PEFR

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PEFR

  1. 1. STUDY OF PEFR IN BRONCHIALASTHMA - ANTHROPOMETRIC CORRELATION Dr.Sushmita Ghosh, DNB Final Year, JLNHRC BHILAI dnbpaediatrics.blogspot.in
  2. 2. INTRODUCTION  Bronchial Asthma derived from ancient greek word meaning pantingdnbpaediatrics.blogspot.in  Paroxysmal and reversible obstruction of airways  Public health problem  Commonest chronic medical condition in children  Acute severe asthma can be life threatening and disease causes significant morbidity
  3. 3. AIMS & OBJECTIVES Measurement of PEFR in asthmatic children during acute exacerbation Comparison of PEFR:prebronchodilation & postbronchodilation Correlation of PEFR with height & chest circumference Comparison of the data with the control group dnbpaediatrics.blogspot.in
  4. 4. MATERIAL & METHODS  Prospective study  Duration of study:-1 yr  Hospitalized children with bronchial asthma in age group 6-14 yrs  Measurement of PEFR:prebronchodilation and 10-15 mts after bronchodilation  Comparison with PEFR of normal children in same age group FERRARI’S PEAK EXPIRATORY FLOW METER  Correlation with height and chest circumference  Statistical analysis of observations dnbpaediatrics.blogspot.in
  5. 5. Measurement of PEFR pre-&postbronchodilation dnbpaediatrics.blogspot.in
  6. 6. OBSERVATION dnbpaediatrics.blogspot.in
  7. 7. AGE WISE DISTRIBUTION(Cases,n=41) 2 5 14 yrs No.of patients 5 13 yrs 4 1 6 12 yrs CASES 11 yrs 5 10 yrs 5 5 9 yrs 4 8 yrs 7 yrs 0 1 2 3 4 5 6 7 6 yrs AGE of patients AGE WISE DISTRIBUTION(Control,n=403) 32 14 yrs 59 AGE of patients 45 13 yrs 59 12 yrsCONTROLS 1 50 11 yrs 39 50 10 yrs 40 9 yrs 35 8 yrs 7 yrs 0 10 20 30 40 50 60 70 6 yrs No.of patients dnbpaediatrics.blogspot.in
  8. 8. CASES SEX DISTRIBUTION(Cases,n=41) 0.7 65.80% 0.6PERCENTAGE 0.5 0.4 34.20% MALES 0.3 FEMALES 0.2 0.1 0 MALES FEMALES SEX DISTRIBUTION(CASES) FEMALE, 34.20% male female MALE 65.8% dnbpaediatrics.blogspot.in
  9. 9. TYPE OF ASTHMA 6 5 4 MOD.PERSISTENT MOD.PERSISTENT 4TYPE MILD PERSISTENT 3 3 MILD PERSISTENT MILD INTERMITTENT 2 1 34 MILD INTERMITTENT 0 10 20 30 40 NO.OF PATIENTS TYPE OF ASTHMA 7% 10% MILD INTERMITTENT MODERATE PERSISTENT MILD PERSISTENT 83% dnbpaediatrics.blogspot.in
  10. 10. BRONCHIAL ASTHMA BRONCHIAL REVERSIBILITY 0.9 0.8 0.7% OF PEFR 0.6 0.5 PREBRONCHODILATION 0.4 POSTBRONCHODILATION 0.3 0.2 0.1 0 1 4 7 10 13 16 19 22 25 28 31 34 37 40 PATIENTS dnbpaediatrics.blogspot.in
  11. 11. dnbpaediatrics.blogspot.in
  12. 12. COMPARISON of PEFR of CASES & CONTROLS 500 400PEFR(L/min) prebronchodilation 300 postbronchodilation 200 control 100 0 1 2 3 4 5 6 7 8 9 HEIGHT 100,110,120,130,140,150,160,170,180 cms) dnbpaediatrics.blogspot.in
  13. 13. CONTROLS SEX DITRIBUTION(Control,n=403) 0.6 56.07% 0.5 43.92%PERCENTAGE 0.4 MALE 0.3 FEMALE 0.2 0.1 0 MALES FEMALES SEX DISTRIBUTION(CONTROL) 43.92% MALE FEMALE 56.07% dnbpaediatrics.blogspot.in
  14. 14. GROUPS- A(6,7,8 yrs) B(9,10,11 yrs) C(12,13,14 yrs) SEX DISTRIBUTION(Groups) 160 140 120 76 58 100 55 FEMALE NO. 80 MALE 60 40 70 73 79 20 0 A B C GROUPS dnbpaediatrics.blogspot.in
  15. 15. GROUP A Ht-PEFR correlation(n=125) 300 250PEFR(L/min) 200 male 150 female 100 50 0 100-109 110-119 120-129 130-139 140-149 Height(cms) dnbpaediatrics.blogspot.in
  16. 16. GROUP B Ht-PEFR correlation(n=149) 400 350 300PEFR(L/min) 250 male 200 female 150 100 50 0 120-129 130-139 140-149 150-159 160-169 HEIGHT(cms) dnbpaediatrics.blogspot.in
  17. 17. GROUP C Ht-PEFR correlation(n=137) 500 400PEFR(L/min) 300 male female 200 100 0 130-139 140-149 150-159 160-169 170-179 180-189 HEIGHT(cms) dnbpaediatrics.blogspot.in
  18. 18. GROUP A CHEST CIRCUMFERENCE-PEFR correlation(n=125) 250 200PEFR(L/min) 150 MALE 100 FEMALE 50 0 40-49 50-59 60-69 CHEST CIRCUMFERENCE(cms) dnbpaediatrics.blogspot.in
  19. 19. GROUP B CHEST CIRCUMFERENCE-PEFR correlation 350 300PEFR(L/min) 250 200 MALE 150 FEMALE 100 50 0 50-59 60-69 70-79 80-89 90-99 CHEST CIRCUMFERENCE(cms) dnbpaediatrics.blogspot.in
  20. 20. GROUP C CHEST CIRCUMFERENCE-PEFR correlation 450 400 350PEFR(L/min) 300 250 MALE 200 FEMALE 150 100 50 0 50-59 60-69 70-79 80-89 90-99 CHEST CIRCUMFERENCE(cms) dnbpaediatrics.blogspot.in
  21. 21. RESULTS Statistical analysis(paired t-test) was applied to see difference in PEFR after bronchodilation was found to be highly significant p<0.001 dnbpaediatrics.blogspot.in
  22. 22. RESULTS Each group subjected to Groups A B C statistical analysis,correlation coefficients of height & chest circumference with PEFR Ht-PEFR M-0.962 M-0.925 M-0.963 estimated F-0.995 F-0.972 F-0.887 Significance noted at p=0.05 (p=0.05) (p=0.05) (p=0.05) for all except for Group B male chest circumference- PEFR correlation CC- M-0.961 M=0.355(p M-0.962 PEFR F-0.934 =0.4) F-0.991 Regression equations- (p=0.05) F-0.874 (p=0.05) Ht(y=3.5x-230.85) (p=0.05) CC(y=3.68x+26.58) dnbpaediatrics.blogspot.in
  23. 23. CONCLUSION There was significant improvement in PEFR after bronchodilation which was comparable to studies done by- -K.Najafizadeh et al,2007 -terzano et al,2007 -P.Aggarwal et al,2006 dnbpaediatrics.blogspot.in
  24. 24. CONCLUSION There was significant correlation of height and chest circumference with PEFR in both sexes and in all age groups which was comparable to studies by- -P.Sitarama Raju et al,2003,2004,2005 -Olamewaju DM et al,1991 -Pande JN et al,1997 PEFR was found to be higher in male children contrary to few studies where PEFR was found to be equal in both sexes in childhood. dnbpaediatrics.blogspot.in
  25. 25. RECOMMENDATIONS Patient and parent education: Teach skills to self monitor PEFR and manage asthma Use of preventors in home management of asthma PEFR measurement in school health programmes dnbpaediatrics.blogspot.in
  26. 26. ACKNOWLEDGEMENT Dr.G.Malini,Sr.DD(Guide) Dr.Omesh Khurana,Jt.DMHS Dr.Uma Chaturvedi,HOD,DMHS Dr.R.Shukla(Jt.DMHS) Visit Dr.S.M.Dewangan,Jt.DMHS Dr.A.Verma dnbpaediatrics.blogspot.in Dr.N.S.Thakur Dr.S.Saha Dr.Motghare Dr.P.N.Agarwal Dr.Meera Bamania Dr.M.R.Soni Dr.Biswal Dr.S.Panda All my seniors & colleagues
  27. 27. Visit dnbpaediatrics.blogspot.in For dnb learning material and discussionsTHANK YOU

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