Effectiveness of Pulmonary Rehabilitation in Patients with COPD

Background: Pulmonary rehabilitation (PR) is beneficial for patients with COPD, with improvement in exercise capacity and health-related quality of life. Despite these overall benefits, the responses to PR vary significantly among different individuals. It is not clear if PR is beneficial for patients with COPD and normal exercise capacity. Although it is believed that longer pulmonary rehabilitation programs can provide better results, most of the evidence comes from short-term programs. Objective: The objective of this analysis was to determine the effectiveness of respiratory services provided in the hospital or community by respiratory therapists (RTs) in reducing health care utilization and improving patient outcomes. The aim was to evaluate the outcomes of a comprehensive pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease. Methodology: All 65 Pakistani patients who met the inclusion criteria with ages between 40 to 65 years, including both male and female, with mild to severe COPD were enrolled in the study on the basis of convenient sampling. Informed consent was taken from each patient starting about the study and their rights to withdraw from study. A demographics detail (name, age, sex) was noted along with the necessary medical history. A questionnaire was made to see the effects of pulmonary rehabilitation in patients with COPD. All necessary tests were performed to evaluate the patient betterment completely. Results: The mean FEV1 in the subjects was 1.29 ± 0.47 L/min, 64.8 ± 23.0% of predicted. Clinically there is a little effect on CXR pattern, FEV1 and FEV1/FVC after pulmonary rehabilitation. But overall quality of life improved after pulmonary rehabilitation. Mainly improvement occurs in peak expiratory flow rate, BORG dyspnea scale, 6 mint walk test distance (meters) and Oxygen saturation after rehabilitation. Conclusion: These results showed that patients with COPD had benefited from a comprehensive PR program in an out-patient setting regardless of disease severity. Exercise training can result in significant improvement in health-related quality of life, exercise capacity, respiratory muscle strength, and exertional dyspnea in subjects with COPD and normal exercise capacity

Vitamin D status and pulmonary exacerbations in children and adolescents with cystic fibrosis: Experience from a tertiary care center

Background: The function of Vitamin D in preventing inflammation and infection has been studied previously for different pathologies in different populations globally. Relationships between serum Vitamin D levels and its effect on pulmonary exacerbations in the cystic fibrosis (CF) population are not well studied in our part of the world. Therefore, we aimed to ascertain the Vitamin D status in pediatric and adolescent CF patients and its association with pulmonary exacerbations.Materials and methods: A retrospective study was conducted at The Aga Khan University Hospital from 2015 to 2018. Patients of CF with sweat chloride value \u3e60 mmol/l and who had at least one measurement of 25 hydroxy Vitamin D (25 OHD) were included in the study. Annual serum Vitamin D levels were documented for enrolled patients and their past 1-year data were analyzed for pulmonary exacerbations, average length of stay, and tracheal/airway colonization with organisms.Results: 69 patients were included in the study. 28 patients (40.57%) were found to be Vitamin D deficient, 22 patients (31.88%) were Vitamin D insufficient and 19 patients (27.53%) were labeled as Vitamin D insufficient. The average number of exacerbations per year was significantly high in Vitamin D deficient group (3.71 ± 0.96) in comparison with insufficient (3.18 ± 1.09) and sufficient groups (2.26 ± 0.93) (P \u3c 0.001).Conclusion: Vitamin D deficiency is related to an increased number of annual pulmonary exacerbations and pseudomonas infections

Income Inequality, Redistribution of Income and Trade Openness

Literature on nexus between trade openness and government spending is impressive [Atif, et al. (2012), Rudra (2004), Dani (1997) and McGuire (1999)]. The literature is growing rapidly. Analysts have documented the positive effects of government social spending [see for example Mesa-Lago (1994); Huber (1996); Weyland (1996); McGuire (1999)]. Unfortunately, Pakistan lacks empirical evidences on the impact of government social spending. Although Government of Pakistan has taken number of initiatives to have some form of redistribution policies, however, inequality in Pakistan is higher as compared to other Least Developed Countries that are open to trade. This situation is alarming. This paper therefore tries to identify the nexus between trade openness and social spending for the period 1975–2012. International evidence suggests that government social spending influences poverty and distribution of income. Pakistan‘s low level achievement in terms of reducing inequality, given the likely adverse economic impact of trade openness, point towards the fact that government has to design the policy in such a way that it affects the distribution of income. Thus, exploring the effect of social spending on income inequality is necessary for the concerned policy makers

Digital information security management policy in academic libraries: A systematic review (2010­2022)

La gestion de la sécurité de l’information numérique est considérée comme un outil important pour assurer la protection des renseignements personnels et des données. Le but de cette recherche est d’examiner la mise en œuvre dans les bibliothèques universitaires. Une analyse documentaire systématique a été effectuée pour atteindre les objectifs de l’étude. Les données ont été recueillies à partir de différentes bases de données bien connues, à savoir, Library Information Science and Technology Abstracts (LISTA), Library and Information Science Abstracts (LISA), IEEE Xplore, Emerald Insight, ACM Digital Library, Scopus, revues Sage, Taylor & Francis, ProQuest, Science Direct, Wiley Online Library, et Google Scholar

Some new lichen records from Pakistan

During a survey of the lichens in the state of Azad Jammu and Kashmir, many specimens were collected from the Jhelum and Neelum valley and characterized using morpho-anatomical, molecular and chemical test methods. Two taxa new for Pakistan, i.e., Physciella chloanta and Xanthoparmelia protomatrae s. l., were found in the collection while Physconia enteroxantha represent range extensions within Pakistan. Morpho-anatomical descriptions, ecology and distribution are provided

The Impact of Colorectal Conditions on Psychosocial Well Being of Caregivers and Patients Presenting to A Tertiary Care Hospital

Colorectal conditions such as Hirschsprung disease, anorectal malformation, fecal incontinence and spinal condition cause a significant stress among patients and their caregivers. Managing such disorders requires not only a one-time definitive surgery but a significant number of follow up visits, dietary modifications and long-term medication. The aim of this study was to estimate the psychosocial wellbeing of caregivers and patients suffering from these conditions