Indian Journal of Public Health Research & Development

Vishvdeep Saini ¹, Sameer Singhal ², Sukhjinder Pal Singh ³, Achchhar Singh ⁴, Aditi Gupta ⁵

Affiliations
1 Junior Resident, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
2 Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
3 Senior Resident, Department of Respiratory Medicine, MMMC & H, Kumarhatti, Solan, Himachal Pradesh, IN
4 Associate Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
5 Assistant Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN

Abstract

Introduction: Spirometry helps us to differentiate between obstructive and restrictive disease, body plethysmography tells about lung volumes and DLCO about diffusion defect. Determining which tests to do depends on the clinical question to be answered i.e. whether test is being done to diagnose a disease or for evaluation for lung surgery or some other reason. Material and Method: 46 patients coming to department of respiratory medicine, who were diagnosed with obstructive lung disease by PFT as per GOLD guidelines were considered for the study. Chest X-ray and CT chest were also done. Then DLCO was performed in every patient. Single breath hold method was used in the study. The report of the DLCO was interpreted according to the American Thoracic Society/European Respiratory Society statement on PFT interpretation. Results: Male preponderance was seen in study cases with 65.2% males to 34.8% females. Mean age of the study group was 54.39 years with most cases (18) from 31-50 years of age group. Most common diagnosis was COPD emphysema (22) followed by chronic bronchitis (12), bronchial asthma (10) and bronchiectasis (2). Among obstructive lung diseases, B. asthma had the highest mean DLCO percentage predicted of 102.20 ± 14.36 followed by COPD-Bronchitis (76.33±5.57), COPD–Emphysema (37.80±13.41) and bronchiectasis (62±4.48). Conclusion: DLCO can be helpful beyond spirometry in classification of obstructive lung diseases. DLCO values in COPD Emphysema variant are decreased, COPD bronchitis variant remains normal or slightly reduced and asthma either normal or increased. So, DLCO can help in differentiation or sub categorization of obstructive disease more than spirometry.

Keywords

DLCO, Obstructive diseases, Lung function test, COPD, Emphysema, Bronchial Asthma.

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Vishvdeep Saini ¹, Jai Kishan ², Sameer Singhal ³, Sukhjinder Pal Singh ⁴, Achchhar Singh ⁵

Affiliations
1 Junior Resident, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
2 Professor and Head, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
3 Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
4 Senior Resident, Department of Respiratory Medicine, MMMC & H, Kumarhatti, Solan, Himachal Pradesh, IN
5 Associate Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN

Abstract

Introduction: CBNAAT is a very useful rapid diagnostic test for the early diagnosis of DS and DR TB. Report of sample can be available in just 2 hours. But the results of these tests are not available for many days to weeks which results in delay in diagnosis and treatment initiation. Material and Method: This study was conducted for a period of 4 months from mid-April to mid-august 2018 in MMIMSR, Mullana. A total of 535 samples were sent for CBNAAT to TB Hospital, Ambala and the time taken from sending of samples to the receiving of report was analysed and time lag was calculated. Results: Out of 535 samples, 429 samples were negative, 104 were positive for MTB and 2 samples resulted as invalid/error. Out of 104 positive samples, 95 were rifampicin sensitive and 9 were rifampicin resistant MTB. The average time lag in reporting of CBNAAT samples was 11.1 days with shortest time being 2 days and longest being 33 days. Conclusion: CBNAAT is a very useful modality in TB diagnosis and should be made available to all eligible patients especially so in high DR-TB prevalence areas. But delay in reporting undermines the purpose of the test i.e. rapid diagnosis and treatment. There is an urgent need to establish more centres with CBNAAT facility throughout India so that there is no delay in reporting and early treatment can be started.

Keywords

RNTCP, CBNAAT, Tuberculosis, NIKSHAY, TB prevalence.

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