Stick Test Research Articles

Prevalence of Persistent Olfactory Disorders in Patients With COVID-19: A Psychophysical Case-Control Study With 1-Year Follow-up.

The purpose of this multicenter case-control study was to evaluate a group of patients at least 1 year after coronavirus disease 2019 (COVID-19) with Sniffin' Sticks tests and to compare the results with a control population to quantify the potential bias introduced by the underlying prevalence of olfactory dysfunction (OD) in the general population. The study included 170 cases and 170 controls. In the COVID-19 group, 26.5% of cases had OD (anosmia in 4.7%, hyposmia in 21.8%) versus 3.5% in the control group (6 cases of hyposmia). The TDI score (threshold, discrimination, and identification) in the COVID-19 group was significantly lower than in the control group (32.5 [interquartile range, 29-36.5] vs 36.75 [34-39.5], P < .001). The prevalence of OD was significantly higher in the COVID-19 group, confirming that this result is not due to the underlying prevalence of OD in the general population.

Participatory Design of a Web-Based HIV Oral Self-Testing Infographic Experiment (HOTIE) for Emerging Adult Sexual Minority Men of Color: A Mixed Methods Randomized Control Trial.

Health communication is a key health promotion approach for translating research findings into actionable information. The purpose of this study was to use participatory design to create and then test the usability and comprehension of an HIV self-testing infographic in a sample of 322 emerging adult, sexual minority men of color. Our study objectives addressed three challenges to HIV self-testing: (1) correct usage of the test stick, (2) understanding the number of minutes to wait before reading the result, and (3) how to correctly interpret a negative or a positive HIV result. This study was a two-phase, sequential, mixed methods, pilot, online, randomized controlled trial. Results suggested a significant mean difference between the control and intervention groups on HIV self-testing knowledge, with the control group outperforming the intervention group. However, two-thirds or better of the participants in the intervention group were able to comprehend the three critical steps to HIV self-testing. This was a promising finding that has resulted in the authors’ development of additional recommendations for using participatory design for visual aid development in HIV prevention research. Participatory design of an HIV self-testing infographic is a rigorous approach, as a health communication strategy, to address public health priorities.

Assessment of olfactory and gustatory functions in COVID-19 patients

Background/aimThis study aims to evaluate of olfactory and gustatory functions of COVID-19 patients and possible risk factors for olfactory and gustatory dysfunctions. Materials and methodsThe cross-sectional study included adult patients who were diagnosed with COVID-19 in Gazi University Hospital between April 2020 and June 2020. Volunteered patients participated in a survey in which olfactory and gustatory functions and various clinical information were questioned. Sinonasal Outcome Test-22 was also administrated to all patients.ResultsA hundred and seventy-one patients participated in this study. Olfactory and gustatory dysfunctions rates were 10.5% (n: 18) and 10.5% (n: 18), respectively. Patients without any symptom other than smell and taste dysfunctions were clustered as group 1 and patients who are clinically symptomatic were clustered as group 2. Olfactory dysfunction occurred in 8% of group 1 and 17.4% of group 2 (p = 0.072). Gustatory dysfunction rate of smokers was 19.7% and significantly higher than gustatory dysfunction rate of nonsmokers (5.5%) (p = 0.007). Twenty-seven-point-eight percent of the patients with olfactory dysfunction (n = 5) were male and 72.2% (n: 13) were female. Sex did not show significant effect on rate of olfactory dysfunction. Twenty-five patients participated in psychophysical olfactory function test. No participant reported olfactory dysfunction at the time of test. Of the participants, 64% (n: 16) were normosmic and 36% (n: 9) were hyposmic according to Sniffin’ Stick test. ConclusionOlfactory and gustatory dysfunctions are more common in patients who are clinically symptomatic than those diagnosed during contact tracing. Objective tests may show that frequency of olfactory dysfunction is greater than frequency of self-reported olfactory dysfunction.

CULTURAL ADAPTATION OF SNIFFIN’ STICKS TEST FOR A MALAYSIAN POPULATION

Introduction: Sniffin’ Stick test is a quantitative olfactory test first introduced in the 1990s and has since been used in several countries after cultural-based modifications. Objective: To develop a culturally adapted Sniffin’ Stick test suitable for a Malaysian population. Methods: The study was done in 3 phases. The first phase involved a questionnaire rating the familiarity of 70 odors based on a Likert scale. Sixteen items were then selected for the second phase where subjects were tested on the identification of the 16 odors. Odors recognized by less than 75% of the subjects or their distractors were replaced. These steps were repeated until all 16 odors were recognized by more than 75% of the subjects. In the final phase, the mean Odor Identification (OI) scores utilizing the newly selected 16 odors were collected among healthy individuals. Results: A total of 417 subjects participated in the study. In the first-phase, 5 odors from the original Sniffin’ Stick Test which were unfamiliar were replaced for the phase 2 of the study. In the second-phase, modifications were performed 3 times requiring change of 41 distractors and an additional odor. Finally, using the modified Sniffin Stick test version-4, preliminary results of the mean odor identification scoring for the age groups 16-35,36-55 and more than 55 years of age were obtained which showed age-related variations. Conclusion: Our study revealed cultural modifications to the original Sniffin’ Stick Test are required to validate its use in a Malaysian population.

Comparison of Olfactory Cleft Width and Volumes in Patients with COVID-19 Anosmia and COVID-19 Cases Without Anosmia

Introduction: The aim of this study was to assess the relationship between olfactory cleft width/volume and COVID-19-related anosmia. Methods: This study consisted of PCR-proven COVID-19 patients. Cases with COVID-19-related anosmia constituted Group 1 and cases without any olfactory dysfunction (OD) throughout COVID-19 infection or after recovery constituted Group 2. A total of 50 patients were included in the study, comprising 24 cases in Group 1 and 26 cases in Group 2. Group 1 patients underwent a 4-item-odor identification test during active symptoms and a Sniffin’ Sticks test after reconversion of PCR results to negative. All patients in Group 2 also underwent the Sniffin’ Stick test to document normosmia. All cases had paranasal sinus CT performed. Olfactory cleft widths and olfactory volumes were measured. The differences in width and volume between groups and the correlation with odor test scores (threshold-discrimination-identification [TDI]) were calculated. In addition, regression analyzes analysis was performed for cleft widths, volumes, and TDI scores according to age. Results: Olfactory cleft widths and olfactory volumes were significantly higher in Group 1 than those in Group 2 (p = 0.001; p < 0.01). There was a significant negative correlation between total TDI scores and olfactory cleft widths and total olfactory volumes (r = −0.665; r = −0.731, respectively). Patients younger than 40 years of age had significantly higher right olfactory cleft width, left olfactory cleft width, and olfactory cleft volume than those in patients older than 40 years of age (p = 0.004, p = 0.005, p = 0.003; p < 0,01, respectively). However, patients younger than 40 years of age had a significantly lower total TDI score and in all other values individually (t-d-i) than those in patients older than 40 years of age (p = 0.004; p < 0.01). Conclusion: Patients with COVID-19-related OD had larger olfactory cleft width and volumes than those without OD in this study. Total TDI score was found to be inversely correlated with cleft width and volume.

Systematic quantitative assessment of motor function in clinically isolated REM sleep behaviour disorder: A diagnostic window into early alpha-synucleinopathies.

Mild motor abnormalities can herald the beginning of Parkinson´s disease but their diagnostic value is limited by multifactorial ageing-related influences on motor function. We characterized mild motor abnormalities in different motor domains by conducting a systematic motor assessment in 20 patients with clinically isolated REM sleep behaviour disorder (iRBD) without parkinsonian motor signs and 20healthy controls. We addressed the influence of lifestyle factors and age on motor function, which needs to be distinguished from neurodegenerative motor features, and assessed the diagnostic value of innovative and established quantitative motor tests in iRBD. Patients with iRBD showed abnormalities in perceptual motor speed (falling stick test), trunk movement coordination (bend, twist and touch test) and dynamic balance (line walk test) without alterations in simple motor speed (alternate tap test), dexterity (grooved pegboard), static balance (force plate) and gait (timed up and go test). The falling stick test showed the highest diagnostic accuracy in identifying subjects with RBD (ROC-AUC 0.85, p≤0.001). Multivariate analysis revealed physical activity and age as additional determinants of motor test performance. iRBD comprises a wide spectrum of mild motor abnormalities which cannot be verified by established tests for motor speed, gait and balance. The falling stick test, an innovative screening test for perceptual motor speed, provides high diagnostic potential in identifying subjects with subclinical neurodegenerative symptoms before parkinsonian motor signs become apparent. Normative data for physical activity and age need to be obtained to ensure correct interpretation of motor test results in prodromal Parkinson-related disease.

Local Allergic Inflammation in Chronic Rhinosinusitis With Nasal Polyps Could Influence on Disease Severity and Olfaction

Background and Objectives: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial disease resulting from inflammation of the nasal cavity and paranasal sinuses. Systemic allergic inflammation is an important cause of CRSwNP; however, the effect of local allergic inflammation is unclear. This study was designed to investigate the effect of local allergic inflammation in CRSwNP.Materials and Methods: The study included 11 patients with CRSwNP and 18 control subjects. Olfactory function was measured with the Korean Version of Sniffin’s stick test. Nasal lavage fluids (NLFs) were collected from all subjects and analyzed for total IgE, eosinophilic cationic protein (ECP), and cytokines (tumor necrosis factor [TNF]-α, interleukin [IL]-4, IL-10, IL-17A, interferon-γ). Flow cytometry was used to measure various inflammatory cells in the NAL fluids.Results: On analysis of flow cytometry and enzyme-linked immunosorbent assay, we found that CRSwNP patients had significantly increased eosinophil (%) and ECP levels in NLFs. In addition, there was significant local-systemic correlation between ECP level in NLFs and blood eosinophils (%) (r=0.391); however, there was no significant association between eosinophils (%) in NLFs and blood eosinophils. Moreover, in CRSwNP patients, the severity of disease was related with blood eosinophil (%), eosinophil (%), and ECP levels in NLFs, whereas olfactory function was associated with blood eosinophil (%) and ECP levels in NLFs.Conclusion: CRSwNP is a disease with high allergic inflammation that has negative impacts on the severity of disease and olfactory function. Therefore, we suggest that control of local allergic inflammation will be helpful to treat CRSwNP patients.

The Dental stick test - Useful to reveal intra-articular conditions in persons with temporomandibular disorder?

BackgroundThere is a need for clinical tests that can reveal intra-articular conditions in the temporomandibular joint to be able to give proper treatment. The Dental stick test, where participants bite with their molars on a wooden stick, is a pain provocation test for the temporomandibular joint. ObjectiveThe purpose of this study was to explore if the Dental stick test can be used to reveal intra-articular conditions in the temporomandibular joint in persons with long-lasting painful disorders. DesignCross-sectional. Materials and methodsForty persons with pain in one or both temporomandibular areas were examined using the Dental stick test. The participants were between 18 and 70 years, and had 65 symptomatic joints. Sensitivity, specificity, false positive and false negative responses, and area under the curve were calculated for the Dental stick test with MRI and/or CT as reference standards. The phi-correlation coefficient (phi) was used to measure the correlation between the Dental stick test and intra-articular findings. ResultsThe sensitivity and specificity for the Dental stick test, revealing intra-articular findings, were 0.62 and1.0 respectively. False positive and false negative responses were 0 and 0.41 respectively, and the area under the curve 81% with p < 0.001. The correlation between a positive Dental stick test and intra-articular findings was not significant (phi = 0.60). ConclusionsWhen the Dental stick test is positive, intra-articular findings will most probably be present on MRI/CT, but the test alone cannot reveal intra-articular conditions in persons with long-lasting painful temporomandibular disorder.

Culturally modified olfactory test adapted to East-Turkey: A comparison with Sniffin' Sticks.

Although the "Sniffin' Sticks" test (SST) is a widely used odor test, aplicability of odor tests is limited because of the high cost of the test and the regional-cultural differentiation of odor recognition. We aimed to evaluate our regional odor norms by applying the SST with a Modified odor test (MOT) we created for this study, and to develop a test similar to the SST, which was less expensive and probably had a higher odor definition for our region. This study includes 201 healthy volunteers: 91 men and 110 women over the age of 18 were included in the study. Tests were compared by applying the SST and MOT to all volunteers. In all subjects, for the SST: the mean Threshold score (TS), Discrimination score (DS), and Identification score (IS) were, respectively, 10.73±2.35, 11.11±11.94 and 11.32±2.15. TheTDI mean score was found to be 33.11±5.9. In the TDI score, the 10th percentile value was found to be 26. For the MOT, the mean TS(mTS), DS(mDS), and IS(mIS) were 10.88±2.31, 12±2.06, and 11.95±2.07, respectively, the modified test TDI(mTDI) mean was 34.68±6.47. The mTDI 10th percentile value was found to be 26. In all volunteers, there was no statistically significant difference between the two tests for the mean threshold score, while the difference in the mean discrimination score, the average identification score, and the average TDI (thresold, discrimination, sum of identification scores) score was statistically significant (P<.01). This study is the first study to compare the SST and the MOT in our region. Making low-cost modifications by adding more probable smells to the smell tests and using them in studies involving more participants will be more meaningful in evaluating normative odor scores and will result in more widespread use.

Incidence of Anosmia among Covid 19 patients in India.

The pandemic COVID-19 has relentlessly caused havoc to human life since its outbreak in December 2019. The disease has been a challenge for all. The clinical manifestations of Covid-19 ranges from no symptoms at all to severe acute respiratory distress syndrome. Anosmia being one of the important clinical features of COVID-19 has always been overlooked by the Indian population. This formed the background for this study. Aim To identify the incidence of anosmia reported in COVID- 19 patients in India. Materials and Methods Literature search was carried out from January 2020 to March 2021 in databases like PUBMED and Google Scholar using the key words “ANOSMIA”, “HYPOSMIA” and “OLFACTORY DYSFUNCTION” in conjunction with “COVID-19”, “SARS-COV-2”, and “CORONAVIRUS”. Boolean operators were used to narrow and broaden the search. The search yielded sixteen eligible articles. Result The scrutiny of the 16 articles revealed an incidence range of anosmia from 9.2% to 82% and an average anosmia incidence rate of 30.19%. The cumulative incidence rate of anosmia in those studies where objective analysis was done is 52.2% and 16.4% for subjective analysis. Discussion The prevalence of anosmia in Indian population is found to be much lesser than that reported by European countries due to ethnicity or negligence. Objective evaluation of anosmia in COVID-19 patients increases the incidence of anosmia drastically. Hence objective evaluations such as UPIST, SNIFFING STICK test, etc. is to be promoted. This study also Emphasises the lack of common gold standard testing for olfaction like vision and hearing.

Hyposmia may predict development of freezing of gait in Parkinson's disease.

To explore the effect of olfactory dysfunction on treatment of motor manifestations in Parkinson's disease (PD). The current longitudinal retrospective cohort study consecutively recruited 108 de novo PD patients. Of whom 29 were normosmia and 79 were hyposmia, respectively, which was determined by the Korean Version of Sniffin' Sticks Test II at the time of diagnosis. All the participants underwent serial clinical examinations including Unified Parkinson's Disease Rating Scale (UPDRS), Mini-Mental State Examination, and Montreal Cognitive Assessment. The normosmic group demonstrated a significantly greater reduction of the UPDRS III score (30.3 ± 5.9 to 21.9 ± 5.1) than that of the hyposmic group (34.5 ± 9.3 to 28.5 ± 8.1) from baseline to 1-year later (p, 0.003; Bonferroni correction for p < 0.0045). Of subdomains in UPDRS III, the axial domain revealed a remarkable decrease in the normosmic group. Further, the hyposmic group exhibited a higher development rate of freezing of gait (FOG) compared to the normosmic group (29/79 (36.7%) vs 2/29 (6.9%); p, 0.002) during 33.9 ± 7.7 months of the mean follow-up period. A Cox proportional hazards model demonstrated the hyposmia to be a significant risk factor for the future development of FOG (HR, 4.23; 95% CI 1.180-17.801; p, 0.05). Our data demonstrated the olfactory dysfunction to be a significant risk factor for the development of the FOG in PD. Hyposmic PD patients should be paid more careful attention to the occurrence of FOG in the clinical practice.

Implementing a clinical protocol for the use of continuous glucose monitoring devices in the hospital

Use of continuous glucose sensor technology in patients with Type 1 diabetes has become widely popular and continues to increase as technology advances. The current standard for hospital management of glucose monitoring is point of care (POC) finger stick testing. Continuous glucose monitors (CGMs) are FDA approved for use without the need of finger sticks to guide insulin treatment decisions. Research demonstrates CGMs are clinically valuable, reducing the risk of glycemic variability through early detection and prevention of hypoglycemia and hyperglycemia.

Persistent olfactory complaints after COVID-19: a new interpretation of the psychophysical olfactory scores

Background: Sudden olfactory loss is a major symptom of SARS-CoV-2 infection and has a negative impact on daily life quality. Almost 80% of disorders regress spontaneously. No precise characterization of the medium- and long-term olfactory symptoms has been carried out yet, apart from self-assessments. The main objective of this work was to characterize persistent smell disorders in this population. Methodology: Consecutive patients consulting to the ENT department with post-Covid19 olfactory loss were included. The clinical examination included an analog scale for the self-assessment of olfactory recovery), a nasofibroscopy, the Sniffin’ Stick Test and the short version of the Questionnaire of olfactory disorders. Results: Among the 34 patients included, based on the Sniffin’ Sticks Test, 29.4% (n=10) could be classified as normosmic, 55.9% (n=19) as hyposmic and 14.7% (n=5) as functional anosmic). Only olfactory identification impairment was significantly correlated with olfactory complaint and daily anxiety and annoyance related to lack of olfaction recovery. This identification disorder seemed to worsen over time. Conclusions: It is crucial to assess odor identification disorders in case of persistent olfactory complaints after COVID-19. It is fundamental to target this disorder, as it does not improve spontaneously and negatively impact quality of life.

Association Between Olfactory Function and Asthma in Adults.

PurposeChronic rhinosinusitis (CRS) and allergic rhinitis (AR) are common asthma-associated upper airway diseases. Olfactory dysfunction, a common symptom among these patients, is an increasingly recognized condition that is associated with a reduced quality of life and major health outcomes. However, there are few studies on the association between olfactory function and asthma. We investigated the relationship between asthma and olfactory function.Patients and MethodsA total of 146 patients with asthma aged >18 years were retrospectively analyzed from August 2019 to February 2020. Olfactory function was assessed using the Sniffin’ stick test or the YSK olfactory function test. We compared the clinical parameters of patients with olfactory dysfunction and patients with normosmia.ResultsOf the total participants, 68 (46.6%) showed olfactory dysfunction (hyposmia, n=31; anosmia, n=37). The patients with olfactory dysfunction were older, had longer durations of asthma, and a higher proportion of those with poor general health, CRS, and nasal polyps compared to patients with normosmia. However, there were no significant differences in the socioeconomic status, lung function, asthma severity, and use of inhaled corticosteroids or intranasal steroids between the two groups. Age (odds ratio: 1.044, 95% confidence interval: 1.009–1.081, P=0.012), poor general health (3.304, 1.231–8.863, P=0.018), CRS (2.589, 1.155–5.804, P=0.021), and nasal polyps (3.306, 1.1–9.94, P=0.033) were significantly associated with olfactory dysfunction.ConclusionOlfactory dysfunction was quite frequently observed in adults with asthma. Age, poor general health, CRS, and nasal polyps were significantly associated with olfactory dysfunction.

Analysis of national coverage of neonatal cystic fibrosis screening in Brazil from 2008 to 2017

Introduction The Brazilian neonatal screening program established in 2001 included the investigation of cystic fibrosis (CF) in the phase III of the program. For this purpose, the immunoreactive trypsin (IRT) measurement was added to the newborn screening test. The purpose of National Neonatal Screening Program is to reach 100% of live births in Brazil. The aim of this study was to analyze the coverage of neonatal Screening for Cystic Fibrosis (CF) in Brazil from 2008 to 2017. Materials and methods This is an ecological study design based on data collected from the Brazilian Outpatient Information System regarding the detection of IRT as a component of the heel stick test from 2008 to 2017. Moreover, we gathered data from the Brazilian Live Birth Information System referring to live births from 2008 to 2017. We calculated the coverage of IRT measurement for every 100 live births, using the number of IRT measurement procedures as the numerator and the number of live births stratified by federative units (states), as well as by the Brazilian regions as the denominator. These regions correspond to the divisions of the national territory based on criteria such as natural, social, cultural and economic aspects. Results From 2008 to 2017, the regions presented the following coverage medians: South (84.1%), Southeast (71.4%), Midwest (47.3%) Northeast (12.3%) and North (10.9%). In the analysis of federative units, in the years 2013 to 2017, Paraná and Distrito Federal presented the highest median of coverage (100%), while the states with the lowest median were Rio Grande do Norte (12.1%), Amazonas (16.8%) and Paraíba (27.5%). Highest coverage was found in the South region, where are located most of the states with high socioeconomic development and high supply of health services, while the lowest coverage was found in the North region, where are located manly the states with low socioeconomic development and low supply of health services. According to data from the Brazilian Ministry of Health, the universalization of neonatal screening for cystic fibrosis occurred in 2013, however, at the end of this year, most states in the North and Northeast regions had not registered IRT measurements in the Outpatient Information System. Conclusion Although the coverage of neonatal screening for CF has improved nationwide over the years of the study, the disparity in the coverage of IRT measurements at the interregional and interstate levels is notable. Systematic implementation of neonatal screening for cystic fibrosis with equity and access to the entire population is suggested, leading to a greater number of children benefiting from treatment and a better quality of life.

Olfactory function and viral recovery in COVID-19.

BackgroundOlfactory and taste disorders were reported in up to 30%–80% of COVID‐19 patients. The purpose of our study was to objectively assess smell impairment in COVID‐19 patients and to correlate olfactory function with viral recovery.MethodsBetween 15 and 30 April 2020, hospitalized patients with confirmed SARS‐CoV‐2 infection underwent an objective assessment of olfactory function with the Smell Identification subtest of the Sniffin’ Sticks Test (SI‐SST). Association between viral recovery and SI‐SST performance was evaluated.Results51 patients were enrolled (49% males, mean age 66.2 ± 14.6 years). At the time of test administration, 45% were clinically recovered and 39% were virus‐free. Objective hyposmia/anosmia was found in 45% of the patients. Subjective olfactory disorders showed no association with the clinical or viral recovery status of the patients. On the contrary, none of the patients with anosmia and the 5% of hyposmic patients at test had viral recovery. The relative risk for hyposmic patients to be still positive at swab test was 10.323 (95% CI 1.483–71.869, p < .0001). Logistic regression analysis showed an independent and significant correlation between viral clearance and SI‐SST scores (OR = 2.242; 95% CI 1.322–3.802, p < .003). ROC curve analysis confirmed that a SI‐SST > 10.5 predicts viral clearance with 79% sensitivity and 87% specificity (AUC = 0.883).ConclusionHyposmia is part of COVID‐19 symptoms; however, only objectively assessed olfactory function is associated with viral recovery. SI‐SST is an easy and safe instrument, and further large multicentric studies should assess its value to predict infection and recovery.

A systematic review to examine the relationship between objective and patient-reported outcome measures in sinonasal disorders: recommendations for use in research and clinical practice.

BackgroundCommon sinonasal disorders include chronic rhinosinusitis (CRS), allergic rhinitis (AR), and a deviated nasal septum (DNS), which often coexist with shared common symptoms including nasal obstruction, olfactory dysfunction, and rhinorrhea. Various objective outcome measures and patient‐reported outcome measures (PROMs) are used to assess disease severity; however, there is limited evidence in the literature on the correlation between them. This systematic review aims to examine the relationship between them and provide recommendations.MethodsA search of MEDLINE and EMBASE identified studies quantifying correlations between objective outcome measures and PROMs for the sinonasal conditions using a narrative synthesis.ResultsIn total, 59 studies met inclusion criteria. For nasal obstruction, rhinomanometry shows a lack of correlation whereas peak nasal inspiratory flow (PNIF) shows the strongest correlation with PROMs (r > 0.5). The Sniffin’ Stick test shows a stronger correlation with PROMs (r > 0.5) than the University of Pennsylvania Smell Identification Test (UPSIT) (r < 0.5). Computed tomography (CT) sinus scores show little evidence of correlation with PROMs and nasal endoscopic ratings (weak correlation, r < 0.5).ConclusionOverall, objective outcome measures and PROMs assessing sinonasal symptoms are poorly correlated, and we recommend that objective outcome measures be used with validated PROMs depending on the setting. PNIF should be used in routine clinical practice for nasal obstruction; rhinomanometry and acoustic rhinometry may be useful in research. The Sniffin’ Sticks test is recommended for olfactory dysfunction with UPSIT as an alternative. CT scores should be excluded as a routine CRS outcome measure, and endoscopic scores should be used in combination with PROMs until further research is conducted.

The correlation between obstructive sleep apnea and olfaction function

Objective:To investigate the olfactory function of patients with obstructive sleep apnea（OSA） without any treatment, and to providereference for clinical olfactory research. Methods:One hundred and thirty-one participants underwent polysomnography（PSG） overnight, and were divided into OSA group （observation group） and non-OSA group （control group） according to the results. The two groups were examined by the Korean version of the olfactory stick test Ⅱ（Korean Bersion） of Sniffin Sticks Test （KVSS Test Ⅱ）. SPSS 26.0 statistical software were used to analyze the data. Results:There was a significant difference in the incidence of olfactory disorders between the observation group and the control group（χ²=12.000, P=0.001）. The rate of olfactory disorders in patients with severe OSA was significantly higher than that in patients with mild OSA（P<0.05）, and the proportion of patients with olfactory disorders increased with the increase of OSA severity（χ²=10.672, P=0.001）. There was no statistically significant difference between the observation group and the control group in the severity of olfactory disorders（hyposmia and anosmia）（P=1.000）. KVSS between two groups of Test Ⅱ total score has no statistical difference（t=1.166, P=0.249）, the sense of smell recognition scores also has no statistical difference（t=1.598, P=0.116）, but the olfactory threshold score and olfactory cognition scores were statistically significant（t=5.346, t=6.405, P<0.001）. Conclusion:OSA has a negative effect on the sense of smell, and the severity of OSA is positively correlated with the incidence of olfactory disorder. OSA olfactory disorder is mainly anosmia, and the main manifestation is the decrease of olfactory cognitive scores.

Evaluation of rapid screening methods in the diagnosis of urinary tract infection

Introduction: Urinary Tract Infection (UTI) is one of the most common bacterial infection encountered in clinical practice. Even though urine culture is considered as the gold standard in detection of bacteriuria, many alternative screening methods like urine microscopy, chemical analysis using dipstick method and Gram’s staining have been evaluated which are more economical and rapid. Hence, this study was undertaken to evaluate various screening methods in the rapid diagnosis of Urinary Tract Infections. Objectives: To evaluate Gram staining of urine, leucocyte esterase and nitrite dipstick test methods in the rapid diagnosis of Urinary Tract Infections. Materials and Methods: All urine samples received at Microbiology laboratory, McGann hospital, attached to Shimoga Institute of Medical Sciences, during study period was subjected to Gram staining, leucocyte esterase and nitrite dip stick test along with culture. Results of these tests were compared to culture results. Sensitivity and specificity of the tests was determined taking culture as standard. Results: A total of 560 urine samples were processed. Culture showed significant bacteriuria in 210 cases. The sensitivity of urine microscopy was 70.9%, leucocyte esterase test was 98% and nitrite test was 74.8%. Whereas the specificity of urine microscopy was 70%, leucocyte esterase test was 79.1% and nitrite test was 98.8%. Similarly, the sensitivity of combined leucocyte esterase and nitrite tests was 90.9% and specifity was 97.4%. Sensitivity and specificity of all the three screening tests combined were 95.7% and 94.8% respectively. Conclusion: Screening tests such as, Urine microscopy by Gram’s staining, Leucocyte esterase and nitrite dipstick test in combination can be used routinely to exclude bacteriuria. Urine culture can be employed only in the screening tests positive cases and in symptomatic cases irrespective of test results, thereby making diagnosis of UTI cost effective and rapid. Keywords: Bact

Test of temperament in mink is influenced by a shelf in the front of the cage and the stimulus size rather than by features of the test person

The study evaluates the effect of different test conditions on the temperament of farm mink, using the stick test. We hypothesised that mink perceive some test conditions as more fear eliciting. Specifically, we hypothesised that (A) the dimension of the presented stimulus in the test, a wooden stick, will not influence the outcome of the stick test, (B1) fear responses will increase when the test person is bending over the cage, (B2) unfamiliarity in colour and type of the test person’s coverall will suppress exploratory behaviour (C) mink will increase their exploratory behaviour in the test when having access to a shelf in the front part of the cage. The experiment was performed over two years with 600 pair-housed (male + female) juvenile mink year 1 and 500 individually housed adult mink females year 2. We studied the acute test conditions in terms of access to a shelf in the front of the cage and the posture of the test person with pair-housed juvenile mink. We studied the influence of the dimension of the stimulus presented and the type of test person clothing on the mink’s response in the stick test with individually housed adult mink females. During access to a shelf in the front of the cage, the prevalence of mink categorised as exploratory was higher (χ12 = 22.9, P < 0.001), and the prevalence of mink categorised as fearful (χ12 = 28.4) and indecisive (χ12 = 7.3) was lower (P < 0.01). This supports our hypothesis that a shelf in the front of the cage increases the mink’s exploratory behaviour in the test. The smaller test stimulus – relative to the standard-sized tongue spatula – resulted in fewer exploratory (χ12 = 8.0, P = 0.005) and more indecisive mink (χ12 = 5.1, P = 0.025). The features of the test person – different postures and type of clothing – did not influence the score of the stick test (P > 0.28), although a bending test posture induced a minor increase in the distance kept by juvenile mink (χ12 = 115.1, P < 0.001). We conclude that the test conditions with a shelf in the front of the cage and the size of the test stimulus influence the temperament of farm mink as categorised in the stick test. The stick test appears robust to relative large differences in test person features; however, it is important to keep a distance between any front shelf and the stick during the test and to use a standard tongue spatula in order to get comparable and valid test results.