Background: As global life expectancy increases, spinal disorders and the need for spinal surgery among elderly individ uals are becoming more prevalent. Postoperative cognitive decline (POCD) is a common complication in this population, adversely affecting functional recovery and quality of life. Despite substantial research, effective preventive strategies for POCD remain limited. Aim: To determine the incidence of POCD and to identify perioperative risk factors associated with its development in elderly patients undergoing spinal surgery. Materials and Methods: A prospective cohort study was conducted at the Second Affiliated Hospital of Inner Mongolia Medical University. Of 200 elderly patients who underwent spinal surgery between, 122 met the inclusion criteria and were enrolled. Preoperative clinical assessments, intraoperative surgical and anesthetic parameters, and postoperative evaluations were systematically collected. Cognitive function was assessed using standardized and validated tools both before and after surgery. Multivariate logistic regression analyses were performed to identify independent predictors of POCD. Results: POCD was observed in a notable proportion of patients postoperatively. Multivariate analysis revealed that prolonged surgical duration (OR=0.989; p=0.005), intraoperative hypotension (OR=0.964; p=0.009), higher intensity of postoperative pain (OR=10.073; p=0.015), and elevated postoperative C-reactive protein levels (OR=1.039; p<0.001) were significantly associated with an increased risk of developing POCD. Conclusion In elderly patients undergoing spinal surgery severe postoperative pain, and systemic inflammatory respons es contribute significantly to the development of POCD. Optimizing perioperative management, including minimizing surgical time, maintaining stable hemodynamics, and controlling postoperative inflammation and pain, may mitigate the risk of cognitive decline.

Abstract Epilepsy, a neurological disorder characterized by recurrent seizures, affects millions of people worldwide. Significant advancements in both diagnostic and therapeutic approaches have greatly improved outcomes, particularly for individuals with drug-resistant epilepsy. Modern neurostimulation techniques such as Responsive Neurostimulation (RNS), Deep Brain Stimulation (DBS), and Vagus Nerve Stimulation (VNS) have demonstrated effectiveness in reducing seizure frequency in these patients. Additionally, emerging technologies like gene therapy and optogenetics are being explored to better understand the underlying mechanisms of epilepsy and hold promise as future treatment modalities.Traditional imaging techniques often fail to detect subtle epileptogenic zones. However, the introduction of ultra high-field 7T MRI scanners represents a major breakthrough. These advanced scanners use eight transmitters to generate higher-resolution images, reducing signal dropout and enabling the identification of previously undetected lesions. In one study involving 31 patients, 58% had their treatment plans modified based on 7T MRI findings, highlighting its potential to inform surgical decision-making. In terms of pharmacological treatment, newer medications such as sultiame, cannabidiol (CBD), and non-pharmacological approaches like the ketogenic diet have emerged as additional therapeutic options for drug-resistant epilepsy. These developments contribute to more effective, personalized management strategies for epilepsy. In summary, the landscape of epilepsy diagnosis and treatment is rapidly evolving. Innovations in imaging and therapeutic interventions are offering new hope for patients with drug-resistant epilepsy. Ongoing research and clinical trials remain essential to further refine these approaches and improve patient outcomes.

Introduction: According to the WHO, being exposed to loud noise for a long time can be very harmful to health. It can lead to heart and blood vessel problems, mental health issues, trouble sleeping, and hearing loss. Noise pollution has a negative effect on the brain and nervous system, and it can cause many problems. High-frequency noise, in particular, can disturb the central nervous system. This can lead to problems like poor concentration, more anxiety, and feeling mentally tired. Many studies around the world have shown that noise levels of ≥85 dB at work increase the risk of noise-induced hearing loss (NIHL) and tinnitus.In Ulaanbaatar, environmental noise pollution continues to grow due to population growth, construction, and urban planning. Therefore, it is important to find out whether environmental noise pollution is linked to mental and behavioral disorders, insomnia, nervous fatigue, high blood pressure, and hearing loss among the population. Goal: The aim of this study is to examine the prevalence of primary hypertension (I10), nervous fatigue (F48.0), sleep disorders (F51.0), and tinnitus (H83.3) caused by environmental noise among the population of Ulaanbaatar. Materials and Methods: A descriptive research design was applied to examine statistical data from the Center for Health Development regarding diseases related to noise pollution. Based on the 10th revision of the International Classification of Diseases (ICD-10), the study focused on conditions such as neurasthenia (F48.0), non-organic sleep disorders (F51), primary hypertension (I10), and hearing disorders (H83.3). The analysis included data recorded between 2014 and 2023 among the population of Ulaanbaatar city. Epidemiological analysis was performed using SPSS-24 software, and the results were calculated per 10,000 population. Ethical Considerations: This study did not receive any external funding or financial support from public or private organizations. It utilizes secondary data from the Health Development Center, which does not contain any personal information. Results: In 2014, the average age of individuals diagnosed with neurasthenia (F48.0) was 40.1±12.6 years; for non-organic sleep disorders (F51.0), it was 48.1±14.5 years; for noise-induced hearing disorders (H83.3), 47.2±12.7 years; and for primary hypertension (I10), the average age was 59.0±11.4 years. By 2023, the average age for primary hypertension had slightly decreased to 58.0±12.9 years. Since 2014, the number of cases of nervous fatigue, non organic sleep disorders, and hearing problems caused by noise has risen in Ulaanbaatar. In 2023, the average age of people with primary hypertension (I10) dropped to 58.0±12.9 years. Noise-related illnesses are common among people aged 40 to 60 in Ulaanbaatar, and this is lowering their quality of life. Conclusion Noise-related illnesses are being recorded among the 40–60 age group in Ulaanbaatar, which is negatively affecting their quality of life. It is urgently necessary to introduce measures for adequate protection of the population from the negative health effects of environmental noise.