The association of primary open-angle glaucoma / normal tension glaucoma and obstructive sleep apnea in Thai patients

 Backgrouds: The association of glaucoma and OSA has been published in many reports. Previous study by Mojon et al demonstrated that repeated hypoxia may affect the development of ganglion cell loss. However, it remains unclear whether glaucoma is association with OSA. Thus, objective of this study is to determine the association of primary open-angle glaucoma / normal tension glaucoma and obstructive sleep apnea in Thai patients.Materials and Methods: Eighty-six patients consecutively admitted for polysomnographic evaluation of suspected obstructive sleep apnea were performed complete ophthalmologic examination. The association between glaucoma and OSA was determined by the Chi-square test and Pearson correlation. P-value < 0.05 were considered statistically significant.Results: Forty-four of the eighty-six patients (51.16 %) who had an AHI higher than 10 and were diagnosed with OSA. Eighteen of them had mild OSA, twelve patients had moderated OSA and fourteen patients had severe OSA. The prevalence of glaucoma in normal group was 7.14 %(3/42). The prevalence of glaucoma in patients with OSA was 13.64%(6/44). There was no statistically significant correlation between presence of glaucoma and OSA. (Chi-square = 9.67; df  = 1; p-value = 0.325)Conclusions: This study indicates that there is no statistically significant association between the presence of glaucoma and OSA in Thai patients. Therefore, the screening for glaucoma in patients with OSA might not be necessary unless further data of the relationship is present

Prevalence of obstructive sleep apnea in pregnancy

The aim of this study is to determine the prevalence of obstructive sleep apnea in Thai pregnant women. The study was carried out from January 2010 through December 2010 at antenatal clinic, HRH princess Maha Chakri Sirindhorn Medical Center, Nakorn-nayok province. One hundred and twelve pregnant women were enrolled. All subjects answered a Berlin questionnaire, which had information on age, gravida, gestational age, prepregnancy body mass index, snoring and sleep apnea. The subjects who answered snoring or sleep apnea were tested by polysomnogram for detecting obstructive sleep apnea. The result showed no obstructive sleep apnea was detected. However, the prevalence of sleep apnea from the questionnaire was 3.57% and the prevalence of snoring in pregnancy was 31.25%

Result of Nasal Irrigation with Neti Pot in Allergic Rhinitis Patients

This study is an experimental research utilizing a group with a pre-test and post-test design that is aimed to examine the results of nasal irrigation using a neti pot in patients with allergic rhinitis and the assessments of the patients’ satisfaction.  The subjects comprised of 30 patients, between 20 - 60 years of age, seen at the ear, nose, and  throat department of the HRH Princess Maha Chakri Sirindhorn Medical Center. A Visual - Analog Rating Scale (VAS) was used for testing sensory levels and to select and analyze the data The research results are as follows: 1. nasal irrigation with a neti pot in patients with allergic rhinitis and when comparing results before and after the procedure; nasal congestion symptoms were (5.47 + 1.76) and (2.77 + 2.25), itch symptoms were (4.40 + 3.10) and (1.73 + 1.95), sneeze symptoms (4.37 + 3.05) and (2.17 + 2.35), and nasal secretions (4.83 + 3.09) and (2.43 + 2.63). There was a significant difference at the 0.05 level and no complications were experienced during nasal irrigation or post irrigation.  2. The mean scores of nasal irrigation with the neti pot had shown results of “very satisfied”. As a result, nasal irrigation with a neti pot is a safe and effective treatment option for patients with allergic rhinitis there are no previous reports of this method that have been done here in Thailand

Contemporary Surgery for Obstructive Sleep Apnea Syndrome

Surgical treatment of obstructive sleep apnea syndrome (OSAS) has been available in some form for greater than three decades. Early management for airway obstruction during sleep relied on tracheotomy which although life saving was not well accepted by patients. In the early eighties two new forms of treatment for OSAS were developed. Surgically a technique described as a uvulopalatopharyngoplasty (UPPP) was used to treat the retropalatal region for snoring and sleep apnea. Concurrently sleep medicine developed a nasal continuous positive airway pressure (CPAP) device to manage nocturnal airway obstruction. Both of these measures were used to expand and stabilize the pharyngeal airway space during sleep. The goal for each technique was to limit or alleviate OSAS. Almost 30 yr later these two treatment modalities continue to be the mainstay of contemporary treatment. As expected, CPAP device technology improved over time along with durable goods. Surgery followed suit and additional techniques were developed to treat soft and bony structures of the entire upper airway (nose, palate and tongue base). This review will only focus on the contemporary surgical methods that have demonstrated relatively consistent positive clinical outcomes. Not all surgical and medical treatment modalities are successful or even partially successful for every patient. Advances in the treatment of OSAS are hindered by the fact that the primary etiology is still unknown. However, both medicine and surgery continue to improve diagnostic and treatment methods. Methods of diagnosis as well as treatment regimens should always include both medical and surgical collaborations so the health and quality of life of our patients can best be served

Stress and depressive symptoms related excessive daytime sleepiness in Thai medical students, Srinakharinwirot University (อาการแสดงของความเครียดและอารมณ์ซึมเศร้าที่สัมพันธ์กับความง่วงมากกว่าปกติในนิสิต คณะแพทยศาสตร์ มหาวิทยาลัยศรีนครินทรวิโรฒ)

Excessive daytime sleepiness (EDS) is a common sleep disorder in general population which can lead to serious consequences including traffic and industrial accidents, decreased productivity, and interpersonal problems. Besides sleepiness, EDS is also related to depression and stress. The objective of this study was to determine the symptoms of stress and depression in medical students that associated to excessive daytime sleepiness. Cross-sectional study was performed. The questionnaires which composed of the diagnostic screening test for depression in Thai population: Health-Related Self-Reported (HRSR) Scale, Suanprung stress test and Epworth sleepiness scale were sent to 646 medical students of all classes at Srinakharinwirot University during February, 11th 2008 to March, 4th 2008. Categorical variables were analyzed using the Chi-square test or Fisher exact test. For binary response variables, odds ratio and significant explanatory variables were identified through logistic regressions. A two-tailed p-value of less than 0.05 was considered significant. EDS was not associated to class, gender and body mass index, but it was associated to depression and stress with odds ratios of 3.3 and 2.8, respectively (