Pakistan Journal of Chest Medicine

Occupational Exposure and Associated Respiratory Diseases in Patients Presenting to a Tertiary Care Hospital in Peshawar

2026-05-01T07:01:47+00:00

Background: Occupational exposure to dust, fumes, gases, and chemical substances is an important cause of respiratory diseases across the world, especially in developing countries. Workers in industries such as construction, mining, agriculture, and textiles are at an increased risk of suffering from occupational respiratory diseases.

Objective: To assess occupational exposure and its association with respiratory diseases among patients presenting to a tertiary care hospital in Peshawar.

Methodology: A cross-sectional descriptive study was conducted in the Department of Pulmonology, Lady Reading Hospital, Peshawar from January to December 2024. In the present study, a structured questionnaire was used for collecting demographic information, occupational history, type of exposure, and duration of exposure. The study also involved clinical evaluation and investigations such as chest X-ray, spirometry, sputum examination, and CT scans for diagnosis.

Results: The highest percentage of participants was exposed to silica/cement dust (31.2%), followed by textile dust (17.5%) and coal dust (16.2%). Chronic obstructive pulmonary disease (COPD) was the most common respiratory disease observed (33.7%), followed by occupational asthma (22.5%), pneumoconiosis/silicosis (17.5%), hypersensitivity pneumonitis (12.5%), and other chronic respiratory diseases (13.7%).

Conclusion: Occupational exposure to dust, fumes, and chemical substances were the major factors that influences the occurrence of respiratory diseases. COPD and occupational asthma were the most common issues. It is necessary to strengthen the measures for ensuring occupational safety, the use of personal protective equipment, and the implementation of health screening programs to combat respiratory diseases.

Preserved Ratio Impaired Spirometry (PRISm) in Mardan: A Retrospective Prevalence Study of Spirometric Patterns and Associated Comorbidities

2026-05-01T06:50:18+00:00

Background: Preserved Ratio Impaired Spirometry (PRISm) is a unique form of spirometric abnormality that is defined as reduced FEV? (<80% predicted) with a preserved FEV?/FVC ratio of ?0.70. Unlike obstructive and restrictive lung disorders, PRISm is increasingly being recognized as a clinically relevant condition that is linked with respiratory symptoms, metabolic syndrome, cardiovascular disease, and increased mortality.

Objective: To determine the prevalence of PRISm among adults undergoing spirometry and to find out its relationship with demographic and comorbid factors.

Methodology: A retrospective study design was used to examine 180 spirometric results from adult patients (?18 years old) in a tertiary care hospital in Peshawar from January 2023 to December 2024. The variables collected for analysis were age, gender, BMI, smoking status, comorbidities, and spirometric values. PRISm was defined as FEV1 <80% predicted with FEV1/FVC ?0.70.

Results: Out of 180 patients, the mean age was 46.7 ± 13.2 years, and 52.2% of them were males. PRISm prevalence was 15.5% (n=28), normal spirometry 51.6% (n=93), and obstructive pattern 32.7% (n=59). PRISm patients had significantly decreased FVC (72.5 ± 6.7%) compared with normal and obstructive patients (p<0.001). PRISm was significantly associated with hypertension (39.2% vs. 21.7%, p=0.024), diabetes mellitus (35.7% vs. 17.7%, p=0.037), and cardiovascular disease (25% vs. 9.8%, p=0.024), diabetes mellitus, and cardiovascular disease (25% vs. 9.8%, p=0.048).

Conclusion: PRISm is a common intermediate spirometric phenotype within this population and has been linked with many cardiometabolic comorbidities and obesity. It may be beneficial to recognize this within clinical practice in order to potentially prevent the progression of this into pulmonary and systemic disorders.

Assessment of Electrolyte Disturbances in Hospitalized Patients with COVID-19

2026-05-01T06:45:11+00:00

Background: Electrolyte abnormalities are commonly observed among patients admitted for coronavirus disease 2019 (COVID-19). These electrolyte imbalances may affect the severity of COVID-19 infection in patients. This study aimed to evaluate the prevalence of electrolyte imbalances among COVID-19 patients admitted in various hospitals and their possible clinical consequences.

Methods: An observational cross-sectional study was carried out among 130 adult patients admitted with confirmed COVID-19 infection in a tertiary care hospital in Peshawar, Pakistan, between January 2021 and December 2022. Serum levels of sodium, potassium, calcium, and chloride were estimated on admission. The abnormalities of these electrolytes were determined based on standard reference ranges. Data was collected, and patterns of electrolyte abnormalities were observed.

Results: The electrolyte abnormalities were found in 64.7% of patients. The electrolyte abnormalities were found to be hyponatremia in 34.6%, followed by hypocalcemia in 29.2%, and hypokalemia in 25.3%. The electrolyte abnormalities were less frequently observed in the form of hypernatremia and hyperkalemia in 5.3% and 7.6%, respectively. The electrolyte abnormalities were associated with comorbid conditions such as hypertension and diabetes mellitus. The electrolyte abnormalities were associated with severe disease and longer hospitalization.

Conclusion: Electrolyte abnormalities like hyponatremia, hypocalcemia, and hypokalemia are commonly observed among hospitalized COVID-19 patients. These electrolyte imbalances are linked with increased severity and worsening outcomes among COVID-19 patients. Therefore, early recognition and management of these electrolyte imbalances are essential for improving the care and prognosis of COVID-19 patients.

C-reactive Protein and D-Dimer as possible Predictors of Clinical Characteristics and Outcome in Community-Acquired Pneumonia

2026-05-01T07:42:42+00:00

Background: Community-acquired pneumonia (CAP) is one of the major causes of morbidity and mortality worldwide. The early recognition of patients at risk of severe disease and poor outcomes is of critical importance. Inflammatory and coagulation biomarkers, including C-reactive protein (CRP) and D-dimer, may play a role in the prediction of severity and prognosis of the disease.

Objective: To evaluate the role of CRP and D-dimer as predictors of clinical characteristics and outcomes in patients with CAP.

Methodology: A cross-sectional analytical study was conducted among 230 CAP patients in a tertiary care hospital in Peshawar, Pakistan, from January to December 2022. The data collected included clinical, demographic, and laboratory data such as CRP and D-dimer levels. The study also included the associations of these biomarkers with the severity of the disease, radiological involvement, ICU admission, length of stay in the hospital, and mortality using SPSS version 26.

Results: The mean values of CRP and D-dimer were 82.6 ± 38.8 mg/L and 1.34 ± 0.82 mg/L, respectively. These two markers were observed to rise with disease severity, bilateral lung involvement, ICU admission, prolonged hospital stay, and mortality (p < 0.001). It is evident that increased values of these two markers were associated with worse outcomes in CAP patients.

Conclusion: The use of CRP and D-dimer as biomarkers for the prediction of the severity of the disease and the outcome of the patients with CAP is significant. Future studies are suggested for the validation of the findings.

Association between ABO Blood Groups and Clinical Characteristics, Severity, and Outcomes of COVID-19 Patients

2026-05-03T06:54:56+00:00

Background:
COVID-19, caused by SARS-CoV-2, presents a wide spectrum of clinical manifestations and severity, from asymptomatic infection to severe illness and death. Various host factors, such as age, comorbidities, and genetic factors such as blood group, may affect susceptibility and outcomes of patients. Elucidating the relationship between blood groups and COVID-19 may help in identifying patients who are at increased risk for severe outcomes.

Objective:
To find out the association between ABO blood groups and the clinical characteristics, severity, and outcomes of COVID-19 patients.

Methodology:
The study was designed as a hospital-based cross-sectional study in which 180 confirmed COVID-19 cases and their blood groups were identified among adults admitted to a tertiary care hospital in Peshawar. Data was analyzed using SPSS software version 26.0.

Results:
The mean age of the study population was 48.5 ± 15.1 years, and 60% were males. The distribution of the blood groups was B (35%), O (30%), A (25%), and AB (10%). Dyspnea was more common in blood groups A (71.1%) and AB (72.2%) than O (42.5%, p=0.05). Hypertension was more common in group A (51.1%, p=0.04). ICU admission was more common in AB (33.3%), A (24.4%), and O (12.9%, p=0.05). Mechanical ventilation was necessary for 17.7% of A, 16.6% of AB, and 12.9% of O (p=0.04). Higher mortality was observed in AB (22.2%) and A (17.7%) than O (7.4%), but it was statistically insignificant (p=0.07).

Conclusion:
ABO blood groups have been found to be associated with the severity and outcome of COVID-19. Blood groups A and AB have a poor outcome, while blood group O has a protective effect. ABO blood grouping may be a useful tool for the management of COVID-19.

Assessment of Sleep Quality and Prevalence of Obstructive Sleep Apnea in Patients with Chronic Obstructive Pulmonary Disease

2026-05-15T11:36:58+00:00

Background: Chronic obstructive pulmonary disease (COPD) is commonly accompanied by sleep disturbances and obstructive sleep apnea (OSA), which have a negative impact on quality of life, symptom burden, and clinical outcomes. There are, however, limited local data on sleep quality and the prevalence of OSA in patients with COPD.

Objective: To assess sleep quality and determine the prevalence of obstructive sleep apnea among patients with COPD.

Methodology: This descriptive cross sectional study was carried out in the Department of Pulmonology, Liaquat University of Medical and Health Sciences Jamshoro, from June 2023 to May 2024. There were 162 patients with COPD who were included. Diagnosis and classification of COPD were made based on GOLD 2023 classification, which is based on spirometry. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). SPSS version 26 was used to analyze the data.

Results: Mean age of patients was 58.9 ± 10.7 years, and 64.2% were men. One hundred thirteen patients (69.8%) had poor sleep quality (PSQI>5) and 68(42%) patients had OSA. The frequency of mild, moderate and severe OSA was 17.9%, 14.8% and 9.3% patients, respectively. There was a significant relationship between the severity of COPD and sleep quality (p=0.002).

Conclusion: sleep disturbances and OSA are very common in COPD patients, and are associated with greater disease severity, smoking and obesity. Prompt detection and treatment of sleep disorders could enhance clinical responses and patient quality of life within COPD patients.

Artificial Intelligence in Pulmonary Diseases: A New Frontier for Pakistan’s Respiratory Care

2026-03-09T17:22:54+00:00

Artificial intelligence (AI) is significantly advancing the field of pulmonary medicine by improving diagnostic accuracy, supporting clinical decision-making, and enabling more patients to receive respiratory treatments. From different areas of the world, evidence suggests that AI performs better than doctors, such as interpreting pulmonary function tests, classifying interstitial lung disease, detecting tuberculosis on chest X-rays, and identifying lung cancer at an early stage. By applying these technologies in Pakistan, where the burden of respiratory issues is high, they are very helpful to the health system. The AI-powered tools can address problems such as a shortage of specialists, delays in diagnosis, and limited resources, especially in remote areas. Nonetheless, effective adoption will necessitate strict checks on data quality, local population validation, ethical safeguards, and clinician training. If Pakistan adopts AI in a proper manner and creates its own datasets, it will not only be able to provide better respiratory care, tele-pulmonology services that are more widely used, and have a role in the advancement of global digital health innovation.