000			02979nam a22002297a 4500
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040			_eNLM
060			_aTHS-00680
100			_aUpadhyay, Devansh.
245			_aClinical profile and outcome of patients with acute exacerbation of COPD presenting to tertiary care center of Nepal.
260			_cc2022.
300			_a19p.
500			_aThesis Report.
520			_aABSTRACT: Background: Chronic Obstructive Pulmonary Disease (COPD) is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and /or alveolar abnormalities usually influenced by several host and environmental factors. Dyspnea, cough, sputum production, history of recurrent lower respiratory tract infections are presenting symptoms that are often under-reported by patients. An exacerbation of COPD is a sustained worsening of the patient's condition, from the stable state and beyond normal day-to-day variations that is acute in onset and may warrant additional treatment in a patient with underlying COPD. This study aims to describe clinical profile and short-term outcome of patients admitted with acute exacerbation of COPD diagnosed either clinically only or with GOLD criteria in a tertiary care hospital. Methodology: A descriptive observational study based on questionnaire and hospital records was carried out in Department of Pulmonology and Critical Care Medicine, TUTH for a period of five months from 9th December 2021 to 8th May, 2022. The study population consisted of consecutive patients admitted to the department for at least one day within the time frame with diagnosis of acute exacerbation of COPD. Results: There were 30 patients, predominantly female (60%) from rural Nepal (80%) with median age of 71 years, mostly smokers (66.67%) and significant firewood smoke exposure (80%), living with COPD for median duration of 7 years [range 1-30 years] and all categorized into group D in GOLD A-D classification. There was a low prevalence of spirometry use to diagnose COPD. ABG, chest x-rays and ECG were performed in all the patients. Antibiotics, short-acting beta agonists, long acting beta agonists and inhaled and systemic corticosteroids were prescribed in majority of the patients based on GOLD guidelines. Substantial proportion (63.33%) had cor pulmonale as well and were under diuretics. Conclusion: A variety of host factors and environmental factor affects the natural course of COPD once diagnosed. The exacerbations accelerates the damage that the lung sustains and invites more severe and frequent exacerbations and hospitalizations. Cessation of smoking and avoiding exposure to firewood smoke and timely medical consults during the exacerbations are recommended.
650			_aClinical profile.
650			_aExacerbation.
650			_aCOPD.
650			_a Nepal.
856			_yhttp://www.nhrc.gov.np/
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