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    Clinical Factors Associated with Very Severe Obstructive Sleep Apnea in Mongolian Patients: A Case-Control Study
    (Mongolian National University of Medical Sciences, 2021-09-21) ; ;
    Objectives: To determine risk factors and clinical characteristics of obstructive sleep apnea patients (OSA) according to the severity of the value of AHI ≥ 60 (Apnea-Hypopnea Index). Methods: A hospital-based, case-control study, December 2018 - 2020. Patients were grouped by severity of AHI as moderate, severe, and very severe. Results: Of 103 male cases, 52 were very severe obstructive sleep apnea (vsOSA). The control group consisted of 16 moderate OSA (mOSA) and 35 severe OSA (sOSA) patients. The case group consisted of 52 vsOSA patients. The average age was 48.7 ± 12.6. There was statistically significant increased body mass index (p < 0.003), systolic blood pressure, and abdominal circumference (p < 0.006) in the vsOSA group. Moreover, on polysomnography there was less deep sleep (p < 0.004), a greater arousal index (p < 0.000), higher apnea-hypopnea index (p < 0.000), and higher night systole pressure (p < 0.010). According to a bivariate analysis, abdominal circumferences were the variable with the closest association to the vsOSA group (crude OR: 9.14, p > 0.004), followed by decreased maximum saturation of O2 (crude OR: 6.6, p > 0.451). Conclusion: Of male OSA patients, 50.1% have vsOSA (AHI > 60) and most of them were obese and suffered from high blood pressure. Lower levels of O2 saturation and increased abdominal and neck circumferences were significant risk factors for the very severe obstructive sleep apnea group.
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    Study of Relationship between Post Stroke Epilepsy and Solar Activity
    (Mongolian National University of Medical Sciences, 2018-03-25) ;
    Etremov Valery Vilyamovich
    ;
    Objective: Symptomatic seizure or post-stroke seizure are the most common seizure subtypes among the elderly. The purpose of our study was to better understand post-stroke epilepsy in relation to their cerebral location, and to find a possible link between epileptic seizure after stroke debut and the differences in solar activity. Methods: This retrospective chart review of patients who died from hemorrhagic stroke in Ulaanbaatar, Mongolia. Only patients with a hemorrhagic stroke from periods with relatively high solar activity (2000-2002 and 2013-2015) and relatively low solar activity (2008-2010) were considered. Results: Hemorrhagic stroke affected mainly patients between 45-59 years of age. Post-stroke epilepsy was less prevalent less during decreased solar activity years. Post-stroke epilepsy was more prevalent in patients with subarachnoid hemorrhage and brainstem hematoma and even more prevalent in patients with diabetes (p<0.01). Conclusion: Post-stroke epilepsy was less frequent during low solar activity years. Post-stroke epilepsy with concomitant brainstem hematoma resulted in poor outcomes following stroke.
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    Some Associations of Primary Headache Disorders in Mongolia: A Nationwide Population-Based Study
    (Mongolian National University of Medical Sciences, 2019-12-29)
    Byambasuren Tsenddorj
    ;
    Dorjkhand Baldorj
    ;
    Delgermaa Purev
    ;
    ;
    Objective: Headache disorders are the most prevalent public-health problem, affecting people in all countries. Epidemiological data on headaches are not available in Mongolia. Our study aimed to estimate the prevalence of each headache disorders of public health importance and examine their socio-demographic associations, in urban and rural areas. Methods: There were 2,043 biologically unrelated adults (aged 18–65 years) in a door to door survey randomly sampled from Ulaanbaatar (capital of Mongolia) and four aimags (rural), and interviewed by trained researchers using a pilot-tested, validated, structured questionnaire. ICHD-II diagnostic criteria were applied. Results: The observed prevalence of any headache was 66.1%, with a female preponderance of 2:1. The age-standardized prevalence of migraines was 24.2%; prevalence was higher among females than males (OR 2.4, 95% CI 1.9; 2.9, p = .0001), and among those with high education (OR 3.0, 95% CI 1.5; 5.8, p = .002). The age-standardized prevalence of tension-type headache was 29.0%, higher among younger people. The estimated prevalence of all headaches on ≥15 days/month was 11.2% (that of probable medication-overuse headaches was about 70%). Conclusion: The prevalence of primary headaches was 63.9%, with migraines being 24.2%, and tension-type headaches 29.0%. Female gender, higher education level, and family history were associated risk factors for primary headaches. There was a relatively high prevalence of headaches on ≥15 days/month and those with probable medication overuse headaches.
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    Structured headache services as the solution to the ill-health burden of headache: 1. Rationale and description.
    (2021-07)
    Steiner, Timothy J
    ;
    Jensen, Rigmor
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    Katsarava, Zaza
    ;
    Stovner, Lars Jacob
    ;
    Uluduz, Derya
    Scopus© Citations 54
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    Scopus© Citations 8
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    Obstructive Sleep Apnea in a Clinical Population: Prevalence, Predictive Factors, and Clinical Characteristics of Patients Referred to a Sleep Center in Mongolia
    Obstructive sleep apnea (OSA) disrupts sleep. This study examined factors related to OSA severity. A cross-sectional, prospective, hospital-based study was conducted with 205 patients who underwent polysomnography (PSG). Demographic, anthropometric, clinical, PSG, and sleep quality assessment data were analyzed. Participants (N = 205) were classified into four groups based on apnea-hypopnea index (AHI); no OSA (AHI < 5/h; N = 14), mild (mOSA, 5 < AHI < 15/h; N = 50), moderate (modOSA, 15 < AHI < 30/h; N = 41), severe (sOSA, 30 < AHI < 60/h; N = 50), and very severe (vsOSA, AHI ≥ 60; N = 50). Men had more severe OSA than women (p < 0.001). Anthropometric characteristics differed with OSA severity (p < 0.001). OSA patients had decreased sleep quality and increased excessive daytime sleepiness (EDS). Body mass index (BMI), neck/waist circumference, and blood pressure (BP) differed between groups (p < 0.001). Patients with vsOSA had the highest Mallampati grades (p < 0.001). Multiple linear regression indicated that OSA severity was related to gender and sleep quality. PSG parameters (oxygen saturation, systolic BP, and arousal/respiratory arousal) were strongly related to OSA severity. In conclusion, about half of study-referred patients had severe/very severe OSA; these groups were predominantly obese men with high BP. OSA severity associated with high BP, BMI, waist circumference, and neck circumference.
    Scopus© Citations 8
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    Scopus© Citations 33
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    Scopus© Citations 3
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    Scopus© Citations 2