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Article
Relationship Between FEV1& PEF in Patients with Obstructive Airway Diseases

Authors: Muhammed .W.AL.Obaidy --- Kassim Mhamed Sultan* --- Basil Fawzi Jameel ** --- ,Rokan Motasher Fadhil
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 2 Pages: 184-190
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Spirometry is the recommended investigation for diagnosis and categorization of the severity of the air flow limitation, however Spirometer is not widely available, while Peak-flow meter is cheap, portable, and easy to operate and maintain, so the PEF is frequently proposed as alternative to FEV1 for this purpose, and widely used in general practice as a surrogate for FEV1 in assessment of airway obstruction diseases.OBJECTIVE:To determine effect of FEV1 & PEF in obstructive airway diseases.PATIENTS AND METHODS:This study was took place between 1st December 2006 and 1st July 2007in Baghdad teaching hospital. A total of 100 patients with history suggestive of obstructive airway diseases (symptoms of cough, wheezes, shortness of breath, and chest tightness), and their pulmonary function test show obstructive pattern (FEV1/FVC <70%) were included. They were (60%) male and (40%) female, and their age ranged from 16 to 82 years.RESULTS:In screening for obstructive airway diseases, there was a significant relationship (P value <0.05) between FEV1% and PEF%, (94%) of patients with obstructive airway disease as assessed byFEV1% (FEV1 %< 80%) had PEF %< 80%.In severity categorization, the PEF% and FEV1% were concordant in only (60%) of patients, with better concordance as severity of obstruction (based on FEV1%) became more. In patients with mild to moderate airway obstruction (FEV1%>40%), PEF% tended to underestimate FEV1%; while in patients with more severe obstruction (FEV1 %< =40%), PEF% tended to overestimate FEV1%. For the entire study population, PEF% underestimated FEV1% by mean of only 0.35%. However, limits of agreement were wide and exceeded-/+ 14.5. In our study 70% of patients had discordance more than 5% apart between PEF% and FEV1%, (which could be considered clinically important error for estimation of severity of airway obstruction), and this discordance more marked in women, short patients, and in patients with mild airway obstruction.CONCLUSION:The PEF% can reliably exclude airway obstruction, when normal value is present. Assumption of parity between PEF% and FEV1% must be avoided especially in categorization of severity of air way obstruction


Article
Correlation Between Helicobacter Pylori Infection and Severity of Asthma
العلاقة بین الإصابة بالملویات البوابیة وشدة الربو القصبي

Authors: Sadiq J. Ali Almuhana --- Ammar Jabbar Majeed --- Abdul-Razzaq Hassan Alkaaby --- Sabah Ali Jaber Alhelu
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2015 Volume: 5 Issue: 2 Pages: 130-137
Publisher: University of Kufa جامعة الكوفة

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Abstract

Background: Microbial exposures have been suggested to confer protection from allergic disorders, and reduced exposures to gastrointestinal microbes have been proposed as an explanation for the increase in asthma severity and prevalence. Since the general prevalence of Helicobacter pylori has been decreasing, we hypothesized that H. pylori serostatus may be inversely related to the severity of asthma. Objective: The aim of this study is to find whether infection with H.pylori reduces the probability of development of severe asthma in patients with persistent asthma.Patients and methods: In this study fifty patients with persistent asthma includes 19 males and 31 females their ages range from (17 – 66) years For all those patients, full history and complete physical examination have been done, then after, the patients subjected to pulmonary function test. After that, two milliliters sample of venous blood have been drawn, then, the sample centrifuged and sent to assess for H.pylori infection serology. Data was analyzed by using SPSS.Results: There is significant association between severity of asthma and result of H.pylori so with increase severity of asthma there is decrease in percentage of positive H.pylori serology. And there is no statistical significant are noted between patients sex or age and results of H.pylori infection test. Conclusion: There is significant inverse association between severity of asthma and result of H.pylori infection serology. This association not affected by ages and sex of patients.Recommendations: Since the exact mechanism by which H.pylori affect asthma is not clear, there is need for further studies to explore it.

خلفية الدراسة: طالما كان يعتقد إن الإصابات الجرثومية توفر حماية من إمراض الحساسية,وقلة التعرض للجراثيم المعوية أعطت تفسير لزيادة انتشار الربو وزيادة شدته,ولذلك بما إن الانتشار العام للإصابة بالملويات البوابية بدأ بالانحسار, لذلك وجدنا أن نتيجة الفحص المناعي للإصابة بالملويات البوابية تتناسب عكسيا مع شدة الإصابة بالربو المزمن.الهدف :الهدف من هذه الدراسة هو تحديد هل أن الإصابة السابقة بالملويات البوابية تقلل من احتمالية حدوث حالة الربو الشديد عند مرضى الربو المزمن.المنهجية : شارك في هذه الدراسة خمسون مريض مصابون بالربو المزمن , يتكونون من 19 ذكر و31 أنثى تتراوح أعمارهم بين 17 و 66 سنة , من كل هؤلاء المرضى تم اخذ تاريخ مرضي شامل وخضعوا لفحص سريري كامل, بعد ذلك اجري لهم فحص وظائف الرئة , من ثم سحب من كل مريض عينة بمقدار 2 مليليتر من الدم الوريدي,من ثم تم إجراء الطرد المركزي للعينة وأرسلت لغرض إجراء فحص الملويات البوابية المناعي.النتائج: تم إيجاد علاقة إحصائية معتبرة بين شدة الربو والنتائج الموجبة لفحص الملويات البوابية المناعي ,حيث كلما زادت شدة الربو كلما قلت نسبة النتائج الموجبة للفحص المناعي,كذلك تم إثبات عدم وجود علاقة إحصائية معتبرة تربط أعمار المرضى أو أجناسهم بنتائج الفحص المناعي.الاستنتاج : هناك علاقة عكسية بين شدة الربو القصبي ونتائج فحص الملويات البوابية المناعي.التوصيات: نظرا لعدم وضوح العلاقة المباشرة بين الملويات البوابية والربو القصبي نوصي بالمزيد من الدراسات لاكتشاف تلك العلاقة .


Article
Spirometric evaluation of gastroesophageal reflux disease (gerd) associated cough and asthma
تقييم وظائف الرئة لمرضى الجزر المعدي المريئي المترافق مع السعال والربو

Authors: Shaimaa A. H. Jassim شيماء عبد الهادي --- Afraa M. AL-Ameen عفراء محمد --- Amjad F. Ahmad امجد فوزي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2014 Volume: 56 Issue: 4 Pages: 422-425
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Gastroesophageal reflux disease can lead to esophageal complications, including esophagitis, ulceration, stricture, hemorrhage, and Barrett's esophagus. However, the spectrum of problems associated with GERD has expanded to extra esophageal sites. Chronic cough and asthma are two clinical problems caused or triggered by GERD. Spirometric changes among GERD associated cough and asthma still a topic of ongoing research.Objectives: This study was designated to evaluate the spirometric picture of GERD associated cough and asthma subjects in relation to different clinical aspects of the disease including body mass index (BMI), disease duration, presence or absence of symptoms as well as endoscopic findings. Subjects and methods: Ninety adult subjects (90) of either sex with a mean age of 40.5±12 year are involved in this study. Fifty five (55) GERD associated cough and asthma subjects served as test group while the remaining (35) served as control group. Each subject underwent spirometry and gastric endoscopy in Pulmonary Function and Endoscopy Units respectively at Ibn-Sina Teaching Hospital /Mosul.Results: Spirometric data of the control group were within the normal predicted range (80-120%) thus excluding the possibility of any asymptomatic obstructive airway disease. Whereas, the measured spirometric parameters (forced vital capacity (FVC), forced expiratory volume in 1 second ratio (FEV1%), peak expiratory flow (PEF), and forced mid expiratory flow(FMF) are significantly reduced in the test group with a clear restrictive pattern among the overweight subjects. In addition, neither the presence nor duration of symptoms affected the spirometric picture of the GERD associated cough and asthma subjects, unlike those with positive endoscopy findings who revealed significant obstructive pattern when compared to those with negative endoscopy findings. Conclusions: GERD associated cough and asthma subjects with positive endoscopy findings showed obstructive pattern of spirometry irrelevant to the presence or absence of symptoms or duration of the disease.Key words: Gastroesophageal Reflux Disease, chronic cough, asthma.

الخلفية :إن الجزر المعدي المريئي قد يؤدي إلى مضاعفات في المرئ مثل الالتهاب , تقرحات ,تضيق ونزف المرئ وممكن أن تمتد ھﺬه المشاكل إلى أجزاء خارج المرئ وقد تكون سببا في السعال المزمن والربو القصبي .الأهداف :تقييم صورة وظائف الرئة في مرضى الجزر المعدي المريئي المرتبط بالسعال والربو القصبي وعلاقتها مع مؤشر كتلة الجسم , مدة المرض ووجود أو غياب الأعراض مع نتيجة فحص التنظير الداخلي .الاشخاص وطريقة العمل :تم اختيار تصميم دراسة المقطع العرضي الوصفي واجريت الدراسة في مستشفى ابن سينا التعليمي في الموصل . شملت الدراسة تسعون شخصا تتراوح اعمارهم بين (19- 65 سنة) من كلا الجنسين 35 شخصا كعينة ضابطة و55 مريضا يعانون من الجزر المعدي المريئي والسعال والربو وبعد أخذ جميع المعلومات اجري فحص وظائف الرئة لجميع المشمولين بالدراسة ثم اجري للمرضى ناظور المعدة .النتائج:أظهرت نتائج وظائف الرئة للعينة الضابطة أنها ضمن المدى الطبيعي (80-120%)مما يؤكد عدم وجود أي مرض في الرئة بينما كانت نتائج وظائف الرئة (FVC و ( FMF, PEF,FEV1% للمرضى منخفضة معنويا مع وجود تحدد واضح في وظائف الرئة لدى المرضى ذوو كتلة الجسم العالية .و وجود نمط انسدادي في وظائف الرئة لدى المرضى اللذين كان فحص الناظور موجب بالمقارنة مع المرضى اللذين كان فحص ناظور المعدة لهم سالب. الاستنتاج: إن وظائف الرئة لمرضى الجزر المعدي المريئي ذوو نتيجة ناظور معدة موجبة أظهرت نمط انسدادي بغض النظر عن وجود أو غياب اعراض المرض أو مع مدة المرض .انخفاض قيم وظائف الرئة للمرضى اللذين كانوا يعانون من الجزر المعدى لفترة اطول من ثلاثة اشهر عند مقارنتهم مع المرضى اللذين كانت فترة مرضهم اقل. مفتاح الدلالة:الجزر(الاسترجاع) المعدي المريئي ,السعال المزمن ,الربو.

Keywords

Background: Gastroesophageal reflux disease can lead to esophageal complications --- including esophagitis --- ulceration --- stricture --- hemorrhage --- and Barrett's esophagus. However --- the spectrum of problems associated with GERD has expanded to extra esophageal sites. Chronic cough and asthma are two clinical problems caused or triggered by GERD. Spirometric changes among GERD associated cough and asthma still a topic of ongoing research. Objectives: This study was designated to evaluate the spirometric picture of GERD associated cough and asthma subjects in relation to different clinical aspects of the disease including body mass index --- BMI --- disease duration --- presence or absence of symptoms as well as endoscopic findings. Subjects and methods: Ninety adult subjects --- 90 of either sex with a mean age of 40.5±12 year are involved in this study. Fifty five --- 55 GERD associated cough and asthma subjects served as test group while the remaining --- 35 served as control group. Each subject underwent spirometry and gastric endoscopy in Pulmonary Function and Endoscopy Units respectively at Ibn-Sina Teaching Hospital /Mosul. Results: Spirometric data of the control group were within the normal predicted range --- 80-120% thus excluding the possibility of any asymptomatic obstructive airway disease. Whereas --- the measured spirometric parameters --- forced vital capacity --- FVC --- forced expiratory volume in 1 second ratio --- FEV1% --- peak expiratory flow --- PEF --- and forced mid expiratory flow --- FMF are significantly reduced in the test group with a clear restrictive pattern among the overweight subjects. In addition --- neither the presence nor duration of symptoms affected the spirometric picture of the GERD associated cough and asthma subjects --- unlike those with positive endoscopy findings who revealed significant obstructive pattern when compared to those with negative endoscopy findings. Conclusions: GERD associated cough and asthma subjects with positive endoscopy findings showed obstructive pattern of spirometry irrelevant to the presence or absence of symptoms or duration of the disease. Key words: Gastroesophageal Reflux Disease --- chronic cough --- asthma. --- الجزرالاسترجاع --- المعدي المريئي --- السعال المزمن --- الربو.

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