Vairakkani, R (2013) A Study on Clinical Profile of Chronic Obstructive Pulmonary Diseases and Correlation of Highly Sensitive C-Reactive Protein with Increasing Severity of Chronic Obstructive Pulmonary Diseases. Masters thesis, Madurai Medical College, Madurai.
|
Text
200100313vairakkani.pdf Download (3MB) | Preview |
Abstract
INTRODUCTION: Chronic obstructive pulmonary disease, a disorder of expiratory airflow has been projected to be the 3rd leading cause of mortality and 5th cause for disability as measured by DALY in 2020 by the Global burden of Disease study. It is one of the few diseases whose morbidity and mortality are increasing at an alarming rate day by day and imposing a heavy economic burden on the countries particularly the developing countries like others. Reasons for this troubling situation include the reduction in other cause mortality increasing the longeivity of the population, increasing tobacco use & increasing environmental pollution. The situation is so alarming that the disease has achieved epidemic proportions. Many advances have been made recently in the diagnosis and management of this disease but the hard fact is that the disease is one of gradual progression, increasing morbidity and incurable and the better way to handle this by prevention by healthy life style, very importantly avoiding tobacco use. Chronic obstructive pulmonary disease is a disorder of pulmonary inflammation and in contrary to yester years belief that it is confined only to the respiratory system, studies over the recent years have thrown much light on the systemic component of the disease largely due to oxidant stress and which in addition to the lung manifestations has been attributed to the extra pulmonary manifestations such as coronary artery disease which is the leading cause of mortality in these patients, osteoporosis, development of diabetes, loss of muscle mass – these impose health burden on these patients with already deranged lung function. As the pathophysiology of the varied manifestations of the disease are being unraveled everyday recent studies are on to find a unified marker which could reliably predict the entire disease manifestations, disease course, which could help in making treatment plan and also studies are on to find a way of halting the unrelenting inflammation and disease progression. Among the various markers being tested, one such is highly sensitive C-Reactive Protein. In the present study the baseline characteristics of our patients are analysed and to possibly see whether highly sensitive C-Reactive Protein correlates with the disease severity. AIMS AND OBJECTIVES: The present study was done 1. To study the clinical profile of COPD patients with respect to their baseline characteristics – age, sex, occupation, symptoms, signs, Xray, ECG, ECHO, BMI, pack years of smoking 2. To categorize the patients based on spirometry into different stages and to study the distribution of the baseline characteristics in each stage 3. To determine the value of hs-CRP in these patients and to correlate it with the various stages, smoking pack years, FEV1 and other variables and its significance 4. To study other markers of inflammation such as ESR, serum albumin and their variation with stages and lung function. MATERIALS AND METHODS Design of Study : Cross sectional study Period of Study : April 2012 – October 2012 Selection of Study Subjects : Outpatients attending the medical and thoracic medicine department Study Population : 70 cases Inclusion Criteria: Patients attending the out patient department with symptoms suggestive of chronic obstructive pulmonary diseases ( chronic cough with sputum , shortness of breath, wheeze ) who were clinically stable were subjected to PFT and whose FEV1/FVC < 0.70 (GOLD guidelines) were chosen. Exclusion Criteria: a. PFT showing features of bronchial asthma (post bronchodilator reversibility > 15% baseline value), b. Patients in acute exacerbations or clinically unstable, c. Pulmonary tuberculosis, d. Diabetes mellitus, e. Ischaemic heart disease, f. Cerebrovascular accident, g. Any acute infection or inflammation (rheumatoid arthritis, autoimmune diseases), h. Malignancy, i. Hepatic or renal impairment. CONCLUSIONS: From our study we conclude that, • Increasing age is associated with severity of the disease. • Males are more commonly affected than females because of smoking. • Occupational exposure to risk factors compounds the risk of developing the disease when associated with smoking. • Incidence of pulmonary hypertension and right ventricular dilatation increases with increasing severity of the disease. • Body mass index decreases with increasing severity and is a poor prognostic marker. • The markers of inflammation – Erythrocyte sedimentation rate, albumin, Highly Reactive C-Reactive Protein correlates with increasing disease severity as evidenced by decreasing FEV1% of predicted value and increasing GOLD stage.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Clinical Profile ; Chronic Obstructive Pulmonary Diseases ; Correlation of Highly Sensitive C-Reactive Protein ; Increasing Severity ; Chronic Obstructive Pulmonary Diseases. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 20 Mar 2018 03:31 |
| Last Modified: | 20 Mar 2018 18:03 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6395 |
Actions (login required)
 |
View Item |
