Gastroesophageal reflux disease (GERD) is most common disease with variable presentation from asymptomatic to frank symptomatic disease having impact on various respiratory disease such as cough, bronchitis, bronchial asthma, chronic obstructive pulmonary disease, and interstitial lung diseases. GERD is defined by retrograde reflux of gastric contents to the esophagus leading to various signs and symptoms that range from heartburn/ regurgitation to the development of extraesophageal respiratory syndromes like asthma. Bronchial asthma and GERD are more common diseases and usually reported more frequently as “two side sides of same coin.” GERD has associated with causal link for asthma, worsening of asthma control, one of the causes for refractory asthma, and main factor in asthma cases with recurrent asthma exacerbation. Asthma itself and medicines used for the treatment of asthma are associated with GERD, worsening of GERD and one of the causes for refractory GERD. However, asthmatics have been found to have a much greater prevalence of GERD symptoms than the general population. There remains debate regarding the underlying physiologic mechanism of this relationship and whether treatment of GERD actually translates into improved asthma outcomes. The clinical prevalence of the two conditions in many patients cannot be ignored, and multiple theories highlighting plausible pathogenic explanations for these associations have been described. The treatment of symptomatic GERD in patients with asthma is important to control the underlying GERD and should be undertaken based on current guidelines for the treatment of the GERD.
{"title":"Gastroesophageal reflux disease in bronchial asthma: What we need to know?","authors":"S. Patil, G. Gondhali, Shubham Choudhari","doi":"10.25259/gjhsr_32_2023","DOIUrl":"https://doi.org/10.25259/gjhsr_32_2023","url":null,"abstract":"Gastroesophageal reflux disease (GERD) is most common disease with variable presentation from asymptomatic to frank symptomatic disease having impact on various respiratory disease such as cough, bronchitis, bronchial asthma, chronic obstructive pulmonary disease, and interstitial lung diseases. GERD is defined by retrograde reflux of gastric contents to the esophagus leading to various signs and symptoms that range from heartburn/ regurgitation to the development of extraesophageal respiratory syndromes like asthma. Bronchial asthma and GERD are more common diseases and usually reported more frequently as “two side sides of same coin.” GERD has associated with causal link for asthma, worsening of asthma control, one of the causes for refractory asthma, and main factor in asthma cases with recurrent asthma exacerbation. Asthma itself and medicines used for the treatment of asthma are associated with GERD, worsening of GERD and one of the causes for refractory GERD. However, asthmatics have been found to have a much greater prevalence of GERD symptoms than the general population. There remains debate regarding the underlying physiologic mechanism of this relationship and whether treatment of GERD actually translates into improved asthma outcomes. The clinical prevalence of the two conditions in many patients cannot be ignored, and multiple theories highlighting plausible pathogenic explanations for these associations have been described. The treatment of symptomatic GERD in patients with asthma is important to control the underlying GERD and should be undertaken based on current guidelines for the treatment of the GERD.","PeriodicalId":369069,"journal":{"name":"Global Journal of Health Sciences and Research","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124461662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Epilepsy is a common health problem and affects humans of any age. Phenytoin is indicated in all types of seizure except in absence epilepsy. It has a wide range of pharmacokinetic properties with a narrow therapeutic range thus often leading to toxicity. Long-term neurological side effects of phenytoin include cerebellar atrophy. Therefore, monitoring of plasma levels should be done in patients on long-term phenytoin. Here, we describe a case of cerebellar degeneration in a post-operated brain abscess patient on chronic phenytoin therapy.
{"title":"A rare case of phenytoin-induced cerebellar atrophy","authors":"P. Yadav, Ashwini Kumar Panda","doi":"10.25259/gjhsr_5_2023","DOIUrl":"https://doi.org/10.25259/gjhsr_5_2023","url":null,"abstract":"Epilepsy is a common health problem and affects humans of any age. Phenytoin is indicated in all types of seizure except in absence epilepsy. It has a wide range of pharmacokinetic properties with a narrow therapeutic range thus often leading to toxicity. Long-term neurological side effects of phenytoin include cerebellar atrophy. Therefore, monitoring of plasma levels should be done in patients on long-term phenytoin. Here, we describe a case of cerebellar degeneration in a post-operated brain abscess patient on chronic phenytoin therapy.","PeriodicalId":369069,"journal":{"name":"Global Journal of Health Sciences and Research","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128789552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The most frequent cause of infectious disease-related mortality globally is tuberculosis (TB), a multisystemic disease with a wide range of presentations and symptoms. Around 12% of extrapulmonary TB cases and 1–3% of all TB cases are caused by abdominal TB. The issue of antituberculosis drug-induced liver injury (ATLI), which has long been a challenge in the management of TB infection, is one of increased significance. The major steps to reduce the occurrence of ATLI are to identify the possible risk factors of hepatotoxicity and to provide an appropriate weight-based anti-tuberculosis treatment (ATT). This case report clarifies the significance of appropriate weight-based dosing of ATT, particularly in a post-operative environment as evidenced in this instance where the patient experienced considerable post-operative weight loss.
{"title":"Anti-tuberculosis treatment-induced hepatotoxicity in a post-operative setting","authors":"Bincy Charley, Rintu Mary Roy, S. Philip","doi":"10.25259/gjhsr_24_2023","DOIUrl":"https://doi.org/10.25259/gjhsr_24_2023","url":null,"abstract":"The most frequent cause of infectious disease-related mortality globally is tuberculosis (TB), a multisystemic disease with a wide range of presentations and symptoms. Around 12% of extrapulmonary TB cases and 1–3% of all TB cases are caused by abdominal TB. The issue of antituberculosis drug-induced liver injury (ATLI), which has long been a challenge in the management of TB infection, is one of increased significance. The major steps to reduce the occurrence of ATLI are to identify the possible risk factors of hepatotoxicity and to provide an appropriate weight-based anti-tuberculosis treatment (ATT). This case report clarifies the significance of appropriate weight-based dosing of ATT, particularly in a post-operative environment as evidenced in this instance where the patient experienced considerable post-operative weight loss.","PeriodicalId":369069,"journal":{"name":"Global Journal of Health Sciences and Research","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122333946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Institute of Aerospace Medicine Indian Air Force regularly conducts Operational Training in Aerospace Medicine (OPTRAM) courses for the fighter, transport, and helicopter pilots, and navigators. The OPTRAM is directly linked with the pilots flying training and operational readiness as well. The COVID-19 pandemic halted training activities globally. Online training was not an option as it is a simulator-based training module. There was an urgent need to continue the course without compromising the safety of our pilots. A standard operating procedure (SOP) was prepared to conduct the course in a safe and timely manner within the available resources of the Institute. This paper intends to bring out the various rationale and considerations that go into formulating an SOP like this which has a huge implication on the operational preparedness of the organization and the operational readiness of our pilots.
{"title":"Operational aeromedical training during COVID-19 pandemic","authors":"Ajay Kumar","doi":"10.25259/gjhsr_21_2023","DOIUrl":"https://doi.org/10.25259/gjhsr_21_2023","url":null,"abstract":"The Institute of Aerospace Medicine Indian Air Force regularly conducts Operational Training in Aerospace Medicine (OPTRAM) courses for the fighter, transport, and helicopter pilots, and navigators. The OPTRAM is directly linked with the pilots flying training and operational readiness as well. The COVID-19 pandemic halted training activities globally. Online training was not an option as it is a simulator-based training module. There was an urgent need to continue the course without compromising the safety of our pilots. A standard operating procedure (SOP) was prepared to conduct the course in a safe and timely manner within the available resources of the Institute. This paper intends to bring out the various rationale and considerations that go into formulating an SOP like this which has a huge implication on the operational preparedness of the organization and the operational readiness of our pilots.","PeriodicalId":369069,"journal":{"name":"Global Journal of Health Sciences and Research","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128316150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Being a health-care worker is in additional psychological impact than the general population. Due to their active involvement in the battle against a bewildering virus outbreak. This create s added stress in fear of spreading the disease to their loved ones. Furthermore, more worried about the stigma feeling and working under extreme pressure. We aimed to assess the job stress, anxiety depression, and coping among health-care workers during COVID 2nd wave pandemic. It is a hospital–based, cross-sectional study conducted in SMVMCH, Puducherry. 364 participants of frontline workers, who worked during the COVID 2nd wave were taken into study after informed consent. The symptoms of anxiety, depression, and stress are assessed using Depression Anxiety Stress Scale-21 scale, Perceived Stress Scale, and the coping measures using Brief Resilient Coping Scale. In our study, 94.1% of participants had depression, 95.8% of participants had anxiety, and 81% of participants had stress. Factors that are associated with stress, anxiety, and depression among the health-care workers were the presence of medical comorbidities in family members of health-care workers, vaccination against COVID virus, health-care workers infected with COVID-19, and family members of health-care workers who have demised due to COVID infection. Frontline employees were found to be working in stressful situations with varying degrees of psychiatric morbidities. COVID hospitals need to build a better psychological support system.
{"title":"Job stress, anxiety, depression, and coping among professionals and non-professionals during COVID 2nd wave in a tertiary care hospital","authors":"Vasanth Kulothungan, Perarul Sivakumar, A. Selvaraj, Anuranjani Dhamodharan, Souganyadevi Mahalakshmi Vijayan","doi":"10.25259/gjhsr_26_2023","DOIUrl":"https://doi.org/10.25259/gjhsr_26_2023","url":null,"abstract":"\u0000\u0000Being a health-care worker is in additional psychological impact than the general population. Due to their active involvement in the battle against a bewildering virus outbreak. This create s added stress in fear of spreading the disease to their loved ones. Furthermore, more worried about the stigma feeling and working under extreme pressure. We aimed to assess the job stress, anxiety depression, and coping among health-care workers during COVID 2nd wave pandemic.\u0000\u0000\u0000\u0000It is a hospital–based, cross-sectional study conducted in SMVMCH, Puducherry. 364 participants of frontline workers, who worked during the COVID 2nd wave were taken into study after informed consent. The symptoms of anxiety, depression, and stress are assessed using Depression Anxiety Stress Scale-21 scale, Perceived Stress Scale, and the coping measures using Brief Resilient Coping Scale.\u0000\u0000\u0000\u0000In our study, 94.1% of participants had depression, 95.8% of participants had anxiety, and 81% of participants had stress. Factors that are associated with stress, anxiety, and depression among the health-care workers were the presence of medical comorbidities in family members of health-care workers, vaccination against COVID virus, health-care workers infected with COVID-19, and family members of health-care workers who have demised due to COVID infection.\u0000\u0000\u0000\u0000Frontline employees were found to be working in stressful situations with varying degrees of psychiatric morbidities. COVID hospitals need to build a better psychological support system.\u0000","PeriodicalId":369069,"journal":{"name":"Global Journal of Health Sciences and Research","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116188182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Modern sciences have some limitations, from scarcity of resources for experimentation to non-availability of data. In the vast universe of “hypotheses not tested,” we have a small lot of proven theories. What is considered as a proven theory is based on certain assumptions; besides they can be colored by the intentions of financers. Truth evolves. Professionals can be proud of achievements but they should not be proud of the principles, which are falsifiable by definition.
{"title":"Limitations of science and intolerance","authors":"S. Damle","doi":"10.25259/gjhsr_23_2023","DOIUrl":"https://doi.org/10.25259/gjhsr_23_2023","url":null,"abstract":"Modern sciences have some limitations, from scarcity of resources for experimentation to non-availability of data. In the vast universe of “hypotheses not tested,” we have a small lot of proven theories. What is considered as a proven theory is based on certain assumptions; besides they can be colored by the intentions of financers. Truth evolves. Professionals can be proud of achievements but they should not be proud of the principles, which are falsifiable by definition.","PeriodicalId":369069,"journal":{"name":"Global Journal of Health Sciences and Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126356182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reena Mohan, Rajalakshmi Mahendran, Subalakshmi Subramaniyan, K. Ganapathy
Compulsory Residential Medical Interns (CRMI) is being a part of health-care professionals they have a role and responsibilities for counseling the patients on tuberculosis (TB). The objective of the study is to assess the awareness about National Tuberculosis Elimination Programme (NTEP) among CRMI and determine the effectiveness of the training program in the improvement of knowledge of CRMI. It was a pre-test and post-test design conducted among CRMI posted in the Department of Community medicine, Sri Manakula Vinayagar Medical College and Hospital in Villupuram district of Tamil Nadu. A total of 600 CRMIs from 2014 to 2022 were trained in batches. The training program was conducted as per NTEP guidelines released by Central TB division guidelines. At the end of the session, feedback was obtained. Pre- and post-test data were entered and analyzed in Epi_Info software. The paired test was used to test the statistical significance. It was found 57.8% improvement in the knowledge of the participants about TB after the training program. In the analysis of feedback, the consensus score for all the responses was above 83%. Manual content analysis of the open-ended feedback was done. Health education dissemination strategies (e.g. campaign to end TB) on TB needs to be continuously done at the community and health facility level by trained CRMI.
{"title":"Effectiveness of NTEP training program in the improvement of knowledge of medical interns","authors":"Reena Mohan, Rajalakshmi Mahendran, Subalakshmi Subramaniyan, K. Ganapathy","doi":"10.25259/gjhsr_8_2023","DOIUrl":"https://doi.org/10.25259/gjhsr_8_2023","url":null,"abstract":"\u0000\u0000Compulsory Residential Medical Interns (CRMI) is being a part of health-care professionals they have a role and responsibilities for counseling the patients on tuberculosis (TB). The objective of the study is to assess the awareness about National Tuberculosis Elimination Programme (NTEP) among CRMI and determine the effectiveness of the training program in the improvement of knowledge of CRMI.\u0000\u0000\u0000\u0000It was a pre-test and post-test design conducted among CRMI posted in the Department of Community medicine, Sri Manakula Vinayagar Medical College and Hospital in Villupuram district of Tamil Nadu. A total of 600 CRMIs from 2014 to 2022 were trained in batches. The training program was conducted as per NTEP guidelines released by Central TB division guidelines. At the end of the session, feedback was obtained. Pre- and post-test data were entered and analyzed in Epi_Info software. The paired test was used to test the statistical significance.\u0000\u0000\u0000\u0000It was found 57.8% improvement in the knowledge of the participants about TB after the training program. In the analysis of feedback, the consensus score for all the responses was above 83%. Manual content analysis of the open-ended feedback was done.\u0000\u0000\u0000\u0000Health education dissemination strategies (e.g. campaign to end TB) on TB needs to be continuously done at the community and health facility level by trained CRMI.\u0000","PeriodicalId":369069,"journal":{"name":"Global Journal of Health Sciences and Research","volume":"7 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117319864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Glomus tumors are rare, painful, and usually benign neoplasms typically occurring at the subungual aspect of digits. Patients usually complain of extremely painful episodes. Symptoms occur spontaneously or elicited by local compression and cold environment, in special if the tumor has an acral location. We describe a case of cervical radiculopathy caused by glomus tumor which developed spontaneously causing pain at the right index finger. Pain was excruciating, which increased on touching and sudden striking on objects. There was no neck pain, no sensory loss, and no weakness. Pain radiates to the elbow and sometimes shoulders. The patient was given trial of neuropathic medications without much relief. Nerve conduction studies were normal. Magnetic resonance imaging spine minimal disk bulge at C5–C6 level with no neural compression. On examination, the neck movements were normal and power, tone, and reflexes were normal. Neurological examination was normal. Severe tenderness on palpating the right index finger nail. MRI of the right index finger revealed a glomus tumour. Glomus tumor was diagnosed and the patient underwent surgical excision. There can be a delay in diagnosis in glomus tumours.Cervical radiculopathy may be diagnosed erroneously in patients if careful physical examination and investigations are not done.
{"title":"Glomus tumor mimicking as cervical radiculopathy","authors":"Pamelle Yadav, Apoorv Deokuliar","doi":"10.25259/gjhsr_13_2023","DOIUrl":"https://doi.org/10.25259/gjhsr_13_2023","url":null,"abstract":"Glomus tumors are rare, painful, and usually benign neoplasms typically occurring at the subungual aspect of digits. Patients usually complain of extremely painful episodes. Symptoms occur spontaneously or elicited by local compression and cold environment, in special if the tumor has an acral location. We describe a case of cervical radiculopathy caused by glomus tumor which developed spontaneously causing pain at the right index finger. Pain was excruciating, which increased on touching and sudden striking on objects. There was no neck pain, no sensory loss, and no weakness. Pain radiates to the elbow and sometimes shoulders. The patient was given trial of neuropathic medications without much relief. Nerve conduction studies were normal. Magnetic resonance imaging spine minimal disk bulge at C5–C6 level with no neural compression. On examination, the neck movements were normal and power, tone, and reflexes were normal. Neurological examination was normal. Severe tenderness on palpating the right index finger nail. MRI of the right index finger revealed a glomus tumour. Glomus tumor was diagnosed and the patient underwent surgical excision. There can be a delay in diagnosis in glomus tumours.Cervical radiculopathy may be diagnosed erroneously in patients if careful physical examination and investigations are not done.","PeriodicalId":369069,"journal":{"name":"Global Journal of Health Sciences and Research","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130986056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Thirumurugan, K. Gomathi, P. Swathy, H. S. Ali Afrin, T. Momeen, R. Famitha, B. Abinayasri
Exercise is the first step of a cardiovascular stress test, including electrocardiography (ECG) and blood pressure monitoring. Typically, a treadmill or bicycle is used to carry out the exercise for this stress test. Computer-derived criteria and a scoring system have been proposed and tested in hopes of improving the diagnostic accuracy of the exercise ECG for diagnosing coronary artery disease (CAD). Many treadmill scores have not been compared with one another in the same population, so questions remain concerning their diagnostic accuracy. The study aimed to correlate the diagnostic accuracy of ST segment response with various treadmill scores. A total of 100 consecutive patients with suspected CAD referred for exercise testing at ACS Medical College and Hospital, Chennai, Tamil Nadu, between December 2021 and June 2022 were included in the study. The Institutional Review Board approved the study protocol at our institution, and all patients provided written informed consent. A treadmill test was conducted using commercially available equipment. All patients were subjected to symptom-limited exercise testing following the standard Bruce and modified Bruce protocols. A series of five scores were calculated using data collected from the patients to calculate the probability of CAD occurrence. The study included 100 patients with an average age of 48.4 ± 1 years. Obesity (41%), hypertension (80%), diabetes (86%), current smokers (62%), family history of CAD (46%), and hypercholesterolemia (46%) were all observed in the study. The receiver operator characteristic (ROC) plot’s area under the curve (AUC) (standard error) for the Detrano score was 0.46 ± 0.59. This was significantly lower than the AUC of each treadmill score. The AUC of the ROC plots of the Duke treadmill score (DTS), veterans affairs (VA), and consensus scores were 0.47 ± 0.58, 0.63 ± 0.56, and 0.61 ± 0.57, respectively. The Morise score remains helpful in our study population for detecting CAD and determining risk strata. DTS and Detrano had comparable accuracy when calculated from intermediate and high probability scores and ST responses (44% and 43%, respectively). VA and consensus had lower accuracy than others (37% and 29%, respectively).
{"title":"An experimental study to diagnose coronary artery disease using five treadmill scores","authors":"E. Thirumurugan, K. Gomathi, P. Swathy, H. S. Ali Afrin, T. Momeen, R. Famitha, B. Abinayasri","doi":"10.25259/gjhsr_18_2023","DOIUrl":"https://doi.org/10.25259/gjhsr_18_2023","url":null,"abstract":"\u0000\u0000Exercise is the first step of a cardiovascular stress test, including electrocardiography (ECG) and blood pressure monitoring. Typically, a treadmill or bicycle is used to carry out the exercise for this stress test. Computer-derived criteria and a scoring system have been proposed and tested in hopes of improving the diagnostic accuracy of the exercise ECG for diagnosing coronary artery disease (CAD). Many treadmill scores have not been compared with one another in the same population, so questions remain concerning their diagnostic accuracy. The study aimed to correlate the diagnostic accuracy of ST segment response with various treadmill scores.\u0000\u0000\u0000\u0000A total of 100 consecutive patients with suspected CAD referred for exercise testing at ACS Medical College and Hospital, Chennai, Tamil Nadu, between December 2021 and June 2022 were included in the study. The Institutional Review Board approved the study protocol at our institution, and all patients provided written informed consent. A treadmill test was conducted using commercially available equipment. All patients were subjected to symptom-limited exercise testing following the standard Bruce and modified Bruce protocols. A series of five scores were calculated using data collected from the patients to calculate the probability of CAD occurrence.\u0000\u0000\u0000\u0000The study included 100 patients with an average age of 48.4 ± 1 years. Obesity (41%), hypertension (80%), diabetes (86%), current smokers (62%), family history of CAD (46%), and hypercholesterolemia (46%) were all observed in the study. The receiver operator characteristic (ROC) plot’s area under the curve (AUC) (standard error) for the Detrano score was 0.46 ± 0.59. This was significantly lower than the AUC of each treadmill score. The AUC of the ROC plots of the Duke treadmill score (DTS), veterans affairs (VA), and consensus scores were 0.47 ± 0.58, 0.63 ± 0.56, and 0.61 ± 0.57, respectively.\u0000\u0000\u0000\u0000The Morise score remains helpful in our study population for detecting CAD and determining risk strata. DTS and Detrano had comparable accuracy when calculated from intermediate and high probability scores and ST responses (44% and 43%, respectively). VA and consensus had lower accuracy than others (37% and 29%, respectively).\u0000","PeriodicalId":369069,"journal":{"name":"Global Journal of Health Sciences and Research","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130978759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Combined pulmonary fibrosis and emphysema (CPFE) is underestimated chronic lung disease presenting with a combo of emphysema plus interstitial lung disease. CPFE is a heterogeneous lung disease documented usually in smokers which includes emphysema in the upper lobes and pulmonary fibrosis in the lower lobes. Although CPFE is commonly called as Smoker’s lung disease , a proportionate number of cases are having concurrent connective tissue disease. High-Resolution Computed Tomography (HRCT thorax) is a gold standard investigation to evaluate CPFE due less reliability of conventional chest radiography. Pulmonary hypertension and lung cancer are two comorbidities associated with poor outcome in CPFE. Echocardiography, diffusion coefficient, and body plethysmography have documented role in composite assessment of CPFE. Combination of bronchodilators, oxygen supplementation during rest and ambulation in selected cases and antifibrotics is having “game changer” role in the management of CPFE.
{"title":"Combined pulmonary fibrosis and emphysema: A new horizon of smoker’s lung disease with obstructive and restrictive lung functions!","authors":"S. Patil, S. Toshniwal","doi":"10.25259/gjhsr_14_2023","DOIUrl":"https://doi.org/10.25259/gjhsr_14_2023","url":null,"abstract":"Combined pulmonary fibrosis and emphysema (CPFE) is underestimated chronic lung disease presenting with a combo of emphysema plus interstitial lung disease. CPFE is a heterogeneous lung disease documented usually in smokers which includes emphysema in the upper lobes and pulmonary fibrosis in the lower lobes. Although CPFE is commonly called as Smoker’s lung disease , a proportionate number of cases are having concurrent connective tissue disease. High-Resolution Computed Tomography (HRCT thorax) is a gold standard investigation to evaluate CPFE due less reliability of conventional chest radiography. Pulmonary hypertension and lung cancer are two comorbidities associated with poor outcome in CPFE. Echocardiography, diffusion coefficient, and body plethysmography have documented role in composite assessment of CPFE. Combination of bronchodilators, oxygen supplementation during rest and ambulation in selected cases and antifibrotics is having “game changer” role in the management of CPFE.","PeriodicalId":369069,"journal":{"name":"Global Journal of Health Sciences and Research","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129610761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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