Clinical Assessment and Patterns of Lung Function Impairmentin Post-Tubercular Obstructive Airway Disease Patients: A Prospective, Single center, Observational Study.

Abstract

Background: Following the completion of treatment with ATT in patients of PulmonaryTuberculosis, some patients develop varieties of lung function impairmenti.e., obstructive, restrictive or mixed patterns. The impairment in lung function can be assessed by spirometry. The aim of the study is to evaluate the patterns of lung function impairment in treated patients of pulmonary tuberculosis and clinical assessment of Post-tuberculosis obstructive airway disease.Materials and Methods: Hospital-based prospective, observational, cross-sectional study conducted in 130 Patients of Post-Tuberculosis admitted at TB & Chest Hospital (Bari) in the period between April 2019 to September 2019.Selected Post Tuberculosis patients were assessed based on spirometry and then patient with obstructive airway disease (OAD) were assessed particularly in terms of demographic data, symptomology, Degree of Airflow Obstruction (FEV1% Pred.), Chest X-ray findings and duration since last Anti-tuberculosis treatment taken.Result:Spirometric assessment of post-TB cases showed that obstructive pattern was predominant type present in 40% cases whereas restrictive and mixed pattern were present in 25% and 20% of Post TB cases, respectively. Only 15% patient had normal pattern.Maximum no. of Post-Tubercular OAD patients were male& were between 5^th to 6^th decade of age. Among Post-Tubercular OAD patients dyspnoea (94%) was the most common symptom and majority of patients (48%) were having Severe airflow limitation i.e. GOLD-3 severity stage with mean FEV1= 43.88(±15.45). Hyperinflation on chest X-ray was present in around half no. of cases (53.8%) of Post-Tubercular OAD patients with flattening of diaphragm seen in around 30% cases. Cardiomegaly on chest x-ray were also present in 17.3% cases of Post-Tb OAD. It was also observed that majority of Post-Tubercular OAD patients (40.38%) have taken ATT between 0-10 years back and only 10% patients had taken ATT beyond 30 years back.Conclusion:Prior history of Tuberculosis has an important role in the development of obstructive airway diseaseand for many persons with tuberculosis, microbiological cure may be the beginning, not the end, of their illness.Therefore,even after completion of treatment with Anti-tubercular drugs, these patients need to be followed up for evaluation of development of obstructive airway disease.

Keywords: Lung Function Impairment, Post-Tubercular Patients, Obstructive Airway Disease.