BackgroundNowadays, there are many methods to reduce microorganisms in the air, such as dehumidifier, air purifier or humidity and temperature controller. The Precise Climate Controller is an instrument for controlling humidity and temperature, a concept that is demonstrated.ObjectiveTo determine the efficacy of this device, in order to reduce the quantity of the fungi and bacteria in the closed system.MethodsThis study is a perspective experimental study and is conducted as follows - the air sample in the closed system, a 42-cubic-meter room, is collected before the installation of the Precise Climate Controller. Next, the room is fumed with Aspergillus flavus and closed for 2 days. Then the instrument is in use in order to keep the relative humidity (RH) and the temperature constant at 55% RH and 25 degrees Celsius (℃). The air samples are collected every 3 days for 5 times during the period of 15 days to identify the type and calculate the quantity of the microorganisms.ResultsBefore the Precise Climate Controller has been installed. Three species of bacteria are found in the air samples, but none of the fungus exists in the testing room. Once the room has been fumed with a large amount of A. flavus and the instrument is in use for 3 days, nine colonies of A. flavus are identified, but later on when the instrument is in use for 6, 9, 12, and 15 days, the air samples contain neither fungus nor bacteria.ConclusionAfter keeping the RH and temperature of the closed system constant at 55% RH and 25℃ by using the Precise Climate Controller, it is found that the efficaciousness in controlling the quantity and species of fungi and bacteria is clinically significant.
BackgroundIt is crucial for the army to know the prevalence of obstructive sleep apnea (OSA) syndrome in active-duty army personnel. Little information has been reported on the prevalence of OSA and clinical features in active-duty army personnel. This study was aimed to estimate the prevalence of snoring and risk of developing OSA in active-duty army personnel in Thailand and to identify the co-morbidities of OSA. In total, 1107 participants who were aged 20–60 years and were deployed to the three southernmost provinces of Thailand were enrolled. All the participants completed the Phramongkutklao (PMK) Hospital OSA Questionnaire that was modified and validated from the Berlin Questionnaire and underwent physical examination. The participants were 1107 active-duty army personnel in the three southernmost provinces of Thailand, both males and females, aged 20–60 years.MethodsThe PMK OSA Questionnaire was used to assess the risk of OSA together with interviewing for snoring, fatigue, falling asleep and day-time sleepiness. Physical examination of the neck, chest and hip circumference, and height was performed. Information concerning physical training, co-morbid diseases, smoking and alcoholic consumption was collected.ResultsThe prevalence of snoring was 58.5, and 4.8% met the PMK OSA Questionnaire criteria, thus indicating a high risk of OSA. The information obtained indicated that laryngopharyngeal reflux (LPR), current smoking and alcoholic consumption were significantly higher in the high-risk OSA group.ConclusionEarly detection and treatment of OSA in active-duty army personnel are imperative. Physical examination and polysomnography can be used to reveal the high-risk group. High body mess index (BMI), laryngopharyngeal reflux, current smoking and alcoholic consumption are modifiable factors for OSA and are avoidable. A policy to decrease the BMI and risk of LPR, as well as to stop smoking and alcoholic consumption, should be applied.
Introduction
Continuous positive airway pressure (CPAP) for treatment of moderate to severe obstructive sleep apnea can produce troublesome nasal symptoms (i.e. congestion, rhinorrhea, sneezing, itching) that may affect the continuity and decrease the compliance of CPAP. Topical nasal steroids are often prescribed to reduce these side effects, although recent studies are scarce supporting any benefit of this treatment for CPAP-induced nasal side effects.
Methods
80 patients who were previously diagnosed with OSA and pretreatment nasal symptoms were enrolled. All of them were selected for CPAP treatment and divided randomly into two groups. The study group was prescribed Fluticasone furoate nasal spray 55 ug daily before bedtime. The patients’ compliance to CPAP was recorded by the memory card in CPAP device. Total nasal symptom score was assessed using a questionnaire by direct interview. The follow-up was performed in 30 and 90 days after treatment.
Results
The compliance to CPAP (Percent days with usage, Average time usage and Percent of days with usage ≥ 4 hours) increased in both groups with higher significance in topical nasal steroid group (P-value=0.002, 0.001, 0.002) after 90 days of treatment. There was no difference in nasal symptom between both groups after 30 days of treatment. However, addition of topical nasal steroid resulted in decreased rhinorrhea and congestion symptom (P-value <0.001, <0.001) after 90 days of treatment.
Conclusion
The addition of topical nasal steroid decreased the frequency of nasal symptoms (esp. rhinorrhea and congestion) in OSA patients initiating CPAP therapy and increased the compliance to CPAP after 90 days of treatment.
Support
Keywords: Obstructive sleep apnea, Continuous positive airway pressure, CPAP, Topical nasal steroid
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