Objectives: To evaluate the use of FEV6 and FEV1/FEV6 as an alternative of FVC and FEV1/FVC in determining airways restriction and obstruction. Study Design: Cross sectional Study. Setting: Department of pulmonology, DHQ Hospital Faisalabad. Period: 6 months (January-June, 2017). Material & Methods: Sample size of 250 patients, with 45-80 years of age who can exhale for 6 seconds were included in the study. Reference equations were used to detect lower normal limits (LNL) of FEV6, FVC, FEV1/FEV6 and FEV1/FVC. A person was said to have obstruction if FEV1/FVC was below LNL. We considered a person to have restriction if FVC was below LNL without any obstructive pattern. FEV1/FEV6 and FEV6 sensitivity and specificity were determined from this data. Results: Sensitivity of FEV1/FEV6 was 97.4% while specificity was 85.2%, in case of airway obstruction positive predictive value was 96.5% and negative predictive value was 88.5%. In case of restrictive pattern detected by spirometry a sensitivity of FEV6 was 96.5 % and 85.71 % was specificity 97.6% was PPVs and 80% was NPVs .Values were close to LNL in case when difference was noted between two indexes. Conclusion: Instead of FEV1/FVC, FEV1/FEV6 can be used for diagnosing airway obstruction, particularly for screening population having high risk for COPD. For determining restrictive pattern by spirometry FEV6 can also be used instead of FVC by providing less confusing and easier results.

Objective: To determine the frequency of various factors leading to un-controlled asthma in our asthmatics population (> 16 years of age). Study Design: Cross-sectional survey. Setting: Indoor and out-patient clinics of Department of Pulmonology of Jinnah Hospital, Lahore. Duration: Study was carried out over a period of six months from 27-08-2014 to 26-02-2015. Sample Size: Total 120 cases of uncontrolled bronchial asthma were included in this study. Methodology: Total 120 cases of uncontrolled bronchial asthma were included in this study. Upon presentation, each patient was asked for general questionnaire. Results: According to distribution of cases by age, majority of the patients 29.0% were between 21-30 years and minim 11.5% cases were more than 50 years of age with mean age of 33.5±4.1 years. Out of 120 patients, 81 cases (67.5%) were male and remaining 39 patients (32.5%) were female. Regarding factors leading to uncontrolled asthma, 32 (26.6%) patients used alternative medicine, 16 (13.3%) patients used oral medication, 59 (49.1%) patients used inhaler improperly while poor compliance was found to be in 63 (52.5%) patients. Conclusion: Self-monitoring and subsequent treatment adjustment on weekly basis can leads to improved asthma control in patients with uncontrolled asthma at baseline.