ABSTRACT
Objective: To study the effect of adding body mass index and neck circumference to Epworth Sleepiness Scale [ESS] for diagnosing obstructive sleep apnea hypopnea syndrome in sleep clinics
Study Design: Cross sectional validation study
Place and Duration of Study: Department of Pulmonology, Military Hospital Rawalpindi from 1st July 2013 to 01 September 2014
Material and Methods: The ESS and ESS plus body mass index [BMI] and neck circumference [NC] data was evaluated for 150 patients hospitalized in our hospital for polysomnographic evaluation of obstructive sleep apnea. Overnight polysomnography [PSG] was done for all patients and was considered the gold standard for diagnosis of OSA. ESS Scoring, BMI and NC data was done using pre-designated questionnaire. All the data was analyzed using SPSS version 19
Results: Age ranged from 18-74 years with mean age of the study group 53 [ +/- 12.1 SD] years. Out of study population 87 [58%] were males and 63 [42%] females. In study population 80 [55.3%] patients had ESS >10. while 102 patients had ESS>10 with BMI > 35 kg/m2 and NC>40 cm. Using an AHI >/= 5 for OSA, 136 patients [90.6%] had OSA. Sensitivity of ESS > 10 for OSA was 55.15% but increased to 72.79% when BMI > 35 kg/m2 and NC > 40 cm was added to patients with ESS > 10. Similarly specificity and predictive values of study population for diagnosing OSA also increased after adding BMI and NC to ESS
Conclusions: In this study adding body mass index [BMI] and NC to ESS score significantly increased the sensitivity and specificity and positive predictive value for diagnosis of OSA
ABSTRACT
Objective: To determine the sensitivity, specificity, negative and positive predictive values, and diagnostic accuracy of Endobronchial Ultrasound Guided Transbronchial Needle Aspiration [EBUS-TBNA]
Study Design: A cross-sectional validation study
Place and Duration of Study: Department of Histopathology, Army Medical College, in collaboration with Department of Pulmonology, Military Hospital Rawalpindi, from March 2014 to March 2015
Methodology: Cases of EBUS-TBNA comprised of both TBNAs and cell block/biopsy of the same patients. Diagnosis was made on the TBNA slides and cell block/biopsy material. Taking biopsy/cell block as the gold standard, the data was analysed to calculate the sensitivity, specificity, negative and positive predictive values, and diagnostic accuracy of EBUSTBNA
Results: The sensitivity of EBUS-TBNA was found to be 96.5%; whereas, specificity and positive predictive values were 100%. The negative predictive value was calculated at 50%. Diagnostic accuracy of the procedure was found to be 96.67%
Conclusion: EBUS-TBNA is a sensitive and a specific test and is accurate in diagnosing mediastinal and hilar pathologies
ABSTRACT
To compare the therapeutic efficacy of Intravenous immune globulin [IVIG] with Plasma exchange [plasmaphoresis] in patients of Acute Inflammatory Demyelinating Polyneuropathy i.e. Guillain-Barre syndrome [GBS]. Randomized Controlled Trial [RCT]. The study was of 12 months duration conducted at Department of Medicine, Neurology Unit of Military Hospital Rawalpindi from Jun 2008 to Jun 2009. 60 Patients of GBS were randomly assigned to two treatment groups. Group A received Intravenous immune globulin [IVIG] and Group B Plasma Exchange. Patient's functional status according to London scale grade was assessed at the time of admission and at 02 and 04 weeks after giving treatment. Improvement in mean London scale Grades in each group was calculated at different weeks from baseline and then both groups were compared to each other. In each group there was significant improvement [P-value< 0.001] from baseline-2weeks and baseline-4 weeks. But when compared to each other both the groups had comparable improvement [p-value> 0.05]. Both IVIG and Plasma Exchange have equal therapeutic efficacy in the treatment of patients of GBS
Subject(s)
Humans , Male , Female , Immunoglobulins, Intravenous , Plasmapheresis , Plasma ExchangeABSTRACT
To compare antihypertensive effect of fixed dose combination Hydrochlorothiazide-Amiloride and Amlodipine in patients of mild essential hypertension. Randomized controlled trial [RTC]. Department of Medicine Combined Military Hospital Multan Cantt from 29 January 2007 to 29 June 2007. After fulfilling the inclusion criteria of mild essential hypertension, defined as per recommendations of Seventh Joint National Committee [JNC 7] for treatment of Hypertension as stage 1 hypertension, systolic blood pressure [SBP] >/= 140-159-mmHg and Diastolic blood pressure[DBP] >/= 90-99-mmHg, 100 patients were randomized into two study groups using a table of random numbers. Group 1 received tab amlodipine [5 mg] and Group 2 received tab hydrochlorothiazide-amiloride [25 mg-2.5mg]. Informed written consent was taken. The patients were followed on subsequent visits [6 in total] for five months and systolic and diastolic blood pressure was recorded carefully. All the data thus obtained were processed and analyzed using SPSS version 10.0. Mean and standard deviation [SD] were calculated for age, diastolic and systolic blood pressure. In group 1 the drop in mean SBP between first and last visit was 15.42 mm Hg. In group 2 the drop in mean SBP between first and last visit was 18.34 mm Hg. In group 1, the drop in mean DBP between first and last visit was 10.08 mm Hg. In group 2 the drop in mean DBP between first and last visit was 14.65 mmHg. Mean drop in SBP of both the groups were compared with each other and found to be significantly different [P=0.003]. Similarly mean drop in DBP of both the groups were compared with each other and found to be significant statistically [P=0.001]. Hydrochlorothiazide-Amiloride had significantly better antihypertensive effect than Amlodipine in patients of mild essential hypertension at the end of five months therapy