The burden of chronic respiratory Diseases that affect both adults and children is constantly increasing globally[1]. The mortality and morbidity reason for respiratory Infections is indistinct; nonetheless, on-going measurements distributed by WHO and other agencies found a gauge of around 400 million individuals all over the planet are enduring with mild to moderate circumstances Asthma and COPD alone Chronic respiratory Diseases affect the airways and other structures of the lungs. Some of the most common are chronic obstructive pulmonary Diseases (COPD), asthma, occupational lung Diseases, bronchictesis, pulmonary hypertension. In addition to tobacco smoke, other risk factors include air pollution, occupational chemicals and dusts, and frequent lower respiratory infections during childhood. CHRONIC RESPIRATORY DISEASES are not curable; however, various forms of treatment that help open the air passages and improve shortness of breath can help control symptoms and improve daily life for people living with these conditions[2]. Chronic respiratory Diseases are Diseases of the airways and other structures of the lung,1 and are among the leading causes of morbidity and mortality worldwide[3-5]. Some of the most common chronic respiratory Diseases are asthma, chronic obstructive pulmonary DISEASES (COPD), and occupational lung Diseases. These Diseases entities are important contributors to the rising burden of non-communicable Diseases (NCDs) globally. [6]

The WHO Worldwide Union against Persistent Respiratory Sicknesses was laid out determined to decrease the weight of constant respiratory Sicknesses, towards a world wherein all individuals inhale openly, and centers around the requirements of individuals with ongoing respiratory Illnesses in low-pay and center pay countries.3 Hazard factors for persistent respiratory Sicknesses are normal: something like 2 billion individuals are presented to the poisonous impacts of biomass fuel use, 1 billion are presented to open air contamination, and 1 billion are smokers who uncover a close equivalent greatness of individuals to the evil impacts of recycled smoke[7]. Every year, it is assessed that 4 million individuals bite the dust rashly from constant respiratory Diseases.5 Albeit word-related respiratory circumstances are a very much described risk factor, their extent is badly characterized; based on the couple of investigations that exist, around 2 million business related passings every year are assessed to happen in light of business related openings pertinent to respiratory circumstances[8].

Study Design: Observational Study.

SAMPLE SIZE: Minimum 200

Calculated using - The adequate required sample size was estimated using the following formula–

n = z2pq / d2

where –

               n = sample size

               z = 1.96 (considering 0.05 alpha, 95% confidence limits and 80% beta)

               p = assumed probability of occurrence or concordance of results

               q = 1 – p

               d = marginal error (precession)

               We took the patient from OPD basis in the Department of Respiratory Medicine School Of Excellence in Pulmonary Medicine NSCB MC.  Jabalpur M.P India in chronic respiratory Diseases patients who fulfilled the study criteria were included. The patients were included. They were subjected to detailed history-taking.

• The study participants shall be enrolled under study as per inclusion and exclusion criteria
• Detailed history and physical examination shall be done and findings shall be recorded in the Data collection form

Inclusion Criteria: Patients who were previously diagnosed with/chronic respiratory diseases based on clinical features and spirometry blood investigation in the Department of Respiratory Medicine in the School of Excellence in Pulmonary Medicine who visited OPD will included in the study.

Exclusion Criteria:

1. Acute exacerbations COPD, asthma Bronchiectasis.
2. Connective Tissue Disorder
3. Sepsis

STATICAL ANALYSIS

The present study is carried out in the School of Excellence Pulmonary Medicine Netaji Subash Chandra Bose Medical College & Hospital, Jabalpur, (M.P). from August  2022   to  Feb  2024.

Table 01: Age Distribution

The chi-square statistic is 5.7802. The p-value is .016208. The result is significant at p < .05. In the current study moderate obstruction (91%), severe (9%), mild, and very severe obstruction (0%) patients were found.

Table 02: FEV1

The chi-square statistic is 64.7902. The p-value is .046511. The result is significant at p < .05. In the current study moderate obstruction (91%), severe (9%), mild, and very severe obstruction (0%) patients were found.

Table 03: FEF25-75%

The chi-square statistic is 4.1568. The p-value is .041467. The result is significant at p < .05.

Table 04: MMRC

The chi-square statistic is 92.0066. The p-value is < .00001. The result is significant at p < .05.

Table 05: spo2

The chi-square statistic is 89.6828. The p-value is .049801. The result is significant at p < .05. The distribution of patients across different SpO₂ categories was statistically significant (p < 0.05), indicating a non-random variation in oxygen saturation levels among the study population.

Table 06: Blood urea

The chi-square statistic is 3.5198. The p-value is .040638. The result is significant at p < .05. Blood urea levels showed a statistically significant distribution (p < 0.05), with the majority of patients having values between 40–100 mg/dL, suggesting preserved renal function in most participants.

In the present study total of 200 cases of COPD were enrolled from August  2022 to February 2024. patients who are previously diagnosed with chronic respiratory diseases based on clinical features, spirometry, and blood investigation in the Department of Respiratory Medicine in the School of Excellence in Pulmonary Medicine (sepm), Netaji Subhash Chandra Bose Medical College  & Hospital, Jabalpur (M.P) after taking ethical clearance from Institutional  Ethical Committee who visited OPD.

All patient visits in OPD were analyzed with all parameters included in the inclusion criteria. A statistically significant difference (p-value <0.5) was found in age distribution, gender distribution, weight distribution, spirometry parameters, blood investigation, urine analysis, glomerular filtration rate, and creatinine clearance[9-10].

In the present study patient age group was the statical significant difference was found (p-value < 0.5). in the study, the maximum number of cases were in the age group of 50-60 and 60-70 years. the finding was similar to the study which was done by Ibrahim I. Elmahallawy et al 2013 their study included 300 COPD patients matured 65.28 ±6.32 years They were signed up for the review during their subsequent visits to the short-term center of the Chest Division, Menoufiya College Emergency clinics from August 2009 to August 2012. The GFR was assessed and patients were arranged by their renal capability as having typical renal capability (GFR P60 mL/min/1.73 m2), covered CRF (typical serum creatinine and GFR < 60 mL/min/1.73 m2), or clear CRF (expanded serum creatinine and GFR <60 mL/min/1.73 m2) [11].

Spo2 on room air: 88-92% (83.5%), >92% (8.5%), <88% (5%). The majority of patients were determined to be within the normal range, with 5% falling outside of it. The p-value for the statistically significant difference was 0.049801.

In the present study prevalence of irregularity in blood urea was analysed. according to blood urea range <40 mg/dl (37.5%), 40 – 100mg/dl (62%), 100-150mg/dl (0.5%), >150mg/dl (0%). A statical significant difference was present (p-value-<0.05). this study was similar to a study which was done by Mohit Bhatia, J.K. Samaria, Shubham Agarwal, and Pradeep Niral. They evaluated 100 cases of COPD[12].  All included patients were evaluated for renal function with the help of serum urea, serum creatinine, and Glomerular filtration rate estimation using the Cockcroft- Gault formula.  In their study, they found that 36% of patients had raised creatinine levels (>1.2mg/dl) while 48% had raised urea levels (>40mg/dl). 8% of patients had severely reduced GFR, 46 % of patients had a moderate reduction in GFR and only 30% of patients had normal GFR.

patients with obstructive pattern FEV1, 91% in the moderate category and 9% in the severe category was significant in renal dysfunction, and fair relationships were found.

In the current study of spirometry patients with obstructive pattern FEF25-75%, 67.5% of patients were found in the moderate category and 23% in the severe category which is a more significant and fair relationship with renal dysfunction. Serum creatinine estimation of more than 7% of patients found slightly deranged in COPD patients correlate with other parameters which are studied in this study was significant in renal dysfunction. Age distribution in our current study fair association found in age >60yr  with renal dysfunction assessment.

ETHICAL CONSIDERATION

The study obtained approval from the Institutional Ethics Committee. Informed written consent was obtained from all participants prior to enrollment, with adherence to the Declaration of Helsinki principles.

1. Global Initiative for Chronic Obstructive Lung Disease - GOLD [Internet]. [cited 2024 Jun 14]. 2024 GOLD Report. Available from: https://goldcopd.org/2024-gold-report/
2. Celli B, Fabbri L, Criner G, Martinez FJ, Mannino D, Vogelmeier C, et al. Definition and Nomenclature of Chronic Obstructive Pulmonary Disease: Time for Its Revision. Am J Respir Crit Care Med. 206(11):1317–25.
3. Agustí A, Melén E, DeMeo DL, Breyer-Kohansal R, Faner R. Pathogenesis of chronic obstructive pulmonary disease: understanding the contributions of gene–environment interactions across the lifespan. Lancet Respir Med. 2022 May 1;10(5):512–24.
4. Cho MH, Hobbs BD, Silverman EK. Genetics of chronic obstructive pulmonary disease: understanding the pathobiology and heterogeneity of a complex disorder. Lancet Respir Med. 2022 May 1;10(5):485–96.
5. Yang IA, Jenkins CR, Salvi SS. Chronic obstructive pulmonary disease in never-smokers: risk factors, pathogenesis, and implications for prevention and treatment. Lancet Respir Med. 2022 May 1;10(5):497–511.
6. Martinez FJ, Agusti A, Celli BR, Han MK, Allinson JP, Bhatt SP, et al. Treatment Trials in Young Patients with Chronic Obstructive Pulmonary Disease and Pre–Chronic Obstructive Pulmonary Disease Patients: Time to Move Forward. Am J Respir Crit Care Med. 205(3):275–87.
7. Wan ES, Castaldi PJ, Cho MH, Hokanson JE, Regan EA, Make BJ, et al. Epidemiology, genetics, and subtyping of preserved ratio impaired spirometry (PRISm) in COPDGene. Respir Res. 2014;15(1):89.
8. Incalzi RA, Corsonello A, Pedone C, Battaglia S, Paglino G, Bellia V. Chronic Renal Failure: A Neglected Comorbidity of COPD. CHEST. 2010 Apr 1;137(4):831–7.
9. Gershon AS, Wang C, Guan J, Vasilevska-Ristovska J, Cicutto L, To T. Identifying individuals with physcian diagnosed COPD in health administrative databases. COPD. 2009 Oct;6(5):388–94.
10. Cleutjens FAHM, Wouters EFM, Dijkstra JB, Spruit MA, Franssen FME, Vanfleteren LEGW, et al. The COgnitive-Pulmonary Disease (COgnitive-PD) study: protocol of a longitudinal observational comparative study on neuropsychological functioning of patients with COPD. BMJ Open. 2014 Mar 3;4(3):e004495.
11. Suzuki N, Matsuki E, Araumi A, Ashitomi S, Watanabe S, Kudo K, et al. Association among chronic kidney disease, airflow limitation, and mortality in a community-based population: The Yamagata (Takahata) study. Sci Rep. 2020 Mar 27;10(1):5570.
12. Incalzi RA, Corsonello A, Pedone C, Battaglia S, Paglino G, Bellia V. Chronic Renal Failure: A Neglected Comorbidity of COPD. CHEST. 2010 Apr 1;137(4):831–7.