Prevalence of Chronic Rhinosinusitis in ENT Departement RSUP Dr. Mohammad Hoesin Palembang Period 2016-2018

Chronic rhinosinusitis (CRS) is an inflammation involving the nose and paranasal sinuses where the patient has two or more major symptoms or one major symptom with two minor symptoms for ≥12 weeks. The prevalence of CRS throughout the world population is around 10-12%. The prevalence of CRS in Indonesia is uncertain. A research has been conducted on the prevalence of CRS in RSUP Dr. Mohammad Hoesin Palembang in 2015, therefore this study aims to find out more about the prevalence of CRS in the ENT Department of Dr. Mohammad Hoesin Palembang General Hospital in the period 2016-2018 and its distribution based on age, sex, major symptoms, minor symptoms, and the number of sinuses involved. This research was an observational descriptive survey with cross-sectional design. This study used medical records of CRS patients undergoing surgery in the Rhinology Division of the ENT Department RSUP Dr. Mohammad Hoesin Palembang period 2016-2018. Sampling was done by consecutive sampling method. The amount of samples in this research is 99 cases. The result of this research is presented in table and narration form. The prevalence of CRS was 33.55%. CRS is most commonly found by the age group 46-53 years (21.2%), male sex (65.7%) with a ratio between men and women 1.9: 1. The most common major symptom was nasal congestion (100%) and the most common minor symptom was headache (62.6%). The most number of sinuses involved based on the paranasal sinus CT scan results was multiple sinusitis (52.5%).

Treatment of Common Cold Patients with the Shi-Cha Capsule: A Multicenter, Double-Blind, Randomized, Placebo-Controlled, Dose-Escalation Trial

This study was designed to determine the therapeutic efficacy and safety of the Shi-cha capsule, a Chinese herbal formula, in the treatment of patients with wind-cold type common cold. In our multi-center, prospective, double-blind, randomized, placebo-controlled, dose-escalation trial, patients with wind-cold type common cold received 0.6 g of Shi-cha capsule plus 0.6 g placebo (group A), 1.2 g of Shi-cha capsule (group B), or 1.2 g placebo (group C), three times daily for 3 days and followed up to 10 days. The primary end point was all symptom duration. The secondary end points were main symptom duration, minor symptom duration, the changes in cumulative symptom score, main symptom score, and minor symptom score 4 days after the treatment, as well as adverse events. A total of 377 patients were recruited and 360 met the inclusive criteria; 120 patients constituted each treatment group. Compared with patients in group C, patients in groups A and B had significant improvement in the all symptom duration, main symptom duration, minor symptom duration, as well as change from baseline of cumulative symptom score, main symptom score, and minor symptom score at day 4. The symptom durations and scores showed slight superiority of group B over group A, although these differences were not statistically significant. There were no differences in adverse events. The Shi-cha capsule is efficacious and safe for the treatment of patients with wind-cold type common cold. Larger trials are required to fully assess the benefits and safety of this treatment for common cold.

Clinical Research of TCM Common Syndrome for Chronic Pulmonary Heart Disease Based on Dynamic Kohonen Network and Decision Tree

To explore the essential characteristic of TCM syndromes for Chronic pulmonary heart disease (CPHD) The CPHD subjects were recruited from four TCM hospitalsrespirations department by means of clinical epidemiological method.The research dates were inputted with Epidata ver.3.1 and analyzed with dynamic Kohonen Network and Decision Tree adopted to analysis the common syndrome for CPHD. There were six common rules before rules transformed and main symptom and minor symptom for common syndrome setted. The diagnostic accuracy rate was72.2% The data mining technology could been used into the TCM syndrome characteristic research.

Rhinosinusitis Task Force Symptoms versus the Sinonasal Outcomes Test in Patients Evaluated for Chronic Rhinosinusitis

Background The aim of this study was to compare Rhinosinusitis Task Force (RSTF) symptom scores with Sinonasal Outcome Test 20 (SNOT-20) in patients with chronic rhinosinusitis (CRS) and controls. Methods An analysis was performed of prospectively collected data in patients with CRS (n = 201) and controls (n = 100). The severity of individual RSTF major and minor symptom scores graded on a visual analog scale and total symptom scores were compared between the two groups. Correlation of the RSTF symptoms with the SNOT-20 was performed using data collected from the CRS group at baseline and at 1 year postoperatively. Results CRS patients had higher RSTF symptom scores compared with control patients when asked to rate the severity of nasal obstruction, facial pain/pressure, facial congestion, alteration of smell, nasal discharge, postnasal drip, headache, halitosis, fatigue, cough, and ear pain (p < 0.005). No statistically significant difference was seen for the symptoms of dental pain and fever. Total RSTF scores were 54.5 ± 1.9 in CRS patients versus 23.4 ± 3.0 in controls. Total SNOT-20 scores were 28.7 ± 0.8 in CRS patients versus 15.2 ± 0.6 in controls. In CRS patients, total RSTF scores correlated with total SNOT-20 scores at baseline (r = 0.36; p < 0.0001) and 1-year postoperatively (r = 0.37; p < 0.0001). Conclusion Total RSTF symptom scores are significantly different in patients with chronic rhinosinusitis compared with those without this disease. The total RSTF symptom scores also correlate with a validated outcome measures instrument.

The Effect of Endoscopic Sinus Surgery on Symptoms of Eustachian Tube Dysfunction

Background The symptom of eustachian tube dysfunction has been categorized as a “minor” symptom in chronic rhinosinusitis. The aim of this pilot study was to determine the frequency of otologic symptoms in patients with confirmed rhinosinusitis and the likelihood of its resolution in those patients undergoing endoscopic sinus surgery (ESS). Methods Questionnaires were obtained from 168 patients who had undergone prior ESS over a 5-year period. Patients were asked to evaluate if they suffered from several different potential symptoms of eustachian tube dysfunction before ESS and whether that symptom changed postoperatively. Results Using the binomial test, 95% confidence intervals were determined for the following otologic symptoms of tubal dysfunction: “ear fullness and congestion,” “ear cracking and popping,” “dizziness,” and “ear pain.” ESS was found to have a significant treatment effect for the indicated otologic symptoms of tubal dysfunction. Conclusion Tubal dysfunction, as manifested by otologic symptoms, is common in patients with chronic rhinosinusitis undergoing ESS. The classification of this as a “minor” symptom of rhinosinusitis needs to be reevaluated. These symptoms improve or resolve in the majority of patients undergoing ESS.

Longitudinal syndromal and sub-syndromal symptoms after severe depression: 10-year follow-up study

BackgroundFew follow-up studies of depression have evaluated depressive symptomatology over time at both threshold and sub-threshold levels.AimsTo evaluate long-term longitudinal symptomatic course after an episode of severe depression.MethodA total of 61 participants from a previous study cohort underwent a detailed interview covering the longitudinal course of depression and pharmacological treatment over 8–11 years of follow-up.ResultsOf the follow-up months, 52% were spent at an asymptomatic level, 15% at minor symptom level, 20% at residual symptom level and 13% at full depression level. Also, 30% of follow-up months were spent in an episode of depression, and 18% of patients never achieved asymptomatic status during follow-up. The percentage of patients at each symptom level remained relatively stable after the first 2 years, but levels in individuals fluctuated, with a mean of two changes in symptom levels per follow-up year.ConclusionsAfter severe episodes, sub-syndromal levels of depression are common and persistent, with considerable fluctuation suggesting a continuum between sub-syndromal subtypes and full depression.

CHANGING CONCEPTS IN OTOLARYNGOLOGY FOR THE PEDIATRICIAN

DURING the past two decades since the advent of chemotherapeutic and antibiotic drugs, the field of otolaryngology has undergone tremendous changes. This is true not only of the specialty as a whole, but also particularly of that portion in which the pediatrician is primarily concerned. It behooves him, as well as the otolaryngologist, to become increasingly aware of formerly hopeless congenital anomalies now amenable to treatment. In addition he must still maintain a high diagnostic acumen and not allow it to become dulled by the promiscuous use of the newest medications for every minor symptom. Too often there is the temptation today to over-treat a simple illness, only to find that a new complication has arisen, which may prove of more concern than the original, self-limited condition. Although it should be axiomatic even today, it must again be emphasized that accurate diagnosis should always precede therapy. The average present-day physician, whatever his field of endeavor, unfortunately is becoming increasingly strong on therapy, and too often weak in diagnosis. The constant barrage of beautifully colored propaganda from highly competitive drug houses does not help to relieve this growing imbalance, and constantly tempts him to give every medication an early trial before a careful diagnosis can be established. The effect of such a situation, particularly in the field of otolaryngology, cannot be denied. According to Hansel whose contributions to our understanding of obscure conditions of the nose and throat are monumental, the three most important problems in otolaryngology today are allergy, infection and immunity.