ABSTRACT
BACKGROUND: Globus pharyngeus is the lump sensation in the throat associated with various conditions including somatoform disorder and gastroesophageal reflux disease. However, many patients with unrelated causes were found to respond to anti-allergic treatment. OBJECTIVE: Determine the results of allergic skin test in globus pharyngeus patients who had unidentified causes. MATERIAL AND METHOD: Fifty-four globus pharyngeus patients were enrolled and referred for complete physical examination, screening psychological status, videostroboscopy, and reflux finding score assessment. All patients including 38 controlled subjects underwent skin prick test and/or intradermal test. The globus patients who had positive test were recommended to have anti allergic treatment. Barium swallowing study, ambulatory double-probe pH monitoring, or plain film cervical spine was done in patients with negative skin tests and in non-response to medication. RESULTS: There was statistically significant difference of positive skin test results between globus and the control group (77.8% vs. 28.6% OR = 13.12, p < 0.001). In positive skin test-globus group, globus symptom was improved in 64.3% after allergic treatment, which 85.2% had moderate and excellent improvement. In patients with negative skin test and non-response group show various conditions including gastroesophageal reflux disease (18.52%), abnormal esophageal manometry (40.74%), and myofascial pain syndrome (3.71%). CONCLUSION: Due to high prevalence of positive skin test in globus pharyngeus patients, this symptom should be considered as one of the atypical allergic manifestations.
ABSTRACT
BACKGROUND AND OBJECTIVE: Hearing impairment from noise exposure has been reported in fix-wing pilots, especially in civilized countries. However, there are few studies on rotary wing aviators and aircraft mechanics, especially in developing countries whose hearing conservative program is not well established. The present study, therefore, was done to evaluate the prevalence of noise induced hearing loss and the contributing factors that may effect both groups of noise-exposed population. MATERIAL AND METHOD: Report questionnaires were reviewed and physical examination combined with audiometric records of 34 pilots and 42 mechanics in the Royal Thai Army Aviation Center, Lobburi, were examined. Hearing loss was studied using four categories of significant threshold shift (STS). Amplitude of noise radiated by aircraft was also measured at different distances. RESULTS: No significant difference was found in prevalence of hearing loss in aviators (32.4%) and aircraft mechanics (47.6%), but in the aircraft mechanics group there were more damage of frequency involvement including speech frequency and high frequency and more decibels loss than aviators. The type of hearing protection and smoking index were strongly correlated with hearing loss. Age, flight time and alcohol habit had no significant effect and ninety percent of the subjects had no self awareness of hearing loss. CONCLUSION: Aircraft mechanics had more severity on hearing loss than aviators. Types of noise protector and cigarette smoking had significant association with hearing loss.