ABSTRACT
Background: Nasal and non-nasal symptoms in allergic rhinitis (AR) can be assessed by measuring health related quality of life (HRQOL). Present study was to assess the impact of use of antihistaminic in AR which will affect the work productivity, sleep, frequent visits to health care professional and expenditure on medicines. For this evaluation, Rhinoconjuctivits Quality Of Life Questionnaire (RQLQ) has been used.Methods: In this study 52 patients with AR were randomized in an open-label, 4-arm, parallel group, single center study. Questionnaire information was obtained about allergy-related RQLQ. Subjects received either Tablet Cetirizine 5 mg, Levocetirizine 5 mg, Loratidine 5 mg or Fexofenadine 120 mg. Changes from baseline until the end of study visit (1 week following) were evaluated by RQLQ.Results: When compared between treatment groups using one-way ANOVA it was observed that there is no variation in RQLQ overall Score in all the four treatment groups and there is no difference from treatment to treatment. Overall RQLQ score was reduced maximum in Levocetirizine group. Individual symptoms of RQLQ that is sleep score, non-hay fever, practical problem, nasal symptom score, Eye symptom Score, activities Score, and emotion score were also improved in the Levocetirizine group.Conclusions: Patients of all four study groups showed an improved perception of their HRQL according to the RQLQ. Significant improvements are reported in nasal symptoms, daily activities, sleep and psychological impact. Our results provide support for an AR and its impact on quality of life. Our recommendation stipulating that levocetirizine is superior to rest drug group for the treatment of AR with safety and tolerability.
ABSTRACT
Background: This study was to assess the usefulness of nasal smear as a quick, easy and inexpensive diagnostic method for allergic rhinitis and for assessment of the cost effectiveness of antihistaminics.Methods: This study was conducted in rural setting of tertiary care hospital. Nasal smears were taken from 52 patients with a clinical history of nasal allergy having nasal congestion score of at least 3 or more. Nasal smears were stained with Hematoxilin-Eosin and examined by pathologists.Results: A total of 52 patients 13 in each groups of the age group 18 to 65 years (Mean age, 33.73±10.23 years); 48.08% are Female and 51.92% are Male were randomized and received either Cetirizine, Levocetirizine, Loratadine, or Fexofenadine over a period of one week. The association of eosinophil before and after the treatment was obtained using logistic regression analysis for each treatment separately. Eosinophil is marginally associated with Cetirizine before and after treatment.Conclusions: Evaluation of eosinophils in nasal smear is an insensitive but cheaper test for the diagnosis of allergic rhinitis and use as a simple tool for comparison of cost effectiveness among commonly used oral antihistaminics. pharmacoeconomic analysis of present comparative clinical study shows that cetirizine is a better choice in comparison with levocetrizine, loratidine and fexofenadine due to its cost effectiveness.