Prevalence of allergic fungal sinusitis among patients with nasal polyposis

2021 ◽  
pp. 1-10
Author(s):  
Rahim Dhanani ◽  
Shayan Khalid Ghaloo ◽  
Basit Salam ◽  
Hamdan Ahmed Pasha ◽  
Farah Hafiz Yousuf ◽  
...  
Keyword(s):  
Nasal Polyps ◽  
Care Center ◽  
Fungal Growth ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Health Care Center ◽  
Ethical Approval ◽  
Allergic Mucin ◽  
The Mean ◽  
Sinonasal Polyposis

Abstract Objective: The objectives of the study were to determine the frequency of AFS among patients with nasal polyps and to compare the Lund-Mackay scores of patients with and without AFS. Methods: The study was carried out at a tertiary health care center of Karachi, Pakistan from December 2016 to November 2018, after taking ethical approval. Total of 114 patients with sinonasal polyposis undergoing surgery were included. Patients were categorized as case of AFS when histopathology showed allergic mucin with fungal hyphae and culture was positive for fungal growth. Lund-Mackay scoring based on CT PNS of each patient was done and mean scores of AFS and non AFS patients were compared. Results: Mean age of 114 participants was 37.3 ± 15.3 years. 61 (53.5%) of them were males. 27 (23.7%) patients met the AFS criteria. 19 (16.7%) patients were asthmatic and a significant relationship was found between asthma and AFS (P = 0.03). The mean Lund-Mackay score was 13.2 for non AFS and 18.8 for AFS patients (P = <0.01). Recurrence was seen in 11 (9.6%) cases. Conclusion: The frequency of AFS in patients with nasal polyps was 23.7% and the patients with AFS showed significantly higher mean Lund-Mackay score compared to non AFS patients. Continuous....

scholarly journals Timing and reasons for antenatal care booking among women in a tertiary health care center in Southern Nigeria

2017 ◽  
Vol 6 (9) ◽  
pp. 3731 ◽  
Author(s):  
Ntiense Macaulay Utuk ◽  
Anyiekere Ekanem ◽  
Aniekan Monday Abasiattai
Keyword(s):  
Antenatal Care ◽  
Care Center ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Safe Motherhood ◽  
Cross Sectional ◽  
Post Secondary ◽  
Health Care Center ◽  
Southern Nigeria ◽  
The Mean

Background: Antenatal care is one of the four pillars of safe motherhood and its benefits in preventing adverse feto-maternal outcome is proven. Commencement of antenatal care early has been shown to be key for this benefit to be fully realized. The aim of this study was to determine the antenatal booking pattern of pregnant women and its determinants in our environment.Methods: A cross sectional study of women attending the booking clinic in the University of Uyo Teaching Hospital, Akwa Ibom State, Southern Nigeria over a three-month period.Results: The mean age of the respondents was 28.5 years. The mean gestational age at booking was 18.3 weeks. The majority of the patients were married (94.1%). 68.1% had a post-secondary education. 33.5% of patients were nultiparous, while 3.5% were grand multiparous. The majority of patients (72.4%) booked late for antenatal care. Age group, marital status, mode of delivery was not significantly associated with timing of booking. High levels of patient’s education, high levels of husband’s education as well as grand multiparity were significantly associated with late booking (P<0.05). Majority (65.4%) of patients claimed that it was safe to book at any time during pregnancy.Conclusions: The majority of women booked late for antenatal care. In our study, we have found that general and health education, subsidisation of cost for antenatal care and introduction of focused antenatal care will help to reverse this trend.

scholarly journals To measure angle of anterior chamber using Topcon SD-OCT: A new technique

2021 ◽  
Vol 7 (3) ◽  
pp. 537-540
Author(s):  
Nida Khan ◽  
Prakash Agarwal ◽  
Saroj Gupta ◽  
Khalid Khan
Keyword(s):  
Anterior Chamber ◽  
Care Center ◽  
Normal Subjects ◽  
Acute Angle ◽  
Angle Closure ◽  
Cross Sectional ◽  
Health Care Center ◽  
Temporal Quadrant ◽  
The Mean ◽  
Sd Oct

The proposed new method of measuring angle of anterior chamber is an effective method of measuring the angles. Identification of narrow anterior chamber angle is important for glaucoma screening and prophylactic treatment prevents acute angle closure glaucoma event.Aim of this study wasto measure the angle of anterior chamber using Topcon spectral domain optical coherence tomography (SD OCT).In this cross-sectional study 120 normal subjects above the age of 40 years were enrolled. The study was done at the tertiary health care center of central Indian. All volunteers had visual acuity of at least 6/9 with no ocular diseases. Using OCT the angle opening distance (AOD-500), trabecular–iris angle (TIA) and trabecular-iris space area (TISA-500) were measured. In this study the mean AOD was 0.430 µm in nasal and 0.433 µm in temporal quadrant. The mean TISA in nasal was 0.405 µm and temporal quadrant was 0.408 µm. While the mean trabecular iris angle (TIA) was 26.9° in nasal and 26.01° in temporal quadrant. The study proved that the proposed method of measuring AOD, TISA, TIA is the effective method as the Topcon-2000 OCT does not have any inbuilt software like that of other ASOCT machines.

scholarly journals Study to Determine the Incidence of Allergic Fungal Sinusitis among Patients with Nasal Polyps and Its Related Risk Factors

2021 ◽  
Vol 15 (7) ◽  
pp. 1860-1863
Author(s):  
Bakht Zada ◽  
Ejaz Ahmed ◽  
Muhammad Habib ◽  
Zafar Iqbal ◽  
Rehan Saleem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nasal Septum ◽  
Nasal Polyps ◽  
Bone Erosion ◽  
Histopathological Examination ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Deviated Nasal Septum ◽  
Allergic Fungal Sinusitis ◽  
Turbinate Hypertrophy

Aim: To govern the incidence of allergic fungal sinusitis in patients with nasal polyposis. Various anatomical risk factors were also investigated, including turbinate hypertrophy, deviated nasal septum and comorbidities such as asthma and diabetes. Study Design: This is a Descriptive cross-sectional study. Place and duration of study:The study was conducted at ENT Head &Neck Surgery department, Lady Reading Hospital MTI, Peshawar and Azra Nahid Medical College, Lahore for the duration of six months from May 2020 to October 2020. Methods: 110 patients with nasal polyps were evaluated and operated on. Samples were sent for histopathological examination and culture. All patients were assessed with clinical examination and detailed history. Laboratory tests were performed including complete blood counts, urea, electrolytes, ECG and chest radiographs for the suitability of general anesthesia as a prerequisite for surgery. In 95% of cases, computed tomography was recommended to check for sinus involvement, bone erosion, osteo-hypertrophic complex, turbinate hypertrophy, nasal septal deviation, and intracranial and intra-orbital enlargement. MRI examinations were also recommended in cases of suspected intraocular and intracranial disease (5%). Data was scrutinized on a computer using SPSS version 22.0. Results:Of the 110 patients, 65 were male and 45 were female, with a mean age of 1and ranged from 7 to 80 years. All patients had nasal polyps. The incidence of AFS was approximately 29.1% and the remaining 78 had a different pathology. Major deviation of the nasal septum and bilateral hypertrophy of the inferior turbinate’s were observed in 6 (18.7%) and 4 (12.5%) patients, respectively. Unilateral nasal polyps were observed in 7 (21.9%) patients and bilateral nasal polyps in 18 (52.3%). 19/32 (59.4%) of the cases underwent functional endoscopic surgery of the paranasal sinuses, and in 6 (18.7%) external fronto-ethmoidectomy. Two patients underwent nasal ethmoidectomy. Septoplasty and endoscopic sinus surgery were performed in a total of 3 (9.37%) cases. Key words:Allergic bronchopulmonary aspergillosis (ABPA), Allergic fungal sinusitis (AFS).

Allergic Mucin With and Without Fungus

2001 ◽  
Vol 125 (11) ◽  
pp. 1442-1447
Author(s):  
Jonathan F. Lara ◽  
J. Daniel Gomez
Keyword(s):  
Tertiary Care ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Radiographic Findings ◽  
Care Institution ◽  
Tertiary Care Institution ◽  
Allergic Mucin ◽  
And Gender

Abstract Context.—Allergic mucin, a lamellated collection of inspissated inflammatory debris, has been a hallmark of allergic fungal sinusitis. While its identification is a clue for pathologists to search for fungi, and directs clinicians toward specific therapy and follow-up, recent reports describe cases with allergic mucin but without concomitant fungus. The absence of such organisms in otherwise typical allergic mucin brings into question the role of fungi in allergic fungal sinusitis. Objectives.—To study clinical and pathologic differences between patients with allergic mucin in surgical nasal resection specimens and to elucidate the role of fungus in allergic sinusitis. Design.—Patients with histologic evidence of allergic mucin, with and without fungus, were identified and retrieved from the surgical pathology files of a tertiary-care institution. The patients were separated into 2 groups for analysis, and their clinical and pathologic findings were reviewed and compared. Setting.—Tertiary-care institution. Patients.—All patients who underwent sinus mucosal resection between 1992 and 1998. Results.—Clinical presentation and radiographic findings were similar in both groups. Incidence, age, and gender distribution were similar to data reported previously. However, the amount of allergic mucin was much greater in the group with fungus than in the group without fungus, which to our knowledge is an unreported observation to date. Conclusion.—The presence of allergic mucin is not unique to allergic fungal sinusitis, but rather is the result of a process that could have other etiologies. While perhaps not always causative to the disease, the fungus continues to fuel the process and is likely an entrapped bystander. Allergic fungal sinusitis is more appropriately termed allergic mucinous sinusitis or eosinophilic mucinous rhinosinusitis.

Nasal polyps: Still more questions than answers

2003 ◽  
Vol 117 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Neil D. Bateman ◽  
Colm Fahy ◽  
Timothy J. Woolford
Keyword(s):  
Surgical Treatment ◽  
Nasal Polyps ◽  
Fungal Spores ◽  
Extracellular Fluid ◽  
Inflammatory Cells ◽  
Preliminary Evidence ◽  
Good Evidence ◽  
Conclusive Evidence ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis

Nasal polyps are common, affecting one to four per cent of the population. Their cause, however, remains unknown and it is possible that it is not the same in all patients. They have a clear association with asthma, aspirin sensitivity and cystic fibrosis. Histologically they demonstrate large quantities of extracellular fluid, mast cell degranulation and an infiltrate of inflammatory cells, usually eosinophils. While this appearance would suggest an allergic pathology there is little conclusive evidence to support this in most patients. There is, however, some preliminary evidence to suggest that a local allergic process could be the cause. While allergic fungal sinusitis is a well defined clinical entity with recognized diagnostic criteria the ubiquitous nature of fungal spores makes the role of fungal infection in patients with nasal polyps difficult to determine and currently this remains unclear.Surgical treatment of nasal polyps has declined in recent years as the benefits of medical treatment have become increasingly recognized. There is good evidence to support the use of corticosteroids both as a primary and post-operative treatment in the majority of patients. Other medical treatments require further evaluation before they could be considered a viable alternative to steroids. Assessment of the literature regarding surgical intervention is difficult and there is little evidence on which to base a surgical treatment philosophy. The authors believe that an endoscopic approach using a microdebrider facilitates accurate removal of polyps with preservation of normal anatomy.

scholarly journals Knowledge, attitude and practices regarding the use of personal protective equipment during COVID-19 pandemic among health care workers at a tertiary health care center

2021 ◽  
Vol 8 (5) ◽  
pp. 2321
Author(s):  
Jatin V. Badgujar ◽  
Gaurav M. Sharma ◽  
Nisha R. Relwani ◽  
Omprakash S. Rohondia ◽  
Tanvi D. Patole ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Care Center ◽  
Knowledge Score ◽  
Senior Resident ◽  
Protective Equipment ◽  
Health Care Center ◽  
Total Knowledge Score ◽  
Care Workers ◽  
The Mean

Background: The aim of the present study was to assess the knowledge, attitude and practices (KAP) regarding the use of personal protective equipment (PPE) during COVID-19 pandemic among health care workers.Methods: A cross-sectional study was conducted among health care workers (HCW) including junior and senior resident doctors and nursing staff working at a tertiary health care center. A pre-designed, pre-validated, semi-structured questionnaire regarding the use of PPE was distributed online to eligible HCW and their responses were recorded electronically between 14 April 2020 and 20 April 2020. The survey questionnaire consisted of questions based on demographic and background characteristics along with KAP; knowledge (K1-K6), attitude (A1-A3) and practices (P1-P4).Results: A total of 423 out of 475 eligible participants successfully submitted their responses and were included in the present study which included junior resident doctors (55.70%), senior resident doctors (19.60%) and nursing staff (24.60%). The mean total knowledge score was 4.169±1.006 with an overall correct response rate of 75.8%. The result of one way ANOVA indicated that there is significant difference in the mean total knowledge score according to designation (F=6602, p<01) with improved knowledge score seen in HCW with higher designation. Majority of HCW had positive attitude and appropriate practices regarding the use of PPE.Conclusions: Optimal use of PPE is crucial to avoid transmission of infection in health care setting. Assessment of KAP of HCW regarding the use of PPE can help hospital authorities to introduce educational programs accordingly to gaps identified in the survey. 

scholarly journals Odontogenic Cervicofacial Infection in Pregnancy: A Need for Oral Care

2021 ◽  
Author(s):  
Benjamin Fomete ◽  
Rowland Agbara ◽  
Kelvin Uchenna Omeje ◽  
Adekunle Olanrewaju Oguntayo
Keyword(s):  
Oral Health ◽  
Care Center ◽  
Oral Care ◽  
Maxillofacial Surgery ◽  
Length Of Hospital Stay ◽  
Oral And Maxillofacial Surgery ◽  
Odontogenic Infections ◽  
Health Care Center ◽  
The Mean ◽  
Fascial Space

Objective: During pregnancy, changes occur in the oral environment with gingivitis predominating. The development of odontogenic infections within the period of pregnancy may endanger the life of the mother as well as that of her unborn baby. Materials and methods: A retrospective observational study of cases of cervicofacial infection in women during pregnancy was conducted at the oral and maxillofacial surgery clinic of a northern Nigerian tertiary health care center from January 2006 to June 2018. Results: Seventy women were managed for cervicofacial infection during the period reviewed, out of which 20 women (28.6%) presented during pregnancy. Their mean age was 33.8 ± 9.35 years with a range of 20 to 55 years. The 30-39 years age bracket had the highest frequency (40%) and the mean duration of pregnancy at presentation was 24.9 ± 11.12 weeks with a range between 10 to 36 weeks. Majority (n=15, 75.0%) presented in the 3rd trimester. At presentation, the frequently involved fascial space was unilateral submandibular space (n=10; 50.0%), All the patients had incision/drainage/decompression on the dental chair under local anesthesia (2% lidocaine with 1:80,000 adrenaline). The mean length of hospital stay was 13.9 ± 6.2 days with a range of 6 to 26 days. The mortality rate was 15% (n=3 cases). Conclusion: There is a need for oral health evaluation in pregnant women during ante-natal visits to prevent these complications. Oral health education should also form part of teachings received by women both in the ante-natal and postnatal clinics.

Allergic Mucin Sinusitis without Fungus

1997 ◽  
Vol 11 (2) ◽  
pp. 145-148 ◽  
Author(s):  
Hassan H. Ramadan ◽  
Huma A. Quraishi
Keyword(s):  
Clinical Picture ◽  
Nasal Polyposis ◽  
Clinical Presentation ◽  
Fungal Sinusitis ◽  
Asthma Treatment ◽  
Allergic Fungal Sinusitis ◽  
Fungal Hyphae ◽  
History Of ◽  
Allergic Mucin

Allergic fungal sinusitis (AFS) is a distinct clinical pathologic entity that has been recognized for over a decade. The hallmark of this process is eosinophilic allergic mucin with fungal hyphae on histopathology. We have identified a subset of patients who present with a clinical picture similar to that of AFS patients in which fungus could not be demonstrated pathologically or on culture. We present four cases of allergic mucin sinusitis without fungus. A comparison of the clinical presentation of this group of patients with those with AFS will be discussed. Both groups had nasal polyposis and a history of multiple sinonasal procedures. By contrast, the patients with allergic mucin sinusitis were older than the AFS group. All of the patients with allergic mucin sinusitis also had asthma. Treatment was the same for both groups of patients.

scholarly journals CLINICAL AND FUNCTIONAL RESULTS IN PATIENTS WITH CERVICAL SPONDYLOTIC MYELOPATHY TREATED SURGICALLY BY ANTERIOR APPROACH IN A TERTIARY HEALTH CARE CENTER

2018 ◽  
Vol 17 (2) ◽  
pp. 95-98 ◽  
Author(s):  
Juan Manuel Gomez ◽  
Eulalio Elizalde Martínez ◽  
Alfredo Javier Moheno Gallardo ◽  
Francisco Fernando Salazar García ◽  
Joel Galindo Avalos ◽  
...  
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Anterior Approach ◽  
Care Center ◽  
Preoperative Evaluation ◽  
Functional Results ◽  
Health Condition ◽  
Level Of Evidence ◽  
Health Care Center ◽  
Significant Difference ◽  
The Mean

ABSTRACT Objective: To evaluate the clinical and functional results in patients with cervical spondylotic myelopathy treated surgically by anterior approach in a reference center. Methods: An observational, longitudinal, analytical study was carried out. The patients were evaluated using the JOA, Nurick and SF12v2 scales at hospital admission, at 3 and 6 months after surgery, analyzing the data with the Student's T test in the IBM SPSS Statistics version 24. Results: The male sex predominated, the mean age was 61 years; the mean JOA score before surgery, at 3 and 6 months was 8, 10.9, and 11.6, respectively. The Nurick scale obtained a presurgical score, at 3 and 6 months of 2.8, 2.2, and 1.9, respectively. Regarding the quality of life (PCS), 93.3% of the patients were found to be below the mean, 2.2% in the mean, and 4.5% above the mean, while at 6 months, 91.1% of the patients were below the mean, 6.7% in the mean, and 2.2% above the mean. In the preoperative evaluation the SF 12v2 scale, 68.9% of the patients were below the mean, 2.2% in the mean, and 28.9% above the mean, being that at 6 months, 31.1% of the patients were below the mean, 15.6% in the mean, and 53.3% above the mean. A statistically significant improvement was observed with the JOA and Nurick scales from preoperative to 3 and 6 months (p<0.05) with a statistically significant difference in the mental component of quality in the same periods. Conclusions: Anterior approach decompression gives a significant clinical improvement at 3 and 6 months. However, this improvement does not correlate with the patient's perception of his or her health condition. Level of Evidence III; Case control study.

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