The Score For Allergic Rhinitis study in Turkey

Detection of microplastics in patients with allergic rhinitis

OBJECTIVE

We aimed to investigate the relationship between microplastics, which are a worldwide health and environmental issue, and their relationship to allergic rhinitis.

MATERIALS AND METHODS

A total of 66 patients participated in this prospective study. The patients were divided into two groups. While there were 36 patients with allergic rhinitis in group 1, there were 30 healthy volunteers in group 2. The participants' age, gender and Score for Allergic Rhinitis results were noted. Microplastics were examined in the nasal lavage fluids of the patients and their numbers noted. The groups were compared on these values.

RESULTS

There was no significant difference between the groups in terms of age and gender. There was a significant difference between the allergic rhinitis group and the control group in terms of the Score for Allergic Rhinitis results (p < 0.001). In the allergic rhinitis group, the microplastic density in the nasal lavage was significantly higher than in the control group (p = 0.027). Microplastics were detected in all participants.

CONCLUSIONS

We found more microplastics in allergic rhinitis patients. According to this result, we can say that there is a relationship between allergic rhinitis and microplastics.

An Investigation Into the Degree of Sinus Mucosal Delivery of Inhaled Black Cumin Volatile and Peppermint Essential Oils

The aim of this study was to investigate the quantity of volatile components reaching the sinus mucosa (SM) by inhalation, which is responsible for the therapeutic effect, as a first step toward targeted drug design. In this study, 18 Wistar-Albino female rats with an average weight between 200 and 250 g were used. The rats to be used in the study were randomized: Black cumin (BC) essential oil group (group 1) (n = 6), Peppermint essential oil (PEO) group (group 2) (n = 6), and Control (group 3) (n = 6). Volatile oils were inhaled in group 1 and 2; in the control group volatile oils were not inhaled. In all groups, SM was removed and essential volatile oil composition was determined. In group 1, α-pinene was identified as the principal component in the gas phase from five different glass bottles containing SM. The data obtained were evaluated using the single sample T-test and results show that the α-pinene component in the group of inhaled BC essential oil reached significance (P < .001) when compared with the control group. The active component of the BC essential oil could not be identified as thymoquinone. In group 2, eucalyptol (1,8-cineole) was identified as the principal component in the gas phase from five different glass bottles containing SM. The data obtained were evaluated using the single sample T-test and it was found that the eucalyptol component in the group which inhaled PEO reached statistical significance (P < .001) compared with the control group. In group 3, no volatile oil compounds were detected. We have demonstrated that both oils (BC and peppermint) are delivered to the SM. There is a need for the optimum dose to be clarified by different methods of measurement than those used in the spectrometric data we have obtained. We are convinced that our work will lead to pharmacological, toxicological, and subsequent clinical trials in this area.

Evaluation of the intranasal steroid treatment outcomes in adenoid tissue hypertrophy with or without allergic rhinitis

PURPOSE

To compare the intranasal steroid (INS) treatment outcomes in patients with adenoid tissue hypertrophy (ATH) with or without allergic rhinitis (AR).

MATERIALS AND METHODS

Medical records of 96 children diagnosed with ATH were retrospectively examined. The pediatric version of the Score for Allergic Rhinitis (SFAR) questionnaire was used to determine the AR status of the patients and classify them. The children were divided into two groups based on the questionnaire: Group 1, low probability of AR (SFAR<9); and Group 2, high probability of AR (SFAR≥9). Intranasal mometasone furoate (100 μg/mL) was used to treat ATH for at least 3 months. The severity of nasal obstruction and snoring was evaluated using the visual analog scale (VAS) score, the adenoid/choana (A/C) ratios before and after treatment were compared, and the rate of patient referral to surgery was recorded among groups.

RESULTS

The change in the A/C ratio within the group between before and after treatment was significant (both P < 0.001). However, the reduction in the adenoid size was more significant in Group 1 than in Group 2 (P = 0.025). A significant improvement in the VAS scores was observed between before and after treatment in both groups (P < 0.001). Furthermore, the rate of surgical referral of Group 1 was significantly lower than that of Group 2 (P = 0.035).

CONCLUSIONS

INS treatment was found more successful for reducing A/C ratio in ATH without AR. Related with this, when considering the INS treatment for ATH, AR status should be kept in mind for predicting the treatment success.

Allergic Rhinitis and Its Epidemiological Distribution in Syria: A High Prevalence and Additional Risks in War Time

BACKGROUND

Allergic rhinitis (AR) is a global disease that affects a huge proportion of people around the world especially in the Middle East, where multiple allergy-promoting factors can be found. Although AR is not fatal, it severely affects the quality of life. However, it is usually overlooked in developing countries due to resource scarcity.

METHODS

An online questionnaire on social media was used which included demographics, smoking, socioeconomic-status (SES), war-related questions, and the score for allergic rhinitis (SFAR), a simple self-reporting tool with the cut-off point at 7. Findings. This study included 968 subjects with 721 (74.5%) females. The mean age was 24.69 years with AR prevalence at 47.9%. AR was associated with male gender [P = 0.001 (OR, 1.677; 95% CI 1.249-2.253)], having a job [P = 0.049 (OR, 1.309; 95% CI 1.001-1.713)], the having a chronic medical condition (P < 0.0001) mainly other allergies [P < 0.0001 (OR, 9.199; 95% CI 3.836-22.063)] and asthma [P = 0.006 (OR, 5.060; 95% CI 1.396-18.342)], using medications (P < 0.0001) and living in particular provinces (P = 0.010). However, no significant correlation was found with type of work and war factors except being distressed by war sounds [P = 0.027 (OR, 1.348; 95% CI 1.034-1.757)]. Finally, no associations were found with age, consanguinity, SES, educational level, and cigarette or/and shisha smoking (P > 0.05). Interpretation. Approximately half of the sample displayed AR symptoms, indicating a potentially high burden of AR in the community. A correlation to being distressed from war noises was found with AR which could reflect a psychological aspect. In addition, in war harmful allergens are released which can be an additional AR risk factor which adds to the environment in the Middle East that is associated with AR. However, we need further studies to discover and minimize this huge prevalence of AR.

The clinical burden of allergic rhinitis in five Middle Eastern countries: results of the SNAPSHOT program

Background

The SNAPSHOT program provides current data on the allergic rhinitis burden in the adult general population of five Middle Eastern countries (Egypt, Turkey, Kuwait, Saudi Arabia and the United Arab Emirates, the latter three grouped into a Gulf cluster).

Methods

A multi-country, cross-sectional, epidemiological program conducted by telephone in a random sample of the adult general population; quotas were defined per country demographics. Subjects were screened for allergic rhinitis using the Score For Allergic Rhinitis questionnaire. Current prevalence (last 12 months) was estimated. Disease severity and control were assessed using the Allergic Rhinitis and its Impact on Asthma classification and Rhinitis Control Assessment Test respectively. Quality of sleep, impact on daily activities and quality of life were measured using the Epworth Sleepiness Scale, Sheehan Disability Scale and EuroQol Five-Dimension questionnaire respectively. Multivariate logistic regression analyses were used to investigate risk factors and co-morbidities.

Results

1808 of 33,486 subjects enrolled in the SNAPSHOT program fulfilled the case definition for allergic rhinitis. Prevalence was 3.6% [95% CI 3.2–4.0%] in Egypt, 6.4% [95% CI 5.9–6.9%] in Turkey and 6.4% [95% CI 6.0–6.9%] in the Gulf cluster. Risk factors identified were country, co-morbid asthma and income. Subjects with allergic rhinitis reported a significantly lower quality of life compared to the general population (p < 0.0001). Overall, 55% of allergic rhinitis subjects were moderate/severe and 33% were uncontrolled. Both these groups reported impaired quality of life and quality of sleep and increased impairment of daily activities compared to mild/well-controlled subjects (p < 0.0001).

Conclusions

Although the observed prevalence of allergic rhinitis in these Middle Eastern countries is low compared to western countries, its burden is considerable. Allergic rhinitis in general, and specifically uncontrolled and severe disease, results in a negative impact on quality of life, quality of sleep and daily activities.

Validation of the Arabic version of the score for allergic rhinitis tool

BACKGROUND

Allergic rhinitis (AR) is a common inflammation of the nasal mucosa in response to allergen exposure. We translated and validated the Score for Allergic Rhinitis (SFAR) into an Arabic version so that the disease can be studied in an Arabic population.

OBJECTIVES

SFAR is a non-invasive self-administered tool that evaluates eight items related to AR. This study aimed to translate and culturally adapt the SFAR questionnaire into Arabic, and assess the validity, consistency, and reliability of the translated version in an Arabic-speaking population of patients with suspected AR.

STUDY DESIGN

Cross-sectional.

SETTING

Tertiary care hospital in Riyadh.

PARTICIPANTS AND METHODS

The Arabic version of the SFAR was administered to patients with suspected AR and control participants.

MAIN OUTCOME MEASURE

Comparison of the AR and control groups to determine the test-retest reliability and internal consistency of the instrument.

RESULTS

The AR (n=173) and control (n=75) groups had significantly different Arabic SFAR scores (P < .0001). The instrument provided satisfactory internal consistency (Cronbach's alpha value of 0.7). The test-retest reliability was excellent for the total Arabic SFAR score (r =0.836, P < .0001).

CONCLUSION

These findings demonstrate that the Arabic version of the SFAR is a valid tool that can be used to screen Arabic speakers with suspected AR.

LIMITATIONS

The absence of objective allergy testing.

Is There An Association between Migraine and Allergic Rhinitis?

We conducted a prospective study to evaluate nasal signs and symptoms and to perform allergen-specific immunoglobulin E (IgE) testing to investigate the relationship between migraine and allergic rhinitis. Our study group consisted of 40 patients diagnosed with migraine—22 men and 18 women, aged 21 to 38 years (mean: 25.7). We compared their findings with a control group of 40 healthy adults—15 men and 25 women, aged 19 to 36 years (mean: 25.1). Allergen-specific IgE measurements were obtained with six groups of allergens: fungi, grass pollens, tree pollens, wild herbs, house dust mite 1, and house dust mite 2. We found no significant difference between the migraine patients and the controls in the incidence of nasal signs and symptoms (i.e., discharge, congestion, itching, and sneezing) or inferior turbinate signs (i.e., color and edema). According to the IgE assays, 14 migraine patients (35.0%) were sensitized to one or more allergens, compared with 11 of the controls (27.5%); the difference was not statistically significant. Sensitization was highest for the grass pollens panel in both groups. Even though we did not find an association between migraine and allergic rhinitis, the recent literature supports a correlation between migraine and atopy. The two conditions share common neural pathways and common mediators, and they can be linked statistically in patients and their families. A pathophysiologic association between the two conditions seems more likely than an etiologic association. In this regard, future efforts could be focused on the determination of atopy in migraine patients and the therapeutic implications of this diagnosis.

Prevalence and triggers of allergic rhinitis in the United Arab Emirates

BACKGROUND AND OBJECTIVES

Allergic rhinitis is a morbid condition that is frequently overlooked by patients and physicians. This type of atopy has not been adequately investigated in the United Arab Emirates.

METHODS

This cross-sectional, population-based observational study was conducted in the seven Emirates (Abu Dhabi, Dubai, Sharjah, Ajman, Umm Al-Quwain, Ras Al-Khaimah, and Fujairah). It used the European Community Respiratory Health Survey (ECRHS II) to screen for allergic rhinitis in people living in this region.

RESULTS

Symptoms of allergic rhinitis were present in 85 (7%) of the 1,229 study population. Only 33 (39%) patients received treatment. Seventy-six (89%) patients had asthma. Thirty-seven (44%) patients were poly-sensitized. Symptoms were aggravated by dust (59%), grass/pollens (44%) and proximity to animals (21%). Winter was the peak season (37%), followed by spring (30%), autumn (18%) and summer (15%). Grass/pollen allergies were clustered in the winter, spring and summer (p ≤ 0.001). Dust was non-seasonal (p ≥ 0.121) and animal allergy was worse in the winter (p = 0.024) and spring (p = 0.044). Spring symptoms were less common in people living in the inner city (p = 0.003).

CONCLUSIONS

At least 7% of the studied population had allergic rhinitis. Most (71%) of these patients had environmental triggers and remained untreated. Allergic rhinitis awareness and measures to control allergens and dust are needed. The impact of preventing allergic rhinitis on other common atopies in the region deserves future studies.