Study population: Patients diagnosed with concomitant diagnosis of Allergic Rhinitis (According to ARIA guidelines) and Bronchial Asthma (according to GINA guidelines), randomly allocated to the following intervention groups.

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of disease and mortality worldwide. In individuals with mild-to-moderate COPD, serum C-reactive Protein (CRP) corresponds with disease severity and poor health outcomes. Mean Platelet Volume (MPV) is also linked to an elevated degree of inflammation in the body, as well as the severity and acute exacerbation of COPD. Aim: To evaluate the relationship between serum CRP levels and MPV and its association with COPD disease severity and the patient’s cardiac abnormality. Materials and Methods: A cross-sectional study was conducted in the Department of Respiratory Medicine, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India, between January 2015 and January 2016. Study was carried out among 55 patients who were diagnosed with COPD in accordance with Global Initiative for Chronic Obstructive Lung Disease 2014 (GOLD) and who were within the age range of 40-70 years were included in the investigation. Severity of airflow obstruction was confirmed by Spirometry using True Flow Easy on PC sensor Pulmonary Function Test (PFT) machine with bronchodilator reversibility testing, as per Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines 2014 and abnormality was evaluated by clinical and radiological assessment. A 3 mL of blood was collected into a clot vial and sent for analysis of CRP using an immunoassay system based on antigen-antibody reaction and fluorescence technology and MPV using the impedance count technique. Receiver Operating Characteristic (ROC) curve was used to find out the sensitivity and specificity of MPV and CRP levels with cardiac abnormality. The study was statistically analysed by Pearson’s Chi-square test. Results: Out of total sample, majority (n=25, 45.5%) were between 51-60 years age group and, there were 35 (63.63%) males and 20 (36.37%) females. The mean CRP levels of mild COPD patients were found to be 6.980±0.7328 mg/dL, moderate and severe COPD patients were found to be 7.243±0.5324 mg/ dL and 7.550±0.4950 mg/dL, respectively and it was statistically significant (p-value <0.0001). In the present study, the mean CRP levels and mean MPV were found to be significantly higher in patients with cardiac abnormality than the patients without cardiac abnormality (p-value <0.0001). Conclusion: Finally, it was concluded that systemic inflammation is common in COPD patients and that CRP and MPV are significant COPD biomarkers for assessing disease severity, predicting cardiac abnormalities, and predicting patient prognosis.

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To study the ECG and Echocardiographic (ECHO) abnormalities in patients of COPD, and its correlation with spirometric severity To study the levels of systemic inflammatory markers-C-Reactive protein (CRP) and Mean Platelet Volume (MPV) and its correlation with spirometric severity. To study the correlation between inflammatory markers (CRP & MPV) and cardiac abnormalities (ECG& ECHO).

BACKGROUND Globally, around 300 million people suffer from Bronchial asthma, the prevalence of which is predicted to increase in the ensuing decades. Prevalence rates range from 4-18% worldwide with around 2.05-3.5% reported in India. In spite of availability of updated guidelines from GINA & recent therapeutic advances, asthma control is still not being achieved in a significant proportion of patients. Uncontrolled asthma is associated with greater exacerbations, poorer quality of life & higher mortality which lead to considerable socioeconomic burden and emotional stress for patients and their families. The complex interaction of several variables including patient and disease related factors play a role in poor asthma control. Limited Indian studies especially in the South are available to assess the prevalence and risk factors of uncontrolled asthma. Hence, the present study was undertaken to enable recognition of modifiable risk factors in uncontrolled asthma which could serve as a platform to plan suitable interventions to achieve optimum asthma control. We wanted to estimate the prevalence of uncontrolled asthma among adult asthma patients and assess the risk factors associated with uncontrolled asthma. METHODS This is a cross sectional observational study. Adults with a diagnosis of asthma (Global Initiative of Asthma-GINA guidelines) for a duration of at least 1 year were administered validated & piloted questionnaire by telephonic interview or physical visit to assess demographic data, risk factors & level of control of asthma. Data was analysed using SPSS 20.0. Quantitative data expressed in Mean & SD. Unpaired T test & Chi square test to assess association of continuous & dichotomous variables. RESULTS A total of 110 asthmatics (M:F=59:51) with a mean age 35.25 ± 12.34 years and mean BMI 25.75 ± 3.80 were included in the study. Well controlled, partly controlled and uncontrolled asthma were 11.8%, 39.1% & 49.1% respectively. Risk factors associated with uncontrolled asthma were elderly, obesity, smoking, pollution & GERD. CONCLUSIONS Asthma control in the majority was uncontrolled. Increasing age, obesity, smoking & GERD were risk factors significantly associated with poor asthma control.