Computed tomography scans image processing for nasal symptoms severity prediction

This paper aims to use a new technique of computed tomography (CT) scan image processing to correlate the image analysis with sinonasal symptoms. A retrospective cross-sectional study is conducted by analyzing the digital records of 50 patients who attended the ear, nose and throat (ENT) clinics at King Abdullah University Hospital, Jordan. The coronal plane CT scans are analyzed using our developed software. The purposes of this software are to calculate the surface area of the nasal passage at three different levels visible on coronal plane CT scans: i) the head of the inferior turbinate, ii) the head of the middle turbinate, and iii) the tail of the inferior turbinate. We employ image processing techniques to correlate the narrowing of nasal surface area with sinonasal symptoms. As a consequence, obstruction in the first level is correlated significantly with the symptoms of nasal obstruction while the narrowing in the second level is related to frontal headache. No other significant correlations are found with nasal symptoms at the third level. In our study, we find that image processing techniques can be very useful to predict the severity of common nasal symptoms and they can be used to suggest treatment and to follow up on the case progression.

Allergic Rhinitis and Depression: Profile and Proposal

In addition to nasal symptoms, patients with allergic rhinitis (AR) often experience mental and psychological disorders such as depression. Depression not only makes the treatment of AR more difficult and expensive but also poses a serious impact on the patients' daily activities and quality of life, thus bringing additional burden to the families and the society. Here we systematically review the recent research advances in the correlation between AR and depression, analyze the possible causes and mechanisms of depression in AR, summarize the current diagnosis and treatment strategies, and provide our insights into the AR-related depression; in addition, we introduce briefly the basic research status on AR-related depression. We hope that this review article will provide evidence for future studies.

Respiratory symptoms of Swiss people with Primary Ciliary Dyskinesia

Background: Mostly derived from chart reviews, where symptoms are recorded in a nonstandardised manner, clinical data about primary ciliary dyskinesia (PCD) are inconsistent, which leads to missing and unreliable information. We assessed the prevalence and frequency of respiratory symptoms and studied differences by age and sex among an unselected population of Swiss people with PCD. Methods: We sent a questionnaire that included items from the FOLLOW–PCD standardised questionnaire to all Swiss PCD registry participants. Results: We received questionnaires from 74 out of 86 (86%) invited persons or their caregivers (age range: 3–73 years; median age: 23), including 68% adults (≥18 years) and 51% females. Among participants, 70 (94%) reported chronic nasal symptoms, most frequently runny nose (65%), blocked nose (55%), or anosmia (38%). Ear pain and hearing problems were reported by 58% of the participants. Almost all (99%) reported cough and sputum production. The most common chronic cough complications were gastroesophageal reflux (n=11; 15%), vomiting (n=8; 11%), and urinary incontinence (n=6; 8%). Only 9 participants (12%) reported frequent wheeze, which occurred mainly during infection or exercise, while 49 persons (66%) reported shortness of breath; 9% even at rest or during daily activities. Older patients reported more frequent nasal symptoms and shortness of breath. We found no difference by sex or ultrastructural ciliary defect. Conclusion: This is the first study that describes patient–reported PCD symptoms. The consistent collection of standardised clinical data will allow us to better characterise the phenotypic variability of the disease and study disease course and prognosis.

A study on otorhinolaryngological manifestations in pregnant women

<p><strong>Background: </strong>Pregnancy is characterized by various endocrinological and physiological changes affecting different organs including ear, nose and throat. Otorhinolaryngological manifestations in pregnant women are mainly due to changes in levels of sex hormones such as estrogen and progesterone. While majority of these conditions are benign and reverse after parturition, some do not. The study was conducted with an objective to find the incidence of various otorhinolaryngological manifestations among pregnant women and to create awareness among the medical professionals to diagnose these conditions.<strong></strong></p><p><strong>Methods</strong>: This is a hospital based cross sectional study of 240 pregnant women who presented to the department of otorhinolaryngology with ENT symptoms. Detailed history, general physical examination and complete ENT examination was done on all subjects.</p><p><strong>Results</strong>: 47.9% of the study cases had otological manifestations among which otitis media was the main finding.</p><p>16.7 % of the cases had nasal symptoms among which rhinits was the main condition predominantly observed in the 3^rd trimester. 19.6% of the cases had oral cavity lesions with stomatitis being the most commonly found cause. 15.8% of the cases had throat complaints, among which gastroesophageal reflux disease (GERD) was the most common cause found during 2^nd and 3^rd trimester.</p><p><strong>Conclusions: </strong>Recognition and understanding of pregnancy related ear, nose throat complaints will allow otolaryngologist to reassure and manage these patients, improving their experience of the gestational period.</p>

Integrative Analysis of Systems Pharmacology and Proteomics to Identify Key Targets and Pathways of Tuomin-Zhiti-Decoction for Allergic Rhinitis

Background: Tuomin-Zhiti-Decoction (TZD) is a polyherbal medicine consisting of eleven different herbs and has a significant effect on Allergic rhinitis (AR), yet its underlying mechanism is still unknown. Methods: Mice were sensitized and intranasally challenged with ovalbumin (OVA), the nasal symptoms, Th1/Th2-related cytokines and histopathology were examinated after TZD treatments. Bio-active compounds, potential therapeutic targets and underlying mechanisms of TZD against AR were systematically elucidated by integrating systems pharmacology approach and proteomics analysis. Then we validated the binding affinity between key targets and their corresponding active compounds using molecular docking evaluation.Results: A total of 280 active ingredients, 240 targets of TZD and 643 AR-related targets were obtained. Furthermore, 74 overlapping targets were identified. TZD oral administrations inhibited allergic responses via reduction of OVA-specific immunoglobulin E (IgE) levels and histamine release. In nasal tissue, TZD not only decreased nasal rubbing and sneezing to AR mice, but also reduced AR-induced damage to nasal mucosa, accordingly, the nasal symptoms were also clearly ameliorated. Moreover, TZD modulated the balance of Th1/Th2/Th17. The proteomics analysis identified 41 differentially expressed proteins (DEPs), protein function analysis showed that the DEPs were mainly involved in PI3K-AKT, MAPK, EGFR tyrosine kinase inhibitor resistance, NF-kappa B signaling pathway. Our results indicate that TZD plays important roles by restoring DEPs, through the selection of key DEPs, IL-6 and CD40 may be potential protein targets of TZD in treatment of AR. Combining the systems pharmacology, quercetin and wogonin may play more effective roles in AR. Molecular docking confirmed that most active compounds of TZD could bind tightly to the key targets.Conclusion: TZD may have therapeutic potential for treating AR, integrating analysis of systems pharmacology and proteomics uncovered the underlying mechanism and targets of TZD, which provides a scientific method for the rational development of traditional Chinese medicine.