Study of Pulmonary Function Impairment by Spirometry in Treated Cases of Pulmonary Tuberculosis (original) (raw)
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To assess the pulmonary impairment in treated pulmonary tuberculosis patients using spirometry
Background: Tuberculosis is one of the leading causes of death due to infectious Disease worldwide, with an estimated 8.9 million new cases and 1.6 million Deaths worldwide. Aim: To study the type and degree of pulmonary impairment in treated pulmonary Tuberculosis patients using spirometry. To co-relate present symptoms and radiological findings and to assess the degree of impairment. For identification of impairment (obstructive, restrictive or mixed) that contribute to long term disability and decreased quality of life. Materials and methods: Retrospective observational study was done in Meenakshi Medical College Hospital. A total of 75 treated pulmonary tuberculosis patients were taken for study with clinical data, chest x-ray pattern, smoking and biomass fuel exposure history were recorded. Their pulmonary function was assessed using spirometry. Results: All patients were symptomatic and most common symptom was breathlessness. Chest radiograph showing 1 or 2 zones involved patients were 40 (53.3%) and more than 3 zones involved were 35 (46.7%).Most of the patients 51 (68%) showed a Restrictive pattern in spirometry, 10 (13.3%) showed an obstructive pattern and 14 (18.7%) showed a mixed pattern. Smoking and Bio-mass fuel exposure did not show a significant co-relation with spirometry pattern but initial sputum positive patients and defaulter patients showed a significant co-relation with spirometry pattern. Conclusion: The most common pulmonary impairment pattern in treated pulmonary tuberculosis patients was Restrictive pattern. Hence pulmonary tuberculosis need follow up even after treatment for early detection and treatment for their pulmonary disability.
Evaluation of Pulmonary Status of Post-Tuberculosis Patients with Spirometry and Chest X-Ray
International Journal of Experimental Research and Review, 2024
In 2022, 7.5 million new cases of tuberculosis were reported worldwide. Mycobacterium tuberculosis results in tuberculosis, an infectious disease mostly affecting the lungs. However, many completely treated post-tubercular patients experience persistent changes in lung anatomy (bronchial and parenchymal structure), Increasing their risk of lung complications and early death. These changes affect the airway's size, leading to higher resistance and decreased airflow. Our study aimed to assess the overall clinical status and lung function of treated post tuberculosis patients using spirometry. The study constituted patients over the age of 18 who presented to the Outpatient department of the Pulmonary Medicine Department, Chettinad Hospital and research institute, Kelambakkam, after receiving complete treatment and being certified cured. Convenience sampling technique was used, 87 patients participated in this trial. The Institutional Ethical Committee approved the study, which lasted 18 months. A proforma was used to collect a complete socio-demographic history and clinical history, particularly in terms of pulmonary symptomatology, and information about previous anti-tb treatment. Each of these patients had chest radiography, smear microscopy, and lung function testing. Mean age was 44.1± 15.2 years, mean BMI was 22.27 ± 3.66 kg/m2. There were 66.2% men and 33.8% females. 42% employed and 52% literate. In the current study, 41(53.25%) of the individuals reported dyspnea and 22(28.57%) had dry cough, cough with expectoration 12(15.58%), Fever 8(10.4%), Haemoptysis 7(9%), chest pain 2(2.6%). Following Post tuberculosis treatment, 38(44%) had normal chest radiographs, 31(35.6%) of the patients had fibrosis/Fibrotic strand, 8(9.1%) had consolidation, 5(5.7%) had ectatic changes, 3(3.4%) had fibrocavity, 1(1%) had calcification and cicatricial collapse. In the current study, we found that 31(40.25%) had normal spirometry followed by 23(29.87%) had mixed pattern and 12(15.6%) had restrictive pattern findings, 11(14.28%) had obstructive pattern findings. In spite of appropriate suggestions, the majority of post-tb pulmonary impairment individuals suffer in quiet or undergo poor medical care. As a result, comprehensive recommendations for patient follow-up following tuberculosis treatment are required in order to monitor lung function and provide appropriate care to improve quality of life.
Assessment of Lung Function using Spirometry and Radiological findings in Post Tuberculosis Cases
Life and Science, 2020
Objective: To assess the prevalence of abnormal radiological changes and their impact on lung function in post tuberculosis cases. Study Design: Descriptive cross-sectional study. Place and Duration of Study: The study was conducted in medical Outpatient Department (OPD) of CMH, Quetta from 30th Nov 2018 to 30th May 2019. Materials and Methods: A total of sixty treated cases of pulmonary tuberculosis, presenting in medical OPD of CMH Quetta for regular follow-up, were included in the study. The subjects were recruited by non-probability consecutive sampling technique according to predefined inclusion criteria. Demographic data including age, gender, post treatment duration, clinical features and history of asthma, atopy, rhinitis, biomass exposure, coalmine exposure, animal and pet exposure was collected. Their lung function was assessed using spirometry and radiological changes were assessed by either chest X-ray or high resolution CT chest. Results: Among the 60 patients, mean age...
Jornal Brasileiro de Pneumologia
Objective: To compare patients with and without previous lung disease, in terms of the spirometry results after they had been treated for pulmonary tuberculosis (PTB) and cured, as well as to analyze risk factors related to functional severity. Methods: This was a cross-sectional, multicenter study conducted at four referral centers in Brazil. Patients were divided into two groups: those with a history of lung disease or smoking (LDS+ group); and those with no such history (LDS− group). Patients underwent spirometry (at least six months after being cured). Sociodemographic and clinical data were collected. Results: A total of 378 patients were included: 174 (46.1%) in the LDS+ group and 204 (53.9%) in the LDS− group. In the sample as a whole, 238 patients (62.7%) had spirometric changes. In the LDS+ group, there was a predominance of obstructive lung disease (in 33.3%), whereas restrictive lung disease predominated in the LDS− group (in 24.7%). Radiological changes were less common in the LDS− group than in the LDS+ group (p < 0.01), as were functional changes (p < 0.05). However, of the 140 (79.1%) LDS− group patients with a normal or minimally altered chest X-ray, 76 (54%) had functional changes (p < 0.01). The risk factors associated with functional severity in the LDS− group were degree of dyspnea (p = 0.03) and moderate or severe radiological changes (p = 0.01). Conclusions: Impaired pulmonary function is common after treatment for PTB, regardless of the history of lung disease or smoking. Spirometry should be suggested for patients who develop moderate/severe dyspnea or relevant radiological changes after treatment for PTB.
Assessment of Symptomatic Post Tuberculosis Patients by Spirometry and Chest X Ray
International Journal of Contemporary Medical Research [IJCMR]
Introduction: TB is an infectious disease caused by the bacillus Mycobacterium tuberculosis which typically affects the lungs. The disease is spread by the people who are sick with active pulmonary TB. Up to half of TB survivors have some form of persistent pulmonary symptom despite microbiologic cure. The aim of the study was to assess the symptomatic post tuberculosis patients by using spirometry and chest x ray. Material and methods: The study was conducted in the Department of Respiratory Medicine, Rohilkhand Medical College and Hospital after seeking clearance from the Institutional Ethical Committee. The aim of the study was to assess the symptomatic post tuberculosis patients by using spirometry and chest x ray. The study duration was from 1 st November 2018 to 31 st October 2019 and 100 patients were enrolled in the study. Data was collected from patients who presented with symptoms within 6 months of completing their treatment for tuberculosis. Results: All the patients (post tubercular) enrolled in the study had symptoms (in some form) even after full course of antitubercular treatment and bacteriological cure and among these breathlessness was the most common presenting symptom (96%) followed by cough (58%). Maximum patients had abnormal findings on chest examination (80%). Fibrosis followed by cavitary lesions were the most common findings on chest x ray in post tuberculosis patients. Maximum patients had restriction (56%) in their spirometry followed by mixed pattern (23%). Conclusion: In patients with restriction on spirometry and having symptom of breathlessness and cough, reassurance and pulmonary rehabilitation may play a major role in relieving their symptoms whereas in patients with mixed or obstructive pattern on spirometry, bronchodilator therapy along with pulmonary rehabilitation may be helpful in relieving their symptoms post tuberculosis treatment.
International journal of health sciences
Background: Tuberculosis remains the world’s deadliest communicable disease. The chronic lung disease as result of tuberculosis is much explored with the available literature. This study assessed the scope of current guidelines and evidence on Post -Tubercular sequalae and pulmonary impairment to inform policy and research action. Material and methods: A cross sectional study was undertaken in patients treated for pulmonary tuberculosis. Pulmonary Function Test (FVC, FEV1, FEV1/FVC and small airway parameters) were performed with a spirometer model (RMS HELIOS 3185) and extent of radiological extent assessed by doing chest X Ray - PA View. The details regarding the demographic factors, duration of disease and duration of treatment were obtained in structured proforma. Results: Most of cases in this study belonged to 41 – 60 years of age group and majority were females. About 51.5% of the cases received treatment with ATT and 64.1% of the cases were diagnosed with disease for less th...
PLOS ONE
Background Burden, phenotype and risk-factors of lung function defects in successfully treated tuberculosis cases are unclear. Methods We performed spirometry with bronchodilators in new drug-sensitive adult (�18 years) pulmonary tuberculosis cases during the 12 months following successful treatment in India. Airflow obstruction was defined as pre-bronchodilator FEV1/FVC<5 th percentile of Global Lung Initiative mixed-ethnicity reference (lower limit of normal [LLN]). Chronic obstructive pulmonary disease (COPD) was defined as post-bronchodilator FEV1/FVC<LLN among participants with obstruction. Restrictive spirometry pattern was defined as FVC<LLN among participants without obstruction. Multivariable logistic and linear regression was used to identify risk-factors for obstruction, restriction and low lung function despite successful treatment. Results Of the 172 participants included in the analysis, 82 (48%) were female, 22 (13%) had diabetes and 34 (20%) ever-smoked with a median (IQR) exposure of 3.5 (0.2-9.9) pack-years. Median (IQR) age and body-mass index (BMI) at enrollment was 32 (23-39) years and 18.1 (16.0-20.5) kg/m 2 respectively. Airflow obstruction was detected in 42 (24%) participants; of whom 9 (21%) responded to short-acting bronchodilators and 25 (56%) had COPD; and
International journal of health sciences
Introduction-Tuberculosis is a major public health problem of all times globally. TB Infects about one fourth of global population. To evaluate and assess the detailed information about the prevalence of abnormal lung function on spirometry of such patients this study was conducted. Material and Methods- Between Nov2017 to Oct2019, we prospectively evaluated all the patients who were diagnosed as case of pulmonary TB after completing full course of ATT at tertiary care hospital RMCH Bareilly. Results-Out of 210 patients (122)58.09% were males and (88)41.9% were females. Majority of patients lies within age group of (20-60 yrs) 163(77.6%).Smoking history were present in 70(33.3%) of patients. About 84(40%) of patients have BMI <18.5 and 97(46.2%) patients had BMI between 18.5- 24.9 and rest patients had BMI >25. After completing ATT the most common symptoms that patient had SOB 201(95.7%) followed by Dry Cough 121(57.6%) and Expectoration 38(18%). Out of 210 patients 172(81.9%)...
Medical Archives, 2011
T he origin of Chronic airflow obstruction (CAO) syndrome in active Tuberculosis (TB), despite significant similarities with chronic obstructive pulmonary disease (COPD), still remains unknown. The aim of the study was to examine the potential causes and risks for the development of CAO syndrome in new cases of pulmonary TB. Design: Prospective, nest casecontrol study. Patients: 40 patients with newly detected cavitary pulmonary TB and initial normal respiratory function, diagnosed and treated according to DOTS strategy. Measurements and results: The average values of Snider's radiological score during TB treatment were significantly reduced (p<0.001), as well as average values of non-specific systemic serum markers of inflammation. The average values of FEV 1 (%), both before, during and at the end of completion of TB treatment were significantly decreased (p<0.05;). Linear regression analysis confirmed a statistically significant association between changes in the values of FEV 1 (%), resulting in TB treatment completion, and the value of Snider's radiological score and the sputum culture conversion rate. From the initial findings of normal pulmonary ventilation tests, upon the completion of TB treatment 35.0% of observed patients developed the CAO syndrome. Logistic regression analysis confirmed a positive familiar burden for COPD, Snider's radiological score at the beginning of TB treatment and sputum conversion rate on culture, as statistically significant predictors, while multivariate logistic regression analysis confirmed Snider's radiological score at the beginning of TB treatment and sputum conversion rate on culture as most significant risk factors for CAO syndrome occurrence and development. Conclusion: The CAO syndrome is often a consequence and significant functional impairment of the respiratory system, during the reparative processes in active TB, even in the absence of risk factors for COPD. Only microbiological cure of TB patients with underlying risks for disorders of lung function, is not sufficient and effective approach for prevention of their further potential health deterioration.