الفهرس 
CHRONIC OBSTRUCTIVE PULMONARY DISEASEOnly 14 pages are availabe for public view
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Abstract
C
hronic obstructive pulmonary disease (COPD) is a disease state characterized by progressive airflow limitation, and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases, primarily caused by cigarettes smoking.
Chronic obstructive pulmonary disease (COPD) is common cause of morbidity and mortality worldwide. One third of patients detected using case finding approaches in primary care settings are asymptomatic or have mild symptoms.
Under diagnosis of COPD is serious problem in many countries world-wide because there are no generally detection tools available to detect high-risk patients for spirometry and patients will not go for COPD check-up until a serious issue happens like exacerbation.
The present study was conducted upon 500 subjects during the period from March 2018 to August 2018 who admitted to our Chest Department or visit our outpatient clinic, employees and visitors to Ain Sham Hospitals.
Type of Study: cross sectional study.
Study Setting: Ain Shams University Hospitals.
Study Period: six months starting from March 2018.
Study Population: Outpatients and Inpatients at the department of Chest Diseases in Ain Shams University Hospitals.
The study population was subjected to
1. Full detailed history including: age, sex, occupation, residency marital state and full medical history,
2. Modified PUMA score is a simple questionnaire that include six variables: sex, age, pack- years smoking, shortness of breath, expectoration and cough, it was provided to at- risk subjects –defined more than 40 years, current or ex-smoker (≥10 pack –years or ≥ 50 pipes per year or ≥ 50 cigar per year). At- risk subjects with a score of more than or equal 5 were considerd as high-risk and spirometry should be performed to confirm or rule out diagnosis.
3. Spirometry.
The results showed that there was significant relationship between modified puma score and each of the following: (age, smoking index, cough, expectoration and dyspnea) and highly significant relationship between age and smoking index with degree of the severity of obstruction by spirometry while no significant relationship between modified puma score and sex.
In our study we enrolled 500 subjects on which questionnaire applied. 152 of them had score ˂ 5 by percentage 30.4%and 348 of them had score ≥5 with percentage 69.6 % those considered had high risk to develop COPD that is why spirometry was done for them.
Of this group 81 subjects were found to have COPD by spirometry (FEV1̸ FVC ˂.7) with percentage 23.3%.
And the percentage of COPD from the total screened number (500subjects) was 16.2 of the total number included in the study so the incidence of final diagnosis of COPD cases by spirometry was 23%.