Smell disorders evolution after chronic rhinosinusitis with polyps surgery

The effects of chronic rhino sinusitis with polyps (CRSWP) surgery on smell symptoms have not been sufficiently studied. The aim of this study was to evaluate the impact of CRSWP surgery on smell symptoms over short and long-term follow-up and to identify the factors that might influence their evolution. Patients and methods: This was a retrospective study about 184 patients operated endoscopically for CRSWP. In post operative period, long-term local steroids were prescribed systematically. The sense of smell was evaluated preand post-operatively according to a subjective score (1: good smell, 2: hyposmia, 3: anosmia). Some factors, related to the patient, the CRSWP and the treatment, were tested in order to identify predictors of smell outcome after surgery.. Results: Before surgery, the anosmia and the hyposmia were noted in 90.8% and in 8.7% of cases, respectively. At six months after surgery, the improvement of olfactory score was significant: 84% of patient had the score 1 compared with 0.5% preoperatively (p < 0.0001). This improvement was maintained during the 2 first years and decreased significantly at 3 years, although an average delay of polyps recurrence was 23.4 months. Among the factors studied in our series, only the observance of postoperative corticosteroids was retained as a predictor of smell recovery after surgery (p = 0,011). Conclusion: CRSWP surgery can significantly improve the smell sense, especially during the two first years. This effect can be sustainable if good post operative compliance for local corticosteroid are achieved.

Mobility impairment and life satisfaction in the Northern Region of Malawi

There exist many psychosocial sequelae associated with mobility impairment, especially in low-resource settings where access to mobility assistive devices is limited. Objectives: This study aims to (1) define the burden and presenting aetiologies of mobility impairment in the rural Northern Region of Malawi and (2) assess the relationship between physical disability, life satisfaction and access to mobility aids. Methods: At mobility device donation clinics throughout the Northern Region of Malawi, adults living with mobility impairment were surveyed with a demographic questionnaire and a series of validated surveys to assess their physical activity levels (Global Physical Activity Questionnaire [GPAQ]), degree of mobility impairment (Washington Group Extended Set Questions on Disability) and life satisfaction (patient-reported outcomes measurement information systems satisfaction with participation in social roles and general life satisfaction). Results: There were 251 participants who qualified for inclusion, of which 193 completed all surveys. Higher physical activity scores were positively correlated with increased life satisfaction: (1) satisfaction with participation in social roles (0.481, p < 0.0001) and (2) general life satisfaction (0.230, p < 0.001). Respondents who had previously used a formal mobility device reported 235.5% higher physical activity levels ([139.0%, 333.0%], p = 0.006), significantly higher satisfaction with participation in social roles ([0.21, 6.67], p = 0.037) and equivocally higher general life satisfaction ([−1.77, 3.84], p = 0.470). Conclusion: Disability and mental health do not exist in isolation from one another. Given the positive correlations between formal mobility device usage and both physical activity and life satisfaction, interventions that increase access to mobility-assistive devices in undertreated populations are imperative. Contribution: This study contributes to the understanding of the complex relationship between physical disability, access to mobility aids, and life satisfaction. Results from this study suggest the potential benefit that increasing access to mobility aids may have in improving the quality of life of mobility impaired persons in resource-limited settings, such as the Northern Region of Malawi

Smell disorders evolution after chronic rhinosinusitis with polyps surgery

: The effects of chronic rhino sinusitis with polyps (CRSWP) surgery on smell symptoms have not been sufficiently studied. The aim of this study was to evaluate the impact of CRSWP surgery on smell symptoms over short and long-term follow-up and to identify the factors that might influence their evolution. Patients and methods: This was a retrospective study about 184 patients operated endoscopically for CRSWP. In post operative period, long-term local steroids were prescribed systematically. The sense of smell was evaluated preand post-operatively according to a subjective score (1: good smell, 2: hyposmia, 3: anosmia). Some factors, related to the patient, the CRSWP and the treatment, were tested in order to identify predictors of smell outcome after surgery.. Results: Before surgery, the anosmia and the hyposmia were noted in 90.8% and in 8.7% of cases, respectively. At six months after surgery, the improvement of olfactory score was significant: 84% of patient had the score 1 compared with 0.5% preoperatively (p < 0.0001). This improvement was maintained during the 2 first years and decreased significantly at 3 years, although an average delay of polyps recurrence was 23.4 months. Among the factors studied in our series, only the observance of postoperative corticosteroids was retained as a predictor of smell recovery after surgery (p = 0,011). Conclusion: CRSWP surgery can significantly improve the smell sense, especially during the two first years. This effect can be sustainable if good post operative compliance for local corticosteroid are achieved

Diastolic versus systolic dysfunction in patients with chronic liver disease ­ a single center study in South-South, Nigeria

Objectives: The term cirrhotic cardiomyopathy (CCM) has been used to describe the constellation of cardiovascular abnormalities including diastolic and systolic dysfunctions in patients with chronic liver disease (CLD). CCM contributes to morbidity and mortality associated with CLD. The aim of the study was to evaluate the left atrial and ventricular geometry, systolic and diastolic functions in patients with CLD. Material and Methods: This was a cross-sectional analytical study that involved 80 patients with CLD seen at University of Calabar Teaching Hospital, Calabar, Nigeria, and 80 apparently healthy controls matched for age/ gender. The participants were interviewed, examined and had resting transthoracic echocardiography. The data were analyzed using IBM SPSS version 20.0. Results: A total of 160 subjects were recruited into the study with a male to female ratio of 2.8:1. There was no difference in the mean age of cases and controls (P = 0.115). Systolic function of the left ventricle was similar in the two arms. However, left ventricular diastolic dysfunction, left atrial enlargement, and increased left ventricular mass index (LVMI) were more prevalent among the patients with CLD compared to controls (P < 0.05). Conclusion: The study demonstrated increased left atrial diameter, increased LVMI associated with diastolic dysfunction, and preserved systolic function at rest among CLD patients. Keywords: Chronic liver disease, Diastolic dysfunction, Systolic dysfunction

Impacts de l'anosmie sur la vie socio-professionnelle. A propos de 180 cas dans une population tchadienne

Introduction : L'anosmie observée dans la population Hadjaraï au Tchad est congénitale et serait d'origine génétique. Le but de cette étude était de déterminer si l'anosmie affectait la qualité de vie et les activités quotidiennes des personnes atteintes.Patients et méthodes:Il s'agit d'une étude prospective, descriptive et comparative concernant 684 personnes, toutes des Hadjaraï, âgées de plus de 15 ans. Elles ont été réparties selon leur état olfactif en deux groupes : un groupe des anosmiques composé de 180 personnes et un groupe des normosmiques comportant 504 personnes. Un questionnaire a été adressé à chaque sujet. Nous avons utilisé le test de Khi-deux de Pearson pour comparer les fréquences de réponse de deux groupes (anosmiques et normosmiques) et le test de corrélation pour rechercher un lien entre l'odorat et la qualité de vie ou les activités quotidiennes ; le seuil de signification étant égal à une valeur inférieure à 0,05.Résultats : Pour les fréquences de réponse aux questions liées à la qualité de vie et aux activités quotidiennes, une différence significative était notée entre les patients anosmiques et les sujets normosmiques (p < 0,001). Parmi les sujets ayant indiqué des handicaps, 33,3% des patients anosmiques n'éprouvaient pas de plaisir pour s'alimenter contre 6,5% chez les normosmiques ; 31,1% des anosmiques étaient incapables de contrôler leurs propres odeurs contre 4% chez les normosmiques ; 32,2% des anosmiques n'utilisaient pas du parfum contre 5% chez les normosmiques ; 28,8% des anosmiques étaient confrontés à des conflits familiaux contre 10,2% chez les normosmiques ; 83% des anosmiques étaient incapables de détecter des aliments avariés contre 0% chez les normosmiques ; 80% des anosmiques étaient incapables de détecter la fumée contre 0% chez les normosmiques ; 52, 2% des anosmiques n'utilisaient pas de l'encens contre 12,5% chez les normosmiques et 41,7% des anosmiques étaient victimes d'accidents domestiques contre 17% chez les normosmiques.Conclusion: Les conséquences socio-professionnelles de l'anosmie sont multiples et potentiellement dangereuses. Les personnes anosmiques sont plus susceptibles d'avoir des accidents domestiques que les normosmiques

Comparison between olfactory function of pregnant women and non-pregnant women in reproductive age group in Ibadan, Nigeria

Background: Pregnant women require normal olfactory function in order to develop good appetite for healthy living and normal fetal development. This study was carried out to investigate and compare olfactory function of pregnant women with non-pregnant women. Methods: This was a case control study of women in reproductive age group at the University College Hospital, Ibadan, Nigeria from July 2014 to February 2015. Consecutive 70 pregnant women and 70 non-pregnant women (controls) without rhinologic symptoms were studied. A structured questionnaire was administered to obtain participants' information on socio-demographics, pregnancy history, and ability to perceive smell. They subjectively rated their olfactory function on a visual analogue scale of 0 ­ 100. Olfactory threshold (OT), discrimination (OD), identification (OI) scores and TDI of both groups were determined with"Sniffin' sticks"kits and compared. The level of significance was P<0.05. Results: The mean age of the pregnant women was 30.5±3.9years and control was 28.5±6.6years. There were more pregnant women (7.1%) with hyposmia than the non-pregnant women (2.9%). The subjective rating of olfactory function was 68.2±24.9 (median 70) and 72.3±21.6 (median 69) in pregnant women and controls respectively. The mean OT, OD, OI, TDI scores were higher in pregnant women than the controls. However, it was only in OI (P=0.000) and TDI (P=0.012) that the differences were significant. Conclusions: Pregnant women have olfactory dysfunction more than the non-pregnant women of reproductive age group. Also, they have tendency to develop loss of cognitive olfactory information more than the non-pregnant women

Déterminisme génétique de l'anosmie : Cas des populations Hadjaraï au Tchad

Introduction :L'anosmie a des causes diverses. Cette affection a été observée chez les «Hadjaraï», originaires de la région du Guéra au centre du Tchad. Le but de cette étude est de montrer l'origine génétique de l'anosmie et de déterminer son mode de transmission chez ces populations.Patients et Méthodes : C'était une étude prospective et descriptive menée dans la ville de N'Djaménaau Tchad. L'étude a concerné 146 personnes anosmiques, toutes des Hadjaraï d'au moins 15 ans. Pour chaque patient, un pedigree a été réalisé. Nous avons tiré au hasard 30 pedigrees pour l'étude.Résultats : L'ensemble de 30 pedigrees était composé de 485 personnes dont 161 anosmiques (93 hommes et 68 femmes).Dans tous les pedigrees, une personne anosmique de la deuxième ou troisième génération avait toujours un des parents anosmique excepté deux individus. La transmission de l'anosmie était verticale dans presque tous les pedigrees. Trois cas probables d'anosmie à pénétrance incomplète avaient été notés, donnant la pénétrance de la maladie à 0,98. La quasi-totalité des enfants issus des couples sains étaient indemnes. Dans trois quart des cas, les hommes malades mariés à des femmes sainesle transmettaient à leurs fils. Dans tous les pedigrees, une transmission de la maladie de père à enfants avait été notée.Conclusion : L'anosmie observée chez les « Hadjaraï » est d'origine génétique et se transmettrait selon le mode autosomique dominant, à pénétrance presque complète et à expressivité peu variable

Non-Motor Symptoms of Parkinson's Disease: Diagnosis and Management

Bacground: Non-motor symptoms (NMS) of Parkinson's disease (PD) are a key determinant of health; quality of life (QoL) and societal cost of PD. They are often less appreciated than motor symptoms but are important sources of disability for manyPDpatients. Methods:Literature search was performed using the reference databases Medline; Science Citation Index and EMBASE. The keywords used were 'non-motor symptoms'; Parkinson's disease; olfaction and constipation. Papers discovered by this search were reviewed; as were references cited therein. Results: Contrary to common perception; many NMS of PD occur early in PD and some may even predate thediagnosis of PD that is based on motor signs. These include olfactory deficit; sleep problems such as rapid eye movement behaviour disorder; constipation and the more recently described male erectile dysfunctionThere is compelling evidence that nonmotor symptoms of PD play a dominant role in the QoL and disability of PD patients and the QoLof their 'informal' carers. Effective clinical management of PD therefore demands that these symptoms be identified and to the extent possible treated