COMPARISON OF OLFACTORY DISTURBANCE IN COVID-19 POSITIVE CASES WITH NON COVID-19 RHINITIS CASES

Objective: To determine association of anosmia as an early symptom of COVID-19 infection. Study Design: Comparative cross sectional study. Place and Duration of Study: ENT department, Combined Military Hospital, Quetta, from Apr to Oct 2020. Methodology: A total of 6411 consenting patients with symptoms of viral upper respiratory tract infection presenting at ENT department, Combined Military Hospital Quetta, from Apr to Oct 2020 were tested for COVID 19 via PCR studies. Results: Out of 6411 individuals 1109 (17.3%) were found to be COVID positive and 5302 (82.7%) were COVID negative. Of the COVID positive cases 611 (55.1%) of COVID positive individuals had anosmia, whereas only 68 (1.2%) of COVID negative individuals had anosmia, this observation was statistically significant (p<0.001 on chi square test). Whereas only 33 (2.9%) patients had nasal obstruction in COVID positive group, and 68 (1.2%) cases in COVID negative group had nasal obstruction, this observation was not statistically significant (p>0.05 on chi square test). Conclusion: Anosmia has a definite association with COVID 19 infection.

Objective sensory testing methods reveal a higher prevalence of olfactory loss in COVID-19 positive patients compared to subjective methods: A systematic review and meta-analysis

Severe acute respiratory syndrome coronavirus 2 (SARS−CoV−2), which causes coronavirus disease 2019 (COVID−19), has currently infected over 6.5 million people worldwide. In response to the pandemic, numerous studies have tried to identify the causes and symptoms of the disease. Emerging evidence supports recently acquired anosmia (complete loss of smell) and hyposmia (partial loss of smell) as symptoms of COVID−19, but studies of olfactory dysfunction show a wide range of prevalence, from 5% to 98%. We undertook a search of Pubmed/Medline and Google Scholar with the keywords 'COVID−19', 'smell', and/or 'olfaction'. We included any study that quantified olfactory loss as a symptom of COVID%[minus]19. Studies were grouped and compared based on the type of method used to measure smell loss − subjective measures such as self−reported smell loss versus objective measures using rated stimuli − to determine if prevalence rate differed by method type. For each study, 95% confidence intervals (CIs) were calculated from point estimates of olfactory disturbance rates. We identified 34 articles quantifying anosmia as a symptom of COVID−19, collected from cases identified from January 16 to April 30, 2020. The pooled prevalence estimate of smell loss was 77% when assessed through objective measurements (95% CI of 61.4-89.2%) and 45% with subjective measurements (95% CI of 31.1-58.5%). Objective measures are a more sensitive method to identify smell loss as a result of infection with SARS−CoV−2. The use of subjective measures, while expedient during the early stages of the pandemic, underestimates the true prevalence of smell loss.

Relationship Between Olfactory Disturbance After Acute Ischemic Stroke and Latent Thalamic Hypoperfusion

Odor detection, recognition, and identification were assessed in 19 acute ischemic stroke patients who had no magnetic resonance imaging-detectable thalamic lesions but in whom technetium-99m ethyl cysteinate dimer single photon emission tomography revealed thalamic hypoperfusion. Although these patients were unaware of reduced olfactory function, they exhibited significantly lower scores in tests for odor identification and recognition threshold as compared with 9 ischemic stroke controls that had normal thalamic hypoperfusion. However, absolute odor detection thresholds were similar in the 2 groups. These results demonstrate the usefulness of cerebral perfusion scintigraphy in assessing sensory loss after ischemic stroke and provide further evidence for the role of the thalamus in olfaction.

To Compare the Results of Endoscopic Sinus Surgery with and without Microdebrider in Patients of Nasal Polyposis

ABSTRACT Objective To compare the results in patients of nasal polyposis undergoing endoscopic sinus surgery with or without the use of microdebrider. Materials and methods The study was conducted on 40 patients of either sex in age group 15 to 60 years with nasal polyposis. They were divided into two groups (20 each), in group A microdebrider was used and in group B it was not used. Symptom scoring of each patient was done on the basis of nasal blockage, headache, olfactory disturbance, nasal discharge and trigeminal pressure pain. Similar scoring was followed for diagnostic endoscopy in which the scoring was done on the basis of extent of polyps, edema of middle turbinate and secretions in middle meatus. Both the left and right sides were examined and scored separately. Results The symptom and endoscopy scores were significantly higher (p < 0.02 and < 0.0001 respectively) in group B post-operatively on 14th day and after 3 months as compared to group A. Conclusion Microdebrider assisted endoscopic sinus surgery gives better results. How to cite this article Kakkar V, Sharma C, Singla P, Gulati A, Singh S, Malik P. To Compare the Results of Endoscopic Sinus Surgery with and without Microdebrider in Patients of Nasal Polyposis. Clin Rhinol An Int J 2014;7(2):61-63.

Gambaran fungsi penghidu dengan Sniffin’ sticks pada pasien rinitis alergi

Background: Allergic rhinitis (AR) is defined as an inflammation of the lining mucosa of the nose induced by allergen exposure. The olfactory disturbance could affect around 21%-23% of AR patients.Purpose: To determine the olfactory performance of AR patients at the Allergy-Immunology outpatientclinic, ENT Department, Cipto Mangunkusumo Hospital. To find out the mean difference of olfactorythreshold, discrimination, and identification (TDI) score between intermittent AR group and persistent ARgroup, and also to determine the percentage of the AR patient who had olfactory disturbance. Method:Observational descriptive study with cross sectional method to assess the TDI in AR patients using theSniffin’ sticks extended test. Results: The olfactory performance characteristics of AR patients were:threshold score 0,25; discrimination score 7,00; identification score 10,10; TDI score 23,50. There wasno statistical difference of the TDI mean score between intermittent AR group and persistent AR group.In our study, 45% of all AR subjects were reported to have olfactory disturbance. Conclusion: The TDIresults which represent olfactory function of AR patients were lower compared to the healthy subjects. Key words: allergic rhinitis, olfactory function, Sniffin’ sticks Abstrak : Latar belakang: Rinitis alergi (RA) adalah penyakit inflamasi mukosa hidung akibat pajanan terhadap suatu alergen. Sekitar 21% sampai 23% pasien RA dapat mengalami gangguan penghidu. Tujuan: Mengetahui gambaran fungsi penghidu pada pasien rinitis alergi (RA). Menentukan perbedaan rerata nilai ambang, diskriminasi dan identifikasi (ADI) pada pasien RA intermiten dan persisten, dan mengetahui persentase pasien RA dengan gangguan fungsi penghidu di poliklinik Divisi Alergi-Imunologi, Departemen THT RSCM. Metode: Penelitian observasional dengan metode potong lintang untuk menilai ADI penghidu pada percontoh RA menggunakan pemeriksaan Sniffin’ sticks extended test. Hasil: Didapati karakteristik fungsi penghidu percontoh RA ambang 0,25; diskriminasi 7,00; identifikasi 10,10; nilai ADI 23,50. Tidak didapatkan perbedaan bermakna rerata nilai ADI antara kelompok rinitis alergi persisten dan intermiten. Diperoleh 45% dari seluruh percontoh RA mengalami gangguan fungsi penghidu. Kesimpulan: Nilai ADI yang merupakan fungsi penghidu pasien RA lebih rendah dibandingkan dengan subjek sehat. Kata kunci: rinitis alergi, fungsi penghidu, Sniffin’ sticks