Safwat A.M. Eldaboosy

Abstract

Many systemic and few respiratory (cough, pulmonary embolism) adverse effects follow anabolic agent use. Pulmonary hemorrhage is not considered one among them. We present a case of an adult Saudi male who developed diffuse alveolar hemorrhage (DAH) as a results of the utilization of injectable anabolic steroid hormone replacement therapy. The literature reported only three cases of DAH related to anabolic agent abuse. The patient was presented with acute dyspnea and hemoptysis with diffuse alveolar shadow on chest radiograph. The symptoms promptly resolved with cessation of exposure and recurrent after the reuse. Pulmonary hemorrhage as an acute complication of anabolic agent use must be considered when clinical and radiological findings support it. It’s important to rule out the autoimmune and infectious-related causes before considering it drug-related. Keywords: Testosterone, Diffuse alveolar hemorrhage.

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Abstract

Aim of the study: To assess if the neck circumference (NC) can be used to predict the presence and the severity of obstructive sleep apnea syndrome (OSA) in a group of patients had snoring and witnessed apnea from Almoosa Hospital, Alhasa, Saudi Arabia. Materials and Methods: A retrospective study for patients had snoring and witnessed apnea referred to a sleep lab for the diagnosis of obstructive sleep apnea (OSA) by overnight full polysomnogram from August 2016 to August 2020. Apnea-hypopnea index (AHI) was used to categorize the severity of sleep apnea. Age, sex, neck circumference (NC) body mass index (BMI), comorbidities, and sleep parameters were recorded. Receiver-operating characteristic (ROC) curve was used to assess the ability of NC for the diagnosis of the OSA. Sensitivity and specificity were calculated for different cut-off points. Results: The study included 450 patients who met the inclusion criteria with a mean age 52.5 14.6. The mean NC (cm), and BMI were 39.4 3.1, and 35.2 9.0, respectively. OSA was diagnosed in 378 (84.0%) patients. OSA was more detected among males, those with an increased age, NC, BMI, and among patients had hypertension and type 2 diabetes. The mean BMI was significantly higher among females (p=0.031) while NC was significantly higher among males. Significant positive correlations were detected between both NC and BMI with the severity of OSA. Conclusion: Neck circumference can be used to predict the presence as well as the severity of obstructive sleep apnea in snoring patients. BMI, and male gender are independent predictors. Keywords: Snoring, Neck circumference, Body mass index, Obstructive sleep apnea.

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