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IntroductionIn obstructive sleep apnea ( OSA), there is increased oxidative stress. Aim of this workThis study aimed to examine the effect of continuous positive airway pressure (CPAP) on oxidative stress occurring in OSA. Participants and methodsThe present study was carried out on 40 individuals classifi ed into four groups: group I included 10 control participants, group II included 10 obese individuals without OSA, group III included 10 patients with mild to moderate OSA, and group IV included 10 patients with severe OSA. Sleep study was carried out, and Thiobarbituric acid-reactive substance and superoxide dismutase enzyme were measured. ResultsThiobarbituric acid-reactive substance was signifi cantly increased, but superoxide dismutase was signifi cantly decreased in group IV, and CPAP led to an improvement in this condition. ConclusionOSA leads to increased oxidative stress that improved with the use of CPAP.

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There is a link between obesity and both, asthma and COPD. Aim of the work: To study effect of weight reduction on pulmonary function tests of obese COPD and bronchial asthma patients.Subjects and methods: 2 groups were included, group(G)I, 30 obese COPD and GII 30 obese bronchial asthma patients. Pulmonary function tests were done to all participants before and after weight reduction.Results: GI showed increased FRC, ERV and RV significantly, IC was significantly decreased and GII showed increased FEV 1 , FVC, FEV 1 /FVC, PEFR, FEF 25-75% and ERV significantly after weight reduction.Conclusion: Weight reduction improved airway obstruction, increased ERV, RV, FRC and DLCO either significant or insignificant in asthma and COPD.

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Many traditional scores such as sequential organ failure assessment score (SOFA score) are used in the ICU to predict outcome and mortality in mechanically ventilated patients with acute respiratory failure. But new simplified parameter now, is used such as oxygen index (OI). Other authors add PEEP to the PaO 2 /FiO 2 ratio called PaFip which is calculated according to the equation = Ln [(PaO 2 /FiO 2 )/(PEEP + 12)] (Ln is the natural logarithm) and used it as an outcome predictor. Aim of the work: is to evaluate the values of oxygen index, PaFip and SOFA score as early predictors of outcome of patients with acute respiratory failure caused by severe CAP who underwent invasive mechanical ventilation. Subjects and methods: this study was carried out on 40 patients with acute respiratory failure due to severe community acquired pneumonia (CAP) who were mechanically ventilated and divided into 2 groups, GI: included 18 non-survivors and GII: included 22 survivors. All patients were subjected to full history and clinical examination, plain X-ray chest and culture and sensitivity of tracheal aspirate. 4 hours after the onset of mechanical ventilation: ABG, measurement of mean airway pressure, calculation of oxygen index, measurement of extrinsic PEEP and calculation of PaFip were done. Results: The SOFA score, PaFip, OI, PaO 2 /FiO 2 and PaO 2 were related to mortality in patients on mechanical ventilation due to acute respiratory failure caused by severe community acquired pneumonia. The SOFA score was the parameter most closely related to mortality (P = 0.00I) followed by PaFip (P = 0.006) and PaO 2 /FiO 2 (P = 0.008) while PaO 2 and OI were the parameters detecting mortality the least (P = 0.020 & 0.025, respectively). Conclusion: PaFip is nearly equal to the SOFA score as an early outcome predictor for mechanically ventilated patients while the value of oxygen index as early outcome predictor is less than the above 2 parameters.

Background: Obstructive sleep apnea (OSA) has been independently associated with cardiovascular diseases, including hypertension, coronary heart disease and heart failure. Also, it had a deleterious impact on renal function and a link to diabetes mellitus (DM) and insulin resistance. Resistin is new adipokine and may play a role in cardiac, diabetics and renal patients.Aim of the work: The aim of this work is screening of cardiac dysfunction, DM and renal impairment in OSA patients and to study the role of resistin serum level in occurrence of these complications.Subjects and methods: This study was carried out on 10 control persons (group I) and 143 patients with OSA (group II). The following were done to all persons: body mass index (BMI), blood pressure measurement, fasting and post prandial blood sugar levels, serum creatinine and ECG, diagnostic sleep study, echocardiogram, estimated glomerular filtration rate (eGFR) and serum resistin assay. According to the above results, group II was divided into 4 subgroups, A (33OSAS patients), B (21 OSAS patients with cardiac troubles), C (40 OSAS patients with DM) and D (13 OSAS patients with renal impairment). 36 OSAS patients were excluded from the study because they had either 2 or more of the above abnormalities (cardiac, DM and renal).Conclusion: OSA patients can be complicated with cardiac diseases, DM and renal impairment through elevated resistin serum levels.Recommendation: Effect of CPAP on resistin serum level must be evaluated in these patients.