Publications (9) View all
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Article: A comparison of cognitive functions in non-hypoxemic chronic obstructive pulmonary disease (COPD) patients and age-matched healthy volunteers using mini-mental state examination questionnaire and event-related potential, P300 analysis.
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ABSTRACT: To assess sub-clinical cognitive dysfunctions in stable chronic obstructive pulmonary disease (COPD) patients having no hypoxemia vs. age-matched healthy volunteers using (i) an electrophysiological test: Auditory event related potential, P300 test and (ii) a questionnaire tool: Mini-mental state examination (MMSE) questionnaire. EIGHTY MALE SUBJECTS WERE INCLUDED: 40 stable COPD patients (smoking history >20 pack years) and 40 healthy volunteers (HVs). Age, duration of illness, smoking pack years, and spirometric indices were assessed. MMSE scores were evaluated in these groups. Latency of P300 wave and amplitude of P300 wave were studied in both groups to detect P300 abnormalities in COPD group. Correlations of P300 abnormalities with patient characteristic parameters and MMSE scores were assessed. In addition, individual COPD patients having significant cognitive dysfunctions beyond cut-off value of 99(th) percentile of HVs were analyzed. We observed significantly prolonged P300 latency (P < 0.001) and decreased P300 amplitude (P < 0.001) in COPD group. MMSE scores were significantly reduced in COPD group (P < 0.001). 10/40 COPD patients had prolongation of P300 latency, and 27/40 COPD patients had reduced MMSE scores beyond 99(th) percentile of HV. However, we did not observe any statistically significant correlation between P300 abnormalities and patients' characteristics or MMSE scores (P > 0.05 for all). Our study explores cognitive dysfunctions in stable COPD patients with no hypoxemia. This study highlights the relative importance of using MMSE and P300. Cognitive dysfunctions were detected both by MMSE and P300; however, MMSE abnormalities were more frequent compared to P300 abnormalities (27/40 vs. 10/40) in COPD patients.Lung India 01/2013; 30(1):5-11. -
Article: A young non-immunocompromised woman with diffuse alveolar opacities.
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ABSTRACT: Diffuse alveolar opacities (DAO) due to pulmonary tuberculosis are usually described in immunocompromised patients. In adult patients residing in high endemic areas such as India, alveolar opacities are not reported frequently in non-immunocompromised pulmonary tuberculosis patients. We describe a twenty-five-year-old woman who presented with bilateral diffuse alveolar opacities and initial diagnostic work up was directed to non-tuberculosis etiologies. Her sputum was not suggestive of tuberculous or any other infective etiology. However, histopathological examination of specimen from fine needle aspiration cytology through percutaneous route suggested chronic granulomatous disease with detection of mycobacterium. Polymerase chain reaction test in BAL and FNAC specimen confirmed tubercular etiology. Though not frequent, pulmonary tuberculous etiology is worth considering in the differential diagnosis of DAO as not only tuberculosis is fully treatable but also early detection shall help to avoid unnecessary invasive tests and cut down transmission to contacts.Lung India 10/2010; 27(4):236-8. -
Article: Assessment of visual evoked potentials in stable COPD patients with no visual impairment.
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ABSTRACT: To assess whether patients having stable chronic obstructive pulmonary disease (COPD) with no clinical evidence of visual impairment or peripheral neuropathy have visual evoked potentials (VEP) abnormalities on electrophysiologic evaluation. In the present study, 80 male subjects with no clinical neuropathy or visual impairment were included; 40 COPD patients and 40 age-matched healthy volunteers. The characteristics of subjects including age, quantum of smoking, duration of illness (in COPD patients only), and spirometric indices {forced expiratory volume in first second (FEV₁), FEV₁/forced vital capacity (FVC) %, and peak expiratory flow rate (PEFR)} were assessed. The mental status was assessed using a questionnaire Mini-Mental State Examination (MMSE) Questionnaire. Electrophysiologic studies for the evaluation of VEP were carried out on computerized equipment. Latency and amplitude of P100 wave were analyzed from the VEP wave patterns obtained through a standardized protocol in both the groups to detect abnormalities in the COPD group. For the COPD group, correlations of P100 parameters with patient characteristics, spirometric indices, and MMSE scores were assessed. Significant abnormality was defined as a variation beyond healthy volunteer mean ± 3 standard deviation. We observed significantly prolonged latency and decreased amplitude of P100 in both eyes of the patients in COPD group compared with healthy volunteers. Twenty-two of the 40 COPD patients (55%) had significant abnormalities in P100 latency, and three COPD patients (7.5%) had abnormalities in P100 amplitude. The latency of P100 on the right side had statistically significant inverse correlation with FEV₁/FVC% and MMSE score. Twenty-three of the 40 stable COPD patients (compared with healthy volunteers) were observed to have significant VEP abnormality detected on electrophysiologic evaluation: 21/40 having prolonged P100 latency and only 2/40 with decreased P100 amplitude. The statistically significant correlations were observed only between P100 latency (right eye) and FEV1/FVC as well as MMSE scores. The rest of the correlations were not statistically significant.Annals of thoracic medicine. 10/2010; 5(4):222-7. -
Article: Assessment of visual evoked potentials in stable COPD patients with no visual impairment
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ABSTRACT: Objective : To assess whether patients having stable chronic obstructive pulmonary disease (COPD) with no clinical evidence of visual impairment or peripheral neuropathy have visual evoked potentials (VEP) abnormalities on electrophysiologic evaluation. Methods : In the present study, 80 male subjects with no clinical neuropathy or visual impairment were included; 40 COPD patients and 40 age-matched healthy volunteers. The characteristics of subjects including age, quantum of smoking, duration of illness (in COPD patients only), and spirometric indices {forced expiratory volume in first second (FEV 1 ), FEV 1 /forced vital capacity (FVC) %, and peak expiratory flow rate (PEFR)} were assessed. The mental status was assessed using a questionnaire Mini-Mental State Examination (MMSE) Questionnaire. Electrophysiologic studies for the evaluation of VEP were carried out on computerized equipment. Latency and amplitude of P100 wave were analyzed from the VEP wave patterns obtained through a standardized protocol in both the groups to detect abnormalities in the COPD group. For the COPD group, correlations of P100 parameters with patient characteristics, spirometric indices, and MMSE scores were assessed. Significant abnormality was defined as a variation beyond healthy volunteer mean 3 standard deviation. Results : We observed significantly prolonged latency and decreased amplitude of P100 in both eyes of the patients in COPD group compared with healthy volunteers. Twenty-two of the 40 COPD patients (55%) had significant abnormalities in P100 latency, and three COPD patients (7.5%) had abnormalities in P100 amplitude. The latency of P100 on the right side had statistically significant inverse correlation with FEV 1 /FVC% and MMSE score. Conclusions : Twenty-three of the 40 stable COPD patients (compared with healthy volunteers) were observed to have significant VEP abnormality detected on electrophysiologic evaluation: 21/40 having prolonged P100 latency and only 2/40 with decreased P100 amplitude. The statistically significant correlations were observed only between P100 latency (right eye) and FEV1/FVC as well as MMSE scores. The rest of the correlations were not statistically significant.Annals of Thoracic Medicine. 01/2010; -
Article: A young non-immunocompromised woman with diffuse alveolar opacities
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ABSTRACT: Diffuse alveolar opacities (DAO) due to pulmonary tuberculosis are usually described in immunocompromised patients. In adult patients residing in high endemic areas such as India, alveolar opacities are not reported frequently in non-immunocompromised pulmonary tuberculosis patients. We describe a twenty-five-year-old woman who presented with bilateral diffuse alveolar opacities and initial diagnostic work up was directed to non-tuberculosis etiologies. Her sputum was not suggestive of tuberculous or any other infective etiology. However, histopathological examination of specimen from fine needle aspiration cytology through percutaneous route suggested chronic granulomatous disease with detection of mycobacterium. Polymerase chain reaction test in BAL and FNAC specimen confirmed tubercular etiology. Though not frequent, pulmonary tuberculous etiology is worth considering in the differential diagnosis of DAO as not only tuberculosis is fully treatable but also early detection shall help to avoid unnecessary invasive tests and cut down transmission to contacts.Lung India. 01/2010;
