Browsing by Author "Bam, N"
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Publication Health Related Quality of Life (HRQOL) assessment using St. George's Respiratory Questionaire in patients with stable Chronic Obstructive Pulmonary Disease(Institute of Medicine, 2017) Das, SK; Bam, N; Ghimire, PAbstract Introduction: Despite being a major cause of chronic morbidity and mortality throughout the world and its relentlessly increasing incidence, Chronic Obstructive Pulmonary Disease (COPD) is an often neglected major public health problem in developing countries like Nepal. Though the health expenditure for management of COPD is gradually increasing, little attention has been given to the Quality of Life (QOL), which should be the main target for management of any chronic diseases. This study assesses the Health Related Quality of Life (HRQOL) of stable COPD patients. Methods: A descriptive observational cross-sectional study of 81 stable COPD patients (who were on regular medication for at least 3 months) was conducted in Respiratory out Patient department of Tribhuvan University Teaching Hospital (TUTH). All the subjects were assessed for their HRQOL using the St. George's Respiratory Questionnaire for COPD (SGRQ-C). Socio- demographic data regarding the patients were also recorded. Data entry and statistical analysis were performed using the SPSS software, version 18.0. Results: The mean age of COPD patients was 67 years. Out of the total 81 study cases, 46(56,8%) were female and 67(82.7%) were either current or past smokers, Patients with COPD showed significantly reduced bealth related quality of life (HRQOL) in all domains. Smoking status and baseline hypoxia showed a highly significant association with HROOL, Age, education status, occupation and gender did not affect the QOL scores in a statistically significant manner. Adding methylxanthine to the standard combination inhaler therapy did not show any significant different in term of HRQOL. Conclusion: This study showed that Nepalese COPD patients had reduced HRQOL Smoking and baseline hypoxia had significant negative impact on HRQOL. Keywords: Chronic obstructive pulmonary diseasePublication The role of blood eosinophil level in acute exacerbation of Chronic Obstructive Pulmonary Disease(Institute of Medicine, 2018) Nizam, S; Yogi, KN; Bam, N; Das, SKAbstract Introduction: Chronic Obstructive Pulmonary Disease (COPD) has great implications on global health accounting for significant morbidity and mortality. The aim of this study was to assess blood eosinophil level in patients presenting with acute exacerbation of COPD and to check whether pre-treatment blood eosinophil level ≥2% has better improvement with the standard therapy (oxygen, corticosteroids IV/Oral and inhaled corticosteroids/ inhaled beta 2 agonist/ inhaled muscarinic antagonists along with antibiotics and diuretics) as well as shorten the duration of hospital stay. Methods: Blood eosinophil level was measured in 106 eligible patients on admission with the diagnosis of AECOPD,under the Department of Pulmonology and Critical Care Medicine, TUTH from December 2016 to August 2017 were included in this observational study. Clinical information was obtained and PFTs were done. Results: A total 106 patients were enrolled. The mean age of the patients was 67±12 years with smoking history of mean pack year 24± 10.7. Among this population, 46.22% patients had blood eosinophil level ≥2% which had better improvement in general physical examination (edema and cyanosis/ P= 0.05 and 0.01), vital signs (tachycardia P=0.05) including (SPO2 P=0.01 ) and chest findings (crackles P= 0.01) with standard therapy compared to blood eosinophil level <2%. Similarly, significant shorter duration of hospital stay was observed in patients with blood eosinophil level ≥2% with standard therapy in comparison with blood eosinophil <2% (p=0.01). Conclusion: Blood eosinophil level represents a potentially important biomarker that could aid treatment decision making as well as gives us a predictive idea regarding the duration of hospital stay upon admission with AECOPD