DOI: 10.36347/sjams.2019.v07i01.055

Pages: 303-309

COPD and Bronchial asthma are global public health challenges. COPD is projected to be third leading cause of death by 2030 and asthma represents 1-18% of world’s population. Both of them are underdiagnosed or misdiagnosed in primary care. Their differentiation based on clinical features and other lung function tests besides spirometry has not been well characterised. Hence there is an utmost need to find an additional method for accurate diagnosis and differentiation between the two entities as management and prevention strategies differ for both. This cross sectional observational study was conducted on 50 cases visiting the outpatient department of Government General and Chest Hospital, Erragadda, Hyderabad with an aim to compare bronchodilator reversibility using spirometry with DLCO and to evaluate whether DLCO can be used as additional diagnostic modality to spirometry in diagnosis and differentiation of COPD and asthma. Cases were categorised into objective asthma and COPD based on history, physical examination, radiology and spirometry. All of them were subjected to DLCO single breath testing. Our study group consisted of 84% (42) males,16%(8) females. Men were predominant in COPD and women among asthmatics. Most common age of presentation in COPD was 5th-6th decades and asthma was 3rd - 4th decades. Smoking was more common in COPD 95.8%(23).FEV1 was lower in COPD than asthmatics indicating more severe obstruction in COPD. Bronchial reversibility in asthmatics was significantly higher than in COPD. Low diffusion capacity was more in COPD group (43.40± 19.14) compared to asthmatics (98.80±18.16) with increasing stage of COPD, there was more decline in DLCO with stage 1 COPD DLCO values between 52.60±12.38 and stage 4 between 32.57±17.80 indicating significant impairment with progression of disease.