Congenital lobar emphysema (CLE) is a clinico-radiological diagnosis, seen usually by four-six weeks of age (50% of patients) and rarely (<5% of patients) after the age of six months. Here, we report a young male with gradual onset of mild exertional breathlessness and physical examination revealing the features of right sided pneumothorax. X-ray of chest, with subsequent CT of chest, leads to the diagnosis of CLE. The pulmonary function tests, bronchoscopic examination and α1-antitrypsin level are normal. Patient is managed conservatively.

A 60-year-old man treated for chronic bronchial asthma for more than 5 decades, presented in a debilitated condition. Chest radiography showed mediastinal widening, electrocardiography revealed left anterior hemiblock, magnetic resonance imaging and angiocardiography confirmed double aortic arch. He underwent excision of the anterior arch and release of the trachea and esophagus. Double aortic arch should be considered in the differential diagnosis of chronic asthma when a patient fails to respond to medical treatment.

Background:Obstructive sleep apnea (OSA) often results in a wide range of comorbid conditions, predominantly of the cardiovascular/respiratory, endocrine/metabolic, and neuropsychiatric symptoms. In view of the ambiguity of literature regarding the association between OSA and depression, we conducted this study to show any association between the two disorders.Objective:The aim of the study was to see the association between OSA and depression and to study the prevalence of OSA in patients suffering from depression.Methods:We performed polysomnography (PSG) studies of patients that were referred from various subspecialty clinics from July 2011 to August 2013. Psychiatric diagnosis was done using mini international neuropsychiatric interview plus scale. This was followed by application of Hamilton Depression Rating Scale (HAM-D). Standard methods of statistical analysis were used for data analysis.Results:Out of 182 patients who underwent PSG, 47 were suffering from depression with a mean age significantly more (P < 0.001) than that of other population (58.60 years vs. 53.60 years). In our 47 depressed patients, 44 (93.6%) had abnormal PSG. Based on apnea-hypopnea index score, 3 (6.8%) patients had mild, 18 (40.9%) had moderate, and 23 (52.3%) had severe OSA. The mean HAM-D score was significantly more in depression patients, (17. 35 ± 5.45) as compared to non depressive patents (8.64 ± 6.24) (P = 0.0001).Conclusion:This study demonstrates significant overlap between the sleep apnea and depression. Health specialists need more information about screening for patients with OSA to ensure proper diagnosis and treatment of those with the condition. Most of the clinicians do not suspect this important comorbidity of depression in the beginning resulting in delayed diagnosis.

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