Effect of ascorbic acid supplementation on pulmonary functions in healthy adults: a randomized controlled pilot study

Objectives The fact that oxidative stress plays an important role in the pathogenesis of various pulmonary diseases is supported by the beneficial effect of antioxidants. It is also well known that an altered oxidant-antioxidant balance after the age of 35 years increases the susceptibility to develop obstructive lung diseases later in life. Given this, the present study was designed to evaluate the effect of antioxidant supplementation on lung functions in healthy adults after the age of 35 years. Methods Persons of age ≥35 years (n=45) were randomized into three arms (each comprising 15 participants) to receive either no intervention (NI arm), ascorbic acid 250 mg daily (AA250 arm), or ascorbic acid 500 mg daily (AA500 arm) for 6 weeks. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, and peak expiratory flow (PEF) were measured at baseline and 6 weeks. Persons of age group (20–30 years) were also enrolled in the study to compare their lung functions and cardiovascular parameters at baseline with those ≥35 years of age. All the adverse events experienced by participants were recorded. Results Baseline pulmonary functions were found to be comparable among the three study arms and compared to ≥35 years age group, these parameters were found to be better in the younger age group (20–30 years). Most of the pulmonary functions were comparable among the three study arms at 6 weeks. A significant improvement in PEF and % predicted PEF was noted in AA250 arm when compared to baseline values (p=0.049 and 0.026, respectively) and in participants with normal pulmonary functions when compared to those with reduced functions at baseline (p=0.059 and p=0.037). Conclusions Although ascorbic acid did not affect most of the pulmonary functions in healthy adults, it improved PEF and % predicted PEF at a daily dose of 250 mg. In this regard, it was found effective in individuals with normal pulmonary indices at baseline.

N-acetylcysteine in Mechanically Ventilated Rats with Lipopolysaccharide-Induced Acute Respiratory Distress Syndrome: The Effect of Intravenous Dose on Oxidative Damage and Inflammation

Treatment of acute respiratory distress syndrome (ARDS) is challenging due to its multifactorial aetiology. The benefit of antioxidant therapy was not consistently demonstrated by previous studies. We evaluated the effect of two different doses of intravenous (i.v.) N-acetylcysteine (NAC) on oxidative stress, inflammation and lung functions in the animal model of severe LPS-induced lung injury requiring mechanical ventilation. Adult Wistar rats with LPS (500 μg/kg; 2.2 mL/kg) were treated with i.v. NAC 10 mg/kg (NAC10) or 20 mg/kg (NAC20). Controls received saline. Lung functions, lung oedema, total white blood cell (WBC) count and neutrophils count in blood and bronchoalveolar lavage fluid, and tissue damage in homogenized lung were evaluated. NAC significantly improved ventilatory parameters and oxygenation, reduced lung oedema, WBC migration and alleviated oxidative stress and inflammation. NAC20 in comparison to NAC10 was more effective in reduction of oxidative damage of lipids and proteins, and inflammation almost to the baseline. In conclusion, LPS-instilled and mechanically ventilated rats may be a suitable model of ARDS to test the treatment effects at organ, systemic, cellular and molecular levels. The results together with literary data support the potential of NAC in ARDS.

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.

Follow-Ups on Persistent Symptoms and Pulmonary Function Among Post-Acute COVID-19 Patients: A Systematic Review and Meta-Analysis

Objective: As the number of recovering COVID-19 patients increases worldwide, the persistence of symptoms and signs through the post-acute phase indicates an urgent need for prolonged follow-up care. To explore existing data about post-acute COVID-19 syndrome, this meta-analysis assesses the prevalence of persistent manifestations in multiple systems and abnormalities in lung function, as well as their related risks in patients with various severities.Methods: Articles about discharged COVID-19 patients (published from January 1, 2020 to February 23, 2021) were obtained by searching four databases. Cohort studies with follow-up periods >1 month post-discharge or >2 months post-admission were included.Results: A total of 4,478 COVID-19 patients from 16 cohort studies were included in this meta-analysis. Fatigue or weakness (47%) were the most prevalent physical effects of post-acute COVID-19 syndrome, while psychosocial (28%) symptoms were the most common manifestations among several systems. Abnormalities in lung function of recovering patients, i.e., DLCO <80% (47%, 95% CI: 32–61%) persisted for long periods. Severe patients were more likely to present joint pain (OR 1.84, 95% CI: 1.11–3.04) and decreased lung functions compared with non-severe patients, with pooled ORs for abnormal TLC, FEV1, FVC, and DLCO of 3.05 (95% CI: 1.88–4.96), 2.72 (95% CI: 1.31–5.63), 2.52 (95% CI: 1.28–4.98), and 1.82 (95% CI: 1.32–2.50), respectively.Conclusions: Our research indicates that patients recovering from COVID-19 manifest long-term, multi-system symptoms, and the adverse effects on psychosocial health and lung functions were the most extensive and persistent. These findings together may facilitate much needed in-depth study of clinical treatments for long-term, post-acute phase symptoms that affect a great number of recovering COVID-19 patients.

Spirometric Values of petrol pump workers of Lahore: A cross sectional study

Background: Petrol pump workers are exposed to air pollution and fumes of petrol and diesel that may lead to poor lung function followed by chronic diseases, where the city is highly polluted. Aim: To determine lung functioning capacity by spirometry among petrol pump workers Methods: A cross sectional study was designed and conducted in the pulmonology department of Mayo, hospital Lahore. Two seventy five (275) subjects were enrolled in the study after fulfilling the inclusion/exclusion criteria and giving informed consent by consecutive sampling. Information like name, age, weight, height, duration of working was recorded. Spirometry was performed to calculate FEV1, FVC and FEV1/FVC ratio. Data was entered and analyzed by SPSS version 23. Mean and standard deviation of age, height, weight, and work duration, Spirometric values for lung functions (FEV1, FVC and FEV1/FVC Ratio) were calculated. Data was divided into groups by age and work duration and spirometric values for lung functions were compared in these groups. T test & Pearson correlation was used for analysis and p value less than 0.05 was considered significant. Results: Participant age was 28.75±6.89.FEV1 was2.35±0.44, FVC 3.18±0.66 and FVC 74.91+9.40. FEV1 & FEV1/FVC ratio were significantly different (p<0.05) in age groups (<30, ≥30) & work duration groups(<8, ≥8yeras). Negative Correlation was found between work duration & lung functions (FEV1, FEV1/FVC ratio). Conclusion: Spirometric values were lower in petrol pump workers. Age and working duration further affects lung function of petrol pump workers. Keywords: FVC, FEV1, Spirometer, Petrol Pump Workers, Pulmonology

Effect of variation in air conditioner temperature on peak expiratory flow rate of air conditioner users

As a result of increasing environmental temperature, use of air conditioner (AC) has become very popular specially in the urban areas mostly during warmer months of the year. Exposure to cold, dry air of AC on a regular basis can cause various alternations in lung functions of AC users which can lead to many future lung diseases. These alternations in lung functions can be influenced by the temperature at which AC is regulated. This cross-sectional study was conducted to observe the effects of air conditioner use and variation of AC temperature on peak expiratory flow rate (PEFR) of apparently healthy adult male and female living in Dhaka city, Bangladesh. The study group (group A) consisted of 48 apparently healthy adult male and female who were exposed to air conditioner for at least 6 hours per day for minimum 5 days per week for the past 2 to 4 years. They were divided into two subgroups based on temperature at which AC was regulated. Group A1 consisted of 24 subjects (12 male and 12 female) who were exposed to AC for at least 6 hours per day for minimum 5 days per week for the past 2 to 4 years and where temperature of the AC was constantly regulated in between 18° C to 22°C. Group A2 consisted of 24 subjects (12 male and 12 female) who were exposed to AC for the same period of time but where AC was constantly regulated in between 23°C to 25°C. The control group (group B) consisted of similar number of age, gender, BMI and socioeconomically matched subjects who did not use air conditioner nearly at all. Actual, predicted and percentage of predicted value of PEFR were estimated in both the study and control group using Minato Autospiro AS-507. Statistical analysis was done by unpaired Student’s ‘t’ test and p value 0.05 was taken as level of significance. In this study mean actual and percentage (%) of predicted value of PEFR were significantly lower in AC users in comparison to nonusers in case of both male and female. Between two groups of AC users, mean actual and percentage of predicted value of PEFR were significantly lower in the group where AC temperature was constantly regulated in between 18°C to 22°C in comparison to the group where AC temperature was constantly regulated in between 23°C to 25°C. Use of AC can significantly reduce lung functions of AC users and lower AC temperature is associated with more reduction of PEFR in AC users.

Spirometric Values of petrol pump workers of Lahore - A cross sectional study

Background: Petrol pump workers are exposed to air pollution and fumes of petrol and diesel that may lead to poor lung function followed by chronic diseases, where the city is highly polluted. Aim: To determine lung functioning capacity by spirometry among petrol pump workers Methods: A cross sectional study was designed and conducted in the pulmonology department of Mayo, hospital Lahore. Two seventy five (275) subjects were enrolled in the study after fulfilling the inclusion/exclusion criteria and giving informed consent by consecutive sampling. Information like name, age, weight, height, duration of working was recorded. Spirometry was performed to calculate FEV1, FVC and FEV1/FVC ratio. Data was entered and analyzed by statistical software SPSS version 23. Mean and standard deviation of age, height, weight, and work duration, Spirometric values for lung functions (FEV1, FVC and FEV1/FVC Ratio) were calculated. Data was divided into groups by age and work duration and spirometric values for lung functions were compared in these groups. T test & Pearson correlation was used for analysis and p value less than 0.05 was considered significant. Results: Participant age was 28.75±6.89.FEV1 was2.35±0.44, FVC 3.18±0.66 and FVC 74.91+9.40. FEV1 & FEV1/FVC ratio were significantly different (p<0.05) in age groups(<30, ≥30) & work duration groups(<8, ≥8yeras). Negative Correlation was found between work duration & lung functions (FEV1, FEV1/FVC ratio). Conclusion: Spirometric values were lower in petrol pump workers. Age and working duration further affects lung function of petrol pump workers. Keywords: FVC, FEV1, Spirometer, Petrol Pump Workers, Pulmonology