BACKGROUND Anaemia is common among chronic kidney disease (CKD) patients. Quality of life (QOL) is a broad multidimensional concept and many factors affect QOL in CKD patients. This study attempted to measure QOL with varying levels of haemoglobin in CKD patients. METHODS The present study was a descriptive cross-sectional study done on CKD patients on maintenance haemodialysis (MHD) after ethical committee approval. All patients aged more than 18 years on MHD for at least 3 months were enrolled in the study. Patients were categorised into 4 separate groups as Hb 4 to < 6 g/dl, 6 to < 8 g/dl, 8 to < 10 g/dl and 10 - 12 g/dl. After obtaining informed consent, participants were given the study questionnaire - kidney disease quality of life (KDQOL) short form (SF - 36) TM V1 .2. RESULTS At different Hb levels, there were significant differences in the kidney symptom/ problem scores (P = 0.000),the burden of kidney disease scores (P = 0.000), the work satisfaction scores (P = 0.014) and the cognitive function scores (P = 0.000). About SF - 36, all of the physical domains were significantly different: physical function scores (P = 0.000), role physical scores (P = 0.045), pain scores (P = 0.000) and general health component scores (P = 0.004) at different Hb levels. For mental domain components, the differences between four groups of Hb levels were significant in the variety of quality of life domains: emotional wellbeing score (P = 0.006), role emotion scores (0.000), social function scores (P = 0.000) and energy/fatigue scores (0.026). CONCLUSIONS KDQOL, SF - 36 showed that the QOL scores are strongly related to Hb concentrations. The higher scores in various quality of life domains were mostly associated with higher Hb levels in the KDQOL - SF scores. Efforts to optimize haemoglobin in CKD patients may show QOL improvement. KEYWORDS Chronic Kidney Disease, Haemodialysis, Anaemia, Quality of Life
Introduction and Aim: Pulmonary function worsens with the intensification of disease severity. Chronic obstructive pulmonary disease (COPD) may cause changes in the shape of the thoracic cage due to increasing lung volumes and dynamic hyperinflation. To assess the association between the severity of COPD and thoracic wall dimensions among COPD patients. Materials and Methods: A cross-sectional study was conducted in a tertiary care teaching hospital on 80 COPD subjects aged above 18 years. Based on the severity of obstruction of COPD, subjects were divided into two groups-moderate obstruction and severe obstruction. Severity of obstruction constituted the primary outcome variable. The primary explanatory variables were the dimensions of the thoracic wall. Their association was assessed by calculating the Spearman correlation and Pearson correlation coefficient and represented in a scatter diagram. Results: Majority (60%) had an MMRC dyspnea grading of 3. Moderate Obstruction was seen in 62.5% of subjects while 37.50% had severe obstruction. There was no statistically significant difference between the groups with respect to antero posterior (AP) diameter, transverse diameter, AP to transverse diameter ratio and Height of Diaphragm (HDI). There was a moderate negative correlation FVC (L) and HDI, FEV1/FVC (%) and HDI which was statistically significant. There was also a weak negative statistically significant correlation between FVC (L) and AP diameter, FVC (L) and transverse Diameter, FVC (L) and AP to transverse diameter ratio, FEV1/FVC (%) and AP diameter, FEV1/FVC (%) and transverse diameter. Conclusion: There was a significant moderate negative correlation between the height of the diaphragm and severity of COPD (FVC, FEV1/FVC %). In COPD, the mechanical deformation leads to difficulty in breathing because of reduction in the lung capacity of patients. Early and aggressive treatment in patients with COPD can be beneficial. Keywords: Chronic obstructive pulmonary disease; global initiative for chronic obstructive lung disease; medical research council dyspnoea scale; barrel-shaped chest; spirometry, diaphragm.
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