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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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BACKGROUND: Obstructive sleep apnea (OSA) often results in a wide range of psychological symptoms. The relationship of depressive disorders and depressive symptoms with body mass index (BMI) and severity of sleep apnea were the subject of numerous studies; results, however, were inconclusive in the majority of studies. Keeping this in view, we studied the correlates of depressive symptoms in patients with OSA. Relationships between BMI and depressive symptoms in patients with OSA. METHODS: We performed polysomnography (PSG) studies of patients that were referred from various subspecialty clinics from July 2011 to August 2013. Ninety-five women and 87 men (total 182) diagnosed with OSA were reviewed for the presence of depressive symptoms and degree of sleepiness using the Epworth Sleepiness Scale (ESS) scores Hamilton Depression Rating Scale (HAM-D). Moreover, Mini-International Neuropsychiatric Interview Scale was applied at the time of PSG. This was followed by application of standard methods of statistical analysis. RESULTS: Our sample included 27 (42.6%) men and 20 (57.4%) women, with a mean age of 58.60 ± 14.75 years. Women (61.6 ± 10.0) had a mean age significantly more (P = 0.011) than that of men (54.0 ± 13.0). BMI has a statistical significant correlation with apnea-hypopnea index (correlation is significant at the 0.05 level [two-tailed]), ESS (correlation is significant at the 0.05 level [two-tailed]), and HAM-D (correlation is significant at the 0.01 level [two-tailed]). CONCLUSION: Depressive symptoms are more common and more severe in women with OSA than in men. There is definite relationship between BMI and depressive symptoms in patients with OSA. There is no causal relationship between OSA and depressive symptoms in the population studied.
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Bronchoalveolar carcinoma presenting as non-resolving consolidation is an uncommon presentation. The typical presentation of bronchoalveolar carcinoma is asymptomatic (solitary nodule) and remains without symptoms even as disease disseminates. We report a case of bronchoalveolar carcinoma presenting as non-resolving consolidation in a young male with productive cough, exertional breathlessness and physical examination revealing the features of right lower consolidation on x-ray chest, with subsequent CT of the chest and bronchoscopic examination revealed bronchoalveolar carcinoma. Patient had a good score and was managed conservatively.
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First-degree heart block is a common electrocardiographic manifestation of acute rheumatic fever and is included in Jones' diagnostic criteria. Other electrocardiographic changes such as sinus tachycardia, bundle branch blocks. nonspecific ST-T wave changes, atrial and ventricular premature complexes have been reported with variable frequency. However, complete heart block is an exceptionally rare manifestation of acute rheumatic fever. We report the clinical course of a 16-year-old boy with acute rheumatic fever who had prolonged P-R interval in the electrocardiogram on admission which subsequently progressed to complete heart block. The patient regained normal sinus rhythm within a few minutes without any pharmacologic or electrical intervention.