Narendra K. Narahari

Abstract

Introduction: Diabetes mellitus (DM) and obstructive sleep apnea (OSA) are common disorders that often coexist. OSA may be an under recognized co-morbidity of DM. The purpose of this study is to estimate the proportion of DM patients who are at risk for OSA and describe factors associated with the risk. Material and Methods: An institutional based study from November 2013 to November 2014 included 50 cases of DMthat were significant for modified Berlin questionnaire. All the 50 cases were subjected to thorough clinical examination and routine investigations like complete blood counts (CBC), blood sugar levels, polysomnography, lipid profile, thyroid profile and modified Berlin questionnaire. Results: A total of 50 DM patients were included in the study, out of which 29(58%) were male and 21(42%) were female patients.  Mean age of the patients was 51.52 ± 11.97 years and mean BMI was 30.20 ± 9.41 kg/m2, mean waist circumference was 90.22 ± 7.58 cm and 25(50%) of patients were obese. All those DM patients with significant Berlin questionnaire score underwent an overnight polysomnography to confirm the diagnosis of OSA. It was found that 35(70%) out of 50 patients screened had apnea–hypopnea index (AHI) ? 5. Conclusion: More than half of adults with DM at high risk for OSA, and many may be undiagnosed. In a primary care setting, the modified Berlin Questionnaire is an easily applied screening tool that identifies patients at increased risk of OSA who may benefit from further diagnostic studies and treatment of OSA. All DM patients should be screened with modified Berlin questionnaire. Control of DM and Body mass index will reduce apnea hypopnea index. Keywords: Obstructive Sleep Apnea; Berlin Questionnaire; Diabetes mellitus; Polysomnography.

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Abstract

Background: Cor pulmonale is defined as an alteration in the structure and function of the right ventricle (RV) of the heart caused by a primary disorder of the respiratory system. Pulmonary hypertension is often the common link between lung dysfunction and the heart in cor pulmonale. Right-sided ventricular disease caused by a primary abnormality of the left side of the heart or congenital heart disease is not considered cor pulmonale, but cor pulmonale can develop secondary to a wide variety of cardiopulmonary disease processes. Materials and Methods: Total 102 patients were included in the study with complaints of respiratory symptoms and relevant clinical signs with the aim of studying the commonest respiratory disease leading to cor pulmonale. Results: Out of 102 patients, 85 were males and 17 females; smoking and agricultural pollutants were the common predisposing factors; and the most common disease leading to cor pulmonale was pulmonary tuberculosis with COPD of various etiologies. Conclusions: Cor pulmonale is a state of cardiopulmonary dysfunction that may result from several different etiologies and pathophysiologic mechanisms. The prognosis for a particular patient with corpulmonale is inextricably linked to that of the underlying pulmonary disease or disorder. Long-term treatment and follow-up is required for better survival and better quality of life. Keywords: Cor pulmonale; Chronic obstructive pulmonary disease (COPD); Tuberculosis.

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