Venkatesh B.C

Abstract

Introduction: There is a need to re-evaluate the concept of asthma and chronic obstructive pulmonary disease (COPD) as separate conditions, and to consider situations when they may coexist, or when one condition may evolve into the other. Materials and Methods: This is prospective, observational and descriptive study conducted at MNR Medical College and Hospital, Sangareddy, India from June 2020 to December 2020 among chronic airway diseases who were classified into three groups (COPD, Asthma, and Asthma and COPD overlap (ACO)). Patients with COPD and ACO were diagnosed according to GOLD guidelines 2020 and patients with asthma were diagnosed according to Global Initiative for Asthma (GINA) guidelines 2020.  Results: Regarding the age difference between groups, it was found that patients who were diagnosed as having COPD and ACO were with mean age of 57.238.54 and 56.267.73 years, respectively. The men age of patients of Asthma was 57.518.43. In our study, 28 (30%) patients as having COPD, 39 (45.5%) patients were diagnosed as having ACO, 23 (24.4%) patients were diagnosed as having asthma. In our study comparison of groups regarding history of atopy. We found that 71.7% of ACO group, 78.2% of asthma group and 25% of COPD group had a positive history of atopy. Comparison of study groups regarding sputum eosinophils revealed that 30.7 % of ACO group, 73.9% of asthma group and 32.1% of COPD group had positive sputum eosinophils. Conclusions: ACO represents a large percentage among patients with obstructive airway diseases. It shares some features of asthma such as atopy and positive sputum eosinophilia, and some features of COPD like old age of presentation and positive smoking history. Keywords: Asthma and Chronic obstructive pulmonary disease, GOLD, FEV1, ATS.

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Abstract

Aims: Assessment of changes in the pulmonary function test before and within 24 hours of thoracocentesis and correlation between the volume of pleural fluid aspirated and changes in FEV1 and FVC. Materials and Methods: Prospective study done in 100 pleural effusion of patients presenting to the OPD/IP of the Department of Pulmonary Medicine, Sapthagiri Institute of Medical Sciences and Research Centre for a period of 2 years included in the study. All the subjects were interviewed after taking the informed consent followed by physical examination and chest X-ray. It reported findings in proforma. Results: Many of the patients belonged to the 40-50 year age group. The mean age was 44.9 years with male preponderance in distribution of cases with 81% being males and 19% females. In the present study there were 10 smokers all were males. Maximum number of patients (50%) had of mild pleural effusion, 21% patients had massive pleural effusion. After thoracocentesis, there was a substantial, improvement in the pulmonary function test FVC,FEV1 and VC though FEV1/FVC showed no significant change. There was a clear link between the volume of aspirated fluid and the measures of pulmonary function. After removal of pleural fluid by thoracocentesis. There was significant relief of dyspnoea these allowing patients to return their routine activities. Conclusion: Thoracocentesis in patients with pleural effusion is recommended for improving lung function and for symptomatic relief. Keywords: Pleural effusion, Thoracocentesis, Pulmonary function tests.

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