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Article
Does Normal Chest X ray in Patients with Chronic Cough Exclude Pulmonary tuberculosis?

Authors: Mohammad Yahya Abdulrazaq --- Abdulla Janger Minshed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 1 Pages: 130-133
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Tuberculosis is the second infection in causing deaths from infectious agent in the world, currently in Iraq approximately 67% of new cases of Tuberculosis involve the lung only ,cough is the most common symptom of pulmonary Tuberculosis , pulmonary Tuberculosis nearly always causes detectable abnormalities on chest film, but still atypical or absent radiologic findings can occur.OBJECTIVE:This study was designed to determine whether in patients with chronic cough normal chest X ray exclude pulmonary tuberculosis.PATIENTS AND METHODS:One hundred seventy two patients attending the respiratory clinic, complaining from chronic cough and they are suspected cases of tuberculosis, were enrolled in this study. A full medical history and physical examination was done then a chest X ray was ordered, for those with normal chest X ray finding (seventy seven patients), sputum smear for acid fast bacilli (AFB) ordered .RESULTS:47 females (61%), 30 males (39%) with chronic cough with females to male ratio = 1.56/1.The age ranged between 17-67, with mean age of 37.16 years. The age of males ranged between 18-67 and the mean was 39.32 years, the age of females ranged between 17-66 and the mean was 34.93 years. X ray finding were negative in all the patients. Positive AFB in sputum smear examination by microscopy was found in only one patient but with ENT examination it was proved to be a case of laryngeal tuberculosis not pulmonary tuberculosis.CONCLUSION:Normal chest x ray in patients with chronic cough excludes pulmonary tuberculosis


Article
Spirometric evaluation of gastroesophageal reflux disease (gerd) associated cough and asthma
تقييم وظائف الرئة لمرضى الجزر المعدي المريئي المترافق مع السعال والربو

Authors: Shaimaa A. H. Jassim شيماء عبد الهادي --- Afraa M. AL-Ameen عفراء محمد --- Amjad F. Ahmad امجد فوزي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2014 Volume: 56 Issue: 4 Pages: 422-425
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Gastroesophageal reflux disease can lead to esophageal complications, including esophagitis, ulceration, stricture, hemorrhage, and Barrett's esophagus. However, the spectrum of problems associated with GERD has expanded to extra esophageal sites. Chronic cough and asthma are two clinical problems caused or triggered by GERD. Spirometric changes among GERD associated cough and asthma still a topic of ongoing research.Objectives: This study was designated to evaluate the spirometric picture of GERD associated cough and asthma subjects in relation to different clinical aspects of the disease including body mass index (BMI), disease duration, presence or absence of symptoms as well as endoscopic findings. Subjects and methods: Ninety adult subjects (90) of either sex with a mean age of 40.5±12 year are involved in this study. Fifty five (55) GERD associated cough and asthma subjects served as test group while the remaining (35) served as control group. Each subject underwent spirometry and gastric endoscopy in Pulmonary Function and Endoscopy Units respectively at Ibn-Sina Teaching Hospital /Mosul.Results: Spirometric data of the control group were within the normal predicted range (80-120%) thus excluding the possibility of any asymptomatic obstructive airway disease. Whereas, the measured spirometric parameters (forced vital capacity (FVC), forced expiratory volume in 1 second ratio (FEV1%), peak expiratory flow (PEF), and forced mid expiratory flow(FMF) are significantly reduced in the test group with a clear restrictive pattern among the overweight subjects. In addition, neither the presence nor duration of symptoms affected the spirometric picture of the GERD associated cough and asthma subjects, unlike those with positive endoscopy findings who revealed significant obstructive pattern when compared to those with negative endoscopy findings. Conclusions: GERD associated cough and asthma subjects with positive endoscopy findings showed obstructive pattern of spirometry irrelevant to the presence or absence of symptoms or duration of the disease.Key words: Gastroesophageal Reflux Disease, chronic cough, asthma.

الخلفية :إن الجزر المعدي المريئي قد يؤدي إلى مضاعفات في المرئ مثل الالتهاب , تقرحات ,تضيق ونزف المرئ وممكن أن تمتد ھﺬه المشاكل إلى أجزاء خارج المرئ وقد تكون سببا في السعال المزمن والربو القصبي .الأهداف :تقييم صورة وظائف الرئة في مرضى الجزر المعدي المريئي المرتبط بالسعال والربو القصبي وعلاقتها مع مؤشر كتلة الجسم , مدة المرض ووجود أو غياب الأعراض مع نتيجة فحص التنظير الداخلي .الاشخاص وطريقة العمل :تم اختيار تصميم دراسة المقطع العرضي الوصفي واجريت الدراسة في مستشفى ابن سينا التعليمي في الموصل . شملت الدراسة تسعون شخصا تتراوح اعمارهم بين (19- 65 سنة) من كلا الجنسين 35 شخصا كعينة ضابطة و55 مريضا يعانون من الجزر المعدي المريئي والسعال والربو وبعد أخذ جميع المعلومات اجري فحص وظائف الرئة لجميع المشمولين بالدراسة ثم اجري للمرضى ناظور المعدة .النتائج:أظهرت نتائج وظائف الرئة للعينة الضابطة أنها ضمن المدى الطبيعي (80-120%)مما يؤكد عدم وجود أي مرض في الرئة بينما كانت نتائج وظائف الرئة (FVC و ( FMF, PEF,FEV1% للمرضى منخفضة معنويا مع وجود تحدد واضح في وظائف الرئة لدى المرضى ذوو كتلة الجسم العالية .و وجود نمط انسدادي في وظائف الرئة لدى المرضى اللذين كان فحص الناظور موجب بالمقارنة مع المرضى اللذين كان فحص ناظور المعدة لهم سالب. الاستنتاج: إن وظائف الرئة لمرضى الجزر المعدي المريئي ذوو نتيجة ناظور معدة موجبة أظهرت نمط انسدادي بغض النظر عن وجود أو غياب اعراض المرض أو مع مدة المرض .انخفاض قيم وظائف الرئة للمرضى اللذين كانوا يعانون من الجزر المعدى لفترة اطول من ثلاثة اشهر عند مقارنتهم مع المرضى اللذين كانت فترة مرضهم اقل. مفتاح الدلالة:الجزر(الاسترجاع) المعدي المريئي ,السعال المزمن ,الربو.

Keywords

Background: Gastroesophageal reflux disease can lead to esophageal complications --- including esophagitis --- ulceration --- stricture --- hemorrhage --- and Barrett's esophagus. However --- the spectrum of problems associated with GERD has expanded to extra esophageal sites. Chronic cough and asthma are two clinical problems caused or triggered by GERD. Spirometric changes among GERD associated cough and asthma still a topic of ongoing research. Objectives: This study was designated to evaluate the spirometric picture of GERD associated cough and asthma subjects in relation to different clinical aspects of the disease including body mass index --- BMI --- disease duration --- presence or absence of symptoms as well as endoscopic findings. Subjects and methods: Ninety adult subjects --- 90 of either sex with a mean age of 40.5±12 year are involved in this study. Fifty five --- 55 GERD associated cough and asthma subjects served as test group while the remaining --- 35 served as control group. Each subject underwent spirometry and gastric endoscopy in Pulmonary Function and Endoscopy Units respectively at Ibn-Sina Teaching Hospital /Mosul. Results: Spirometric data of the control group were within the normal predicted range --- 80-120% thus excluding the possibility of any asymptomatic obstructive airway disease. Whereas --- the measured spirometric parameters --- forced vital capacity --- FVC --- forced expiratory volume in 1 second ratio --- FEV1% --- peak expiratory flow --- PEF --- and forced mid expiratory flow --- FMF are significantly reduced in the test group with a clear restrictive pattern among the overweight subjects. In addition --- neither the presence nor duration of symptoms affected the spirometric picture of the GERD associated cough and asthma subjects --- unlike those with positive endoscopy findings who revealed significant obstructive pattern when compared to those with negative endoscopy findings. Conclusions: GERD associated cough and asthma subjects with positive endoscopy findings showed obstructive pattern of spirometry irrelevant to the presence or absence of symptoms or duration of the disease. Key words: Gastroesophageal Reflux Disease --- chronic cough --- asthma. --- الجزرالاسترجاع --- المعدي المريئي --- السعال المزمن --- الربو.

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