Impact of Pulmonary Tuberculosis Activity on Exhaled Breath Markers Levels in the Egyptian Population

Introduction: Tuberculosis still characterizes till now a major respiratory insult with concurrent pulmonary manifestations and later disability. Aim of Work: To evaluate the level of exhaled fraction of nitric oxide (FENO) and fraction of exhaled carbon monoxide (FECO) as markers of pulmonary tuberculosis TB activity in patients under chemotherapy in comparison to healthy negative patients and latent TB patients. Patients and Methods: This cross-sectional study was conducted on 130 patients recruited from the outpatient clinic of Mansoura Chest hospital during the period from May 2019 to December 2019. They were categorized into the three groups: 1) Pulmonary tuberculous patients PTB (group1) which included 48 cases with positive sputum for TB bacilli in the initiation phase after 1 month of starting anti-tuberculous chemotherapy;2) Latent patients (group 2): included 40 patients with positive tuberculin skin test (Mantoux test) > 10 mm. 3) Control patients (group 3) which included 42 healthy volunteers with negative sputum for TB bacilli. They were subjected to portable spirogram as well as exhaled fractional NO and CO measurement. Results: FECO and FENO levels prevailed in pulmonary TB patients followed by Latent TB patients and lastly healthy volunteers (42 ± 12.32/5 ± 0.16 & 38 ± 8.25/6 ± 2.25 and 23 ± 3.25/2 ± 0.40 respectively). Conclusion: Measurement of CO and NO level in expired air may correlate with active pulmonary TB infection in comparison to healthy negative tuberculous patients and latent tuberculous patients.

Pulmonary Misfortune Ensuing to Petroleum Related Employments

Background: toxic gases and fumes prompted from petrol and gas stations imply their disabling and deadly risks on human lungs. Aim of Work: The aim of this work was to assess the pulmonary function derangements in petrol pump workers at Al-Medina Al-Munawara city. Patients and Methods: This cross sectional study was conducted on 189 cases out of them in control group (group I) with age and sex matched healthy adult males gathered from nonsmokers students and employees in Taibah University. The study group (group II) comprised of 89 males who were working in different petrol pump stations. History, clinical examination and pulmonary functional assessment were carried out by using portable spirometry, Co detector and puls oximeter. Results: The study’s results showoed that the lung function parameters (FEV1, FVC, PEFR, FEFR25% - 75%) were significantly reduced in petrol pump workers (Group II) as compared to the values for these parameters in subjects belonging to Group II (Control group), Similar findings were observed in previous studies on pulmonary functions in petrol-pump workers. This finding specified the restrictive nature of pulmonary involvement in the study group. Measurement of the exhaled CO was slightly higher in Group II than Group I. Conclusion: Fuel vapors and fumes in petrol stations showed direct incapacitating impact on workers pulmonary functions regarding spirometric measurements showing predominantly restrictive pattern and to less extent obstructive. Exhaled CO level was higher in addition to hypoxemia identified in these cases.

Recovery after Ordeal: Respiratory Alterations Linked to Quitting Smoking

Background: Smoking cessation has been long considered a sole precautionary mode of respiratory disability in both developed and developing countries. Aim of Work: our study aims to assess the impact of smoking cessation on clinical features as well as pulmonary functional measurement and exhaled CO level in ex-smokers. Patients and Methods: This observational cross sectional study was conducted on 306 subjects who were attending to outpatient pulmonology clinic in Center of medical services in Taibah University at Al-Medina Al-Munwara, Kingdom of Saudi. Subjects included in this study were selected as being ex-smoker for more than 6 months. They were classified according to the duration of smoking cessation into a) recent smoking quitter (stopped smoking ≤2 years) and;b) remote smoking quitter (stopped smoking >2 years). They were subjected to clinical evaluation, spirometry and exhaled CO level measurement in exhaled air. Results: All clinical features including cough, dyspnea, chest pain, hemoptysis, wheezes, hospitalization and relapse in both recent quitter and remote quitter subjects were statistically comparable but without statistical significant difference. There was statistical positive correlation between duration of smoking cessation and actual FEV1, actual FVC, actual PEFR, actual TLC, functional defect FEV1, functional defect of FVC, functional defect of PEFR and functional defect of TLC while statistical negative correlation was with CO exhaled level. Conclusion: Smoking cessation demonstrated an appreciated role in recovering patient clinical as well as pulmonary functional and gaseous characters towards healthy side.