Analysis of the prevalence of myasthenia gravis in Ukraine depending on the place of residency and type of settlement

Aim: to study the prevalence of myasthenia gravis among adults in certain regions of Ukraine, taking into account the type of settlement and place of residence. The biostatistical, medical-statistical and epidemiological methods was used in the study. A study of the prevalence of myasthenia gravis in Ukraine was conducted on a sample of ten regions of Ukraine. 757 cases of myasthenia gravis were studied in selected territories, of which 465 (61.43 %) were among urban residents, 292 (38.57 %) were among rural residents. The average annual prevalence of myasthenia gravis was 5.16 (95 % CI —4.79—5.53) per 100,000 population. An analysis of the prevalence of myasthenia gravis in each region showed that this indicator among rural residents was statistically signifi cantly higher than the prevalence of myasthenia gravis among urban residents in Vinnytsia, Zaporizhzhia and Kirovohrad regions (p < 0.05), and in Volyn, Ivano-Frankivsk, Mykolaiv and Chernivtsi regions — without statistically significant differences (p > 0.05). The highest prevalence of myasthenia gravis in rural residents compared with urban residents was in the Vinnytsia region with an excess of 5.63 times (p < 0.001). The city prevalences of myasthenia in the Dnipropetrovsk (+39.14 %; p = 0.001) and Poltava regions (+35.87 %; p = 0.048) signifi cantly exceeded the average city prevalence of myasthenia gravis in Ukraine. They were signifi cantly lower in Vinnytsia (–75.07 %; p < 0.001), Volyn (–51.49 %; p < 0.001), Ivano-Frankivsk (–42.58 %; p = 0.004) and Chernivtsi (–37.35 %; p = 0.046) regions. The chances of rural residents to have myasthenia gravis were signifi cantly higher compared to urban residents. In general, according to the data of mya sthenia gravis prevalence rate in the context of the place of residence, it was proved that living in rural areas is associated with the presence of myasthe nia gravis. Key words: myasthenia gravis, epidemiology, prevalence, incidence, urban residents, rural residents,

Functioning of Patients with Myasthenia Gravis after Plasmapheresis

Introduction. Myasthenia gravis is an autoimmune disease of the postsynaptic part of the neuromuscular junction. A characteristic symptom of myasthenia gravis is the so-called fatigability or muscle fatigue, which also affects the respiratory muscles. Plasmapheresis is one of the treatments that improve breathing and reduce the symptoms that cause muscle weakness. Aim. The aim of the study was to assess the functioning of patients with myasthenia gravis before and after plasmapheresis. Material and Methods. The research was conducted in 2019 in the Anaesthesiology and Intensive Care department on a group of 30 patients with clinically confirmed myasthenia gravis. The author’s questionnaire was used to assess the functioning of patients. The research was approved by the Bioethics Committee. Results. The patient’s condition improved after the procedure in each of the analysed areas of functioning (physical activity, movement, breathing, swallowing, mood, social functioning). The plasmapheresis most preferably affected the area of physical activity of the subjects. The conducted statistical analysis proved a significant difference (p = 0.000) for all results, in every aspect (before and after the procedure). At the same time, the highest average increase was observed in relation to physical activity — an increase of 3.17 points. Conclusions. Plasmapheresis had a positive effect on patients’ health in both physical and mental aspects. (JNNN 2019;8(4):143–147) Key Words: myasthenia gravis, plasmapheresis, functional assessment