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Abdullah B, Ramli RR, Shukri NM, Mohamad S. Closing the knowledge gap in Malaysian pharmacists: a virtual Allergic Rhinitis Boot Camp initiative. Multidiscip Respir Med 2021; 16:775. [PMID: 34584690 PMCID: PMC8441537 DOI: 10.4081/mrm.2021.775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/18/2021] [Indexed: 11/23/2022] Open
Abstract
Background In primary care, general practitioners (GPs) and pharmacists are at the frontline to identify, classify and manage patients suffering from allergic rhinitis (AR). The Allergic Rhinitis and its impact on Asthma (ARIA) guidelines aid clinicians in disease management by providing evidence-based recommendations. A recently published ASEAN primary care survey demonstrated that the awareness of ARIA guidelines was high among GPs but notably lower in pharmacists. Hence, this study seeks to evaluate the effectiveness of a Boot Camp education initiative in bridging the unmet needs in pharmacist awareness and education. Methods The boot camp was organised as a virtual event. The participants answered the same questionnaire before (pre-assessment) and immediately after (post-assessment) the boot camp session. Statistical analysis was performed on the data paired between the pre- and post- assessments using SPSS v. 25.0 software. Results The boot camp survey results showed that second-generation oral antihistamines and allergen avoidance are the most preferred options for AR treatment in pharmacy practice, irrespective of the disease severity. In both pre- and post-assessments, efficacy was ranked as the most important factor considered for choosing an antihistamine and which affects patient adherence. With the boot camp initiative, there was a statistically significant increase in awareness about the patient profiling tool (from 31.6% to 88.2%) and ARIA guidelines (from 40.4% to 91.2%) among the pharmacists (p<0.05). The proportion of pharmacists who were able to identify, classify and refer AR patients was significantly increased in post-assessment (p<0.05). Post the boot camp, among the proportion of pharmacists (91.2%) who were already aware of ARIA, a high percentage of them further agreed that ARIA guidelines were useful in identifying and treating patients with AR, as well as classifying AR, respectively (97.6%, 95.2%, and 93.5%). Conclusions Based on improvements in knowledge and understanding of disease management post assessment, the Allergic Rhinitis Boot Camp initiative is effective and relevant to pharmacy practice. Outreach programs like this reiterate the emphasis on patient compliance and importance of utilizing ARIA guidelines in pharmacy practice that facilitates better management of AR in primary care.
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Yusuf M, Farooqi AS, Keong LK, Hellgardt K, Abdullah B. Latest trends in Syngas production employing compound catalysts for methane dry reforming. ACTA ACUST UNITED AC 2020. [DOI: 10.1088/1757-899x/991/1/012071] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kumarasamy G, Ramli RR, Singh H, Abdullah B. Tualang honey versus steroid impregnated nasal dressing following endoscopic sinus surgery: a randomized controlled trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2020; 18:433-438. [PMID: 34187130 DOI: 10.1515/jcim-2020-0001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 07/09/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Recurrence rate of nasal polyps is high following endoscopic sinus surgery. To improve the surgical outcome, steroid impregnated nasal dressing is used postoperatively We aimed to compare the effect of Tualang honey impregnated nasal dressing with steroid impregnated nasal dressing on wound healing and surgical outcomes in post endoscopic sinus surgery patients. METHODS A prospective, randomized, controlled trial was carried out at two tertiary hospitals. 32 patients diagnosed with chronic rhinosinusitis and had underwent endoscopic sinus surgery were enrolled. The study group received 2 mL of Tualang honey nasal dressing and the control group received nasal dressing with 2 mL of triamcinolone 20 mg/mL as positive control. A 2 cm nasal dressing was placed longitudinally into the middle meatuses of both nasal cavities. Postoperative healing assessments of edema, crusting, secretions, scarring and symptoms were performed at postoperative day 7, 14, 28 and at 3 months using Sinonasal Outcome Test 22 questionnaire and modified Lund-Kennedy scoring system. RESULTS There were no significant differences noted in the scores of Sinonasal Outcome Test 22 and modified Lund-Kennedy at Day 7, 14 and 28 (p>0.05) for both groups. At 3rd month, patients in the triamcinolone group had lesser symptoms and better endoscopic findings (p<0.05). CONCLUSION Tualang honey is not as effective as steroid in achieving good wound healing and surgical outcomes in post endoscopic sinus surgery patients. Thus, it is not suitable as a substitute for steroid to reduce symptoms and prevent recurrence of disease.
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Saniasiaya J, Islam MA, Abdullah B. Prevalence and Characteristics of Taste Disorders in Cases of COVID-19: A Meta-analysis of 29,349 Patients. Otolaryngol Head Neck Surg 2020; 165:33-42. [PMID: 33320033 DOI: 10.1177/0194599820981018] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The purpose of this meta-analysis is to assess the pooled prevalence of taste disorders and their subtypes in patients with COVID-19. DATA SOURCES PubMed, Scopus, Web of Science, Embase, and Google Scholar databases were searched to identify studies published between December 1, 2019, and June 23, 2020, without language restrictions. There was no restriction on the study design; therefore, observational studies, clinical trials, and case series were included. In addition, preprints were considered if data of interest were reported. REVIEW METHODS Two authors independently screened articles for eligibility. A random effects model was used to estimate the pooled prevalence with 95% CIs. Quality assessment was done with critical appraisal tools of the Joanna Briggs Institute. The robustness of the pooled estimates was checked by subgroup and sensitivity analyses. RESULTS Fifty-nine studies were included (N = 29,349 patients, 64.4% female). The pooled prevalence of taste disorders in patients with COVID-19 was 48.1% (95% CI, 41.3%-54.8%). The prevalence of taste disorders in studies with objective assessments was higher as compared with subjective assessments (59.2% vs 47.3%). The disorders were observed in 55.2% of European patients; 61.0%, North American; 27.1%, Asian; 29.5%, South American; and 25.0%, Australian. Ageusia, hypogeusia, and dysgeusia were detected in 28.0%, 33.5%, and 41.3% of patients with COVID-19. We identified 91.5% of the included studies as high quality. CONCLUSIONS The prevalence of taste disorders in patients with COVID-19 was 48.1%. Objective assessments have higher prevalence than subjective assessments. Dysgeusia is the most common subtype, followed by ageusia and hypogeusia.
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Abdullah B, Snidvongs K, Recto M, Poerbonegoro NL, Wang DY. Primary care management of allergic rhinitis: a cross-sectional study in four ASEAN countries. Multidiscip Respir Med 2020; 15:726. [PMID: 33376593 PMCID: PMC7750812 DOI: 10.4081/mrm.2020.726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/19/2020] [Indexed: 11/23/2022] Open
Abstract
Background In primary care, general practitioners (GPs) and pharmacists are tasked with the frontline responsibility of identifying and managing allergic rhinitis (AR) patients. There are currently no consolidated data on current treatment practices, patient compliance, and usage of guidelines within Southeast Asian Nations (ASEAN). Objective: To assess the attitudes and practices on AR of GPs and pharmacists in 4 ASEAN countries (Philippines, Indonesia, Thailand, and Malaysia). Methods A cross-sectional survey of 329 GPs and 548 pharmacists was conducted from May to November 2019. Participants answered a questionnaire focused on their i) current practice in the management of AR, ii) views on patient compliance, iii) understanding and usage of guidelines. Results Clinical history was the most preferred method to diagnose AR by 95.4% of GPs and 58.8% of pharmacists. Second-generation antihistamines were the most widely available treatment option in GP clinics and pharmacies (94.8% and 97.2%) and correspondingly the most preferred treatment for both mild (90.3%, 76.8%) to moderatesevere rhinitis (90.3%, 78.6%) by GPs and pharmacists, respectively. Loratadine was ranked as the most preferred 2nd generation antihistamines (GP vs pharmacists: 55.3% vs 58.9%). More than 90% of GPs and pharmacists ranked length and efficacy of treatment as important factors that increase patient compliance. Awareness of the ARIA guidelines was high among GPs (80%) and lower among pharmacists (48.4%). However, only 63.3% of GPs and 48.2% of pharmacists knew how to identify AR patients. Conclusions The survey in the 4 ASEAN countries has identified a need to strengthen the awareness and use of ARIA guidelines among the primary care practitioners. Adherence to ARIA guidelines, choosing the appropriate treatment option and prioritizing factors that increases patient compliance may contribute to better management outcomes of AR at the primary care practice
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Saniasiaya J, Islam MA, Abdullah B. Prevalence of Olfactory Dysfunction in Coronavirus Disease 2019 (COVID-19): A Meta-analysis of 27,492 Patients. Laryngoscope 2020; 131:865-878. [PMID: 33219539 PMCID: PMC7753439 DOI: 10.1002/lary.29286] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/26/2020] [Accepted: 11/18/2020] [Indexed: 01/08/2023]
Abstract
Objectives/Hypothesis Olfactory dysfunction has been observed as one of the clinical manifestations in COVID‐19 patients. We aimed to conduct a systematic review and meta‐analysis to estimate the overall pooled prevalence of olfactory dysfunction in COVID‐19 patients. Study Design Systematic review and meta‐analyses. Methods PubMed, Scopus, Web of Science, Embase, and Google Scholar databases were searched to identify studies published between 1 December 2019 and 23 July 2020. We used random‐effects model to estimate the pooled prevalence with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic and Cochran's Q test. Robustness of the pooled estimates was checked by different subgroup and sensitivity analyses This study is registered with PROSPERO (CRD42020183768). Results We identified 1162 studies, of which 83 studies (n = 27492, 61.4% female) were included in the meta‐analysis. Overall, the pooled prevalence of olfactory dysfunction in COVID‐19 patients was 47.85% [95% CI: 41.20–54.50]. We observed olfactory dysfunction in 54.40% European, 51.11% North American, 31.39% Asian, and 10.71% Australian COVID‐19 patients. Anosmia, hyposmia, and dysosmia were observed in 35.39%, 36.15%, and 2.53% of the patients, respectively. There were discrepancies in the results of studies with objective (higher prevalence) versus subjective (lower prevalence) evaluations. The discrepancy might be due to false‐negative reporting observed in self‐reported health measures. Conclusions The prevalence of olfactory dysfunction in COVID‐19 patients was found to be 47.85% based on high‐quality evidence. Due to the subjective measures of most studies pooled in the analysis, further studies with objective measures are advocated to confirm the finding. Level of Evidence 2 Laryngoscope, 131:865–878, 2021
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Abdullah B, Kandiah R, Hassan NFHN, Ismail AF, Mohammad ZW, Wang DY. Assessment of perception, attitude, and practice of primary care practitioners towards allergic rhinitis practice guidelines: Development and validation of a new questionnaire. World Allergy Organ J 2020; 13:100482. [PMID: 33294114 PMCID: PMC7689322 DOI: 10.1016/j.waojou.2020.100482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 10/06/2020] [Accepted: 10/21/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Primary care practitioners (PCPs), being the front liners, play an important role in treating allergic rhinitis (AR). As there is no proper tool to assess their perception, attitude, and practice in utilizing the guidelines, we aimed to develop and validate a new questionnaire for such purpose. METHODS The development phase consists of both literature and expert panel review. The validation phase consists of content validity, face validity, and construct validity. Cronbach's alpha was used to verify internal consistency. The development phase produced a questionnaire with 3 domains: perception, attitude, and practice consisting of 60 items (PAP-PCP questionnaire). Item response theory analysis for perception demonstrated the difficulty and discrimination values were acceptable except for 3 items. Exploratory factor analysis for attitude and practice domains showed the psychometric properties were good except for 3 items in practice domain. Experts judgement was used to decide on the final selection of questionnaire which consists of 59 items. RESULTS The final validated questionnaire has 3 domains with 59 items. All domains had Cronbach's alpha above 0.65 which was reliable. 302 physicians completed the questionnaire. 98% PCPs diagnosed AR based on clinical history. Although, majority agree AR guidelines is useful (67%), they had difficulty in using it to classify AR (54.9%) and determine AR severity (73.9%). Oral anti-histamines (first and second generation) were the most prescribed (>75%) followed by intranasal corticosteroids (59%) and combined intranasal corticosteroid and oral anti-histamine (51%). Majority agreed that treatment efficacy (81.8%), adverse effects (83.8%), fear of adverse effects (73.5%), route of administration (69.4%), dosing frequency (72.5%), taste (64.6%) and cost (73.5%) affect treatment compliance. CONCLUSIONS The newly developed and validated questionnaire is a promising instrument in understanding the treatment gap in AR. Although further testing and refinement are needed, it provides an initial means for evaluating knowledge and understanding of PCPs in treating AR.
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Key Words
- 2-PL IRT, Two-parameter logistic item response theory
- ARIA, Allergic Rhinitis and its Impact on Asthma
- Allergic rhinitis guidelines
- Attitude
- CVI, Content Validity Index
- EAR, Allergic rhinitis
- EFA, exploratory factor analysis
- FVI, Face Validity Index
- GINA, Global Initiative for Asthma
- IgE, immunoglobulin
- KMO, Kaiser-Meyer-Olkin test
- ORL, Otorhinolaryngologist
- PCPs, Primary care practitioners
- Perception
- Practice
- Primary care practitioners
- S-CVI/Ave, Scale-level CVI of averaging calculation method
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Tai Li Min E, Abdullah B. Nasal Polyps and Chronic Obstructive Pulmonary Disease-An Oft Overlooked Association. EAR, NOSE & THROAT JOURNAL 2020; 99:NP103-NP104. [PMID: 31184208 DOI: 10.1177/0145561319856576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Rosli AH, Nadarajan C, Abdullah B, Embong Z, Wan Hitam WH. Sinonasal undifferentiated carcinoma – a rare cause of proptosis in elderly. PEDIATRIA I MEDYCYNA RODZINNA 2020; 16:334-336. [DOI: 10.15557/pimr.2020.0062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023] Open
Abstract
Sinonasal undifferentiated carcinoma is a rare and extremely aggressive sinonasal tract malignancy. It is a rapidly enlarging tumour and a highly destructive lesion. We hereby report a 71-year-old Malay male with progressive left proptosis for one month, associated with reduced vision in the left eye, intermittent diplopia and anosmia. He was later diagnosed as having sinonasal undifferentiated carcinoma. The patient subsequently underwent a series of radiotherapy and showed improvement following treatment. This case was reported to highlight the importance identifying this entity and emphasise that sinonasal undifferentiated carcinoma should be considered in an elderly patient with proptosis associated with nasal symptoms.
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Abdullah B, Vengathajalam S, Md Daud MK, Wan Mohammad Z, Hamizan A, Husain S. The Clinical and Radiological Characterizations of the Allergic Phenotype of Chronic Rhinosinusitis with Nasal Polyps. J Asthma Allergy 2020; 13:523-531. [PMID: 33149624 PMCID: PMC7602905 DOI: 10.2147/jaa.s275536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/22/2020] [Indexed: 12/31/2022] Open
Abstract
Purpose The allergic phenotype of chronic rhinosinusitis (CRS) and central compartment atopic disease (CCAD) have been described. The CCAD is a radiological phenotype in patients with CRS that presents as a central mucosal disease due to allergy. The subset of patients having chronic rhinosinusitis with nasal polyps (CRSwNP) has not been well characterized. We aim to describe the clinical and radiological characterizations of patients presenting with the allergic phenotype of CRSwNP. Patients and Methods A cross-sectional study at a tertiary hospital was performed. Adult patients diagnosed with CRSwNP who had both allergology and radiological assessments were enrolled. The symptoms of allergic rhinitis, Lund-Kennedy (LK) endoscopic scoring, Lund-Mackay (LM) computed tomography scan of paranasal sinuses (CTPNS) scoring, CCAD features, skin prick test (SPT) and level of specific IgE were assessed. All the patients underwent SPT for house dust mites. Results A total of 38 patients were enrolled. Symptoms, endoscopic and CTPNS scores were higher in the allergy and CCAD groups compared to the nonallergy and nonCCAD groups. The symptom of "need to blow nose" was statistically significant in allergy vs nonallergy (p=0.01) and CCAD vs nonCCAD (p=0.02). There were significant differences in the endoscopic scores in both allergy and CCAD (allergy vs nonallergy, p=0.01; CCAD vs nonCCAD, p=0.03), and CT scores in both allergy and CCAD (allergy vs nonallergy, p=0.02; CCAD vs nonCCAD, p=0.02). All patients with CCAD have worse scoring than nonCCAD (LK score, p=0.03; LM score, p=0.02). Patients with allergy have more polypoidal involvement of the middle turbinates (left middle turbinate, p=0.141; right middle turbinate, p=0.074) and CCAD (left middle turbinate, p=0.017; right middle turbinate, p=0.009) than nonallergy and nonCCAD patients. Conclusion Allergic phenotype of CRSwNP has a worse clinical and radiological disease burden. Optimal treatment of allergy is essential for a better outcome.
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Umar NF, Mazlan MZ, Abdullah B. Foreign body ingestion or aspiration? VISUAL JOURNAL OF EMERGENCY MEDICINE 2020; 21:100770. [DOI: 10.1016/j.visj.2020.100770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
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Mohamad S, Hussein A, Abdullah B. Urgent treatment is necessary in lacrimal abscess to prevent blindness. VISUAL JOURNAL OF EMERGENCY MEDICINE 2020; 20:100751. [DOI: 10.1016/j.visj.2020.100751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
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Abdullah SN, Abdullah B. Supreme Nasal Turbinate as an Additional Surgical Landmark in Endoscopic Sinus and Skull Base Surgeries. Cureus 2020; 12:e8132. [PMID: 32550052 PMCID: PMC7294892 DOI: 10.7759/cureus.8132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
During endoscopic sinus and skull base surgeries, surgical landmarks are routinely used to guide surgeons navigating in the narrow corridor of the sinonasal region. Risk of complications is higher in difficult cases when there is excessive bleeding or alteration of the normal anatomical landmarks by tumour. An additional landmark is advantageous to prevent complications and serves as a guide. We present a case of supreme turbinate found incidentally during an endoscopic transsphenoidal surgery. Not much is known about the role of supreme turbinate. When it is present, the sphenoid ostium is located medial to its posteroinferior attachment, and behind its vertical part. Hence, the identification of this structure serves as an additional landmark besides superior turbinate during surgery.
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Ghafar MHA, Mohamed H, Mohammad NMY, Mohammad ZW, Madiadipoera T, Wang DY, Abdullah B. Mometasone furoate intranasal spray is effective in reducing symptoms and adenoid size in children and adolescents with adenoid hypertrophy. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2020. [DOI: 10.1016/j.otoeng.2019.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abdullah B, Rasid NSA, Lazim NM, Volgger V, Betz CS, Mohammad ZW, Hassan NFHN. Ni endoscopic classification for Storz Professional Image Enhancement System (SPIES) endoscopy in the detection of upper aerodigestive tract (UADT) tumours. Sci Rep 2020; 10:6941. [PMID: 32332848 PMCID: PMC7181723 DOI: 10.1038/s41598-020-64011-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/07/2020] [Indexed: 12/31/2022] Open
Abstract
The diagnostic procedure for upper aerodigestive tract (UADT) tumours is by white light endoscopy (WLE) combined with biopsy. However, WLE has difficulty identifying minute epithelial changes which hinders early diagnosis. Storz Professional Image Enhancement System (SPIES) is designed to enhance the visualization of microvasculature on the mucosal surface and detect any epithelial changes. In this study, we aimed to evaluate the use of Ni endoscopic classification with SPIES endoscopy in the detection of UADT tumours. Fifty-nine patients with suspected UADT tumours underwent WLE followed by SPIES endoscopy. All the tumours were biopsied and sent for histopathological examination (HPE). The kappa index (κ) was used to evaluate the agreement between the methods. The level of agreement between SPIES using Ni classification and HPE showed almost perfect agreement as compared to moderate agreement between WLE and HPE. The sensitivity and specificity for WLE and HPE were 77.5% and 84.2% respectively with positive predictive value (PPV) of 91.2% and negative predictive value (NPV) of 64%. The sensitivity and specificity for SPIES endoscopy using Ni classification and HPE were 97.5% and 94.7% respectively with PPV of 97.5% and NPV of 94.7%. SPIES endoscopy using Ni classification is a valid tool for earlier tumour detection.
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Sani MM, Ashari NSM, Abdullah B, Wong KK, Musa KI, Mohamud R, Tan HTT. Reduced CD4+ terminally differentiated effector memory T cells in moderate-severe house dust mites sensitized allergic rhinitis patients. Asian Pac J Allergy Immunol 2020; 37:138-146. [PMID: 29981564 DOI: 10.12932/ap-191217-0220] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Terminally differentiated effector memory (TEMRA) T cells exert potent effector function after activation. The proportions of CD4+ T cell subsets especially memory cells in allergic rhinitis (AR) patients sensitized to house dust mites (HDMs) have not been extensively studied. OBJECTIVE This study aimed to compare the mean percentages and absolute counts of CD4+ memory T cell subsets between: (i) non-allergic controls and AR patients; (ii) mild AR patients and moderate-severe AR patients. METHODS Sensitization to Dermatophagoides farinae and Dermatophagoides pteronyssinus were determined in 33 non -allergic controls, 28 mild AR and 29 moderate-severe AR patients. Flow cytometry was used to determine the percentage of CD4+ na?ve (TN; CD45RA+CCR7+), central memory (TCM; CD45RA-CCR7+), effector memory (TEM; CD45RA-CCR7-) and TEMRA (CD45RA+CCR7-) T cells from the peripheral blood. The absolute counts of CD4+ T cell subsets were obtained by dual platform method from flow cytometer and hematology analyzer. RESULTS There were no significant differences in the mean percentages and absolute counts of CD4+ T cell subsets between non-allergic controls and AR patients sensitized to HDMs. However, there were significant reduction in the mean percentage (p=0.0307) and absolute count (p=0.0309) of CD4+ TEMRA cells in moderate-severe AR patients compared to mild AR patients sensitized to HDMs and 13/24 (54.2%) moderate-severe AR patients sensitized to HDMs had persistent symptoms. CONCLUSION Reduction in the mean percentage and absolute count of CD4+CD45RA+CCR7- TEMRA cells were observed in moderate-severe AR patients compared to mild AR patients in our population of AR patients sensitized to HDMs.
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Aini R, Sachlin IS, Chee LC, Abdullah B. A Unilateral Nasal Mass With Generalized Seizures: Potential Diagnostic Pitfalls in Giant Pituitary Adenoma. ALLERGY & RHINOLOGY 2020; 10:2152656719896580. [PMID: 31897352 PMCID: PMC6920587 DOI: 10.1177/2152656719896580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Giant pituitary adenomas are clinically nonfunctioning adenomas, and the clinical
presentation is usually secondary to compression of the neighboring structures.
Visual impairment and visual field defect are the most common preoperative
symptoms, followed by headache. Generalized seizures may occur in giant
pituitary adenomas when there is involvement of frontal lobes or medial temporal
lobes. We present a case of a unilateral nasal mass with generalized seizures in
a 55-year-old woman without prior episode of seizure and any predisposing
factors. Imaging showed a sinonasal tumor with intracranial extension and
histopathological examination confirmed a corticotroph adenoma. On seeing a
patient with a unilateral nasal mass extending down from the roof of nasal
cavity, olfactory neuroblastoma, or meningo-encephalocoele readily comes to
mind. To avoid misdiagnosis and delay in treatment, imaging and, if possible, a
biopsy should be considered. Giant pituitary adenoma although not common should
be thought of as one of the differential diagnosis.
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Abdullah B. Presentation and Management of Frontoethmoid Osteoma. J Neurosci Rural Pract 2019; 10:551. [PMID: 31599271 PMCID: PMC6779552 DOI: 10.1055/s-0039-1698031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Shinee T, Sutikno B, Abdullah B. The use of biologics in children with allergic rhinitis and chronic rhinosinusitis: Current updates. Pediatr Investig 2019; 3:165-172. [PMID: 32851312 PMCID: PMC7331348 DOI: 10.1002/ped4.12146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 07/23/2019] [Indexed: 01/25/2023] Open
Abstract
The therapeutic goals of the treatment of allergic rhinitis (AR) and chronic rhinosinusitis (CRS) are symptom relief, avoiding complications, and improving quality of life. In the treatment of AR and CRS, several limitations of currently prescribed medicines have been identified. Antihistamine administration (both oral and topical) together with intranasal corticosteroids bring relief to the majority of patients, but their dependency on the medications and a necessity to maintain strict compliance with regular medication regimes pose a challenge. Immunotherapeutic agents are an option in some patients, but polysensitized patients, the risk of anaphylaxis, and the need for daily administration for years are limiting it from becoming the main therapy modality. Immunotherapy in any form requires commitment by the patient, which renders adherence and compliance issues particularly relevant. The procedure involved are generally time-consuming and entail an associated risk of severe adverse reactions. The use of biologics could overcome the limitations of other therapeutic modalities. They could be used as a monotherapy or combined with pre-existing medications. The benefits of targeted therapy include less adverse effects and optimal efficacy. The aim of the present review was to investigate the collective literature to date pertaining to the role of biologics in managing children with AR and CRS.
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V S, Thamby SP, Al-Hatamleh MAI, Mohamud R, Abdullah B. A Diagnostic Dilemma of Sinonasal T Cell Lymphoma: Report of A Unique Case and Literature Review. Gulf J Oncolog 2019; 1:83-89. [PMID: 31591996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Natural Killer/T-cell non-Hodgkin lymphomas are rare and aggressive disease of non-Hodgkin lymphoma characterized by angioinvasion, angiodestruction and necrosis. It has a strong association with Epstein-Barr virus (EBV) as the lymphoma cells are almost invariably infected with the clonal episomal form of EBV. Because of their rarity, it is a challenge to diagnose and treat them even to the experienced pathologists. CASE PRESENTATION The featured case describes a 40-year-old male who presented with symptoms suggestive for sinusitis. Further diagnostic investigation by the functional endoscopic sinus surgery (FESS) revealed a chronic sinusitis with multiple biopsies showing negative for malignancy, viral and bacterial infections and therefore undiagnosed for sinonasal NK/T-cell lymphoma. Subsequently after a month of surgery, he developed multiple lymph nodes in inguinal where biopsy revealed extranodal NK/T-cell non-Hodgkin lymphoma, high grade but in no time for treatment, he finally succumbed to the illness. CONCLUSION The case presented here was initially diagnosed as a chronic sinusitis, not as sinonasal NK/Tcell lymphoma which later developed into extranodal NK/T-cell lymphoma. The prognosis showed improvement for nasal lymphomas but remains poor for disseminated and extranasal lymphomas which are more aggressive with lower survival rate. It is clinically important to differentiate diseases for proper staging and monitoring as they require completely different treatment strategies.
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Lazim NM, Abdullah B. Multidisciplinary approach to children with sinonasal tumors: A review. Pediatr Investig 2019; 3:173-179. [PMID: 32851313 PMCID: PMC7331448 DOI: 10.1002/ped4.12147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 08/12/2019] [Indexed: 12/20/2022] Open
Abstract
Sinonasal tumors in children are rare and difficult to manage. These tumors can be broadly categorized into congenital or acquired and benign or malignant. The tumors mainly arise from the mucosa, cartilage, or bone of the nasal cavity and may occupy areas of the nasal septum, turbinates, osteomeatal complex, sinuses, and nasopharynx. The management of pediatric sinonasal tumors is challenging, especially in cases of malignancy. Malignant tumors pose a treatment dilemma because most such tumors tend to be aggressive and carry a poor prognosis. Multiple complications associated with the primary disease or treatment may occur, and such complications need to be fully addressed to provide optimal care. In most cases, a multidisciplinary team approach will offer the best possible outcome for children with sinonasal tumors.
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Saniasiaya J, Abdullah B. Quality of life in children following nasal septal surgery: A review of its outcome. Pediatr Investig 2019; 3:180-184. [PMID: 32851314 PMCID: PMC7331304 DOI: 10.1002/ped4.12145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/20/2019] [Indexed: 12/03/2022] Open
Abstract
Nasal septal surgery among children remains controversial because of its adverse effect on craniofacial development. Recent studies, however, have demonstrated that early nasal septal correction prevents the midfacial and nasal growth deformity that is the inevitable consequence of nasal septal abnormality. Nasal septal surgery in children has been reported to lead to significant improvement in quality of life. We reviewed the existing literature to evaluate the outcomes of pediatric nasal septal surgery.
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Ghafar MHA, Mohamed H, Mohammad NMY, Mohammad ZW, Madiadipoera T, Wang DY, Abdullah B. Mometasone furoate intranasal spray is effective in reducing symptoms and adenoid size in children and adolescents with adenoid hypertrophy. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2019; 71:147-153. [PMID: 31400807 DOI: 10.1016/j.otorri.2019.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/14/2019] [Accepted: 04/26/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The use of mometasone furoate (MF) intranasal spray in treating adenoid hypertrophy (AH) has a variable outcome due the different methods of adenoid size evaluation. The aim of our study was to evaluate the effect of MF intranasal spray in children and adolescents with AH using a reliable and consistent endoscopic evaluation. MATERIAL AND METHOD A prospective interventional study was conducted. Evaluation took place during the first visit (week 0) and second visit (week 12). Symptoms of nasal obstruction, rhinorrhoea, cough and snoring were assessed, and an overall total symptoms score was obtained. A rigid nasoendoscopic examination using a four-grading system of adenoid size from 1 to 4 was performed. Patients were treated with MF intranasal spray for 12 weeks. Patients' aged 7-11-years old used 1 spray in each nostril once daily, while patients aged 12-17 used two sprays in each nostril once daily. Reassessment was carried out during the second visit (week 12). RESULTS A total of 74 patients was recruited. There were significant improvements from week 0 to week 12 in the symptoms' score for nose obstruction, rhinorrhoea, cough, snoring including the total nasal symptoms' score (p<0.001). AH significantly reduced in size from week 0 (2.89±.87) to week 12 (1.88±.83) (p<0.001). CONCLUSION MF intranasal spray is effective in improving the symptoms attributed to AH as well as reducing the adenoid size. MF intranasal spray is advocated as a treatment option before adenoidectomy is considered.
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Tengku-Fatishah A, Abdullah B, Sanjeevan N, Nurul-Shuhada AH, Sharifah-Emilia TS, Haron J, Shatriah I. Dermoid cyst simulating recurrent dacryocystitis in a toddler. Can J Ophthalmol 2019; 54:e196-e199. [PMID: 31358169 DOI: 10.1016/j.jcjo.2018.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 11/19/2022]
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Mohamad Umbaik NA, Ramli R, Abdullah B. Endoscopic excision of nasal septal schwannoma:case report and review of literature. BANGLADESH JOURNAL OF MEDICAL SCIENCE 2019. [DOI: 10.3329/bjms.v18i3.41646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Schwannomas are benign tumors arising from Schwann cells of myelinated nerve sheath. Schwannomas of the nasal cavity and paranasal sinuses are rare, with only 4% occurrence. We report a case of a 48-year-old lady who presented with 1-year history of progressively worsening left nasal blockage. Rigid nasoendoscopy showed a smooth, globular mass occupying the left nasal cavity. The mass arose from the left nasal septum and impinged on the anterior part of the middle turbinate posteriorly and inferior turbinate anteriorly. Computed tomography of the paranasal sinuses showed a 3.8 × 1.8 x 3.7- cm enhancing soft tissue density in the left nostril. The mass obliterated the left nasal cavity and caused deviation of the septum to the right. The patient underwent an endoscopic excision and histopathologic examination confirmed the diagnosis of Schwannoma. Postoperative recovery was uneventful and no recurrence was seen in the follow-up period.
Bangladesh Journal of Medical Science Vol.18(3) 2019 p.660-662
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