Background. Anxiety and panic are known to be associated with bronchial asthma with variety of impact on clinical presentation, treatment outcome, comorbidities, quality of life, and functional disability in patients with asthma. This study aims to explore the pattern of panic symptoms, prevalence and severity of panic disorder (PD), quality of life, and disability in them. Methods. Sixty consecutive patients of bronchial asthma were interviewed using semistructured proforma, Panic and Agoraphobia scale, WHO Quality of life (QOL) BREF scale, and WHO disability schedule II (WHODAS II). Results. Though 60% of the participants had panic symptoms, only 46.7% had diagnosable panic attacks according to DSM IV TR diagnostic criteria and 33.3% had PD. Most common symptoms were “sensations of shortness of breath or smothering,” “feeling of choking,” and “fear of dying” found in 83.3% of the participants. 73.3% of the participants had poor quality of life which was most impaired in physical and environmental domains. 55% of the participants had disability score more than a mean (18.1). Conclusion. One-third of the participants had panic disorder with significant effect on physical and environmental domains of quality of life. Patients with more severe PD and bronchial asthma had more disability.

Background. Diabetes is a systemic disease with-well known complications involving eyes, kidneys and nerves. The presence of an extensive pulmonary microvascular circulation and abundant connective tissue raises the possibility that lung may also be a target organ in diabetes. Methods.A total of 45 subjects were included in the study. All patients were evaluated for diabetic microangiopathies: nephropathy (by 24-hour protein excretion), retinopathy (by direct ophthalmoscopy) and neuropathy (by clinical examination). The patients were divided into following three groups: Group A: patients with type-2 diabetes mellitus (DM) with evidence of microangiopathy (n=15); Group B: patients with type-2 DM without any evidence of microangiopathy (n=15); Group C: non-diabetic subjects (n=15) as controls. Glycosylated haemoglobin (HbA1C) was measured as an indicator of glycemic control. Spirometry and single-breath diffusion capacity for carbon-monoxide (DLCO) were performed on all patients using Elite Series Body Plethysmograph machine.Results. A significant reduction of diffusion capacity corrected for alveolar volume (%DL/VA) was observed in group A (p<0.001), as compared to the other groups. There were no differences among the three groups for other pulmonary functions. There was a significant correlation between DL/VA percent predicted and albuminuria (r= -0.975, p<0.001), and DL/VA percent predicted and the retinopathy (r = -0.550, p< 0.05). Conclusion.This study shows a mild reduction in diffusing capacity in patients with type-2 DM with microangiopathy.

Background. Objective assessment of severity in patients with chronic obstructive pulmonary disease (COPD) is mainly limited to pulmonary function testing performed at rest. But, accurate assessment of exercise capacity in patients with COPD may be possible with cardiopulmonary exercise testing (CPET).Methods. Forty-three patients with stable COPD were included and were divided into three groups based upon the spirometry data as per the Global Initiative for Obstructive Lung Disease (GOLD) guidelines as follows: Group A: mild COPD, Group B: moderately severe COPD and Group C: severe COPD. Symptom-limited CPET was performed using treadmill on incremental continuous ramp protocol in all of them.Results. Five patients (11.6%) had mild COPD; 16 (37.2%) had moderately severe COPD and the remaining 22 (51.6%) patients had severe COPD. Anaerobic threshold was attained in all the 43 patients. The dominant symptom at peak exercise were dyspnoea (n=19) and both dyspnoea and leg fatigue (n=7). The other causes of exercise limitation included dyspnoea with significant oxygen desaturation (n=6); and dyspnoea with severe oxygen desaturation (n=2). Six patients complained only of leg fatigue at peak exercise.A significant correlation between forced expiratory volume in the first second (FEV 1 ) percent predicted and the predicted maximum oxygen uptake (VO 2 max % predicted) was observed in all the three groups (r=0.39, p=0.011) but with marked variability of peak VO 2 for a given degree of airflow obstruction. Twenty-three (53.5%) patients with low anaerobic threshold (<30%) were identified as potential group likely to benefit from exercise training for pulmonary rehabilitation. Conclusions.Cardiopulmonary exercise testing is useful to determine the causes of exercise limitation and to assess the maximal exercise capacity of patients with COPD.

Background: Co-morbid psychological impairments (depression and anxiety) are common in COPD and are often associated with increased disability, health care usage and morbidity. They also impair quality of life in COPD and are often not fully explored in the clinical management of COPD patients. Psychological distress may, however, contribute to sleep difficulties in all stages of disease severity. Both anxiety and depression have been shown to have a negative effect on the sleep and quality of life (QoL).Objectives: To study the correlation between depression, anxiety and sleep with quality of life in patients with COPD.Methodology: In a tertiary care hospital, this Observational study was conducted on 39 patients of age group 40-70 years, with spirometry confirmed COPD GOLD category I-IV and smokers with more than 5 years of disease who fulfilled were included  in the study. Quality of life was assessed using SGRQ-C, SF-12 and CAT. Depression, Anxiety and Sleep were assessed using PHQ-9, GAD-7 and PSQI questionnaires respectively. The correlation between quality of life scores and mental health scores were analysed using Pearson’s correlation coefficient.Results: Anxiety was significantly correlated with all the sub domains of SGRQ-C, PCS, MCS of SF-12 and the CAT score. (p value<0.001) Similarly, sleep was significantly correlated with all the three QoL Scales. (p value< 0.001) However, depression significantly correlated with all the subdomains of SGRQ-C and CAT except activity sub-domain of SGRQ-C and MCS of SF-12. (p value<0.001)Conclusion: Anxiety, Depression and Sleep moderately correlated with QoL scores in patients with COPD.

No abstract