymphocyte count. COPD patients were diagnosed with Spirometry. Then the NLR was compared in patients having stable COPD (n = 50), and healthy controls (n = 50.
Results: The neutrophil count was considerably greater in COPD patients matched with the healthy individuals (p < 0.001) whereas the lymphocyte count was suggestively lower in patients having COPD patients when compared to perfectly healthy individuals (p < 0.001).NLR values were considerably higher among patients with stable COPD patients than controls (p < 0.001). There were no noteworthy variance in the total leucocyte of COPD patients and healthy individuals.
Conclusion: It is concluded that the increase in the neutrophil-lymphocyte ratio in COPD patients compared to healthy individuals may be an indicator of systemic inflammation in patients with COPD.

“Effectiveness Of Structured Teaching Programme On Knowledge Regarding Adverse Effects Of Tobacco Usage Among B.Sc Nursing Students Of Sree Balaji College Of Nursing, Chrompet – Chennai”

Yerram Sai Rama Krishna Reddy

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 6075-6079

Smoking leads to disease and disability and harms nearly every organ of the body. Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. It increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis. Secondhand smokers are also at great risk of developing certain disease conditions like stroke, lung cancer, and coronary heart disease in adults.