No abstract

Diffuse parenchyma lung disease (DPLD) encompasses a hetero-geneous group of disorders, characterized by a spectrum of inflammatory and fibrotic changes affecting alveolar walls and air spaces. They comprise over 200 entities and include a wide spectrum of diseases, many uncommon and many of unknown etiology. The incidence and prevalence rates of DPLD have not been precisely estimated due to difficulties in ascertaining a specific diagnosis on a specific disease.

Obstructive Sleep Apnea (OSA) is the most common unrecognized, Undiagnosed and undertreated presentation which represents a major Public health problem. It affects 2-6% of middleaged men and 1-2% of middle-aged women. OSA is a condition characterized by the episodic cessation of breathing during sleep despite persistent ventilatory efforts, associated with sleep fragmentation, arousals, and reductions in oxygen saturation. OSA is a heterogenous disease process. Therefore polysomnography which is considered as the gold standard in diagnosis is useful in all individuals

BACKGROUNDSleep is a highly organized, complex behaviour characterized by a relative disengagement from the outer world and variable, but specific brain activity. It is an endogenously generated, homeostatically regulated and reversible. During sleep, there are profound physiological changes. This is particularly true of breathing and in number of conditions this had important implications. Breathing alters according to the state of consciousness. In healthy subjects, ventilation falls with the onset of sleep and is reduced during all phases of sleep compared with waking levels, alterations in the pattern of breathing occur including periodic breathing, apnoea, hypopnoea with gradual progression from stage I, II (18% decreased) to REM sleep (35% of decrease ventilation to awake stage). REM sleep related alterations in ventilation is more severe in respiratory disordered patients who had already some Hypoxemia, COPD is of best example.

Diffuse parenchymal lung diseases (DPLD) encompasses a hetero-geneous group of disorders, characterized by a spectrum of inflammatory and fibrotic changes affecting alveolar walls and air spaces. The onset, rate of progression and duration of symptoms are extremely variable, and presentations range from asymptomatic with long standing radiological changes to an acute onset of breathlessness. MATERIALS AND METHODS: Prospective study conducted on 30 patients admitted in Government general and chest hospital Hyderabad, All patients with clinical features and HRCT diagnostic of Idiopathic pulmonary fibrosis are included in the study. Study was done between February 2013 to December 2014. BAL was done based on ATS guidelines. RESULTS: Out of 30 patients, 19 were females and 11 were males. Out of 30 patients, 21 patients were having neutrophils as predominant cell type in BAL fluid, 6 patients were having lymphocytes as predominant cell type and 2 were having eosinophils and 1 patient was having macrophages as predominant cell type in BAL fluid. In patients with neutrophil predominant BAL fluid, 8 patients found to be having exclusively neutrophils and other cells were within normal limits and 5 were having raised lymphocytes, 5 were having raised eosinophils along with neutrophils and 3 patients were having both lymphocytes and eosinophils along with neutrophils. In patients with lymphocyte predominant BAL fluid, 1 patient is having exclusively raised lymphocytes and 5 patients were having raised neutrophils along with lymphocytes in BAL fluid. 2 patients were having exclusively raised eosinophils in BAL fluid.