Balaji G Tuppekar

Abstract

Background: COPD is the major cause of morbidity and mortality across the world. In addition to this, the major factor that is contributing in this disease is smoking. This kind of problem occurs due to airflow obstruction that influences the progressive and accompanied hyper-responsiveness. The patients with Asthma and COPD overlap (ACO) have a poor quality of life and more rapid decline in lung functions and high mortality. Also, they consume a disproportionate amount of health care resources. Moreover, sputum cell counts are extensively used in the treatment of asthma and COPD. The clinical application of sputum cell count in patients with both COPD and asthma remain elusive. Aim: The study aims to study the role of sputum cytology in patients with Bronchial Asthma and COPD. Materials and Methods: It was a prospective study carried out in the Department of Pulmonary Medicine, D Y Patil Medical College, Nerul, Navimumbai, Maharashtra, India. The period of the study was from January 2020 to June 2021. The number of healthy patients recruited for the current study was 20, along with 20 asthmatic patients and 30 COPD patients. Spirometry and body plethysmography was used to measure the capacity and volume of the lungs of all the patients. One-Way Analysis of Variance (ANOVA) test was conducted for counting the differences in counts of lung function variables and sputum cells. Results: The mean age of healthy patients was 62.78±6.1 years, asthmatic patient was 55.9±12.8 years and COPD patients was 65.8±5.2 years. According to the analysis, the specific airway's conductance for aesthetic patients was [0.60±0.04 kPa.Sec??1;] and for the patient who was suffering from COPD, the score was [1.82±0.19 kPa.Sec??1;] and the outcome for healthy patients was [1.19±0.12 kPa.Sec??1;]. Conclusion: The study has found a strong relationship between sGaw and neutrophil and the neutrophil-macrophage ratio of COPD patients. According to the analysis of the study outcome, eosinophils are important for the respiratory inflammatory infiltrates in asthma patients as well as in COPD.   Keywords: COPD, Bronchial Asthma, Sputum Cytology

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Abstract

Background: The use of Isoniazid Prevention Therapy (IPT) helps normalize the health issues of patients with TB. The majority of patients suffering from these diseases are from a low-income group with poor education. They do not have adequate knowledge related to prevention and approaches that reduce the occurrence of TB disease soon after ART initiation where risk is higher. Aim: The study aims to determine the incidence of tuberculosis disease among patients with HIV while taking IPT and after its completion. Materials and Methods: This is a retrospective, observational, longitudinal study that used existing records of patients from Department of Pulmonary Medicine, D Y Patil Medical College, Nerul, Navimumbai, Maharashtra, India. The period of the study was from January 2020 to June 2021. STATA statistical software Version 12 was used to analyse the data. The sample size was estimated based on simple proportion formula taking incident TB disease after starting IPT 1.5% based on the study in a similar setting. Results: In this study, 960 patients were involved with mean age of 30 years, ranged between 25-37 years. TB was developed in 9.2% patients, out of which, 2.2% of patients were diagnosed while receiving IPT and 6.97% after IPT. Moreover, 55.2% of patients were on this treatment at the last observation. The unfavourable count of patients was 152 (15.8%). Most of the patients with unfavourable follow-up outcomes were lost to follow-up. 0.6% of patients have stopped treatment during the follow-up and 28.9% was transferred out. Finally, 4.7% of patients died and remaining were recovered. Conclusion: Breakthrough TB was uncommon and shown a significant proportion of it occurrence in the first month of treatment. This could be due to difficulty in diagnosing TB disease with HIV. The proper screening of patients is essential for offering treatment and providing effective care services. Keywords: Tuberculosis (TB), HIV, Isoniazid Prevention Therapy (IPT)

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