ABSTRACT
Introduction: The association between obstructive sleep apnea (OSA) and insomnia is relatively common but is underrecognized. There are important diagnostic and therapeutic implications of comorbid OSA杋nsomnia overlap but there is no data available from India. Objectives: (1) To find out the prevalence of insomnia among patients with OSA; (2) To compare the demographic characteristics, Epworth sleepiness scale (ESS) scores and the presence of comorbidities among patients of OSA with insomnia vs OSA without insomnia. Materials and methods: It was a prospective observational study involving 250 patients with suspected OSA. A total of 189 patients had OSA based on type I polysomnography and were further analyzed. Insomnia was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria. Results: The prevalence of insomnia among OSA was 15.34% (29/189). Overlap was seen in 22.45 and 12.86% of women and men respectively among patients with OSA. The prevalence of overlap increased with decreasing severity of obesity and OSA. Those with OSA杋nsomnia overlap had significantly lower ESS scores as compared to OSA without insomnia (12.31 vs 15.24; p = 0.019). A total of 10.34% (3/29) of patients of overlap had depression whereas none from OSA alone had depression. Conclusion: There is a high prevalence of insomnia among patients with OSA (15.34%), similar to findings worldwide. Insomnia is more common among women with OSA. Overlap patients have lower ESS scores and are likely to be depressed.
ABSTRACT
Introduction: Occupational exposure is an important risk factor for lung cancer in never smokers contributing to 10�% of lung cancers. We conducted this study to evaluate the clinico-radiological and pathological profile of occupational lung cancer among patients of Employees State Insurance (ESI) Hospital, a tertiary care center. Materials and methods: This was a cross-sectional observational study conducted over 6 years on patients diagnosed with lung malignancy at ESI Hospital and Postgraduate Institute of Medical Sciences and Research (PGIMSR), Basai Darapur, New Delhi. The details regarding their clinical history including onset and progress of the disease were interviewed. Also, the details of whole life, past, and present occupational history in a chronological order were recorded for all subjects. Results: Our study included 171 patients with mean age of 58.34 � 11.52 years and 137 (80%) men. About 80.7% of the patients had a smoking history. The most common histological type was adenocarcinoma seen in 35.09%, followed by squamous cell carcinoma (SCC) in 23.39% of patients. About 70.19% (120/171) patients had occupational exposure. The most common exposure was of polycyclic aromatic hydrocarbons (PAH) seen in 24.8% cases. Others being silica, diesel fumes, organic dust, metal fumes, etc. Fourteen patients had occupational exposure alone in the absence of smoking. Those with pure occupational exposure in the absence of smoking had a significantly lower mean age compared to the nonexposed group (52.21 � 11.92 vs 58.65 � 13.93, p-value = 0.017). SCC was significantly more common in the exposed group compared to the nonexposed (37/120 vs 3/51, p-value = 0.0004). Conclusion: Occupational exposure was found in 70.19% of patients with lung cancer. The occupational lung cancer manifests at an early age and is more commonly associated with squamous cell lung cancer compared to nonoccupation-related cancer