Yuvarajan S

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD), is preventable and treatable disease which poses significant public health challenge. The impact of COPD on an individual patient doesn’t depend solely on the severity of airway obstruction, but also on the progression of clinical symptoms. A significant number of COPD patients suffer from tissue hypoxia and impaired oxidative metabolism. Hence this study was done to assess the progression of the disease by measuring the level of serum uric acid (UA) and serum uric acid to creatinine ratio (UA/Cr) in these patients. Methodology: This hospital based cross sectional study was carried out in the department of Respiratory Medicine, in a tertiary care hospital from September 2017 to December 2018 on sixty COPD patients. Serum uric acid and creatinine were assessed with the Uricase and Modified Jaffe’s method respectively. Finally serum uric acid creatinine ratio was calculated. Results: The mean level of serum uric acid (UA) in COPD patients with mild, moderate, severe and very severe obstruction were 2.62(mg/dl), 3.81(mg/dl), 4.53(mg/dl) and 5.72(mg/dl) respectively. The levels of serum uric acid to creatinine ratio in patients with mild, moderate, severe and very severe obstruction were in the mean of 2.24, 3.60, 5.12, and 8.12 respectively. Thus, both serum uric acid levels and serum uric acid to creatinine ratio increased with increase in the severity of airflow obstruction in patients with stable COPD which was statistically significant (p Conclusions: Thus, the levels of serum uric acid and serum UA/Cr ratio is raised in stable COPD patients and correlates with severity of airway obstruction. Thus serum UA/Cr ratio can be a useful marker to monitor the disease severity in addition to spirometric parameters like FVC, FEV1 and FEV1/FVC. Keywords: Serum uric acid, Serum uric acid creatinine ratio, COPD.

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Abstract

Introduction: Community acquired pneumonia (CAP) is recognized as a common problem that carries a substantial morbidity and mortality in preantibiotic era. With the advent of newer diagnositics and advanced antimicrobials there is reduction in morbidity and mortality, but in era of MDR pathogens its often difficult and challenging to manage CAP. However, pneumonia in younger individuals can be severe and fatal. Pneumonia in the pregnant patient is the most frequent cause of life threatening non-obstetric infection. Aims and Objective: The aim of this study was to assess the pattern of community acquired pneumonia among pregnant women in tertiary care hospital. Materials and Method: 32 pregnant ladies presented with signs, symptoms & radiological findings consistent with community acquired pneumonia were selected from out patient’s clinics of obstetrics and gynecology department. Results: The present study included 32 pregnant ladies with community acquired pneumonia, who were selected from out patient’s clinics of obstetrics and gynecology department. Their ages ranged from 20–40 years old with mean age of 25.32 years old (±4.20 SD). Cough (90%) was the most common symptom followed by fever (70%) among the patients. Chest x ray done with abdominal shield showed pulmonary infiltrates in (65%). The most common radiological findings are consolidation (75%) nodular infiltrates (20%), cavity (3%), pleural effusion (2%). The most common organisms isolated were streptococcus pneumonia, hemophilus influenza, staphylococcus aureus mycobacterium tuberculosis. Conclusion: Morbidity and mortality in pregnant patients with pneumonia continue to pose a significant challenge. Early recognition of the diseases process and appropriate antibiotic treatment are required to ascertain an optimal outcome. The treatments in the gravid patients generally follow standard guide lines for the treatment of pneumonia in adults. Concern for fetal outcome should not delay any treatment strategies as improvement in maternal oxygenation and status is the best way to ensure fetal protection. Keywords: Pneumonia, Pregnancy.

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