Prevalence of hypothyroidism in newly diagnosed patients with obstructive sleep apnea syndrome: a prospective cross-sectional study

Introduction: One of the most common presentations of OSAS is daytime sleepiness, which is also seen in patients with hypothyroidism. We hypothesized that hypothyroidism is one of contributing factors in the development of OSAS; thus, adequate management of hypothyroidism can simply help to alleviate OSAS symptoms. Aim of the Study: The aim of this study was to evaluate the prevalence of hypothyroidism in OSAS patients in our locality and to compare respiratory polysomnographic parameters of OSAS patients with hypothyroidism versus those without hypothyroidism. Patients and Methods: In a descriptive prospective cross-sectional study, our patients attending Sleep Disordered Breathing Clinic at Sleep Disordered Breathing Unit, Chest Medicine Department, Mansoura University Hospital. All patients were subjected to full history taking with stress on sleep questionnaires, pulmonary complaints, physical examination, anthropometric measures, diagnostic PSG, laboratory evaluation (serum TSH and free T4 levels), and chest radiology and echocardiography. Results: There were two groups of OSAS participants (hypothyroid and euthyroid). Hypothyroidism was evident in 12% of patients;they were classified according to AHI, 13, 15, and 60 of Euthyroid patients had mild, moderate, and severe OSAS, respectively. hypothyroid patients, 2 mild OSAS, 1 moderate OSAS and 9 severe OSAS. Epworth sleepiness scale scores were significantly higher in the hypothyroid group with a mean score of 18 ± 4.8 vs 12.47 ± 6 in the euthyroid group (P = 0.003). Different PSG parameters showed no difference between the two groups. AHI, serum TSH level, and T4 levels were positively correlated but with insignificant P values. Conclusion: Hypothyroidism is thought to be one of the key players in the development of sleep-breathing disorders. It was evident in 12% of OSAS patients; however, the a proven insignificant difference in PSG parameters in OSAS with hypothyroidism versus euthyroid group, except for affection of daytime sleepiness

Heavy metals assessment in Egyptian smokers with lung cancer

Background Smoking and heavy metals are major risk factors and have an important role in development of lung cancer. Purpose The purpose of this study was to investigate the relationship between development of lung cancer and the synergistic effect of smoking and heavy metals in Egyptian smokers. Patients and methods A total of 41 participants enrolled in this study and were subdivided into three groups: smokers with lung cancer (n=11), nonsmokers with lung cancer (n=15), and apparently healthy smokers (n=15). The diagnosis and types of lung cancer based on pathological examination of biopsies taken either by computed tomography-guided, ultrasound-guided, fiberoptic bronchoscopy (FOB), and blind or thoracoscopic pleural biopsy. Serum levels of five heavy metals (zinc, lead, nickel, manganese, chromium) were assayed using inductive plasma spectrometry. Results Squamous cell carcinoma represents the major type of lung cancer (72.7%) among group of smokers with lung cancer; however, adenocarcinoma either primary or metastatic represents the major type (93.4%) among the nonsmoker group, and all investigated heavy metals in this study (zinc, lead, nickel, manganese, chromium) express significantly higher mean value of their serum levels (P=0.005, 0.005, 0.006, <0.001, and 0.007, respectively) in case of squamous cell carcinoma compared with adenocarcinoma. There is no impact of the degree of severity of smoking on serum levels of all investigated heavy metals. Conclusion Squamous cell carcinoma has been strongly associated with higher serum levels of all investigated heavy metals. There is no association between degree of severity of smoking and serum levels of all investigated heavy metals