scholarly journals Laryngopharyngeal Reflux Disease in War-torn Syria and its Association with Smoking and other Risks.

2020 ◽  
Author(s):  
Ameer Kakaje ◽  
Mohammad Marwan Alhalabi ◽  
Ayham Alyousbashi ◽  
Aya Hamid ◽  
Yousef Mahmoud
Keyword(s):  
Cigarette Smoking ◽  
Laryngopharyngeal Reflux ◽  
Cross Sectional Study ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Cross Sectional ◽  
Medical Sector ◽  
Laryngopharyngeal Reflux Disease ◽  
The Mean

Abstract Backgrounds: Syria has entered its ninth year of conflict and as its medical sector facing major hurdles, laryngopharyngeal reflux (LPR) is often overlooked although it has an association with worsening quality of life and affecting many aspects as it is chronic and left untreated although it can lead to many complications such as dysphonia. This study is to evaluate LPR prevalence and its association with different aspects such as cigarette, and shisha smoking, and the effect of war on LPR.Methods: Cross-sectional study by using online questionnaires that included demographics, smoking, war related questions and reflux symptom index (RSI) were used online in many cities around Syria.Findings: This research included 734 responders with 75.5% being female and the mean age being 23.97 years. 31.9% of subjects had symptoms suggestive of LPR. Participants were Syrians and we included every responder who agreed and did not neglect any question. We only found that being distressed from war noises was associated with positive LPR symptoms [P=0.009 (OR, 1.562; 95% CI 1.117-2.183)], but losing someone or changing place of living due to war were not associated with LPR. LPR was associated with cigarette smoking (P<0.05). Finally, having asthma, and male gender in the younger population were associated with LPR (P<0.05). No clear association with age, or shisha and no significant associations were found with consanguinity, marital status, educational level and SES.Interpretations: About one third had LPR symptoms. War distress from war noise, cigarette smoking, asthma, and allergic were significantly correlated with LPR.

scholarly journals Allergic rhinitis, asthma and laryngopharyngeal reflux disease: a cross-sectional study on their reciprocal relations

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ameer Kakaje ◽  
Mohammad Marwan Alhalabi ◽  
Ayham Alyousbashi ◽  
Ayham Ghareeb
Keyword(s):  
Allergic Rhinitis ◽  
Reflux Disease ◽  
Medical Condition ◽  
Laryngopharyngeal Reflux ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Cross Sectional ◽  
Wide Range

AbstractAllergic rhinitis (AR) is a common medical condition worldwide. It is an inflammation in the nasal mucosa due to allergen exposure throughout the year. Laryngopharyngeal reflux (LPR) is another medical condition that can overlap with AR. LPR can be considered an extra oesophageal manifestation of gastro-oesophageal reflux disease (GORD) or a different entity. Its diagnosis imposes a real challenge as it has a wide range of unspecific symptoms. Although AR and LPR are not life-threatening, they can severely affect the quality of life for years and cause substantial distress. Moreover, having AR is associated with having asthma which is also in turn associated with GORD. This is a cross-sectional study which used surveys distributed online on Social Media and targeted people across Syria. All participants who responded to the key questions were included. Reflux symptom index (RSI) was used for LPR, and score for allergic rhinitis (SFAR) was used for AR. Demographic questions and whether the participant had asthma were also included in the survey. We found that there was an association between the symptoms of LPR and AR p < 0.0001 (OR, 2.592; 95% CI 1.846–3.639), and their scores were significantly correlated (r = 0.334). Having asthma was associated with LPR symptoms p = 0.0002 (OR 3.096; 95% CI 1.665–5.759) and AR p < 0.0001 (OR 6.772; 95% CI 2.823–16.248). We concluded that there was a significant association between having LPR, AR, and asthma. We need more studies to distinguish between their common symptoms and aetiologies.

scholarly journals Laryngopharyngeal reflux in war-torn Syria and its association with smoking and other risks: an online cross-sectional population study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041183 ◽  
Author(s):  
Ameer Kakaje ◽  
Mohammad Marwan Alhalabi ◽  
Ayham Alyousbashi ◽  
Aya Hamid ◽  
Yousef Mahmoud
Keyword(s):  
Response Rate ◽  
Laryngopharyngeal Reflux ◽  
Cross Sectional Study ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Cross Sectional ◽  
Laryngeal Mucosa ◽  
Respiratory Conditions ◽  
Allergic Disorders ◽  
Associated Variables

ObjectivesTo demonstrate the burden of laryngopharyngeal reflux (LPR) in Syria and its associated variables.DesignThis is a cross-sectional study that used online questionnaires that included demographics, smoking, war-related questions and reflux symptom index (RSI).SettingThis research was conducted online across Syria and included the general population.ParticipantsParticipants who lived in Syria, agreed to participate, and responded to all the RSI questions were included. This research comprised 734 participants, with 94.6% response rate, 75.5% being females, and a mean age of 24 years.ResultsOverall, 31.9% of subjects had symptoms suggestive of LPR. Participants who were 30 years and younger had fewer symptoms suggestive of LPR compared with the older group p=0.012 (OR 0.534; 95% CI 0.325 to 0.877). While having an epigastric burning sensation, chest pain and indigestion were the most common symptoms, having a sore throat was the least common. Being distressed from war noises was associated with more symptoms p=0.009 (OR 1.562; 95% CI 1.117 to 2.183). However, losing someone or changing place of living due to war were not significantly associated with these symptoms p>0.05. RSI scores were associated with cigarette and/or shisha smoking p<0.05. Finally, asthma, allergic disorders and having a job were associated with having LPR symptoms p<0.05. No significant findings were observed in consanguinity, marital status, educational level and socioeconomic status.ConclusionsWar, smoking, asthma, allergies, respiratory conditions and having a job were associated with LPR symptoms. However, they may be associated with these symptoms independently from LPR; for instance, similar symptoms can be caused by the mental disorders from war, the unique environment and irritant substances of the laryngeal mucosa.

scholarly journals Association Between Voice Handicap Index and Reflux Symptom Index: A cross-sectional study of undiagnosed general and teacher cohorts in Saudi Arabia

2018 ◽  
Vol 18 (3) ◽  
pp. 350 ◽  
Author(s):  
Rawan Alanazi ◽  
Ahmed Alrahim ◽  
Sara Bayounos ◽  
Abdulrahman Al-Ghuwainem ◽  
Mohammad H. Al-Bar
Keyword(s):  
Saudi Arabia ◽  
General Population ◽  
Response Rate ◽  
Laryngopharyngeal Reflux ◽  
Voice Disorders ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Cross Sectional

Objectives: This study aimed to assess potential associations between self-reported symptoms of laryngopharyngeal reflux (LPR) and voice disorders among two undiagnosed cohorts in Saudi Arabia. Methods: This cross-sectional study was conducted from February to April 2017 in Khobar, Saudi Arabia. Validated Arabic versions of the Reflux Symptom Index (RSI) and 10-item Voice Handicap Index (VHI-10) were distributed to 400 teachers at 13 schools and 300 members of the general population attending an ear, nose and throat clinic in Khobar. Scores of >13 and >11 on the RSI and VHI-10 indicated a potential subjective diagnosis of LPR and voice disorders, respectively. Results: A total of 446 individuals took part in the study, including 260 members of the general population (response rate: 86.7%) and 186 teachers (response rate: 46.5%). The mean age was 32.5 years. In total, 62.2% complained of voice and/or reflux problems, with the remaining 37.8% not reporting/unaware of any problems in this regard. Among the teachers, 30.6% and 18.3% had positive RSI and VHI-10 scores, respectively, while 43.1% and 14.6% of the individuals from the general population had positive RSI and VHI-10 scores, respectively. Overall, VHI-10 scores were significantly associated with RSI scores (P <0.001). Conclusion: A significant association between RSI and VHI-10 scores suggests that there may be an association between LPR and voice disorders. These tools would therefore be a valuable method of monitoring patients; however, they cannot be used to confirm a diagnosis. Thus, more detailed studies are needed to confirm this association using a larger sample size.Keywords: Voice Disorders; Laryngopharyngeal Reflux; Hoarseness; Diagnostic Self Evaluation; School Teachers; Saudi Arabia.

scholarly journals Does laryngopharyngeal reflux affect voice quality? a cross-sectional study

2021 ◽  
Vol 7 (6) ◽  
pp. 1021
Author(s):  
Almas J. Vakil ◽  
Pratibha Vyas ◽  
Shreya Prasad ◽  
Praveen Singh
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Voice Quality ◽  
Voice Disorders ◽  
Empirical Therapy ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Reflux Symptom Index ◽  
Voice Change ◽  
Symptom Index ◽  
Cross Sectional

<p class="abstract"><strong>Background: </strong>Laryngopharyngeal reflux (LPR) is a rising disease that leads to voice changes. This study aimed to assess the potential association between the symptoms of laryngopharyngeal reflux (LPR) and voice disorders using the Reflux symptom index (RSI) and the Voice handicap index (VHI-10) scales, respectively.</p><p class="abstract"><strong>Methods:</strong> This cross-sectional study was conducted in the Department of Otorhinolaryngology at Mahatma Gandhi Medical College and Hospital, Jaipur, India, from June 2019 to November 2019, on a sample size of 144 patients having complaints related to voice change and laryngopharyngeal reflux. The participants filled the RSI and the VHI-10 questionnaires. RSI scores of &gt;13 and VHI-10 scores of &gt;11 indicated LPR-related symptoms and voice disorders, respectively.</p><p class="abstract">Results: The study included 70 (48.61%) patients who were males and 74 (51.38%) patients who were females. The mean age was 33.5 years. Overall, 89(61.80%) patients had RSI scores of &gt;13 while 102 (70.83%) patients had VHI-10 scores of &gt;11. A significant association was found between positive RSI and VHI-10 scores (p&lt;0.001).</p><p class="abstract"><strong>Conclusions: </strong>A significant association between RSI and VHI-10 scores reflects an association of laryngopharyngeal reflux with long-standing voice change. RSI and VHI-10 may constitute valuable tools in diagnosing suspected patients with voice change and direct early start of empirical therapy with PPI.</p>

scholarly journals Cross sectional study of prevalence of LPRD at tertiary care hospital

2019 ◽  
Vol 5 (2) ◽  
pp. 445
Author(s):  
Raghvendra Singh Gaur ◽  
Paromita Patra
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Tertiary Care ◽  
Treatment Protocol ◽  
Stomach Contents ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Cross Sectional

<p class="abstract"><strong>Background:</strong> Reflux means return or regurgitation of fluid. When symptoms arise due to reflux of stomach contents into the pharynx and larynx it is termed as laryngopharyngeal reflux disease (LPRD). GERD and LPRD are two different entities and the management principle of GERD doesn’t apply to LPRD. We designed a cross sectional study to evaluate the prevalence of laryngopharyngeal reflux among the patients visiting the ENT outpatient department over a duration of one year.</p><p class="abstract"><strong>Methods:</strong> Patients presenting with throat and voice symptoms for more than a month were included in the study. The reflux symptom index (RSI) put forward by Belafsky et al was used to assess the symptoms of reflux. A diagnosis of reflux was made if the patient had an RSI score &gt;13.  </p><p class="abstract"><strong>Results:</strong> A total of 2669 patients included in study period, out of which 1316 (49.3%) were males and 1353 (50.7%) were females. Out of the 2669, 1938 (72.6%) patients were found to have a RSI of &gt;13. Out of the 1938 patients subjected to 70 laryngoscopy 1842 patients (95%) were found to have a RFS &gt;7. Of the 1842 patients with RFS &gt;7, 1234 were males (67%) and 608 were females (33%).</p><p class="abstract"><strong>Conclusions:</strong> In a developing country like India, where resources and man power are limited, symptoms of laryngopharyngeal reflux might often be overlooked. The diagnosis and treatment protocol for LPRD needs to be standardized through more long term studies in the manner it has been done for GERD.</p>

A Randomized Clinical Trial of Proton Pump Inhibitors Combined with Traditional Chinese Medicine in the Treatment of Laryngopharyngeal Reflux Disease

2021 ◽  
Author(s):  
Feng Pei ◽  
Wei Jia Hu ◽  
Yi Nan Mao ◽  
Yu Liang Zhao
Keyword(s):  
Proton Pump ◽  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Short Form ◽  
Therapeutic Effects ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Laryngopharyngeal Reflux Disease ◽  
Group A ◽  
Group B

Background:To explore whether combined with TCM based on classical proton pumpinhibitors PPIs therapy can achieve better efficacy for patients withlaryngopharyngeal reflux disease. Methods: There were 150 laryngopharyngeal refluxpatients enrolled and divided into three groups randomly, with 50 cases in each group.Patients in group A were treated with the proton pump inhibitor (PPI) lansoprazole.Patients in group B were treated with lansoprazole combined with Banxia Houpudecoction, and patients in group C were treated with acupuncture treatments and acombination of Chinese and Western medicine. The reflux symptom index (RSI), refluxfinding score (RFS), and quality of life (36 item short form health survey questionnaire)were assessed before and 4 and 8 weeks after treatment. Results: The RSI and RFSscores of the three groups were significantly reduced after treatment (P < 0.001). Ingroup B and C, they were lower than in group A at 8 weeks (P < 0.01). The SF 36 scoreof 3 groups increased after treatment. At both 4 and 8 weeks (P < 0.001), and patientsin groups B and C scored higher than patients in group A (P < 0.001). The total effectiverate of group B and group C was higher than that of group A (P < 0.05). Conclusion:All three treatments have therapeutic effects on the disease, but the efficacy of a PPIalone is not as good as the combined treatments’ efficacies. Moreover, PPI combinedwith Banxia Houpu decoction and/or acupuncture treatment substantially affects lifeimprovement.

Usefulness of Matrix Metalloproteinase-7 in Saliva as a Diagnostic Biomarker for Laryngopharyngeal Reflux Disease.

2021 ◽  
Author(s):  
Nu-Ri Im ◽  
Byoungjae Kim ◽  
Kwang-Yoon Jung ◽  
Seung-Kuk Baek
Keyword(s):  
Matrix Metalloproteinase ◽  
Sensitivity And Specificity ◽  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Diagnostic Methods ◽  
Reflux Symptom Index ◽  
Enzyme Activity Assay ◽  
Symptom Index ◽  
Laryngopharyngeal Reflux Disease ◽  
Matrix Metalloproteinase 7

Abstract Introduction Several diagnostic methods are currently being used to diagnose LPRD (laryngopharyngeal reflux disease), but have the disadvantage of being invasive, subjective, or expensive. Objectives Our purpose in this study was to investigate the correlation between pepsin and MMP-7 (Matrix Metalloproteinase-7) in pharyngeal secretions of subjects according to RSI (Reflux Symptom Index) score to find out the diagnostic value of MMP-7. Method We recruited 173 subjects aged between 19 and 85 years who completed the RSI scale. All samples were taken after waking up, and the amount of the pepsin and MMP-7 in saliva were measured by means of an enzyme activity assay. Results There was a significant increase of pepsin and MMP-7 activity in the study group with an RSI score of 13 or higher. The sensitivity and specificity of MMP-7 for predicting the possibility of an RSI of 13 or more was higher than that of pepsin. When MMP-7 and pepsin were combined, this sensitivity and specificity increased. Conclusion An enzyme assay of MMP-7 in saliva may be a noninvasive and easy technique for diagnosing LPRD.

scholarly journals Laryngopharyngeal Reflux: Is It the Real Culprit in Patients with Laryngeal Complaints?

2017 ◽  
Vol 7 (1) ◽  
pp. 6-9 ◽  
Author(s):  
Rajesh Vishwakarma ◽  
Ruta V Shah
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Female Ratio ◽  
The Real ◽  
Body Sensation ◽  
Male Female Ratio ◽  
The Mean ◽  
Nose And Throat

ABSTRACT Aim The aim of this study is to evaluate the role of laryngopharyngeal reflux (LPR) in patients with laryngeal complaints and study the correlation between reflux symptom index (RSI) and reflux finding score (RFS). Materials and methods This is a study of 104 patients, who presented in the ear, nose, and throat outpatient department at the Civil Hospital, Ahmedabad, India, from April 2015 to April 2016, with complaints like change of voice, chronic cough, foreign body sensation, throat clearing, difficulty swallowing, and regurgitation. All the patients were examined with 90° endoscope by a single examiner, and an RSI ≥13 was considered as indicative of reflux. Observation and discussion The mean age of the 104 patients was 47.2 years. The male-female ratio was 1:1.8. The RSI ranged from 5 to 44, with a mean of 22.99 and standard deviation (SD) of 7.43. The RFS ranged from 4 to 22, with a mean of 11.04 and SD of 3.07. Both the parameters showed high correlation (correlation coefficient 0.98). Conclusion The LPR plays an important contributory role in patients with laryngeal complaints. The RFS and RSI can be used as routine parameters in establishing the diagnosis of reflux. How to cite this article Shah RV, Vishwakarma R. Laryngopharyngeal Reflux: Is It the Real Culprit in Patients with Laryngeal Complaints? Int J Phonosurg Laryngol 2017; 7(1):6-9.

scholarly journals Quality of Care Delivered to Tuberculosis Patients among Public Hospitals in Central Northeast Ethiopia

2020 ◽  
Vol 30 (5) ◽  
Author(s):  
Balkew Asegidew Tegegn ◽  
Betregiorgis Zegeye Hailu ◽  
Birhanu Damtew Tsegaye ◽  
Gashaw Garedew Woldeamanuel ◽  
Wassie Negash
Keyword(s):  
Quality Of Service ◽  
Quality Of Care ◽  
Quality Of Healthcare ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional ◽  
The Mean ◽  
Process Dimension

BACKGROUND: Inappropriate Tuberculosis (TB) diagnosis and treatment contributes to unfavorable health outcome among TB patients. Improving quality of healthcare service helps to avert TB related morbidity. Despite these facts, the level of quality of service is not known in the hospitals. Hence, the present study was conducted to assess the quality of care delivered to TB patients among publichospitals.METHODS: A facility-based cross-sectional study was conducted from March 15 to April 30, 2019 in North Shewa Zone, Amhara region, Ethiopia. All TB patients who had follow-up in the hospitals were included. This resulted in the involvement of 82 TB patients. Data was collected by trained data collectors using facility audit, clinical observation checklists, structured questionnaire and in-depth interview. Data was analyzed using SPSS version 20. Binary logistic regression analysis was done to identify the predictors of patients’ satisfaction.RESULTS: In this study, 82 respondents with a mean age of 36.48 (±13.27) years were participated. The mean quality score for structural dimension was 59.5%, and 53.7% of participants were found to be satisfied in outcome dimension. The mean score for process dimension of quality of service were 67.9%. Having TB symptoms were significantly associated with the level of patientsatisfaction towards TB care [AOR = 0.217, p = 0.015].CONCLUSION:Quality of TB services from structural and outcome dimension were low and higher in process dimension. Thus, careful attention on the quality of services will help to reduce the burden of TB.

scholarly journals Assessment of quality of life in type 2 diabetes mellitus patients using World Health Organization quality of life-BREF questionnaire and appraisal of diabetes scale - a cross-sectional study

2021 ◽  
Vol 15 (3) ◽  
Author(s):  
Supriya Patil ◽  
Yamini Patil ◽  
Sanjay Kumar Patil
Keyword(s):  
Quality Of Life ◽  
Cross Sectional Study ◽  
World Health ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean ◽  
Health Organization

Diabetes is a chronic metabolic disorder that disturbs the quality of life (QOL) of patients. Therefore, evaluation of diabetes- related QOL could be a key outcome measure for its management. This study assessed the QOL in type 2 diabetes mellitus (T2DM) patients using the World Health Organization (WHO) quality of life (QOL)˗BREF questionnaire and disease-specific appraisal of diabetes scale (ADS). In this cross-sectional study, 520 T2DM patients were included. Patients’ demographic data, clinical information was collected through interviews, and the WHOQOL-BREF instrument and ADS were used for the QOL of patients. Statistical analysis was performed by using R software (Version 3.6.0). The mean ADS scores were lower in controlled diabetic subjects (18.50±3.08) and higher in uncontrolled diabetic subjects (19.29±2.73) (P<0.05). For WHOQOL-BREF, the mean scores for all the domains (overall general health, physical, psychological, social, and environmental) were significantly higher in controlled diabetic subjects (P<0.001). In addition, the age, duration of diabetes, associated comorbidities, treatment, and HbA1c level of patients showed a highly significant correlation with WHOQOL-BREF (P<0.001). Diabetic patients had poor-to-average QOL. Therefore, public health measures and education of diabetic patients are essential to create more awareness for improving the QOL of T2DM.

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