OBJECTIVE: To determine whether excessive daytime sleepiness (EDS) as assessed by the Epworth Sleepiness Scale (ESS) is significantly correlated with body mass index (BMI) and Apnea-Hypopnea Index (AHI) in patients suspected of OSAS and whether obesity as assessed by BMI is associated with AHI.
METHODS:
Design: Non-concurrent cohort study
Setting: Tertiary Private Hospital
Population: The charts of 389 patients suspected to have sleep disorders and referred for polysomnography (PSG) at the Center for Snoring and Sleep Disorders in year 2009 were reviewed. Inclusion criteria were patients aged 19 and above with complete data. A total of 238 patient charts were included in the study.
RESULTS: The study included a total of 238 patient charts. Results showed no significant association between ESS and AHI (p-value >0.05) even when correlated with the different severities of OSAS (p-value>0.05). Sensitivity and specificity of ESS was found to be 54% and 57%, respectively, indicating that ESS is not a sensitive and specific tool to predict the presence of OSAS. These findings suggest that ESS may not be able to significantly identify patients with OSAS. However, BMI showed a significant association with ESS (p-value<0.05) representing more patients with EDS belonging to the obese category. Conversely, obese patients were twice more likely to have EDS, represented by ESS scores of >=10. BMI was also significantly associated with AHI using one-way Anova test.
CONCLUSION: This report concludes that the ESS alone is insufficient to identify patients with OSAS. Nevertheless, questionnaires like the ESS supplement relevant history to help diagnose patients with sleep disorders particularly OSAS. On the other hand, the ESS showed a significant association with BMI representing more obese patients had excessive daytime sleepiness. The likelihood ratio of having excessive daytime sleepiness is two times more for obese patients. BMI was also significantly associated with AHI which confirms the well established relationship of obesity with OSAS, and shows that obese patients are at higher risk for severe OSAS.

Human ; Male ; Female ; Adult ; Adolescent ; Child ; Child Preschool ; Sleep ; Apnea ; Body Mass Index ; Sleep Apnea, Obstructive ; Syndrome ; Snoring ; Polysomnography ; Sleep Wake Disorders ; Obesity

Objective: To describe a rare case of Kimura’s disease initially misdiagnosed as malignancy then tuberculosis. Methods: Design: Case report Setting: Tertiary Private Hospital Patient: One Results: A 30-year-old male with a 6-year history of gradually-enlarging right infra-auricular mass revealed an enlarged mass in the right infraauricular area and multiple cervical lymphadenopathies on physical examination. Initial fine-needle aspiration biopsy was interpreted as pleomorphic adenocarcinoma but succeeding work-ups and imaging studies led to treatment for tuberculosis. Subsequent biopsies finally led to the proper histopathologic diagnosis of Kimura’s disease and the patient was shifted to appropriate treatment with oral prednisone. Conclusion Kimura’s disease is rare and may be confused with other diseases such as malignancy or tuberculosis. Histopathologic diagnosis is necessary as its treatment differs from tuberculosis and other diseases.
Human ; Male ; Adult ; ANGIOLYMPHOID HYPERPLASIA WITH EOSINOPHILIA ; TUBERCULOSIS ; PHYSICAL EXAMINATION ; DIAGNOSIS ; DIAGNOSTIC TECHNIQUES AND PROCEDURES BIOPSY, FINE-NEEDLE ; BIOPSY ; PREDNISONE ; Diagnostic Errors ; history ; diagnosis

Objective:To determine the sensitivity, specificity and positive predictive value of the STOP BANG questionnaire in diagnosing Obstructive Sleep Apnea (OSA) in adults admitted for polysomnography at the Rizal Medical Center from January 2019 to June 2024

Methods:
Design:Review of Records
Setting:Tertiary Government Training Hospital
Participants:166 adult patients

Results:A total of 166 patient records were included with an average age of 35.6 ± 12 years, BMI of 29.3 ± 6.44 and 67% were male. The STOP-BANG questionnaire had a sensitivity of 77% to screen for all (AHI ≥ 5), mild (AHI = 5-14.9), moderate (AHI = 15-19.9), and severe OSA (AHI > 30), respectively. The specificity was 62% and the area under the curve was 0.717 for all, mild, moderate and severe OSA

Conclusion:A STOP-BANG score of 3/8 can predict the presence of OSA with a sensitivity of 77% and specificity of 62% with AUC of 0.717. The increase in score does not predict the severity. Further research can be done to identify other co-morbidities associated with OSA.

Human ; Apnea ; Obstructive Sleep Apnea ; Sleep