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Pulmonary Function Tests - Why So Important?

Pulmonary Function Tests - Why So Important?

Lung function is a major indicator of health since it determines the amount of Oxygen that a body gets. Doctors resort to Pulmonary Function Tests if there is a problem with breathing or the lungs. Pulmonary tests give insight into how the lungs are functioning.

These tests measure parameters like lung capacity, lung volumes, gas exchange, rate of flow, etc.

Armed with information from these tests, the doctor can decide whether a person has some issues with the lungs or not, and accordingly diagnose and decide the line of treatment for accelerated recovery.

Type Of Pulmonary Function Tests

  • For all practical purposes, PFT can be divided into two broad categories: Basic and Advanced.
  • Basic PFT is Routine Spirometry but advanced PFT includes a plethora of tests.

Basic PFT: Spirometry-

  • This test measures how much air a person can inhale and exhale, as well as how fast one can empty the lungs.
  • In this test, a person needs to breathe into a tube. The tube is attached to a computerized Spirometer.
  • Before the test, nostrils will be closed with a clip. The person will also need to create a seal around the tube so that there is no leakage of air.
  • The patient will be asked to take a deep breath and then breathe out as hard as possible through the tube.
  • The doctor may ask the person to repeat the effort three times or more so that he gets a consistent result.
  • Estimating PEFR(peak expiratory flow rate) by Peakflometry and measurement of peripheral oxygen saturation(SpO2) by Pulse Oximetry can be included as a part of basic PFT for the purpose of completion.
  • These tests apart from giving valuable information are very simple to perform and patient-friendly which can be done by patients at home or at the doctor’s clinic on a regular basis.

Advanced PFT
Advanced Pulmonary Function Testing includes different tests like:

  • FeNO(fractional exhaled nitrous oxide),
  • DLCO or TLCO(diffusion capacity or transfer factor),
  • Body Plethysmography,
  • Impulse Oscillometry,
  • 6MWT (6-minute walk test), etc

Why Undergo Pulmonary Function Tests?

Doctors may conduct Pulmonary Function Tests even on healthy people. It is a mandatory part of pre-employment and peri-employment workups in most industrial and corporate health checkup programs. If a person works in certain hazardous environments like graphite factory, coal mine, chemical factory, etc., the employer may order such tests on a regular basis. People working in such places are at increased risk of developing respiratory problems which could be detected on PFT at an early stage.

PFT is an important investigation for evaluating common respiratory symptoms like:

It is a very crucial diagnostic tool for diagnosing chest diseases like:

  • Asthma,
  • COPD,
  • Other Airway disorders,
  • Interstitial lung diseases,
  • Occupational lung diseases,
  • Pulmonary fibrosis,
  • Connective tissue diseases related to lung involvement, etc.

In a Nutshell-

  • PFT is a set of tests which act as a window to lungs functioning of an individual.
  • One of the Pulmonary Function Tests may be advised by a doctor for a variety of reasons.
  • These tests are a way to measure the parameters of working/functioning of the Lungs so that a Physician can treat the problem effectively (if detected) and then follow up to assess the effectiveness of treatment or progression of the disease process.
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Occupational Lung Disorders - Know Everything!

Occupational Lung Disorders - Know Everything!
Black lung disease actually causes the lungs to char and turn black in colour? True or False? Take this quiz to find out.
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Lung Surgery- An Overview

Lung Surgery- An Overview
Lung surgery may involve complete removal of a lung? True or false? Take this quiz to find out.
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Dr. I have A nodular lesion over back of my neck. It's really painful and headache also. What do I do?

For pain take tablet paracetamol 650 mg and if necessary after clinical examination we should plan for its excision
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I want to become a pilot but my opacity in the lung is becoming a problem! Can lunch opacities go away when the treatment is over & will there be patches visible to stop me from the course?

YOur lung opacities need to be tested and treated . It can be a infection like pneumonia and you must get rid of it
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What Is Farmer's Lung?

What Is Farmer's Lung?
Farmer s lung is a temporary disease and can be reversed. True or false. Take this quiz to find out.
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Hi Sir, My brother is having a major chest infection according to doctors and he is deaf and dumb according to MRI and X-ray it shows that 70% chances of TB. But the TB injection test is negative. There is no mark and swelling anywhere. Still doctor has started the TB treatment just for one month trail. His urine is red in color and having itching on legs. Weight is reducing. Also having mild fever. What best we can do please suggest. Is it right to start TB treatment and how long it will take to cure the infection.

X rays show a typical appearance in TB. So doctors can diagnose fairly accurately based on it. Many times the actual TB bacillus is not found because it is very slow growing organism. Doctors are correct in starting treatment. If it is limited to chest it takes around 6 months. If bone involved then it may take 18 months.
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World No Tobacco Day - Making An Effort To Control Tobacco Usage!

World No Tobacco Day - Making An Effort To Control Tobacco Usage!

When man first started using tobacco, he probably did not know that it would grow to be an epidemic that could cause multiple health issues. Be it smoking or chewing, tobacco has severe negative effects on health. Take any of current lifestyle diseases from diabetes to infertility to obesity, the common risk factor is tobacco abuse. In addition, depending on the form of tobacco used, specific organs are affected. For instance, chewing tobacco leads to oral cancer while smoking causes lung cancer.

The statistics around tobacco abuse are extremely startling and can be read below:

  • A total of about 90 trillion rupees are spent on various tobacco products.
  • About 1.4 trillion is spent on healthcare related to conditions caused by tobacco abuse.
  • India has about 120 million tobacco users.
  • More than 7 million people die every year due to tobacco usage.
  • The Government has levied a GST of 28% on cigarettes, making them unaffordable, which is one of the ways to promote quitting.
  • For those who want to quit but are not able to, there is a quit-line setup, which is toll-free, 1800-11-2356 and is accessible from 8 a.m. to 8 p.m.

Tobacco is a menace in all the strata of society. The lower economic classes are adversely affected both due to lack of knowledge and healthcare facilities. Therefore, the government uses the World No Tobacco Day (WNTD) that is observed by all members of the World Health Organization as an opportunity to drive this awareness.

This is celebrated on May 31st every year. Some measures that are taken to promote 'say no to tobacco' campaign are listed below.

  1. In 1975, the Cigarettes (Regulation of Production, Supply, and Distribution) Act was introduced, which made it mandatory for cigarette packs to have a warning stating “Smoking Kills” or “Smoking is injurious to health.”
  2. Marketing campaigns are shown in the movie theaters at the beginning of movies which depict the hazards of tobacco
  3. Smoking is banned in most public areas, and warnings are on display.
  4. Children below 18 are not sold tobacco products. If in doubt, the seller can ask for age identification.
  5. Schools and colleges do not have tobacco selling within 100 meters of the campus.
  6. The price increase ensures that not everybody has easy access to cigarettes.
  7. Celebrities promote quitting tobacco and smoking by talking about their personal stories.
  8. Restaurants have separate smoking sections where children are not allowed to sit
  9. Tobacco in form of beedi and gutkha also needs to be targeted, as the lower income groups often use these. Also, beedi is sold as single units, so cost is not a deterrent.

How can a healthcare professional help you?

A healthcare professional plays a vital role in a smokers life, as it the healthcare professional that can increase the odds of quitting with guidance, medication, and support. 

What should a healthcare professional do?

  • Identify people who smoke 
  • Motivate them to quit or think about quitting
  • Refer a person who smokes for treatment and support
  • Support ongoing abstinence

What is the right smoking cessation strategy?

  • Ask: Every smoker to visit a healthcare professional
  • Advise: Urge the smoker to leave smoking
  • Assess: Assess whether the person is willing to quit in 30 days
  • Assist: Plan and help Rx Quit
  • Arrange: Arrange a follow-up through phone or sms or in person

What is that people who smoke need help with?

  • First and  the foremost challenge are the withdrawal symptoms 
  • Urge to smoke and borderline depression with a possibility of relapse
  • People who have high pre-abstinence nicotine intake

How to get over the initial withdrawal discomfort?

  • Behavioral support is of proven efficacy
    • Can be delivered in different formats
      • Face-to-face
      • Telephone
      • Internet
  • Nicotine replacement therapy and nortriptyline are of proven efficacy

Facts On Nicotine Replacement Therapy (NRT)

  • There are no real contradictions related to NRT
  • No drug interactions 
  • Side effects, if there are any are localized e.g.
    • Taste of oral products
    • Hiccups with the mouth spray 
    • Skin irritation with patch 

Treatment for quitting Nicotine 

  • Medications: Medicines which are useful adjuncts in the determined but unsuccessful quitters are Varenicline and Bupropion
  • Electronic cigarette: Electronic cigarettes are not as effective as imagined and have few side effects 

Though smoking out in the open has reduced, there are miles to cover when it comes to eradication of tobacco. 

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