Showing 6 results for Sinusitis
T Shokohi, A Madani,
Volume 15, Issue 3 (11-2001)
Abstract
Allergic fungal sinusitis (AFS) has been clinicopathologically defined as a
noninvasive form of fungal infection. This study was designed to distinguish AFS
among patients with chronic sinusitis who failed to respond to repeated courses
of antibiotics and were therefore candidates for functional endoscopic sinus surgery
(FESS) in Sari.
Allergic mucin and sinus lavage was collected during FESS from 100 patients
meeting the diagnostic criteria for AFS and were submitted for mycology
and pathology investigations. The specimens were centrifuged and the sediment
was mounted in 10% KOH and Gram's stain for direct examination. The specimens
were inoculated in Sabouraud's Dextrose Agar. Multiple fragments of mucosa
were removed at surgery and stained with H&E and PAS for the pathology
evaluation.
In this study we report 9 proven cases of AFS (with demonstration of fungal
hyphae by direct exam and culture) and 8 suspected cases (confirmed by direct
exam or culture). The patient's age ranged from 12 to 62 years, with a mean age of
24.5 years with female predominance. All of the patients were immunocompetent.
47% of the patients had a history of atopy. Histopathologically, hyphae were
not seen. The genera of the fungi were identifiable in all but one patient. 53% of
isolated fungi were from the hyaline hyphomycete group particularly Aspergillus
and Penicillium and 47% of them were members of the dematiaceous family particularly
Cladosporium and Nigrospora. In eleven out of the seventeen, fungal
hyphae were noted and in all of the seventeen there were positive fungal cultures.
Fungal sinusitis should be considered in all patients with chronic sinusitis
that fails to repond to repeated courses of treatment. Recent advances in endoscopy
and computed tomography and physician awareness will lead to improved
diagnosis and treatment and will prevent multiple surgical procedures
Morteza Javadi, Shabahang Mohammadi,
Volume 22, Issue 3 (11-2008)
Abstract
Abstract
Background: Invasive fungal infection is an opportunistic infection caused commonly
by mucoraccae and aspergillus. It mostly occurs in patients with underlying disease.
Since it has a high mortality and morbidity rate, considering a treatment strategy seems
necessary.
Objective: Since there has not been a clear protocol for treating these patients, we decided
to establish a protocol for fungal infection of sinus and anterior skull base management.
Methods: This retrospective and descriptive case study series included 30 patients.
After confirming the pathogen, the authors came to a proper protocol for treatment which
is mentioned later.
Results: The site involvement included nose and orbital cavity (53.3%), anterior skull
base and brain in conjunction with sinonasal (36.6%) and simple nasal cavity involvement
(10%). 86.6% of the patients had underlying diseases. 56.6% of patients had diabetes
as a single underlying disease, while 13.3% had both diabetes and renal failure in
combination. Acute lymphocytic leukemia was present in 6.6%, renal failure in 3.3%, lupus
in 3.3% and chronic lymphocytic leukemia in 3.3% of patients. Mortality rate was
40%. We categorized the patients into 3 groups: only sinonasal, sinonasal and orbit, and
associated anterior skull base and brain involvement.
Conclusion: Early diagnosis is an important factor in improving survival. Anterior
skull base and brain involvement has a very poor prognosis.
Ahmad Ghasemi, Atabak Allafasghari, Mani Mofidi,
Volume 32, Issue 1 (2-2018)
Abstract
Background: Computed tomography scans (CT scan) and X-rays are used to diagnose paediatric maxillary sinusitis. This study aimed at exploring the diagnostic value of the conventional and colour Doppler ultrasounds and their specific findings in cases of paediatric sinusitis.
Methods: A total of 60 children diagnosed with sinusitis were included in this study. The conventional and colour Doppler ultrasounds of the sinus were performed on each of them. The symptoms that suggested increased blood flow to the sinuses were interpreted as positive findings on the colour Doppler ultrasound and were named “Ghasemi signs” for the purpose of this study. Such symptoms included unilateral artery bumps on the front artery, reduction of arterial resistive index (RI) to less than 0.5, and diameter of 2 mm or above for maxillary arteries. Sensitivity, specificity, and positive and negative predictive values, and accuracy of the conventional and colour Doppler ultrasounds were also calculated.
Results: Compared to CT scan, the conventional ultrasound showed sensitivity and specificity of 73.4% and 100%, respectively. Sensitivity and specificity for the colour Doppler ultrasound were 89.36% and 100%, respectively. The maxillary artery diameter in normal and affected maxillary sinuses were, respectively, 2.4 mm (2.1–2.6, 95% CI) and 1.7 mm (1.6–1.9, 95% CI), with p<0.001. The RI of the affected sinuses were 0.47 (0.45–0.49, 95% CI), and those of the normal sinuses were 0.58 (0.54–0.61, 95% CI), with p<0.001.
Conclusion: The findings of this study revealed that the conventional ultrasound agrees with the CT scans in the diagnosis of paediatric maxillary sinusitis. This diagnostic modality becomes even more valuable when the colour Doppler is used, particularly when considering the specific symptoms (Ghasemi signs) suggested by this study.
Hossein Aazami, Farhad Seif, Babak Ghalehbaghi, Alireza Mohebbi, Aslan Ahmadi, Pegah Babaheidarian, Kobra Zinat Entezami, Majid Khoshmirsafa, Sahand Ghalehbaghi, Reza Falak,
Volume 32, Issue 1 (2-2018)
Abstract
Background: Different inflammatory mechanisms take part in the immunopathogenesis of chronic rhinosinusitis (CRS). Immunoglobulin (Ig) A is the first-line defense in the airway tracts and other mucosal sites, but little is reported regarding its serum level in CRS patients. The purpose of current study is to determine the serum levels of total IgA, and its subclasses (IgA1, and IgA2) in CRS with nasal polyps (CRSwNP), CRS without nasal polyps (CRSsNP), and control groups.
Methods: In this case-control study the serum levels of total IgA and IgA subclasses were determined by Nephelometry and ELISA methods, respectively. The difference of the median concentrations was analyzed with the Kruskal-Wallis test. Collected data were analyzed using SPSS and presented by GraphPad Prism software.
Results: A total of 10 CRSwNP patient, 10 CRSsNP patients and 10 healthy controls participated in our study. The mean age of the groups were 38.2±12.6, 25.6±10.54, and 30.1±9.5, respectively. The concentrations of total IgA were 156(120-165), 165 (149-173), and 172 (152.8-184.3) mg/dl, respectively. The concentrations of IgA1 were 107 (77.9-169.9), 156.1(112.8-175.6), and 130.4 (118.8-175.2) mg/dl, respectively. The concentrations of IgA2 were 26.11 (18.41-38.11), 26.96 (15.48-38.39), and 23.2 (18.42-31.78) mg/dl, respectively. There was no significant difference in total IgA (p=0.120), IgA1 (p=0.397) and IgA2 (p=0.925) serum levels among three groups.
Conclusion: Our study showed there is no difference in total IgA and IgA subclasses in the serum of CRS patients in comparison to healthy controls.
Seyed Hesamedin Nabavizadeh, Mozhgan Moghtaderi, Soheila Alyasin, Hossein Esmaeilzadeh, Saeed Hosseini Teshnizi, Farahzad Jabbari-Azad, Maral Barzegar-Amini, Tooba Momen, Morteza Sadinejad, Farhad Abolnezhadian, Sara Iranparast, Negin Namavari, Hamidreza Houshmand, Majid Sartipi, Mojgan Safari, Mohammad Hossein Eslamian, Sepideh Darougar, Akefeh Ahmadiafshar, Mobina Amirsoleymani, Ali Fouladvand, Javad Ghaffari, Nasrin Bazargan, Sarehossadat Ebrahimi, Gholam Reza Sedighi, Iraj Mohammadzadeh, Mohammadmehdi Araghi, Behzad Darabi, Maryam Babaei, Shirzad Javidi Alesaadi,
Volume 36, Issue 1 (1-2022)
Abstract
Background: It is well established that upper and lower airways are often clumped together when diagnosing and treating a disease. This study was designed to determine the prevalence of upper and lower airway diseases and to assess the effect of sociodemographic factors on the prevalence and the comorbidity of these disorders.
Methods: This cross-sectional population-based study included patients with ages ranging between 15 to 65 years, who were referred to allergy outpatient clinics in various provinces of Iran from April to September 2020. A modified global Allergy and Asthma European Network (GA2LEN) screening questionnaire was filled out by local allergists of the 12 selected provinces in Iran. Information about the patients and sociodemographic factors was also recorded. Statistical analysis was done by univariate statistical analyses and multiple logistic regressions in SPSS software Version 26.
Results: Out of 4988 recruited patients, 1078 (21.6%) had the symptoms of allergic rhinitis (AR) and 285 (5.7%) met the criteria of asthma. The prevalence of acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS) was 21.6 % and 22%, respectively. The highest prevalence of AR and ARS was in Tehran with the arateof of 33.9% each. Asthma was more prevalent in Khuzestan (14.2%) and CRS in Baluchestan (57.5%). Our analysis showed that the patients with asthma were most likely to have other allergic diseases as well—CRS (OR = 4.8; 95% CI, 2.02- 5.82), AR (OR= 2.5, 95% CI, 2.10-3), ARS (OR = 1.8; 95% CI, 2.10-3), followed by eczema (OR = 1.4; 95% CI, 1.13-1.67).We found that those individuals with CRS were most likely to have painkiller hypersensitivity (OR= 2.1; 95% CI, 1.21-3.83). Furthermore, smoking has been found more than 1.5 folds in patients with ARS. After adjusting variables, there was no correlation between education, occupation, and ethnicity with the studied diseases.
Conclusion: Rhinosinusitis is a common condition among Iranian patients. This study confirmed that inflammation of the upper and lower airways can occur simultaneously. Gender, education, occupation, and ethnicity were found to be irrelevant in the development of either AR, asthma, ARS, or CRS.
Mohammad Nabavi, Saba Arshi, Mohammad Hasan Bemanian, Morteza Fallahpour, Rasoul Molatefi, Mahsa Rekabi, Narges Eslami, Javad Ahmadian, Kian Darabi, Gholamreza Sedighi, Zeinab Moinfar, Fatemeh Faraji, Majid Khoshmirsafa, Sima Shokri,
Volume 37, Issue 1 (2-2023)
Abstract
Background: NSAID-exacerbated respiratory disease (N-ERD) is a highly heterogeneous disorder with various clinical symptoms. The aspirin challenge test is a gold standard method for its diagnosis, and there are still no reliable in vitro diagnostic biomarkers yet. Oral challenge tests are time-consuming and may be associated with a risk of severe systemic reactions. This study aimed to evaluate whether patients with poor responses to medical management are more susceptible to being aspirin-sensitive.
Methods: In this cohort study, after CT scanning of all patients and subject selection, conventional medical treatment was started as follows and continued for three consecutive months: at first, saline nose wash twice per day, intranasal beclomethasone spray one puff in each nostril twice per day, montelukast 10 mg tablet once daily, a ten-day course of oral prednisolone starting with the dose of 25 mg per day and taper and discontinued thereafter. Sinonasal outcome test 22 (SNOT22) was used for the evaluation of symptom severity. Statistical analyses were performed with SPSS version 23, and data were analyzed using an independent samples T-test, paired T-test, and Receiver operating curve analysis
Results: 25 males and 53 females were enrolled in this study, with an average age of 41.56 ± 11.74 years old (18-36). Aspirin challenge test results were positive in 29 (37.2%) patients. The average SNOT22 scores before the treatment were 52.97 ± 17.73 and 47.04 ± 18.30 in aspirin-sensitive and aspirin-tolerant patients, respectively, and decreased to 27.41 ± 16.61 and 24.88 ± 16.72 in aspirin-sensitive and aspirin-tolerant patients after the treatment, respectively. There was no significant difference in SNOT22 scores between the groups.
Conclusion: The severity of symptoms before treatment and clinical improvement after treatment are not good predictors of N-ERD.
