scholarly journals Comparision of the Spirometric Measurements of Multi-National Under-graduate Medical Students from a Medical College of Central Nepal

2019 ◽  
Vol 15 (2) ◽  
pp. 144-149
Author(s):  
Sameer Timilsina ◽  
Sirisa Karki ◽  
Bhuwan Baskota

Background: The application of pulmonary function testing is increasing in many areas of clinical medicine, including assessment of airflow limitation, diagnosis of airflow obstruction and lung restriction, evaluation of pulmonary impairment, preoperative assessment as well as public health screening. In this study, attempt has been made to evaluate Pulmonary Function Test (PFT) of healthy Nepalese young adults and compare their values with healthy Indian and Sri Lankan counterparts. Further, it tries to shed light on the correlation of these data with anthropometric parameters. Methods: A total of 133 pre-clinical medical students of Manipal College of Medical Sciences were included in the study. PFT was done using a computerized automatic spirometer. Results: All the pulmonary parameters showed significant gender differences. All mean value of PFT parameters were higher in males. The comparisons of different parameters of PFT according to gender between three countries namely Nepal, India and Sri Lanka showed that Nepalese and Indian females had a higher FEV1 and FVC values than Sri Lankan females (p<0.05). Sri Lankan females had lower FEV1 and FVC as compared to Nepalese and Indian females (p<0.05). However, no correlation was observed between PFTs and BMI. Conclusions: Although some significant differences on PFT parameters were observed in Sri Lankan data when compared with Nepalese and Indian data, no significant difference was noticed between Nepalese and Indian values of PFT. Therefore Indian prediction equation for PFT can be used for Nepal but only after further study with a larger sample size.

2018 ◽  
Vol 9 (1) ◽  
pp. 21-26
Author(s):  
Jasim N Al-Asadi

Background: Handgrip is a predictor of physical fitness, hand functions, and nutritional status. It is affected by many factors including age, sex, body mass index, and hand dimensions.Aims and Objectives: To assess the handgrip strength among medical students and to examine its correlation with body mass index and hand dimensions.Materials and Methods: This cross-sectional study included 256 students of both sexes selected from College of Medicine, Basrah University, Iraq using non-probability purposive sampling method. Their anthropometric parameters including height, weight, and hand dimensions were assessed using routine techniques. The handgrip was measured by using a handheld dynamometer. Hand preference was determined by asking which hand was used to write.Results: The mean age of the participants was 21.1 ± 1.9 years. The mean of handgrip strength was 34.1 ± 11.9 Kg. Males had significantly (P <0.001) greater handgrip strength than females. Statistically significant correlation was detected between body mass index, hand dimensions and handgrip strength. The right-handed students scored significantly higher grip strength with their preferred hand. While among left-handed students, no significant difference in handgrip strength was noticed between left and right hands. Multivariate logistic regression analysis showed that gender, hand span, height, and body mass index were independent determinants of handgrip strength. They accounted for 70.6% of the variation in handgrip strength.Conclusion: A significant effect of body mass index and hand span on handgrip strength among medical students was observed.Asian Journal of Medical Sciences Vol.9(1) 2018 21-26


Author(s):  
Manoj Tukaram Jiwtode ◽  
Premanand Ramkrishna Raikar

Background: Pulmonary function tests (PFT) are considered as an essential component for evaluation of lung functions. PFTs are influenced by various parameters like anthropometric, geographic, ethnic, socio-economic parameters. Anthropological parameters are affected by nutrition and physical activities in young age, which directly affect the lung size and function. The aim of this study was to compare PFTs in urban and rural children of same district and to find out significant difference, if any.Methods: It was observational study. 150 each healthy children in the age group of 10 to 14 years were selected from urban and rural schools. After recording anthropometric data, PFTs were measured in all the children of both the groups. PFTs were compared among urban and rural children using unpaired t-test.Results: All the independent variables like age, weight and height were having linear positive correlation with PFTs (p<0.05). On comparing PFTs like Forced Expiratory Volume (FEV), Forced Expiratory Volume at the end of one second (FEV1), Percentage of Forced Expiratory Volume (FEV1%) between rural and urban children no statistically significant difference was noted (p>0.05)., but Peak Flow Expiratory Flow Rate (PEFR) was significantly more (p<0.05) in rural than urban students.Conclusions: We can conclude that during measurement of PFTs especially PEFR in children, the factor of urban and rural background must be considered in prediction equation.


2020 ◽  
Author(s):  
Shuyun Chen ◽  
Xiaochen Li ◽  
Zihui Wang ◽  
Yumin Zhou ◽  
Dongxing Zhao ◽  
...  

Abstract Background: The use of simple and affordable screening tools for chronic obstructive pulmonary disease (COPD) is limited. We aimed to assess the validity of a handheld expiratory flow meter (COPD-6®, Vitalograph Ltd., Ireland) for COPD screening in Chinese primary care settings.Methods: In our cross-sectional study, subjects were randomly selected in eight primary care settings. Testing with the Vitalograph-COPD-6® and conventional spirometry were sequentially performed on subjects. The correlation between COPD-6® and conventional spirometry was determined. Validity was analyzed by the area under the receiver operator characteristic curve (AUC) of the forced expiratory volume in one second (FEV1) / forced expiratory volume in six seconds (FEV6) that used to detect airway obstruction. The sensitivity, specificity, predictive values, and likelihood ratio were calculated according to different FEV1/FEV6 cut-off points.Results: 229 subjects (15.4%) were diagnosed with airflow limitation by standard spirometry. FEV1, FEV6, and FEV1/FEV6 measured by COPD-6® were correlated with FEV1, FVC, and FEV1/FVC measured by spirometry (r=0.889, 0.835and 0.647, p<0.001), respectively. AUC of the FEV1/FEV6 to determine airflow obstruction was 0.857 (95%CI: 0.826 to 0.888). No significant difference of AUC was observed between the symptomatic group and the asymptomatic population (AUC=0.869 vs. 0.843, P=0.425). A similar phenomenon was found in the AUC of smokers and never-smokers (AUC=0.862 vs.0.840; P=0.515). The value of AUC was largest (i.e., 0.80) when the cut-off point for FEV1/FEV6 was 0.77.Conclusions: The handheld COPD-6® could be used as a pre-screening device on early diagnosis of COPD in Chinese primary care settings.


2017 ◽  
Vol 3 (1) ◽  
pp. 8
Author(s):  
Dina Oktavia ◽  
Sally Aman Nasution ◽  
Anna Uyainah ◽  
C Martin Rumende

Pendahuluan. Disfungsi ventrikel kanan merupakan salah satu komplikasi penyakit paru obstruktif kronik (PPOK). Penilaianfungsi ventrikel kanan penting untuk dilakukan karena berkaitan dengan keterbatasan kemampuan kerja pasien sertaprognosis yang buruk.Metode. Studi potong lintang dilakukan pada 30 pasien PPOK stabil (rerata usia: 65 ± 6 tahun). Pemeriksaan yang dilakukanmeliputi pemeriksaan spirometri, pemeriksaan ekokardiografi standar, TAPSE, pengukuran dimensi ruang jantung kanandan inflow trikuspid.Hasil. Rerata nilai rerata FEV1 28 ± 8% prediksi. Tidak terdapat pasien dengan derajat obstruksi yang ringan, 57% subjek mengalami derajat obstruksi yang sangat berat. Semua pasien menunjukan pola spirometri campuran obstruktif dan restriktif. Rerata dimensi ruang jantung kanan pasien dalam batas normal. Terdapat 40% pasien yang mengalami disfungsi diastolik. Rerata nilai TAPSE 16, 96 ± 96 mm. Terdapat 60% pasien yang mengalami penurunan nilai TAPSE. Tidak terdapat beda rerata nilai TAPSE antara kelompok dengan derajat obstruksi sedang-berat dengan derajat obstruksi sangat berat. Tidak terdapat korelasi yang signifikan antara FEV1 % prediksi dengan TAPSE, sehingga titik potong kedua variabel tidak dapat ditentukan.Simpulan. Proporsi disfungsi sistolik ventrikel kanan 60% dan disfungsi diastolik 40%. Tidak terdapat korelasi nilai FEV1 %prediksi dengan nilai TAPSE, sehingga nilai titik potong kedua variabel tidak dapat ditentukan pada PPOK stabil.Kata kunci: FEV1 % prediksi, fungsi diastolik, fungsi sistolik, PPOK stabil, TAPSE, ventrikel kanan Right Ventricular Systolic and Diastolic Function Profile in Patient with Stable Chronic Obstructive Pulmonary DiseaseIntroduction. Right ventricular dysfunction is one of the common complication of chronic obstructive pulmonary disease(COPD). Right ventricular assessment is importance, since it related with exercise intolerance and poor prognosis.Methods. Thirty stable COPD men (mean age: 65 ± 6 yr) underwent spirometry. In addition to conventional echocardiographicparameters, TAPSE, right heart chambers, and trans tricuspid inflow were determined.Results. The mean value of FEV1 was 28 ± 8% of the predicted value. There was no subject with mild airflow limitation,57% subjects were with very severe airflow obstruction. All of pulmonary function test showed mixed restrictive-obstructivepattern. Mean of right chamber was in normal limit. Forty percent of the patients suffered right ventricular diastolicdysfunction. Means of TAPSE was 16.96 ± 96 mm. Sixty percent of the patients suffered right ventricular systolic dysfunction.There was no significant difference in TAPSE between groups with moderate-severe flow obstruction and very severe airflowobstruction. There was no significant correlation between FEV1 % prediction and TAPSE, so the cut-off value between thetwo variables cannot be determined.Conclusions. The proportion of right ventricular systolic dysfunction was 60% and diastolic dysfunction was 40%. There wasno correlation between FEV1 % prediction and TAPSE. The cut-off value between the two variable in stable COPD patientscannot be determined.Keywords: diastolic function, FEV1 % prediction, right ventricular function, stable COPD, TAPSE


2013 ◽  
Vol 66 (suppl. 1) ◽  
pp. 39-41
Author(s):  
Aleksandra Dudvarski-Ilic ◽  
Spasoje Popevic ◽  
Mihailo Stjepanovic ◽  
Branislav Gvozdenovic ◽  
Branislava Milenkovic ◽  
...  

Introduction. Aberrations in pulmonary function test are present in about 20% of patients with radiographic stage I sarcoidosis, whereas the pulmonary function is damaged in 40-80% of patients with parenchymal infiltrates (stages II, III or IV). Discussion and Review of Literature. Reductions in lung volumes (vital capacity and total lung capacity) are characteristic. The diffusing capacity of lungs is often reduced, but it is less pronounced in sarcoidosis than in idiopathic pulmonary fibrosis. Oxygenation is usually preserved until late in the course of sarcoidosis. Airflow obstruction (reduced forced expiratory volume in one second and expiratory flow rates) and bronchial hyper-reactivity occur in 30-50% of sarcoidosis patients with pulmonary parenchymal involvement. Conclusion. While restrictive spirometry pattern could easily be explained by fibrous changes in lung parenchyma, especially in late stages of the lung disease, pathogenesis of airflow limitation can be attributed mostly to endobronchial involvement (intraluminal granuloma or fibrous scars formation), airway compression due to enlarged lymph nodes and to distortion of small airways due to established pulmonary fibrosis.


2021 ◽  
Vol 8 ◽  
pp. 238212052110283
Author(s):  
Taylor M Coe ◽  
Trevor J McBroom ◽  
Sarah A Brownlee ◽  
Karen Regan ◽  
Stephen Bartels ◽  
...  

Background: Patient care restrictions created by the COVID-19 pandemic constrained medical students’ ability to interact directly with patients. Additionally, organ transplant recipients faced increasing isolation due to the rise of telemedicine, the importance of social distancing and their immunosuppressed state. We created a pilot program to pair students with transplant patients for structured, virtual encounters and studied its impact on medical students and patients. Methods: In May 2020, medical students conducted virtual visits with patients via telephone or video conferencing. Patients and students were surveyed regarding their experiences and independent focus groups were conducted. The survey responses and focus group discussions were deidentified, transcribed, and analyzed for themes. Results: Ten participating students were in their first, second, or final year of medical school. The 14 patients were liver or kidney transplant recipients or kidney donors. All interactions lasted longer than 30 minutes, with 56% greater than 1 hour. Three themes emerged related to the student experience: improvement of their clinical communication skills, development of knowledge and attitudes related to organ transplantation and donation, and independent management of a patient encounter. Three themes related to the patient experience: appreciation of the opportunity to share their personal patient experience to help educate future physicians, a cathartic and personally illuminating experience and an opportunity to share the message of donation. Conclusions: This pilot program provided a novel opportunity for virtual student-patient interactions that was feasible, well-received, and mutually beneficial. The use of virtual non-medical patient experiences allowed for experiential learning during which students learned about both clinical medicine and enhanced their communication skills directly from patients. Additionally, patients were able to engage with medical students in a new way, as teachers of clinical interactions, and reported a high level of satisfaction in addition to deriving personal benefit.


2021 ◽  
Vol 28 (3) ◽  
pp. 328-338
Author(s):  
Ogbutor Udoji Godsday ◽  
Nwangwa Eze Kingsley ◽  
Nwogueze Bartholomew Chukwuebuka ◽  
Chukwuemeka Ephraim ◽  
Ezunu Emmanuel ◽  
...  

Decline in normal physiological pulmonary function has been attributed to premorbid conditions such as prehypertension. Research evidence suggests that physical activity reduces age-related decline in pulmonary function and improves the efficiency of the lungs in prehypertensive patients. However, there is a scarcity of data evidence relating to isometric exercise and pulmonary function. Furthermore, the interrelationship between the intensity and duration of isometric exercise and pulmonary function in these patients is still uncertain. Therefore, this study was undertaken to investigate the effect of isometric handgrip exercise on pulmonary function capacity in adults with prehypertension. To determine the effectiveness of isometric handgrip exercise on pulmonary function capacity in adults with prehypertension. A quasi experiment using a pre- and post-exercise method was carried out in two out-patients hospital settings. The sample comprised 192 sedentary pre-hypertensive subjects, aged between 30–50 years, that were randomly distributed into three groups of 64 participants each. The subjects performed, for 24 consecutive days, an isometric handgrip exercise at 30% Maximum Voluntary Contraction (M.V.C.). At the end of the 24 days, group one (GP1) discontinued, while group two (GP2) continued the exercise protocol for another 24 consecutive days and group three (GP3) continued with the exercise protocol for another 24 consecutive days but at 50% M.V.C. Determinants of lung function (outcomes) were Forced Expiratory Volume in 1 s (FEV1), Forced Vital Capacity (FVC), FEV1/FVC Ratio and Peak Expiratory Flow Rate (PEFR). The study shows that there was no statistically significant difference in the pre- and post-exercise outcomes for FEV1, FVC, FEV1/FVC Ratio and PEFR after 24 days for group 1. In group 2, there was a statistically significant difference in the FVC [(mean = 0.12 ± 0.12), (p = 0.002)], FEV1 [(mean = 0.15 ± 0.17), (p = 0.003)] and PEF [(mean = 0.85 ± 0.35), (p = 0.001)] after 48 days. In group 3, there was a statistically significant difference (p = 0.001) in all the outcomes assessed after 48 days. There was a between groups difference in favour of group 2 compared with group 1 for outcomes of FEV1 [(mean = 0.142 ± 0.68), (p = 0.005)] and PEF [(mean = 0.83 ± 0.19), (p = 0.0031)]. There was statistically significant difference in favour of group 3 compared to group 2, by increasing the exercise intensity from 30% to 50% M.V.C., for outcomes of FVC [mean change = 0.10 ± 0.052), (p = 0.005)], FEV1/FVC [mean change = 3.18 ± 0.75), (p = 0.017)] and PEF [(mean change = 0.86 ± 0.35), (p = 0.001)] after 48 days. Isometric handgrip exercise (after 48 days at 30% to 50% M.V.C.) improves outcomes of pulmonary function capacity in adults with prehypertension. Meanwhile, duration and/or increase in intensity of the isometric effort significantly contributed to the affects attained.


2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Chi-Tung Cheng ◽  
Chih-Chi Chen ◽  
Chih-Yuan Fu ◽  
Chung-Hsien Chaou ◽  
Yu-Tung Wu ◽  
...  

Abstract Background With recent transformations in medical education, the integration of technology to improve medical students’ abilities has become feasible. Artificial intelligence (AI) has impacted several aspects of healthcare. However, few studies have focused on medical education. We performed an AI-assisted education study and confirmed that AI can accelerate trainees’ medical image learning. Materials We developed an AI-based medical image learning system to highlight hip fracture on a plain pelvic film. Thirty medical students were divided into a conventional (CL) group and an AI-assisted learning (AIL) group. In the CL group, the participants received a prelearning test and a postlearning test. In the AIL group, the participants received another test with AI-assisted education before the postlearning test. Then, we analyzed changes in diagnostic accuracy. Results The prelearning performance was comparable in both groups. In the CL group, postlearning accuracy (78.66 ± 14.53) was higher than prelearning accuracy (75.86 ± 11.36) with no significant difference (p = .264). The AIL group showed remarkable improvement. The WithAI score (88.87 ± 5.51) was significantly higher than the prelearning score (75.73 ± 10.58, p < 0.01). Moreover, the postlearning score (84.93 ± 14.53) was better than the prelearning score (p < 0.01). The increase in accuracy was significantly higher in the AIL group than in the CL group. Conclusion The study demonstrated the viability of AI for augmenting medical education. Integrating AI into medical education requires dynamic collaboration from research, clinical, and educational perspectives.


2021 ◽  
Vol 8 ◽  
pp. 238212052098418
Author(s):  
William Beedham ◽  
Kasun Wanigasooriya ◽  
Georgia R Layton ◽  
Ley Taing Chan ◽  
Adnan Darr ◽  
...  

Background: Starting work as a junior doctor can be daunting for any medical student. There are numerous aspects of the hidden curriculum which many students fail to acquire during their training. Objectives: To evaluate the effectiveness of a novel foundation year one (FY1) doctor preparation course focusing on certain core topics, practical tips and components of the hidden curriculum. The primary objective was to improve the confidence level and knowledge of final year medical students transitioning to FY1 doctors. Method: A 2-day, practical course titled ‘Preparation 2 Practice’ delivering hands-on, small-group and lecture-based teaching, covering core medical student undergraduate curriculum topics in medicine and surgery. The course content spanned therapeutics, documentation skills and managing acute clinical tasks encountered by FY1 doctors during an on-call shift. A pre- and post-course survey and knowledge assessment were carried out to assess the effectiveness of the course. The assessment was MCQ-based, derived from topics covered within our course. The 20-question test and a short survey were administered electronically. Results: Twenty students from a single UK medical school attended the course. 100% participation was observed in the pre- and post-course test and survey. The median post-course test result was 22 (IQR 20.25-23.75) which was higher than the median pre-course test score of 18.75 (IQR 17-21.75). A Wilcoxon sign rank test revealed a statistically significant difference between the pre- and post-course test results ( P = .0003). The self-reported confidence score of delegates on starting work as a junior doctor was also significantly higher following the course ( P = .004). Conclusion: The results show a significant improvement in perceived confidence and knowledge on core curriculum topics amongst final year medical students having attended our FY1 doctor preparation course. We conclude that there is scope for similar supplementary courses as an adjunct to the undergraduate medical curriculum.


2021 ◽  
Vol 8 ◽  
pp. 238212052110164
Author(s):  
Abbie West ◽  
Cara Cawley ◽  
Elizabeth Crow ◽  
Alexis M. Stoner ◽  
Natalie M. Fadel ◽  
...  

Objective: Approximately 1 in 6 adults 60 and older have experienced a form of abuse in the past year. Many cases remain under-reported due to lack of knowledge and awareness. This study created an educational program on elder abuse for medical students to determine if participation would increase knowledge and awareness of elder abuse. Methods: This study used a pre and post survey methodology to evaluate students’ knowledge and awareness of elder abuse before and after participating in this educational program. Sixty first and second year osteopathic medical students at the Edward Via College of Osteopathic Medicine, Carolinas Campus participated in this study. Students were emailed a pre-survey to evaluate their pre-existing knowledge and awareness. The survey was, previously created by the Student Training on Preventing Domestic Violence (STOP-DV) team using validated measures. Participants then attended educational events about various forms of elder abuse and recognizing its associated signs, and afterward completed the post-survey. The results were compared using t-tests to determine if there was a significant difference. Results: First and second year students differed significantly in pre-survey results of knowledge but not post-survey results. The results showed a significant difference in overall mean knowledge ( P-value < .001) and awareness scores ( P-value < .001) in all students. Conclusion: These results suggest education on elder abuse can enable future physicians to better recognize, understand, and support older adults regarding elder maltreatment.


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