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This protocol describes a systematic scoping review of chronic respiratory disease surveys in low/middle-income countries (LMICs) undertaken as part of the Four Country ChrOnic Respiratory Disease (4CCORD) study within the National Institute for Health Research Global Health Research Unit on Respiratory Health (RESPIRE). Understanding the prevalence and burden of chronic respiratory disease (CRD) underpins healthcare planning. We will systematically scope the literature to identify existing strategies (definitions/questionnaires/diagnostics/outcomes) used in surveys of CRDs in adults in low-resource settings. We will search MEDLINE, EMBASE, ISI WoS, Global Health and WHO Global Health Library [search terms: prevalence AND CRD (COPD, asthma) AND LMICs, from 1995], and two reviewers will independently extract data from selected studies onto a piloted customised data extraction form. We will convene a workshop of the multidisciplinary 4CCORD research team with representatives from the RESPIRE partners (Bangladesh, India, Malaysia, Pakistan and Edinburgh) at which the findings of the scoping review will be presented, discussed and interpreted. The findings will inform a future RESPIRE 4CCORD study, which will estimate CRD burden in adults in Asian LMICs.

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Background: Lower heart rate variability has been proven to be associated with a greater risk for developing hypertension among normotensive men, and hypertension is one of the major risk factor of coronary heart disease. Hormonal factors in premenopausal women may cause variance in heart rate variability and impact lipid profile. Objectives: The study was designed to evaluate the relationship of gender and lipid profile with cardiac parasympathetic reactivity. Materials and Methods: Sixty premenopausal and 60 postmenopausal women along with 60 young and 60 elderly, age and body mass index (BMI) matched men without any apparent illness were selected. Cardiac parasympathetic reactivity during Valsalva maneuver, deep breath test, and 30:15 R-R interval ratios were studied and lipid profile analyzed. Results: Lipid profile showed significant increase in values of total cholesterol, low density lipoprotein (LDL), triglyceride, and significant decrease in high density lipoprotein (HDL) values in younger males when compared with premenopausal females and no difference in these parameters were noticed when comparison was done between elderly males and females. Deep breath test and 30:15 R-R interval ratios showed significant decrease in values in younger males when compared with age matched premenopausal females. Total cholesterol, triglyceride, LDL were negatively correlated with parasympathetic function tests; whereas HDL was positively correlated with parasympathetic function tests. Conclusion: Sex hormone levels may alter the autonomic nervous system response and lipid metabolismand lipids play an important role in modulation of autonomic functions.

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