Pakistan Journal of Chest Medicine

Occupational Exposure and Associated Respiratory Diseases in Patients Presenting to a Tertiary Care Hospital in Peshawar

Safia Khanam — 2026-03-02

Background: Occupational exposure to dust, fumes, gases, and chemical substances is an important cause of respiratory diseases across the world, especially in developing countries. Workers in industries such as construction, mining, agriculture, and textiles are at an increased risk of suffering from occupational respiratory diseases.

Objective: To assess occupational exposure and its association with respiratory diseases among patients presenting to a tertiary care hospital in Peshawar.

Methodology: A cross-sectional descriptive study was conducted in the Department of Pulmonology, Lady Reading Hospital, Peshawar from January to December 2024. In the present study, a structured questionnaire was used for collecting demographic information, occupational history, type of exposure, and duration of exposure. The study also involved clinical evaluation and investigations such as chest X-ray, spirometry, sputum examination, and CT scans for diagnosis.

Results: The highest percentage of participants was exposed to silica/cement dust (31.2%), followed by textile dust (17.5%) and coal dust (16.2%). Chronic obstructive pulmonary disease (COPD) was the most common respiratory disease observed (33.7%), followed by occupational asthma (22.5%), pneumoconiosis/silicosis (17.5%), hypersensitivity pneumonitis (12.5%), and other chronic respiratory diseases (13.7%).

Conclusion: Occupational exposure to dust, fumes, and chemical substances were the major factors that influences the occurrence of respiratory diseases. COPD and occupational asthma were the most common issues. It is necessary to strengthen the measures for ensuring occupational safety, the use of personal protective equipment, and the implementation of health screening programs to combat respiratory diseases.

Preserved Ratio Impaired Spirometry (PRISm) in Mardan: A Retrospective Prevalence Study of Spirometric Patterns and Associated Comorbidities

Nabi Rahman — 2026-03-02

Background: Preserved Ratio Impaired Spirometry (PRISm) is a unique form of spirometric abnormality that is defined as reduced FEV? (<80% predicted) with a preserved FEV?/FVC ratio of ?0.70. Unlike obstructive and restrictive lung disorders, PRISm is increasingly being recognized as a clinically relevant condition that is linked with respiratory symptoms, metabolic syndrome, cardiovascular disease, and increased mortality.

Objective: To determine the prevalence of PRISm among adults undergoing spirometry and to find out its relationship with demographic and comorbid factors.

Methodology: A retrospective study design was used to examine 180 spirometric results from adult patients (?18 years old) in a tertiary care hospital in Peshawar from January 2023 to December 2024. The variables collected for analysis were age, gender, BMI, smoking status, comorbidities, and spirometric values. PRISm was defined as FEV1 <80% predicted with FEV1/FVC ?0.70.

Results: Out of 180 patients, the mean age was 46.7 ± 13.2 years, and 52.2% of them were males. PRISm prevalence was 15.5% (n=28), normal spirometry 51.6% (n=93), and obstructive pattern 32.7% (n=59). PRISm patients had significantly decreased FVC (72.5 ± 6.7%) compared with normal and obstructive patients (p<0.001). PRISm was significantly associated with hypertension (39.2% vs. 21.7%, p=0.024), diabetes mellitus (35.7% vs. 17.7%, p=0.037), and cardiovascular disease (25% vs. 9.8%, p=0.024), diabetes mellitus, and cardiovascular disease (25% vs. 9.8%, p=0.048).

Conclusion: PRISm is a common intermediate spirometric phenotype within this population and has been linked with many cardiometabolic comorbidities and obesity. It may be beneficial to recognize this within clinical practice in order to potentially prevent the progression of this into pulmonary and systemic disorders.

Assessment of Electrolyte Disturbances in Hospitalized Patients with COVID-19

Nazish Saleem — 2026-03-02

Background: Electrolyte abnormalities are commonly observed among patients admitted for coronavirus disease 2019 (COVID-19). These electrolyte imbalances may affect the severity of COVID-19 infection in patients. This study aimed to evaluate the prevalence of electrolyte imbalances among COVID-19 patients admitted in various hospitals and their possible clinical consequences.

Methods: An observational cross-sectional study was carried out among 130 adult patients admitted with confirmed COVID-19 infection in a tertiary care hospital in Peshawar, Pakistan, between January 2021 and December 2022. Serum levels of sodium, potassium, calcium, and chloride were estimated on admission. The abnormalities of these electrolytes were determined based on standard reference ranges. Data was collected, and patterns of electrolyte abnormalities were observed.

Results: The electrolyte abnormalities were found in 64.7% of patients. The electrolyte abnormalities were found to be hyponatremia in 34.6%, followed by hypocalcemia in 29.2%, and hypokalemia in 25.3%. The electrolyte abnormalities were less frequently observed in the form of hypernatremia and hyperkalemia in 5.3% and 7.6%, respectively. The electrolyte abnormalities were associated with comorbid conditions such as hypertension and diabetes mellitus. The electrolyte abnormalities were associated with severe disease and longer hospitalization.

Conclusion: Electrolyte abnormalities like hyponatremia, hypocalcemia, and hypokalemia are commonly observed among hospitalized COVID-19 patients. These electrolyte imbalances are linked with increased severity and worsening outcomes among COVID-19 patients. Therefore, early recognition and management of these electrolyte imbalances are essential for improving the care and prognosis of COVID-19 patients.

Artificial Intelligence in Pulmonary Diseases: A New Frontier for Pakistan’s Respiratory Care

Zia Ullah — 2026-05-01

Artificial intelligence (AI) is significantly advancing the field of pulmonary medicine by improving diagnostic accuracy, supporting clinical decision-making, and enabling more patients to receive respiratory treatments. From different areas of the world, evidence suggests that AI performs better than doctors, such as interpreting pulmonary function tests, classifying interstitial lung disease, detecting tuberculosis on chest X-rays, and identifying lung cancer at an early stage. By applying these technologies in Pakistan, where the burden of respiratory issues is high, they are very helpful to the health system. The AI-powered tools can address problems such as a shortage of specialists, delays in diagnosis, and limited resources, especially in remote areas. Nonetheless, effective adoption will necessitate strict checks on data quality, local population validation, ethical safeguards, and clinician training. If Pakistan adopts AI in a proper manner and creates its own datasets, it will not only be able to provide better respiratory care, tele-pulmonology services that are more widely used, and have a role in the advancement of global digital health innovation.