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1.  Assessment of visual evoked potentials in stable COPD patients with no visual impairment 
Annals of Thoracic Medicine  2010;5(4):222-227.
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.
PMCID: PMC2954376  PMID: 20981182
Chronic obstructive pulmonary disease; Mini Mental State Examination Questionnaire; spirometry; VEP abnormalities; visual evoked potentials
3.  Evaluation of brain stem auditory evoked potentials in stable patients with chronic obstructive pulmonary disease 
Annals of Thoracic Medicine  2008;3(4):128-134.
Though there are few studies addressing brainstem auditory evoked potentials (BAEP) in patients with chronic obstructive pulmonary disease (COPD), subclinical BAEP abnormalities in stable COPD patients have not been studied. The present study aimed to evaluate the BAEP abnormalities in this study group.
In the present study, 80 male subjects were included: COPD group comprised 40 smokers with stable COPD with no clinical neuropathy; 40 age-matched healthy volunteers served as the control group. Latencies of BAEP waves I, II, III, IV, and V, together with interpeak latencies (IPLs) of I-III, I-V, and III-V, and amplitudes of waves I-Ia and V-Va were studied in both the groups to compare the BAEP abnormalities in COPD group; the latter were correlated with patient characteristics and Mini–Mental Status Examination Questionnaire (MMSEQ) scores to seek any significant correlation.
Twenty-six (65%) of the 40 COPD patients had BAEP abnormalities. We observed significantly prolonged latencies of waves I, III, V over left ear and waves III, IV, V over right ear; increased IPLs of I-V, III-V over left ear and of I-III, I-V, III-V over right side. Amplitudes of waves I-Ia and V-Va were decreased bilaterally. Over left ear, the latencies of wave I and III were significantly correlated with FEV1; and amplitude of wave I-Ia, with smoking pack years. A weak positive correlation between amplitude of wave I-Ia and duration of illness; and a weak negative correlation between amplitude of wave V-Va and MMSEQ scores were seen over right side.
We observed significant subclinical BAEP abnormalities on electrophysiological evaluation in studied stable COPD male patients having mild-to-moderate airflow obstruction.
PMCID: PMC2700451  PMID: 19561894
Brainstem auditory evoked potentials; chronic obstructive pulmonary disease; correlation analysis; Mini–Mental Status Examination
4.  Correlation between high-resolution computed tomography features and patients' characteristics in chronic obstructive pulmonary disease 
Annals of Thoracic Medicine  2008;3(3):87-93.
During the last few decades, high-resolution computed tomography (HRCT) has come up as a new diagnostic modality to diagnose emphysematous and chronic bronchitis components of chronic obstructive pulmonary disease (COPD). The present study was undertaken to evaluate for various quantitative and qualitative HRCT features in patients with COPD, and to detect patients' characteristics that correlate with these HRCT features.
Forty male patients with COPD attending the COPD clinic at a tertiary referral hospital and postgraduate medical institute were included in the study. Various HRCT features, including tracheal index, thoracic cage ratio, sterno-aortic distance, thoracic cross-sectional area, vascular attenuation, vascular distortion, mosaic attenuation pattern, and directly visible small airways, were evaluated and correlated with patients' characteristics, including age, duration of illness, quantum of smoking, dyspnea score, quality-of-life index, and various spirometric indices.
We found significant correlations of various quantitative and qualitative HRCT features with age, duration of illness, quantum of smoking, quality-of-life index, and the spirometric indices showing the extent of airways obstruction.
Various quantitative and qualitative HRCT features were found to correlate with patients' characteristics, spirometric indices, and health-related quality-of-life score, suggesting that HRCT is useful not only in detecting emphysema and its various subtypes but also in predicting the extent and severity of COPD.
PMCID: PMC2700439  PMID: 19561886
Chronic obstructive pulmonary disease; correlation analysis; high-resolution computed tomography features
5.  Recurrent pneumothorax developing during chemotherapy in a patient with miliary tuberculosis 
Annals of Thoracic Medicine  2007;2(4):173-175.
Despite the fact that miliary tuberculosis is frequently seen, associated pneumothorax developing during antitubercular chemotherapy for miliary tuberculosis is rare. Pneumothorax is potentially life threatening in association with miliary tuberculosis; and its symptoms may be masked by those of miliary tuberculosis, leading to avoidable delay in the diagnosis of pneumothorax. Here we describe a 24-year-old female patient developing recurrent pneumothorax while on antitubercular chemotherapy for miliary tuberculosis.
PMCID: PMC2732102  PMID: 19727372
Computed tomogram features; miliary tuberculosis; nonimmunocompromised patient; recurrent pneumothorax
6.  Pneumothorax: A rare presentation of pulmonary mycetoma 
Annals of Thoracic Medicine  2007;2(4):171-172.
Pneumothorax due to mycetoma is extremely rare and has been described only in patients undergoing intensive cytotoxic therapy for hematologic malignancies. A non-immunocompromised subject presenting with pneumothorax due to rupture of the mycetoma into the pleural cavity is being described here.
PMCID: PMC2732101  PMID: 19727371
Invasive fungal infection; mycetoma; pneumothorax
7.  A comparison of peak expiratory flow measured from forced vital capacity and peak flow meter manoeuvres in healthy volunteers 
Annals of Thoracic Medicine  2007;2(3):103-106.
Spirometry measures the mechanical function of lungs, chest wall and respiratory muscles by assessing the total volume of air exhaled from total lung capacity to residual volume. Spirometry and peak flow measurements have usually been carried out on separate equipments using different expiratory maneuvers.
The present study was carried out to determine whether there is a significant difference between peak expiratory flow (PEF) derived from a short sharp exhalation (PEF maneuver) and that derived from a full forced vital capacity (FVC) maneuver in healthy volunteers.
A medical college and tertiary level hospital.
The present study was carried out during the period from January 2006 to July 2006. The study included 80 healthy volunteers with no coexisting illnesses, who were in the 15-45 years age group and belonging to either sex. They were asked to perform two sets of PEF and FVC maneuvers using the same turbine spirometer; the order was randomly assigned.
The difference between PEF obtained from a peak flow maneuver (PEFPF) and that obtained from a forced vital capacity maneuver (PEFVC) in healthy volunteers was analyzed separately for males and females, as well as for both groups combined, and statistical significance of its correlations with study data parameters was analyzed.
The difference between PEF obtained from a peak flow maneuver (PEFPF) and that obtained from a forced vital capacity maneuver (PEFVC) was statistically significant (P < 0.001) in males and in females separately and also for both groups combined. PEFPF (517.25 ± 83.22 liters/min) was significantly greater than PEFVC (511.09 ± 83.54 liters/min), as found on combined group mean analysis. However, the difference was small (6.16 + 7.09 liters/min).
FVC maneuver can be used over spirometers to detect the PEF; and on follow-up subsequently, the same maneuver should be used to derive PEF. If we are using a peak flow maneuver subsequently, corrections are required to compensate for the difference due to the different maneuver.
PMCID: PMC2732084  PMID: 19727355
Forced vital capacity maneuver; healthy volunteers; peak expiratory flow maneuver; peak expiratory flow rate; turbine spirometer

Results 1-7 (7)