The Indian Practitioner

K. B. Gupta ¹, S. Vishvkarma ¹, A. S. Sandhya ¹, S. Magu ², U. Choudhary ³, M. Gupta ⁴

Affiliations
1 Department of Respiratory Medicine, Pt B D Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, IN
2 Department of Radiodagnosis and Imaging, Pt B D Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, IN
3 Department of Microbiology, Pt B D Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, IN
4 Department of Pulmonary Medicine and Critical Care, Pt B D Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, IN

Abstract

Rationale: To study the correlation between the sputum bacteriology and lung function in patients with stable bronchiectasis.

Materials and Methods: 80 patients suffering from stable bronchiectasis belonging to both the sexes and age above 14 years were included in study. All patients were assessed clinically with detailed history and thorough clinical examination. Patients were subjected to assessment of microbiological flora in their sputum. Lung functions were measured with spirometry and parameters recorded were PEFR in l/min, FEV1 in litres, FVC in litres, and FEV1/FVC. Sputum samples of +1 and +2 grade were inoculated on blood agar, MacConkey's agar and chocolate agar at 37°C for 48 hours.

Results: P aeruginosa was seen as the most common colonizing bacteria and these patients had de-creased % predicted FEV1, FVC, FEV1/FVC and PEFR with mean values of 43.61±14.6, 51.87±16.8, 79.83±14.6, 42.17±14.6 respectively as compared to patients of non P aeruginosa group. The % predicted FEV1, FVC, FEV1/FVC and PEFR in non P aeruginosa group were 47.67±21.8, 59.32±22.8, 81.89±17.7, 49.58±21.7 respectively. Though the values of FEV1, FVC, FEV1/FVC and PEFR in P aeruginosa group were decreased they were not statistically significant.

Conclusion: P aeruginosa was the main colonizing bacteria especially in patients having air fluid levels on radiology which can also be a predictor of bacterial colonization. Lung functions were de-creased in patients having P Aeruginosa in their sputum as compared to non P Aeruginosa group but they were statistically not significant.

Keywords

Bronchiectasis, Sputum, Lung Function, P aeruginosa.

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K. B. Gupta ¹, A. S. Sandhya ¹, Mohit Aggarwal ², Sarita Maggu ³, Harpreet Singh ⁴

Affiliations
1 Pt. B D Sharma Post Graduate Institute of Medical Sciences, IN
2 Department of Respiratory Medicine and Tuberculosis, Pt. B D Sharma Post Graduate Institute of Medical Sciences, IN
3 Department of Radiodiagnosis, Pt. B D Sharma Post Graduate Institute of Medical Sciences, IN
4 Department of Medicine, Pt. B D Sharma Post Graduate Institute of Medical Sciences, IN

Abstract

Interstitial lung diseases are large group of disorders (approximately 200), most of which cause progressive scarring of lung tissue. Although less frequent than COPD and asthma, ILD accounts for 15% of the respiratory disease in general practice. The present study was conducted to determine the clinical and radiological profile and etiological frequencies of ILDs among patients presenting in the Department of Tuberculosis and Respiratory Medicine in collaboration with Department of Medicine and Department of Radiology at Pt. B.D. Sharma Postgraduate Institute of Medical Sciences Rohtak. 40 patients belonging to either sex and >18 years of age initially suspected to have ILDs and subsequently confirmed on HRCT to have ILD were included in the study. There were 21 (52.5%) females and 19 (47.5%) males and most of the patients were from rural (57.5%) background. 55% patients were non-smokers. Dyspnea was the most common symptom present in 38 (95%) patients with other relevant symptoms being cough, expectoration and fever. The lung involvement was bilateral in all cases with HRCT in these patients showing predominantly septal thickening followed by honeycombing, ground glass opacity, nodular and reticular pattern. In the present study, most common ethology of ILD observed was IPF followed by CTD-ILD and NSIP. Present study suggests that ILDs are not uncommon in India but lack of recognition and inadequate diagnostic facilities explains why there are so few Indian series on this subject. Diagnosis of ILDs at an early stage is paramount to prevent/ /delay progression to irreversible damage to the lungs.

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