ABSTRACT
INTRODUCTION: For 7 years we gained experience of how asthma and chronic rhinosinusitis with nasal polyposis respond to biologics. In contrast, it is much less known, how ASA/NSAID intolerance (Widal's disease) behaves under biologicals. We therefore describe the case of a patient with both clinical conditions who reacted with a severe intolerance reaction under perioperative metamizole administration.
Subject(s)
Asthma, Aspirin-Induced , Nasal Polyps , Rhinosinusitis , Female , Humans , Male , Middle Aged , Anti-Asthmatic Agents/adverse effects , Anti-Asthmatic Agents/therapeutic use , Antibodies, Monoclonal, Humanized/adverse effects , Antibodies, Monoclonal, Humanized/therapeutic use , Asthma, Aspirin-Induced/drug therapy , Asthma, Aspirin-Induced/diagnosis , Diagnosis, Differential , Dipyrone/adverse effects , Dipyrone/therapeutic use , Nasal Polyps/drug therapy , Rhinosinusitis/drug therapyABSTRACT
STUDY OBJECTIVES: As in many other Low and Middle Income Countries (LMICs) around the world, sleep disorders in the Kyrgyz Republic remain mostly undiagnosed and untreated. This article aims to describe the current state of practice of sleep medicine in the Kyrgyz Republic from the perspective of local and international health care workers who are active in the field and to propose a strategy to challenge the status quo. METHODS: We performed a policy analysis and interviewed local doctors working in the field. RESULTS: We identified 3 major barriers to the practice of sleep medicine and namely education and training, financial constraints and infrastructure and equipment. We then propose a multistep strategy to improve the current situation based on 3 pillars: knowledge sharing, implementation research activities and policy changes. CONCLUSIONS: Despite being at its early days and facing major challenges, sleep health in the Kyrgyz Republic is being recognized as a priority by health care workers in the field and now requires attention at local and government level. Furthermore, north-south academic partnerships represent an effective tool for knowledge sharing and should be further incentivised. CITATION: Cirri L, Bolotbek uulu A, Shakiev N, et al. Sleep medicine in the Kyrgyz Republic: past, present, and future. J Clin Sleep Med. 2024;20(7):1213-1216.