Outcomes of biological therapy in patients with severe asthma with chronic rhinosinusitis in Saudi Arabia: patients with nasal polyps versus those without nasal polyps.

BACKGROUND: This study's purposes were to evaluate the impact of biological therapies on outcomes in patients with severe asthma (SA) and chronic rhinosinusitis (CRS) and to compare these effects among those with NP (CRSwNP) versus those without NP (CRSsNP) in the "real-world" setting in Saudi Arabian patients. METHODS: From March to September 2022, a retrospective observational cohort study was undertaken at the severe asthma clinics of the Armed Forces Hospital-Southern Region (AFHSR) and King Khalid University Hospital, Abha, Saudi Arabia, to delineate the effects of dupilumab therapy. Outcomes were assessed, including clinical outcomes, FEV1, and laboratory findings before and one year after dupilumab. Post-therapy effects were compared between CRSwNP and CRSsNP. RESULTS: Fifty subjects were enrolled, with a mean age of 46.56. There were 27 (54%) females and 23(46%) males. Significant improvements in clinical parameters (frequency of asthma exacerbations and hospitalizations, the use of OCs, anosmia, SNOTT-22, and the ACT), FEV1, and laboratory ones (serum IgE and eosinophilic count) were observed 6 and 12 months after using dupilumab (p < 0.001), respectively. However, after 12 months of dupilumab therapy, there were no significant differences between those with and without NP with regards to clinical (anosmia, ACT, and OCs use), laboratory (eosinophilic count, serum IgE level) parameters, and FEV1%. CONCLUSIONS: Patients with CRS experienced significant improvements in clinical, FEV1, and laboratory outcomes after dupilumab therapy. However, these improvements were not maintained when comparing CRSwNP with CRSsNP. There were no significant differences between those with and without NP regarding ACT and OCs use or laboratory (eosinophilic count, serum IgE level) parameters. Further prospective multicenter studies are warranted.

Comparative Efficacy of Different Therapeutic Interventions in Eustachian Tube Dysfunctions: A Cross-Sectional Analysis.

Eustachian tube dysfunction (ETD) affects a significant portion of the population, manifesting symptoms that impact the quality of life. Despite the prevalence of ETD, there remains a notable gap in comprehensive studies exploring the condition's dynamics within specific demographic contexts, particularly within Saudi Arabia. This study aimed to assess the prevalence and severity of ETD across different demographic groups, to evaluate the efficacy of various treatment modalities, and to identify key predictors of treatment response in a Saudi Arabian cohort. A cross-sectional study was conducted from June 2022 to May 2023 in tertiary care hospitals in the Aseer region, Saudi Arabia. Participants included adults diagnosed with ETD, assessed through clinical symptoms, otoscopic examinations, audiometric evaluations, tympanometry, and the ETDQ-7 questionnaire. The study incorporated advanced diagnostics such as nasopharyngoscopy and pressure equalization tube function tests and involved 154 participants, revealing significant variations in ETD severity, with the 46-60 age group exhibiting the highest mean ETDQ-7 score of 4.85, and urban residents displaying lower severity scores compared to rural counterparts. Pharmacological interventions were most effective, achieving the highest symptom relief and audiological improvement rates of 87.78%. Multivariate regression highlighted age, geographic location, and treatment modality as key predictors of treatment efficacy, with notable interaction effects between climate conditions and treatment types influencing outcomes. The findings underscore the heterogeneity in ETD presentation and the differential efficacy of treatment modalities.

Machine learning framework for simulation of artifacts in paranasal sinuses diagnosis using CT images.

In the medical field, diagnostic tools that make use of deep neural networks have reached a level of performance never before seen. A proper diagnosis of a patient's condition is crucial in modern medicine since it determines whether or not the patient will receive the care they need. Data from a sinus CT scan is uploaded to a computer and displayed on a high-definition monitor to give the surgeon a clear anatomical orientation before endoscopic sinus surgery. In this study, a unique method is presented for detecting and diagnosing paranasal sinus disorders using machine learning. The researchers behind the current study designed their own approach. To speed up diagnosis, one of the primary goals of our study is to create an algorithm that can accurately evaluate the paranasal sinuses in CT scans. The proposed technology makes it feasible to automatically cut down on the number of CT scan images that require investigators to manually search through them all. In addition, the approach offers an automatic segmentation that may be used to locate the paranasal sinus region and crop it accordingly. As a result, the suggested method dramatically reduces the amount of data that is necessary during the training phase. As a result, this results in an increase in the efficiency of the computer while retaining a high degree of performance accuracy. The suggested method not only successfully identifies sinus irregularities but also automatically executes the necessary segmentation without requiring any manual cropping. This eliminates the need for time-consuming and error-prone human labor. When tested with actual CT scans, the method in question was discovered to have an accuracy of 95.16 percent while retaining a sensitivity of 99.14 percent throughout.

Psychological Impact and Quality of Life in Adults With Tinnitus: A Cross-Sectional Study.

BACKGROUND: Tinnitus may directly or indirectly influence professional, personal, and leisure activities and disrupt family and social relationships in severe cases. This study aimed to explore the impact of tinnitus on the quality of life (QoL) and psychological well-being among Saudi Arabian adults. METHODS: This study used a cross-sectional design to collect data from adults experiencing tinnitus. Data collection took place between September 5, 2023 and October 7, 2023 at King Khalid University, Abha, Saudi Arabia. The study involved adults aged 18 to 65 with tinnitus. Participants were recruited from audiology clinics. A multi-stage stratified random sampling method was used to recruit the study participants. The severity of tinnitus handicap was assessed using the 25-item Tinnitus Handicap Inventory (THI) questionnaire. THI consists of 25 items divided into functional, emotional, and catastrophic subscales. The total score ranges from 0 to 100, with higher scores indicating greater tinnitus-related handicap. THI scores are categorized into 0-16, 18-36, 38-56, 58-76, and 78-100. RESULTS:  A total of 163 participants were included in this study. The largest age group category was 18-29 years, comprising 57.05% (n = 93) of the sample. The study included a slightly higher percentage of female participants (65.03%, n = 106). More than three-fifths (61.96% ) of the participants were from the Western Region (n = 101), 91.40% (n = 149) were Saudi nationals, 55.21% (n = 90) were single, 67.5% (n = 110) had university education, 46.0% (n = 75) had income less than 500 SAR, 44.78% (n =73) was employed, and 74.23% (n = 121) did not smoke. Tinnitus hurts emotions and QoL. The largest proportion of the studied patients with tinnitus faced catastrophic handicaps (24.5%, n = 40), and nearly equal proportions experienced mild and moderate handicaps (23.3%, n = 38 and 23.9%, n =39, respectively). Severe handicap was reported in 15.3% (n = 25), while a slight effect was reported in (12.9%, n = 21). Tinnitus affected their hearing (36.81%, n = 60); interfered with daily life (33.74%, n = 55), social activities (30.06%, n = 49), social relationships (29.45%, n = 48), and concentration (37.42%, n = 61); caused fatigue (38.04%, n = 62) and sleep disturbances (36.81%, n = 60); and prevented them from enjoying life (25.77%, n = 42). Tinnitus caused anger (47.85%, n = 78), confusion (42.94%, n = 70), anxiety (43.56%, n = 71), feeling unsafe (33.74%, n = 55), desperation (36.81%, n = 60), frustration (30.06%, n = 49), being upset (38.04%, n = 62), experiencing depression (30.67%), and challenges in coping with stress (31.29%). There was a significant association between the THI score and region of residence (p = 0.02), income (p = 0.041), occupation (p = 0.013), and smoking (p = 0.014). CONCLUSIONS: Our research underscored the profound impact of tinnitus on the QoL among adults in Saudi Arabia. A significant portion of the studied patients faced catastrophic handicaps, emphasizing the severity of the condition. These findings underscore the multifaceted and far-reaching consequences of tinnitus, highlighting the need for comprehensive support and management strategies tailored to the unique sociodemographic factors influencing individuals' experiences.

Computed Tomography (Ct) Scan Assisted Machine Learning in the Management of Artifacts Related to Paranasal Sinuses and Anterior Cranial Fossa.

Computed tomography (CT), through the use of ionizing radiation, allows us to assess the different parts of the body. It is made up of an X-ray tube that rotates rapidly around the patient generating the radiation beam. This is attenuated with the patient producing information, which is collected by the detectors that are opposite to the tube located in the gantry (part of the tomography equipment); finally, these collected data are sent to the computer that will reconstruct the information obtained and will represent it as an image on the monitor. In the practice of a study, artifices or artifacts may appear regardless of their origin, which limits the scan examination; this leads to stopping the examination and starting again, and added to this with the contrast media, they have to apply these drugs again. State-of-the-art scanners allow complete reconstructions to be performed with few projections, limiting radiation doses, by means of statistical algebraic reconstruction methods. The present work shows the simulation of artifacts in sinusitis diagnosis computed tomography images, the extraction of features from each image, and an automatic classification algorithm for the differentiation of artifacts. The results show that the algorithm is able to classify the simulated artifacts with a percentage of 90%.

Olfactory Change Pattern After Endoscopic Sinus Surgery in Chronic Rhinosinusitis Patients.

Background Chronic rhinosinusitis (CRS) is a chronic inflammation of the sinonasal mucosa that is clinically associated with sinus pressure, nasal congestion, rhinorrhea, and a decreased sense of smell that lasts more than 12 weeks. Endoscopic sinus surgery (ESS) for medically refractory CRS is mainly undergone to improve sinus function and access to topical medicinal treatments. However, olfactory changes after ESS can be unpredictable. Aim The current study aimed to assess olfactory change patterns after endoscopic sinus surgery in patients with chronic rhinosinusitis. Methods A record-based retrospective study was conducted in Aseer Central Hospital (ACH) ear, nose, and throat outpatient (ENT OPD) department and Khamis Mushayt General Hospital from August 15, 2021, to December 15, 2021. Data were collected using pre-structured data extraction sheet to avoid errors. Data extracted and collected included patients' biodemographic data, CRS-associated symptoms, and endoscopic surgery-related data, including duration since surgery, presurgical medications, and duration of surgery. Also, postsurgical complications were extracted, especially olfactory complications. Results A total of 168 patients with chronic rhinosinusitis (CRS) and who had undergone endoscopic sinus surgery in the Aseer region were included. Patient ages ranged from 10 to 61 years, with a mean age of 39.8 ± 12.4 years old. Regarding the associated symptoms and complaints of the study patients, 110 (65.5%) complained of sinusitis, and 86 (51.2%) had allergic RS. The postsurgical complications of patients with CRS who had undergone endoscopic sinus surgery were olfactory dysfunction (OD) in 32 (19%), no complications in 115 (68.55%), and other nonspecific complications, such as headache, drowsiness, nose dryness, and bleeding, in 21 (12.55%). Also, 71 (42.3%) reported that they hardly perceive the fragrance in perfumeries. Conclusion In conclusion, olfactory impairment is a frequent clinical presentation in patients with CRS. In this study, olfactory dysfunction was improved, except among nearly one out of each five patients after ESS. Olfactory dysfunction was more among patients who had undergone recent surgery and those with chronic rhinosinusitis with nasal polyps (CRSwNP). Also, among patients who reported no complications, olfactory function did not return to normal in most patients as they hardly perceive fragrance.

Cauterization tonsillectomy as compared to traditional tonsillectomy technique.

BACKGROUND: Tonsillectomy is one of the most frequently applied and oldest surgical procedures in otorhinolaryngology. Various surgical techniques are used to perform this operation including traditional and cauterization techniques. OBJECTIVES: To assess morbidity and efficacy and compare objectively the techniques in tonsillectomy, i.e., traditional technique and cauterization technique. This study compares the traditional and cauterization tonsillectomy techniques in view of their advantages and complications. METHODS: This is a retrospective study and comparative study, conducted during the period from January 2017 to March 2018 from the patients attending to Alnamas General Hospital, Aseer Region, Saudi Arabia. The questionnaire was designed to compare the traditional and cauterization tonsillectomy. Fifty patients underwent traditional technique and fifty patients underwent cauterization method. The data analyzed using SPSS V.16.0 (SPSS Inc; Chicago, IL, USA). RESULTS: A total of 100 patients, 62 males and 38 females, aged 8 to 16 years were included in the study. A total of 100 patients were enrolled in the study. Traditional and cauterization tonsillectomy were performed. 50 (27 male and 23 female) patients, whose ages ranged from 9 to 16 years old underwent the traditional tonsillectomy, 50 (35 male and 15 female) patients whose ages ranged from 8 to 16 years underwent cauterization. The two groups were similar for demographic parameters. The difference between mean operative times of the two methods was statistically significant. Postoperative bleeding is significantly higher in the traditional technique compared to cauterization method. Postoperative pain is significantly less in cauterization method. Only a few patients experienced fever, bleeding, and other complications related to anesthesia. The bleeding severity is significantly lower in the cauterization technique. Postoperative pain was less in cauterization technique on day 1 and day 5. Postoperative pain was from mild to severe. CONCLUSION: This study revealed significantly less postoperative complications in traditional tonsillectomy in comparison with the cauterization method. Healing time was significantly faster in cauterization technique than in traditional method.

The Magnitude and Determinants of Tinnitus among Health Science Students at King Khalid University.

BACKGROUND: Tinnitus is a symptom that is defined as a subjective perception of noise in an absence of external sound. It is an indicator of auditory system abnormalities. It can also be present in individuals without any hearing abnormalities. Difficulty to consternate, insomnia, and decreased speech discrimination are the most common symptoms related to tinnitus. AIM: To assess the magnitude and pattern with determinants of tinnitus among health science students at King Khalid University. Methodology. A descriptive cross-sectional survey was conducted targeting all accessible students in health science colleges in King Khalid University which is the main university in the Aseer region, south of Saudi Arabia. Students were included consecutively from different faculties and different grades. Data were collected through a self-administered prestructured questionnaire, which was distributed and recollected the next day. Tinnitus was screened using an adapted form of the National Health and Nutrition Examination Survey (NHANES). RESULTS: A total sample of 400 students have been included with their ages ranging from 18 to 30 years with a mean age of 22 ± 1.8 years), and 28.5% of the students recorded positive findings. Tinnitus was bilateral among 51.8% of students, and 44.7% of tinnitus students hear buzzing sound while 21.1% have hissing sound and 10.5% had pulsating sound. Among 46.5% of students with tinnitus, the heard sound was of moderate loudness and intermittent among 64.9% of them. Conclusions and Recommendations. In conclusion, the study revealed that just more than a quarter of students complained of tinnitus which was bilateral among half of them. Tinnitus frequency was mainly moderate in intensity and intermittent. Having ear problems, loud sounds, and allergy were the most important predictors of having Tinnitus.