Postinfectious Bronchiolitis Obliterans

Childhood bronchiolitis obliterans (BO) is an uncommon complication that is characterized clinically by persistent and continuous obstructive respiratory symptoms, and has been described secondary to various etiologic factors, including drugs, exposure to toxic fumes, allergic reactions, collagen vascular disease or infections. BO occurs most commonly in children after an episode of acute bronchiolitis and is considered a long-term sequela of viral infection.Postinfectious Bronchiolitis Obliterans (PIBO) is characterized by persistent airway obstruction with functional and radiological evidence of small airway involvement that is in general unresponsive to bronchodilator treatment.Although the condition is relatively rare, and its exact incidence is unknown, it is important to keep it in mind. PIBO is complication of lower respiratory tract epithelial injury, and is often misdiagnosed, delaying recognition and potential treatment. A PIBO diagnosis is usually based on a few factors, including a good medical history, positive clinical findings, and lung function test and imaging results, although biopsy and histopathology remain as the optimum diagnostic approach. There have to date been few studies proposing treatments for the condition, and no accepted protocol exists in literature. There is usually a fixed airway obstruction in PIBO. Various treatment approaches have been extrapolated from studies of post bone marrow transplantations and lung transplant BO. The clinical course is variable, and good supportive therapy is essential, with anti-inflammatory therapy often being employed.

Estimation of Lung Function Test among Healthy and Blow out Whistle Beginners

Introduction: Pulmonary function test is a non-invasive test. It is measured by the spirometer and it gives an idea about the lung volume, lung capacities, rates of flow and gas exchange. Breathing exercise can increase lung function. The commonly performed breathing exercises are blowing bubbles, blow out whistle, pinwheels, Hoberman spheres etc. The aim of this study is to estimate lung function among healthy and blow out whistle beginners. Materials and methods: 60 Dental students consisting of 2 groups were involved in this study. Group 1: Control individuals (30). Group 2 individuals: blow out whistle beginners (30). Standardised RMS Helios spirometer was used. Age of 18-22, Healthy individuals and non-smokers were included in this study and smokers, alcoholic individuals, respiratory disorder individuals and post- COVID individuals were excluded from the study. Data was collected and analysed using paired ‘t’ tests. Significance is considered at P<0.05 level. Results: In this study FVC, FEV1, FEV3 were found to be significant and FEV1/FVC, FEF 25-75, PEFR were found to be insignificant. The post test values of FVC and FEV1 are comparatively higher than the pre test values. The pre test values of FEF 25-75 and FEV3 are comparatively higher than the post test values. Conclusion: When this blow out exercise is performed there was a significant difference between healthy individuals and blow out whistle beginners. Significant increase in lung function is found. This recreational activity increases lung function which can be a preventive for many pulmonary diseases.

Effect of Box Breathing Technique on Lung Function Test

Background: Box breathing exercise is a technique of slow breathing rhythm also known as square breathing used universally. It increases the performance and concentration level, it also acts as a powerful stress relief. It is tested with a spirometer for the lung function test that measures the airflow of the upper and lower respiratory tract. This method builds up carbon dioxide in blood which calms down and regulates the ANS (Autonomic Nervous System), which enhances the cardio- inhibitory response of the vagus nerve that improves the mood. The main aim of the study was to analyze the effect of box breathing technique on lung function Materials and Methods: The present study was carried out among the participants at the age of 18-25 years from Saveetha Dental College. A total of 30 participants were included in this study (15 males, 15 females). The experimental training procedures consisted of 2 sessions of box breathing day and night for a period of 30 days. Participants were informed of the procedures of the box breathing technique. RMS Helios spirometer was used to measure lung volumes and capacities. Statistics analysis was done using SPSS software, paired t test. P value of less than or equal to 0.05 was considered significant statistically. Results: There was a significant increase among the participants FVC (Forced Vital Capacity), FEV1 (Forced Expiratory Volume), FIVC (Forced Inspiratory Vital Capacity) parameters after 2 sessions on each day of box breathing technique for a period of 30 days. Other parameters increased to 10% but not significantly. Conclusion: The present study illustrates the potential for box breathing practice to improve lung performance and reduce stress in healthy individuals. Despite the significant difference in FVC, FEV, FIVC levels supporting improved lung function, further investigation is needed to delineate mechanisms that underlie these benefits

Respiratory Responses to Short Term Sustained Isometric Muscle Contraction among Undergraduates

Aim: This study sets out to investigate whether a short-term isometric abdominal exercise can benefit adults with improvement in ventilatory functions. Materials And Methods: The present study was performed in 20 adults from the student population of I-BDS students with no history of smoking and respiratory illness. The participants did a daily 20-minute static abdominal exercise over a period of three days. The lung function test was assessed using spirometry and the values of FVC, FEV1, FEV1/FVC, PEFR, FEF 25-75. Paired dependent t test was done to evaluate the anthropometric variables and changes in lung functions pre-exercise on day 1 and post-isometric exercise on day 3. Results: The study demonstrated a significant increase in the mean values of forced vital capacity and forced expiratory volume in one second. The FEV1/FVC ratio, PEFR, FEF 25-75% did not reveal significant changes. Conclusion: The study concluded an innovative finding that ventilatory functions improved after short term isometric training.

Lung Function Tests in Children with and without Sickle Cell Anaemia at South Western Nigerian Tertiary Hospitals

Sickle cell anaemia (SCA) is a common cause of morbidity and mortality in Nigerian children. Sickle cell haemoglobin disorder and carrier state have incidence at birth in Nigeria of about 2% and 25% respectively. The Chronic anaemia and recurrent vaso-occlusion in this disease condition can lead to impairment of function of body organs or systems. The knowledge on how SCA affects the lung and pulmonary tissue function in Nigerian children is inadequate. Aims: To compare lung function tests results of apparently healthy sickle cell anaemia patients recruited from tertiary hospitals in South West Nigeria with those of apparently healthy controls. Method: A comparative cross sectional study of children attending the Sickle Cell anaemia clinics of Wesley Guild Hospital, Obafemi Awolowo University Teaching Hospital Complex and Ladoke Akintola University of Technology Teaching Hospital was done. Ethical approval was obtained from the Ethical review boards of the different hospitals where the studies were conducted. Randomly selected consenting matched apparently well children and children with Sickle cell anaemia had their weights, height and Packed cell volume on the days of their clinics. In addition the Forced Expiratory Volume at one second, Forced Vital capacity and Peak expiratory flow rates were measured and recorded. The data obtained was analyzed using SPSS 12 version. Results: The total of 74 HBSS patients studied comprised of 35(43.7%) boys and 39 (52.7%) girls, giving a male to female ratio of 1: 1.1, while the 73 apparently healthy controls were made up of 39(53.4%) boys and 34(46.6%) girls, giving a male to female ratio of 1.2 : 1.0. The mean weight and BMI of the children with SCA were 24.9 ± 8.0kg and 14.4 ± 1.8m2 compared with 29.4 ± 2.9kg and 15.4 ± 1.8m2 in the apparently healthy controls. Higher values of weight and BMI in healthy controls than in the SCA subjects and statistically significant p< 0.05. The mean values of the FEV1 , FVC, PEFR and FEV percent were 1.54 ±0.51, 1.76 ± 0.45, 271.37 ± 72.20 and 87.5 ± 4.43 respectively in children with SCA as against 1.83 ± 0.61, 2.03 ± 0.65, 296.44±75.0 and 90.2 ± 5.76 respectively in the healthy controls. Higher lung function tests are statistically significant (p < 0.05). Conclusion: Children with Sickle Cell anaemia have significantly lower anthropometric measurement and lung function test values (FEV1, FVC, & PEFR) than controls. The lower lung function test values in the sickle cell anaemia patients may be as a result of the lower anthropometric measurements. Further studies need to be conducted find out why the lung function tests are lower in children with sickle cell anaemia preferably after eliminating cofounders such as anthropometry. Key words: Lung Function Tests, Sickle Cell Anaemia, Children.

Evaluation on Lung Functions after Examination Stress in Student Population

Background: Professional degrees are daunting to the learning group because of a modern curriculum that is dramatically different from high school curricula and other educational courses. It is more pronounced among first year students in educational institutions because of rivalry and demands from institution managers, academic staff and parents. Stress causes many detrimental effects in the body. Aim: The present study planned to evaluate the effect of examination stress on the changes in lung functions among dental college students. Materials and Methods: 20 normal students were selected and categorised into normal and stressed students. They were assessed for a lung function test using RMS helios 702 Spirometer. The parameters such as FVC, FEV1, FEV1/FVC, PEFR, FEF25-75 were assessed. Results: It is observed that there was a decrease in the values of FVC, FEV1, FEV1/FVC, PEFR, FEF25-75 in exam stressed students when compared to normal students. The values of FEV1/FVC and FEF25-75 were statistically significant. Conclusion: Thus, the study concluded an innovative finding that there was an inverse association with depressive symptoms in the pulmonary function test of exam stressed students which was shown by a statistically significant decrease in FEV1/FVC and FEF25-75. Exam is really a stressful experience and affects both male and female students. Awareness should be conducted among students about ill effects of stress. Decreased stress, increased lung function results in increased academic performance.

Competitive sport after SARS-CoV-2 infection in children

Background With the gradual resumption of sports activities after the lock-down period for coronavirus pandemic, a new problem is emerging: Allow all athletes to be able to return to compete after SARS-CoV-2 infection in total safety. Several protocols have been proposed for healed athletes but all of them have been formulated for the adult population. The aim of the present study is to evaluate the adequacy of Italian practical recommendations for return-to-paly, in order to exclude cardiorespiratory complications due to COVID-19 in children and adolescents. Methods Between April 2020 and January 2021 the Italian Sports Medical Federation formulated cardiorespiratory protocols to be applied to athletes recovered from SARS-CoV-2 infection. The protocols take into account the severity of the infection. Protocols include lung function tests, cardiopulmonary exercise test, echocardiographic evaluation, blood chemistry tests. Results From September 2020 to February 2021, 45 children and adolescents (aged from 9 to 18 years; male = 26) with previous SARS-CoV-2 infection were evaluated according to the protocols in force for adult. 55.5% of the subjects (N = 25) reported an asymptomatic infection; 44.5% reported a mild symptomatic infection. Results of lung function test have exceeded the limit of 80% of the theoretical value in all patients. The cardiorespiratory capacity of all patients was within normal limits (average value of maximal oxigen uptake 41 ml/kg/min). No arrhythmic events or reduction in the ejection fraction were highlighted. Conclusion The data obtained showed that, in the pediatric population, mild coronavirus infection does not cause cardiorespiratory complications in the short and medium term. Return to play after Coronavirus infection seems to be safe but it will be necessary to continue with the data analysis in order to modulate and optimize the protocols especially in the pediatric field.

Evaluation of Lung Functional Status among People Living in Different Type of Housing in Chennai City

Background: Different housing has its influence on the health of the residents. The high rise apartment is a type of living adapted by people in urban areas of India. It becomes inevitable and poses much convenience and economy without occupying much land area. It is known that the floor of residence is related to the pulmonary function of the individuals. Objective: The aim of the present study was to comparatively evaluate the lung functional status among the people living in high rise apartments and individual houses in Chennai city. Materials and Methods: The study included 20 healthy individuals, 10 residents from Individual houses and 10 residents from high rise apartments from the 10th to 15th floor. The lung function was measured using RMS Helios 702 spirometer. They were assessed for a lung function test using RMS Helios 702 spirometer. The parameters such as FVC, FEV1, FEV1/FVC, PEFR, FEF25-75 were assessed, and the statistical test used was independent t test. Results: The mean of FVC, FEV1, FEV1/FVC ratio, FEF 25-75, PEFR were maximum in high rise apartment residents compared to individual house residents. Statistically significant change was observed in the FEF25-75 value among the two groups. Conclusion: The study concluded an innovative finding that subjects living in high rise apartments showed innovation in finding better lung functions and this may be attributed to the pollution free zone in high floors.

Short-term effects of exposure to PM2.5, PM10, NO2, CO, SO2, O3 on lung function test indices among students of Tehran city, Iran

Introduction: The adverse health effects of air pollution have been observed in many epidemiological studies. The aim of this research was to study the effects of air pollution on pulmonary functions in schoolchildren in Tehran city. Materials and methods: Total number of 167 schoolchildren were selected to participate in this study. Data were analyzed using analysis of variance (ANOVA) and generalized estimating equation (GEE) to determine the relationship of air pollution and lung function tests. Results: The result of this study showed that there are statistically significant differences in value of air pollution between areas. The results present that concentration of O3, PM10, NO2 has a negative association with lung function tests but concentration of CO, PM2.5, and SO2 had no association with decreased lung function tests. Time variable of air pollution was not statistically significant effect on lung function test. Conclusion: In this study, we conclude that air pollution in Tehran city can be decreased lung function test indexes that may be affected by short-time exposure to air pollutant.

Adhesiolysis and Decortication for Reccurent Hydropneumothorax Associated with Pleural Tuberculosis

Introduction: Pleural tuberculosis is a pleural infection of tuberculosis caused by Mycobacterium tuberculosis which commonly manifests as hydropneumothorax. Initial treatment with anti-tuberculosis drugs is aimed to prevent progression of the disease and relieve patient’s symptoms. Indication of adhesiolysis and decortication is to remove layer of fibrous tissue and allow the lung to reexpand. Case: A 60 year old woman with shortness of breath, cough, and right-sided chest pain. She had a history of treatment with first-line anti-tubercular drugs for a year stop in September 2016. She was identified with recurrent right-sided hydropneumothorax by chest imaging and thorax CT-scan. Adhesiolysis and decortication were performed on her. Two months later she was diagnosed again with recurrent right-sided hydropneumothorax. VATS (Video-Assisted Thoracoscopic Surgery) revealed fistula involving inferior lobe of the lung. Then, she was treated with second-line anti tuberculosis drugs. After four times reccurent hydropneumothorax, patient showed significant improvement in clinical condition, radiology finding, and lung function test after she finished the tuberculosis treatment. Discussion: Definitive diagnosis of pleural tuberculosis is by the finding of mycobacterium tuberculosis in pleural biopsy, or Mtb culture, and it was difficult to perform. In this case pleural fluid analysis revealed that cause of recurrent right-sided hydropneumothorax was tuberculosis infection. Summary: A 60 year old woman with four times reccurent right-sided hydropneumothorax, and the pleural fluid analysis suggested it was tuberculosis infection. Providing anti-tuberculosis medication based on clinically diagnosed tuberculosis based on flowchart of tuberculosis diagnosis from national tuberculosis programmed are essential to prevent progression of the disease.