Sleep is the natural periodic suspension of consciousness during which the powers of the body are recovered. It is a natural periodic state of rest for the mind and body, in which the eyes usually close and consciousness is completely or partially lost so that there is a decrease in bodily movement and responsiveness to external stimuli. Present study was planned to study the sleep patterns in various respiratory diseases at Tertiary care Hospital in India.The present study was conducted in sleep laboratory of the Department of Pulmonary Medicine of a tertiary care hospital that caters to population of diverse groups. Patients after clinical examination and spirometry with post bronchodilator reversibility were categorized into bronchial asthma and COPD. Subsequently polysomnography was done of these patients to study the sleep pattern. Total sleep time appears to be decreased in COPD patients with mean value of 284.3 (± 43.02) minutes, with decreased sleep efficiency of 66.64 % (± 0.074). Study group patients have frequent awakenings with average of 17.73 (± 6.15). They have decreased slow wave sleep (S3 and S4 stages) with mean value for S3 is 2.81% (± 0.68) and for S4 is 6.45% (± 1.64). The mean value for REM sleep in these patients is 12.42% (± 2.72) and that for S1 and S2 is 13.99% (± 4.84) and 64.62% (± 4.72) respectively. Total sleep time appears to be decreased in asthmatic patients with mean value of 299.89 (± 45.17) minutes, with decreased sleep efficiency of 68.38% (± 0.065). Study group patients have frequent awakenings with average of 21.03% (± 7.44). In patients with Asthma & COPD, polysomnography study suggests poor sleep quality characterized by decreased total sleep time, decreased sleep efficiency, frequent awakenings, altered sleep architecture with decreased slow wave sleep and REM sleep.
We report a case in which ARDS was the Presentation of Primary Malignant mixed germ cell tumor of Testis with numerous metastases to lung. We also review the literature for other cases in which ARDS developed as result of neoplastic infiltration in the lung that may be indistinguishable from ARDS from other causes. As potentially Effective chemotherapy for the most commonly involved Neoplasms (i.e. germ cell tumors, leukemia, lymphomas etc.) is available, there is the importance of considering a neoplastic etiology in the differential diagnosis of case of unexplained ARDS. Early accurate diagnosis could result in an improved outcome in these cases.
Obstructive sleep apnea if remains untreated can lead to excessive daytime sleepiness, diminished performance and overall poor quality of life. Factors that increase vulnerability of sleep apnea include age, male sex, obesity, family history, craniofacial abnormalities and certain health behaviors such as alcohol abuse and smoking. Previously diagnosed cases of COPD and bronchial asthma (as per guidelines) having symptoms of obstructive sleep apnea were also included in this study. This present study was planned to study assessing of severity of sleep apnea in obstructive airway diseases patients.The present study was conducted in sleep laboratory of the Department of Pulmonary Medicine of a tertiary care hospital that caters to population of diverse groups. Patients after clinical examination and spirometry with post bronchodilator reversibility were categorized into bronchial asthma and COPD. Subsequently, polysomnography was done of these patients to study the sleep pattern. Amongst patients with COPD, 11 (16.42%) had mild COPD, 26 (38.80%) had moderate COPD, 22 (32.84%) had severe COPD and 08 (11.94%) patients had very severe COPD. 38.71% and 29.03% that is 12 and 09 out of 31 patients had moderate and severe asthma respectively. Again 19.36% and 12.90% that is 06 and 04 patients had mild persistent and intermittent asthma respectively. 17(25.37%) patients of COPD were found to have obstructive sleep apnea and 09 (29.03%) patients of asthma had obstructive sleep apnea. In patients with overlap syndrome had more severe hypercapnia (mean PaCO 48.88 ±0.017), and nocturnal desaturation (mean 85.35% ±0.022) Patients having moderate COPD had severe OSA. Patients having severe asthma had severe OSA with correlation coefficient R = -0.527 with p value <0.001 meaning negative linear correlation between AHI and % FEV1 of predicted of asthma patients.
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