Pulmonary Function Tests are a broad range of tests which measure how well the lungs take in and exhale air and how efficiently they transfer oxygen into the blood. These tests are offered by the department in an out-patient basis. To make an appointment for PFT, Please call 10663

PFT include the following procedures:

• Spirometry: A person performs the test by breathing in to the mouthpiece that is connected to an instrument called “spirometer”. The spirometer records the amount of air and rate of air that is breathed in and out over a specified time. Some of the measurements are obtained by normal, quiet breathing, and other tests require forced inhalation or exhalation after a deep breath.

• Lung Volume: Lung volume is measured when a person breathes helium gas through a tube for a specified period of time. The concentration of the gas in a chamber attached to the tube is measured, allowing estimation of the lung volume.

• Diffusion Capacity: The diffusion capacity is measured when a person breathes carbon monoxide for a very short time (often one breath).The concentration of the amount of gas in the amount of carbon monoxide inhaled and the amount exhaled allows estimation of how rapidly gas can travel from the lungs into the bloom.

How to prepare for the test: Do not smoke for 4 to 6 hours prior to the test.

How the test will feel: Since the test involves some forced breathing and rapid breathing, some temporary shortness of breath or lightheadedness may be experienced.

Bronchoscopy is offered by the department on an out-patient basis, as well as for in-patients. The procedure is provided in the Endoscopy Unit, located on level-8 of the main building. After the procedure, the patient can rest for a few hours in the hospital’s Day Care Unit. Patients can resume daily activities within a few hours of the procedures.

What is Bronchoscopy?

Bronchoscopy is a procedure that allows the doctor to examine a patient’s throat, larynx, trachea, and airway through a thin viewing instrument called a “bronchoscope”. Bronchoscopy may be done to diagnose problems with the airway, the lungs, or with the lymph nodes in the chest, or to treat problems such as an object or growth in the airway.

Preparation for Bronchoscopy

Do not eat or drink anything 6 – 12 hours before the test. The doctor may also advice the patient to avoid any aspirin, ibuprofen, or other blood-thinning drugs before the procedure.

During Bronchoscopy

During bronchoscopy, the patient is asked to lie down on his/her back. Local anaesthesia is given to relax the throat muscles. The bronchoscope is then passed through the patient’s mouth or nose, through the windpipe (trachea), and then into the lungs. Until the anaesthesia begins to work, patient may feel fluid running down the back of the throat and have the need to cough or gag. Once the anaesthesia takes effect, patient may have sensations of pressure or mild tugging as the tube moves through the windpipe (trachea). Please note that there is NO risk of suffocation. If the patient coughs during the exam, more anaesthesia will be given.

The tiny camera at the tip of the bronchoscope transmits images of the respiratory tract to a video monitor for the doctor to examine. If abnormalities are found in the respiratory tract, the doctor may record images for later examination. The doctor can also insert instruments through the channel to take tissue samples (biopsies) or remove polyps or foreign objects, guided by images on the monitor. After the examination, the bronchoscope is slowly retracted back through the same channel.

After Bronchoscopy

After Bronchoscopy, the patient will be taken to our Day Care Unit (opposite the Endoscopy/Bronchoscopy Unit) to rest. Patient may stay at this unit for an hour or so, depending on his/her situation. This allows the health care team to monitor the patient as the sedative begins to wear off. After the sedative wears off, the throat may feel scratchy. The cough reflex will return in 1 – 2 hours. The patient will not be allowed to eat or drink until his/her cough reflex returns.

Once at home, the patient may experience sore throat, cough and hoarseness for the first few days. The patient should rest for the rest of the day and take it easy during the first few days. The doctor should be called right away if the patient develops a fever, has chest pain or trouble breathing, or coughs up more than a few tablespoons of blood.

Broncho Provocation Test (BPT) diagnoses asthma or confirms diagnosis, determines the relative risk of developing asthma, assesses the severity of asthma, as well as the response to asthma therapy. BPT is performed in level-2 Respiratory Centre Procedure Room under purview and supervision of Senior Consultant. This test can be performed any time of the working day with pre-scheduled appointment. If any patient performs this test before 1:00 pm, the report can be delivered on the same day by 5:00 pm.

Why is BPT Important?

Asthma is a common respiratory illness in both adults and children. Many asthmatic patients suffer from asthma attacks, particularly during winter, during exercise, or on exposure to allergens. In between the asthma attacks, a patient may be absolutely normal and the commonly performed tests are normal. Thus, sometimes, a patient may remain undiagnosed, and suffer from long-term consequences of misdiagnosis.

• Broncho-provocation tests most often are considered when asthma is a serious possibility and traditional methods, most notably spirometry performed before and after administration of a bronchodilator, have not established or eliminated the diagnosis. These tests using pharmacological agents are also alternative to exercise or hyperventilation to identify pts with Exercise-induced asthma.
• Broncho-provocation test (BPT) is also valuable in excluding a diagnosis of asthma when the diagnosis is in doubt.
• These tests are also useful in excluding a diagnosis of asthma, particularly in those who are engaged in high-risk occupational tasks and environmental or pollution exposure.
• It is also a valuable tool in the evaluation of occupational asthma.
• It is sometimes used to determine the relative risk of developing asthma, assess the severity of asthma, and assess the response to asthma therapy, because improvement in clinical severity of asthma is associated with improvement in airway responsiveness.
• A positive broncho-provocation test (BPT) has also been reported as a predictor of persistent asthma and airflow limitation in adulthood. These significant applications of BPT make them a requirement and in many instances a gold standard, in the evaluation of asthma.

QuantiFERON TB Gold Test (QFT), introduced by Evercare for the first time in Bangladesh, diagnoses tuberculosis. QFT is a whole-blood test for detection of infection to the pathogenic bacteria M. tuberculosis, as occurs in active tuberculosis (TB) and latent tuberculosis infection (LTBI). If not detected and treated, LTBI may later develop into TB disease.

The QFT measures the patient’s cell-mediated immune reactivity to M. tuberculosis, the bacterium that causes TB. Blood samples are mixed with TB antigens and incubated for 16 to 24 hours. The antigens include ESAT-6 and CFP-10, proteins specific to M. tuberculosis complex. These antigens are not found in BCG strains or atypical mycobacteria. If the patient is infected with M. tuberculosis, the patient’s lymphocytes will recognize the antigens and release interferon-gamma (IFN-g) in response. The QFT results are based on the amount of IFN-g that is released. Additional tests (such and chest radiograph) are needed to exclude TB disease and confirm the diagnosis of LTBI. Results of the test are available within 10 days of deposit of blood samples.

The advantages of QuantiFERON TB Gold Test are:

1. More likely to be positive with active TB disease than the tuberculin skin test (TST), which is more sensitive
2. Less likely to be positive in patients with past exposure to BCG or atypical mycobacteria and contains no TB risk factors, i.e. it is more specific
3. Only needs a single patient visit; no return visit is required to determine the result as in TST
4. Does not cause the booster phenomenon which can happen with repeat tuberculin skin test (TST)
5. Less subjective to reader bias and error when compared to the TST
6. Results are not known to be affected by past TST