RESUMO
Background: Rhinitis medicamentosa is a nonallergic inflammation of the nasal mucosa caused by topical decongestants overuse. It mainly affects young and middle-aged adults. Therefore, the aim of this study was to investigate the attitudes of pharmacists regarding the utilization of over-the-counter intranasal decongestants. Methods: An online cross-sectional study was conducted from November 2021 to January 2022. The target population of the study included pharmacists who work in community pharmacies in Saudi Arabia. Binary logistic regression analysis was used to identify predictors of having positive attitude towards controlling the use of decongestant. Results: A total of 220 participants were included in this study. Around 15.0% of them reported that ND come with a physician prescription. The majority of the participants (87.3%) reported that the less than 5 days is the maximum safe duration for the use of NDs. Overall, the study participants demonstrated moderately positive attitude towards controlling the use of decongestant with a mean attitude score of 2.5 (standard deviation: 1.2) out of 5; which represents 50.0% of the maximum score. Binary logistic regression analysis identified that pharmacists aged 31-40 years were two-folds more likely to have positive attitude towards controlling the use of decongestant compared to others (p<0.05). Around 45.9% of them reported that they recommend other over-the-counter treatments like nasal irrigation, nasal steroids, or antihistamine if they see a patient with RM asking for ND with or without prescription. Conclusion: The majority of pharmacists in Saudi Arabia demonstrated sufficient awareness and understanding on the adverse effects associated with the excessive use of NDs. Rhinitis medicamentosa can be avoided by appropriate measures, highlighting the importance of raising awareness about the excessive use of decongestants among healthcare professionals and patients alike.
RESUMO
BACKGROUND: Otosclerosis is a common cause of progressive hearing impairment that causes fixation of the stapes. Surgical intervention is the preferred treatment approach to ameliorate the conductive hearing loss associated with stapedial otosclerosis. However, given that it is a difficult and delicate procedure, the surgery may fail for a number of reasons. Therefore, it is very important to evaluate the success rate of the surgical approach used in each regional center. OBJECTIVE: To examine the effectiveness of stapedotomy in improving hearing sensitivity for otosclerotic patients at King Abdul Aziz University Hospital in Riyadh. DESIGN: Retrospective chart review with an analysis of pre- and postoperative surgical treatment. SETTING: Tertiary referral otolaryngology clinic. PATIENTS AND METHODS: All cases who underwent stapedotomy between 1997 and 2009 were retrospectively reviewed. Preoperative and postoperative audiometric assessments were conducted using conventional pure tone audiometry. Differences were analyzed by two-way repeated measures ANOVA. MAIN OUTCOME MEASURE(S): Pre- and postoperative pure tone thresholds for air and bone conduction. RESULT: Fifty-three patients underwent stapedotomy. Stapedotomy yielded significant improvements in mean (SD) postoperative air-conduction thresholds of about 18.7 (11.7) dB (P < .0001) and mean (SD) post.operative bone-conduction thresholds of about 2 (7.2) dB (P < .05). Additionally, a significant correlation was found between improvement in air-conduction thresholds and the size of preoperatve air-bone gap (P < .01) About 70%of patients achieved an air-bone gap of 20 dB or better. None of the cases examined in this study exhibited sensorineural hearing loss or adverse complications following stapedotomy. CONCLUSIONS: Stapedotomy is a safe and effective treatment option for patients with otosclerosis. Given that the majority of participants in this study exhibited mixed hearing loss preoperatively, the results further suggest that stapedotomy can also be effective in improving thresholds for these patients. LIMITATIONS: The sample size was relatively small.
