Viral Rhinosinusitis Research Articles

Topical therapy of acute viral rhinosinusitis in case of incomplete epithelialization of surgical wound during the long-term period of adenoid surgery

Topical therapy of acute viral rhinosinusitis in case of incomplete epithelialization of surgical wound during the long-term period of adenoid surgery

PECULIARITIES OF THE COURSE AND TREATMENT OF ACUTE INFECTIOUS RHINOSINUSITIS IN VOICE-SPEAKING PROFESSIONALS

Numerous scientific studies are dedicated to the study of the morphological structure of the vocal cords and the diagnostic criteria of their lesions. The purpose of the work: the study of changes in the quality of the voice and the condition of the vocal cords in persons of voice-speaking professions who were treated for acute viral or bacterial rhinosinusitis and continued to work (had vocal strain) during the illness.Research material and methods. The examination data of 24 patients (16 women and 8 men) of voice-speaking professions who were treated for acute viral or bacterial rhinosinusitis and continued to work (had voice strain) during the illness were analyzed. For each patient, a phoniatric patient study card was filled out, in which passport data was noted, including profession, patient complaints, data on life history, disease history and objective examination of ENT organs: pharyngoscopy, rhinoscopy, otoscopy, indirect laryngoscopy, which was performed with the help of 700 or 900 rigid endoscope. Research results. The analysis of the examination data of 24 patients (16 women and 8 men) of voice professionals who were treated for acute viral or bacterial rhinosinusitis and continued to work (had vocal strain) during the illness showed that during the control examination of the data of the patients for 7-10 days since the beginning of treatment, indirect laryngoscopy and stroboscopy revealed: hemorrhage in one fold - 3 cases, prenodular thickening of the edges of the vocal folds - 8 cases. The mobility of the folds was preserved in all patients, but during phonation, a gap formed between the folds in 19 patients, which was accompanied by hypertonus of the vestibular folds in 3 cases. During stroboscopy of this group of patients, vocal fold asynchrony was detected in 21 cases. The PMF was shortened in 21 patients and was 12 + 1.3 s (norm – 16s), and in men – 16 + 1.5 s (norm – 21s). Conclusions. In the treatment of patients of voice-speaking professions with acute viral or bacterial rhinosinusitis, changes in the vocal folds are observed, with possible hypertonus.

Potential of topical therapy for acute rhinitis in paediatric practice

Rhinitis is an inflammation of the nasal mucosa with rhinorrhea, nasal congestion, sneezing and nasal itching. Rhinitis can be acute or chronic (allergic rhinitis, non-infectious rhinitis, infectious rhinitis) with nasal symptoms, ophthalmological symptoms, ear congestion, sore throat, postnasal drip, cough. Up to 98% of cases of acute infectious rhinitis develop against the background of an acute respiratory viral infection. The pathogenesis of acute viral rhinitis and acute viral sinusitis is based on nasal congestion, difficulty in mucociliary transport and blockage of the paranasal sinuses. When prescribing treatment for children with acute viral rhinitis and acute rhinosinusitis, it is necessary to take into account the age and weight of the child, use elimination therapy and improve drainage of the paranasal sinuses. The use in pediatric clinical practice of the combined decongestant, which includes α2-adrenomimetic and dexpanthenol, is effective and safe in the treatment of almost all conditions accompanied by nasal congestion, promotes rapid restoration of nasal breathing.

Novel nasal formulation of xylometazoline with hyaluronic acid: In vitro ciliary beat frequency study

Acute viral rhinosinusitis (viral ARS), or commonly referred to as the “common cold”, is caused by respiratory viruses that cause disruption of the airway epithelial barrier and mucociliary dysfunction. Treatment of ARS is mainly symptomatic, with xylometazoline, a direct-acting α-adrenoceptor agonist, commonly used as a nasal decongestant. Unfortunately, this treatment does not resolve the epithelial dysfunction observed in ARS, and its use might negatively impact the nasal mucosa causing issues such as dryness, stinging, burning, rebound congestion, as well as atrophy. In light of this, a novel nasal spray formulation containing both xylometazoline and hyaluronic acid (HA) was developed to provide a more effective and safer treatment for viral ARS. HA is a natural polysaccharide known to hydrate and moisturise the upper respiratory tract, maintain the integrity of the nasal mucosa, and promote mucociliary clearance and wound healing. To investigate the potential of this combination, this study was conducted using the nasal MucilAirTMin vitro model and high-speed phase-contrast microscopy to examine the effect of xylometazoline and HA on ciliary function by measuring ciliary beat frequency and their cytotoxicity by morphological, histological and ultrastructural analysis. This research is the first to assess the effects of a specific dose and molecular weight of HA as an active pharmaceutical ingredient in nasal spray formulations. The combination of a fast-acting decongestant and an additional active agent targeting nasal epithelial dysfunction has the potential to provide an improved, reliable and safe treatment for viral ARS, and may serve as the basis for future clinical studies.

Efficiency of using deflu silver nose in patients with acute rhinosinusitis

ABSTRACT. Acute rhinosinusitis is one of the most common diseases that affects up to 15% of the world's population every year and can occur at any age. The provisions of EPOS 2020 do not provide for the appointment of antibiotics in acute viral and acute post-viral rhinosinusitis. Thus, there is a need to find medicines to improve the well-being of patients, speed up recovery and prevent complications. One of such promising means of combating viral and bacterial infection of the ENT organs is the use of drugs with silver nanoparticles. Purposes. The purpose of this work was to study the effectiveness of using Deflu Silver Nose in the treatment of patients with acute rhinosinusitis. There was a study of its influence on the clinical course of the disease and parameters of local immunity.Materials and methods. Two groups of patients with acute rhinosinusitis were under our observation. The first group (main) consisted of 32 patients who, together with traditional symptomatic therapy (saline solution intranasally for 2 injections 3 times a day, multivitamins) received the aid Deflu Silver Nose (intranasally for 2 injections 3 times a day for 7 days). The drug was used from the 3rd day after the onset of the disease. The second group (comparison group) consisted of 30 patients who received similar therapy, except for Deflu Silver Nose.Clinical examinations and studies of local immunity were carried out before and after the start of therapy (on the 3rd and 7th day, on the 6th and 10th day of the disease). The results of the examination of 10 healthy people were used as an indicator of the norm. Rhinocytograms (cytological studies of scrapings from the nasal mucosa) were studied.Immunoglobulins, lysozyme, and cationic proteins were carried out in oropharyngeal secretions. Results. Clinical observations showed that under the influence of Deflu Silver Nose, patients with acute rhinosinusitis on the 3rd day from the start of treatment had a noticeable reduction or complete disappearance of the clinical symptoms of the disease. On the 3rd day of treatment, in the rhinocytograms, in the patients of the main group, there was a decrease in the nasal mucosa of destroyed cells and the percentage of lymphocytes in the scraping of cells of the flat and prismatic epithelium. On the 7th day of using Deflu Silver Nose, the level of all antimicrobial factors in nasal secretions in patients of group 1 decreases to normal levels.During this period, the inflammatory process was stopped and excessive swelling of the nasal mucosa was not observed in the vast majority of patients in the main group. No such positive changes were observed in the 2nd group of patients. Conclusion. Intranasal use of Deflu Silver Nose has a positive effect on the clinical course of acute rhinosinusitis, contributes to the prevention of bacterial complications, and increases the local immunoreactivity of the body. Under the influence of the nasal spray, the duration of the disease is reduced and the quality of life of patients improves.

The effectiveness of essential oils in the treatment of acute viral rhinosinusitis

Introduction. Acute respiratory viral infections are the most widespread diseases, accounting for up to 90% of all infectious pathology, which supports the relevance of optimizing the treatment of acute viral rhinosinusitis.Aim. Evaluate the dynamics of clinical symptoms of acute viral rhinosinusitis, which arose as part of an acute respiratory infection, when supplementing therapy with the drug Respero Myrtol (Pol-Boskamp GmbH and Co.KG, Germany), the active ingredient of which is myrtol standardized 120 mg in 1 capsule.Materials and methods. The dynamics of clinical symptoms of 20 cases of acute viral rhinosinusitis in comparison groups was analyzed. Traditional treatment of patients included taking propionic acid derivatives, ascorbic acid, intranasal use of decongestants and irrigation of the nasal cavity with isotonic saline solutions. Patients who have received traditional treatment are defined as a “standard therapy group”. To assess the effectiveness of therapy using standardized myrtol, 20 cases of acute viral rhinosinusitis against the background of acute respiratory viral infections with a similar severity were analyzed, in which patients received outpatient therapy with Respero Myrtol 2 capsules 3 times a day for 7 days in addition to the above treatment (the “myrtol therapy” group). The dynamics of the disease assessed: the number of days of disability before recovery, the period of normalization of body temperature in feverish patients, the need for vasoconstrictive intranasal agents after the seventh day of therapy, the period of complete relief of pain syndrome, the period of normalization of night sleep, the number of cases of bacterial superinfection and the need for systemic antibacterial therapy.The results. In the observed patients, the quality of sleep was restored faster, the pain syndrome was stopped earlier, less often there was a need for systemic antibiotics and prolonged use of intranasal decongestants. The disease proceeded with fewer days of disability.Conclusion. The study results have been shown to report the clinical efficacy of Respero Myrtol essential oils in the outpatient treatment of patients with acute rhinosinusitis.

504 Topical adenosine treatment inhibits inflammation and mucus production in viral acute rhinosinusitis

OBJECTIVES/GOALS: Viral acute rhinosinusitis (ARS), a.k.a, the common cold, affects millions every year. The symptoms caused by viral ARS dramatically affect the general well-being and functional levels of patients, causing work and school absence, and antibiotic abuse. In this study, we examined the therapeutic potential of topical adenosine in viral ARS METHODS/STUDY POPULATION: Rhinosinusitis was induced in WT and adenosine receptor (AR) knockout mice by respiratory syncytial virus (RSV) infection in the upper airways. Mice were subjected to adenosine or vehicle control within the sinuses. Adenosine receptor expression, inflammatory cytokine expression, and histologic mucus and inflammation score was assessed. The effect of endogenous adenosine accumulation within the sino-nasal tract was assessed in adenosine deaminase knockout (ADA-/-) mice. RESULTS/ANTICIPATED RESULTS: Topical administration of adenosine significantly inhibited the expression of pro-inflammatory cytokines, mucus production, and cell damage in the nose of mice with viral ARS, without prolonging virus clearance. This inhibitory effect was primarily mediated by the A2A adenosine receptor (AR). We also examined and compared the expression of ARs in the nasal tissue, trachea, and lungs. The nasal tissue exhibited the lowest baseline expression of ARs as compared to the lung and trachea which was further downregulated following adenosine treatment. Additionally, accumulation of endogenous adenosine in ADA-/- mice showed no signs of inflammation within the nasal tissue. Together, we demonstrated that topical adenosine effectively decreased inflammation and mucus production in a mouse model of viral ARS. DISCUSSION/SIGNIFICANCE: Previously, we found that topical adenosine dramatically enhances mucociliary clearance in the nose and sinuses. In this study, we found that nasal topical adenosine effectively decreased inflammation and mucus production in viral ARS. Our data suggest that nasal topical adenosine is an effective topical therapeutic option for viral ARS.

Intranasal Treatment of Acute Rhinosinusitis - Recommendations, Efficacy and Safety

Introduction and purpose: Acute rhinosinusitis is a common condition worldwide, usually caused by respiratory viruses. Nasal epithelium is their primary point of entry and an active responder to the infection. Therefore, it seems reasonable for the treatment approach to include locally applied drugs. Our purpose is to bring forward up-to-date recommendations of intranasal treatment options for acute rhinosinusitis, and assess their efficacy and safety.
 Description of the state of knowledge: Rhinosinusitis is an inflammation of the mucosa present in the nose and the paranasal sinuses. It affects many patients yearly, bearing significant adverse effects on quality of life, productivity and healthcare expenditure. Acute rhinosinusitis lasts less than 12 weeks and is divided into viral, post-viral and acute bacterial rhinosinusitis. It is one of the prevailing reasons for unfounded antibiotics prescription, although it is usually self-limiting. Its treatment depends on the clinical stage of the infection, however, each of them encloses medications administered intranasally. Based on EPOS2020 and scientific publications it seems that nasal decongestants may be prescribed in viral rhinosinusitis, nasal corticosteroids in post-viral rhinosinusitis and nasal saline can prove beneficial in all clinical stages of rhinosinusitis. While used appropriately all aforementioned medications prove to be safe.
 Conclusions: In the light of the findings presented in this paper, it can be concluded that acute rhinosinusitis should be treated not only with oral, but also with intranasal drugs. Nasal decongestants are to be considered in viral rhinosinusitis mainly. Nasal corticosteroids show some positive effect in post-viral rhinosinusitis. Nasal saline can be administered in all clinical stages of acute rhinosinusitis. It is crucial to caution the patients against misuse of the medications, in order to prevent their adverse effects.

Possibilities of usage of modern herbal medicinal product in the treatment of patients with acute viral rhinosinusitis

Possibilities of usage of modern herbal medicinal product in the treatment of patients with acute viral rhinosinusitis

Topical Adenosine Inhibits Inflammation and Mucus Production in Viral Acute Rhinosinusitis.

Viral acute rhinosinusitis (ARS) is the leading cause of work and school absence and antibiotic over-prescription. There are limited treatment options available to ameliorate the symptoms caused by viral ARS. We have previously demonstrated that topical adenosine treatment enhances mucociliary clearance in the sino-nasal tract. Here, we assessed the therapeutic potential of topical adenosine in a mouse model of viral ARS. The effect of topical adenosine on inflammatory response and mucin gene expression was examined in a mouse model of viral ARS induced by respiratory syncytial virus (RSV) nasal-only infection. We also investigated the inflammatory effect of both endogenous and exogenous adenosine in the sino-nasal tract. Topical adenosine significantly inhibited the expression of pro-inflammatory cytokines, goblet hyperplasia, mucin expression, and cell damage in the nose of mice with viral ARS. This treatment did not prolong virus clearance. This inhibitory effect was primarily mediated by the A2A adenosine receptor (AR). Although previous studies have shown that adenosine induces a robust inflammatory response in the lungs, neither endogenous nor exogenous adenosine produced inflammation in the sino-nasal tract. Instead, exogenous adenosine inhibited the baseline expression of TNF and IL-1β in the nose. Additionally, baseline expression of ARs was lower in the nose than that in the trachea and lungs. We demonstrated that intranasal adenosine administration effectively decreased inflammation and mucus production in a mouse model of viral ARS. N/A Laryngoscope, 133:2095-2103, 2023.

Local treatment of acute rhinosinusitis in the era of COVID-19

Introduction. Acute rhinosinusitis accounts for 40 % to 60 % of the morbidity in the structure of ENT pathology. COVID-19 pathogen, similarly to other respiratory viruses, can cause acute rhinosinusitis, which is the most relevant at the present time due to the ongoing pandemic. Viral etiology accounts for 90–98 % of all cases of acute rhinosinusitis. Accordingly, the choice of treatment tactics with antibacterial drugs in a number of cases is unreasonable and leads to the growth of antibiotic resistance. Local antiseptics containing sodium hypochlorite with a high safety profile that do not cause pathogen resistance are used to increase the effectiveness of therapy for acute rhinosinusitis. Objective. To evaluate the effectiveness of nasal spray containing sodium hypochlorite on the duration of the course of exacerbation and severity of acute rhinosinusitis during the epidemiological season. Materials and methods. The study involved 50 patients who were divided into 3 groups: 10 patients (group 1) with acute viral rhinosinusitis (therapy: sodium hypochlorite + decongestants); 20 patients (group 2) with acute bacterial rhinosinusitis (therapy: sodium hypochlorite + systemic antibacterial therapy); 20 patients (group 3) with acute bacterial rhinosinusitis (therapy: nasal lavage with isotonic sea salt solution + systemic antibacterial therapy). Results and discussion. Pathogen eradication – the absence of the original pathogen at the locus of the inflammatory process during dynamic microbiological examination – was found in 14 (35 %) clinical cases: in Group 2 (sodium hypochlorite) – 10 (25 %) and in Group 3 (nasal irrigation with isotonic sea water solution) – 4 (10 %). Conclusions. The results of microbiological studies showed effective antimicrobial properties of sodium hypochlorite when applied to the inflamed mucous membranes, expressed in a statistically significant reduction of bacterial semination of the nasal cavity epithelium.

Результати аналізу епідеміологічного дослідження медичних даних щодо ефективності Назірус Синус сироп у комплексній терапії гострого вірусного та поствірусного риносинуситу в дітей

In pediatric practice, the prevalence of rhinosinusitis (RS) depends on age: so, in the age category of 6-7 years old, acute RS at least 1 time per year old affects 8.5% of children, and at the age of 13-14 years old - 14.6%. Acute RS is one of the most common reasons for prescribing antibiotics, so correct treatment is extremely important, given the global crisis of antibiotic resistance. The tactics of treatment of acute RS depends on the form, nature of the inflammatory process and the presence of complications. Purpose - to study the effectiveness of the plant-based dietary supplement Nasirus Sinus syrup in the complex therapy of children 3-11 years old with acute viral and postviral RS. Materials and methods. Were analyzed medical data of 1176 children 3-11 years old who received outpatient therapy with a clinical diagnosis of “Acute viral RS” and “Acute postviral RS” (ICD-10: J01.9). The difference between these patients was only the duration of the disease. Results. It has been established that the use of a plant-based dietary supplement Nasirus Sinus syrup in the complex therapy of children 3-11 years with acute RS helps to reduce subjective (nasal congestion, difficulty in nasal breathing, cough, snoring) and objective (mucous membrane hyperemia, postnasal drainage, rhinorrhea, wheezing, goopiness) manifestations of acute RS in a shorter time compared to the control group. The assessment of the severity of acute viral and postviral RS by Major Sinusitis Severity in absolute numbers in the main group was significantly different from the control group. Conclusions. When using the complex therapy of acute viral and postviral RS in children 3-11 years with the inclusion of a plant-based dietary supplement Nasirus Sinus syrup, the results indicate a decrease in the manifestation of symptoms already on the 3rd day of therapy, reliably demonstrates positive dynamics on the 5th and 7th days. Nasirus Sinus syrup should be recommended for use in children in the complex therapy of RS. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Phytomedicine ELOM-080 in Acute Viral Rhinosinusitis: A Randomized, Placebo-Controlled, Blinded Clinical Trial.

ELOM-080 is a phytomedicine approved for the treatment of acute and chronic inflammatory diseases of the respiratory tract, sinusitis, and bronchitis in particular. This prospective, randomized, placebo-controlled, double-blind clinical trial was conducted to assess efficacy and safety of ELOM-080 in the treatment of acute viral rhinosinusitis (AVRS). Patients with AVRS received oral treatment (4 × 1 capsule per day) with either ELOM-080 or matching placebo. Primary endpoints were the change in major symptom score (MSS) after 7 and 14 days of treatment assessed by the investigator (MSSINV ). Secondary endpoints were changes in MSS assessed by the patients (MSSPAT ), olfactory function (12-item Sniffin' Sticks), 20-Item Sino-Nasal Outcome Test (SNOT-20 GAV; German adapted version), influence of treatment on viral load, and safety. Four hundred and sixty-three patients were randomized. At day 4, subjective burden of disease (MSS) was significantly ameliorated compared to placebo (p=0.012). During the first treatment week MSS scores improved about 1 day earlier, and 3 days earlier in the second week. Effect with ELOM-080 on mean MSSINV was statistically significantly superior to placebo at visit 3 (p=0.016) and visit 4 (p=0.014). In chemosensory testing identification scores improved comparably in both treatments. The improvement of the SNOT-20 GAV was more pronounced in ELOM-080 patients. Treatment with ELOM-080 indicated a potential for decreasing viral load. Both treatments were well tolerated. ELOM-080 improves the burden of AVRS significantly in comparison to placebo, remission of symptoms occurred 3 days earlier. The results confirm the efficacy and safety of ELOM-080 for treatment of AVRS. 1 Laryngoscope, 133:1576-1583, 2023.

37-Year-Old Man With Headache and Nasal Congestion

37-Year-Old Man With Headache and Nasal Congestion

Herbal medicinal product Sinupret extract (BNO 1016) is safe and effective in the treatment of acute viral rhinosinusitis

Aim. The pooled efficacy data of two similar randomized placebo-controlled clinical trials were analyzed. Safety was evaluated on the basis of the individual trials.
 Materials and methods. The efficacy analysis was based on 589 patients. Treatment was performed orally with either 3160 mg BNO 1016 (n=294) or 31 tablet placebo (n=295) for 15 days. In both trials patients underwent five visits to the investigational sites. Symptoms were evaluated according to the EPOS 2012 guideline. Ultrasonography was used to confirm the diagnosis at onset of treatment and the remission of symptoms at the last visit. Efficacy was evaluated by the investigator as the mean major symptom score (MSS) at the end of treatment (visit 5, day 14). Patients reported symptoms and social/emotional consequences of rhinosinusitis using a quality of life questionnaire (SNOT-20 GAV).
 Results. MSS improved during the treatment period by a mean of 10.021.61 score points to 2.472.55 for BNO 1016 and of 9.871.52 to 3.633.63 for placebo. Differences between treatment groups at end of therapy (1.163.14 score points; p0.0001) and patient-assessed quality of life (p=0.0015) were statistically significant in favor of BNO 1016.
 Conclusion. Daily intake of 480 mg of BNO 1016 for 15 days is an effective treatment in acute viral rhinosinusitis.

Modern approach to the treatment of acute viral rhinosinusitis

Relevance: Treatment of acute viral rhinosinusitis is one of the current problems of modern medicine. Coldrelated diseases are now receiving a lot of attention due to the worldwide pandemic SARS-CoV-2, the choice of therapy becomes a difficult task even for experienced physicians. The study provides an assessment of the efficacy of treatment of patients with acute viral rhinosinusitis with combined phytotherapeutic agents. Materials and methods: During the study, 54 patients were followed up and divided into 2 groups: the study group (28 patients) and the control group (26 patients). During treatment, patients in the control group received basic treatment, which included: Nasal cavity irrigation with an isotonic saline solution (0.9% NaCl solution) [4] by 2 doses into each nasal half 3 times a day, topical glucocorticosteroids (Mometasone furoate) by 2 doses into each nasal half 2 times a day. Patients in the study group received: "Sinuvit" complex phytopreparation by 2 capsules after meals 2 times a day, nasal cavity irrigation with isotonic saline solution (0,9% NaCl solution) by 2 doses into each nasal half 3 times a day, topical glucocorticosteroids (Mometasone furoate) by 2 doses into each nasal half 2 times a day. The results of treatment were evaluated by means of subjective and objective indicators. Results: Efficient symptom relief was found in the study group, reflected in improved patient well-being and renewed physiological function of the mucociliary apparatus. Conclusion: Based on the obtained results of the study and our previous experience in treatment of rhinosinusitis, we have made a conclusion about the effectiveness of the presented scheme of treatment with combined phytotherapeutic agents.

Effect of Moringa Leaf Ethanol Extract on Reduced Levels of Mda, TNF-α and Description of Inflammatory Cells in Rat Sinus Mucosa Model of Acute Rhinosinusitis

Background: Symptoms and signs of acute viral and bacterial rhinosinusitis that are not specific cause difficulties in diagnostic enforcement, causing difficulties in administering therapy, so often doctors provide antibiotic therapy on acute viral rhinosinusitis. Irrelevant antibiotics will cause frequent antibiotic resistance. Adjuvant therapy is required to prevent infections that continue to become chronic, shorten the duration of infection, and avoid unwanted complications. Moringa leaves (M. oleifera)contains antioxidant components that can help rebalance redox metabolism and reduce excess free radicals so as to prevent oxidative stress. Method: posttest only control group research design. Male strain Sprague Dawley white rat was maintained and treated at the Nutrition Laboratory of the Center for Food and Nutrition Studies of Gadjah Mada University (UGM). Mice were divided into 4 groups. Group 1: standard feed., group 2: standard feed and staphylococcus-induced aureus, group 3: standard feed, Staphylococcus aureus-induced given amoxicillin dose of 27 mg/day, group 4: standard feed, Staphylococcus aureus-induced was given amoxicillin dose of 27 mg/day and given (EEDK) 200 mg/KgBW/day. Data analysis Of Normality test using Shapiro-Wilk Test and homogeneity using Levene’s Test obtained results p>0.05. Then conducted One Way AnovaTest obtained p<0.05 and continued with post-hoc LSD test. The data is analyzed using SPSS 25.0 for Windows. Result: MDA test Anova obtained p value (Sig.) = 0.000 (p< 0.05), Post Hoc with LSD all groups (p-value) < 0.05, indicated a significant mean difference in average MDA levels among all groups. The lowest mean difference in MDA levels in group K with P3 was 0.92 pg/mL; while P1 with P3 has the largest average MDA rate difference of 7.47 pg/mL. TNF-α Anova test obtained p value (Sig.) = 0.000 (p< 0.05), Post Hoc with LSD of all groups (p-value= 0.000) < 0.05, there is a meaningful difference in the average level of TNF-α between all groups. The smallest average difference in TNF-α levels in group K with P3 was 0.31 pg/mL; while P1 with P3 has the largest average TNF-α rate of 5.01 pg/mL. Description of inflammation of the mucosa cavum rice and sinus K score 0; P1 score 3; P2 score 2; P3 score 1. Conclusion: Moringa leaf ethanol extract in this study can be used as adjuvant therapy because it can lower MDA and TNF-α levels in mice induced with Staphylococcus aureus along with amoxicillin standard therapy. Extract ethanol moringa leaves in this study can be used as adjuvant therapy because it can lower the score of inflammatory cells better than by only given standard therapy only Bangladesh Journal of Medical Science Vol. 21 No. 02 April’22 Page : 311-317

Akutni rinosinuzitis - patogeneza, dijagnostika i lečenje

Acute rhinosinusitis (ARS) is an inflammation of the mucous membranes of the nasal cavity and paranasal sinuses with symptoms lasting up to 12 weeks. In more than 98% cases, ARS begins as a viral infection with common cold symptoms, usually caused by rhinoviruses or more severe acute viral rhinosinusitis usually caused by coronaviruses, influenza and parainfluenza virus. Worsening of symptoms after 5 days or persistence of symptoms after 10 days indicate the diagnosis of acute postviral rhinosinusitis, which indicates the presence of bacterial superinfection on the basis of previous viral infection. In about 0,5-2% of cases, complications of ARS with bacterial infection occur, so we have a clinical history of acute bacterial rhinosinusitis (ABRS). The most common causes of ABRS are Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. Diagnosis and treatment of uncomplicated ARS are the responsibility of primary care physicians. Failure in treatment indicates a potential complication of the disease, when the patient needs to be referred by an otorhinolaryngology specialist. The first line of the antimicrobial treatment of ARS is the use of amoxicillin. Inadequate response to firstline antimicrobial therapy within the 72 hours indicates the need for some broad-spectrum antibiotics. Complementary therapy consists of the use of saline solutions for rinsing the nasal cavity, decongestants in the form of drops, sprays or tablets, herbal drugs, as well as intranasal corticosteroids in the form of sprays.

Upper Airway Disorders

Upper airway disorders are frequently encountered in the primary care setting and present in both adults and children. This review covers earache, sinusitis, sore throat, peritonsillar abscess, sialolithiasis and sialadenitis, parotitis, epiglottitis, epistaxis, foreign body in the ear, nose, or throat, and Ludwig angina. Figures show right-sided peritonsillar abscess demonstrating swelling and distortion of the anterior and posterior tonsillar pillars and uvular deviation, peritonsillar abscess demonstrated by an ultrasound image of a hypoechoic fluid collection, ultrasound imaging of sagittal view of the tonsillar pillars, lateral radiograph of the neck demonstrating a swollen epiglottis and widened vallecula, photographs of brawny swelling of the submandibular region of the neck in Ludwig angina, and a patient with peritonsillar abscess with extension to the base of the tongue. Tables list criteria for diagnosing acute sinusitis, and clinical presentations that best identify patients with acute bacterial versus viral rhinosinusitis. This review contains 7 figures, 11 tables, and 61 references. Key words: Epiglottitis, epistaxis, parotitis, peritonsillar abscess, pharyngitis, sialolithiasis, sinusitis

Upper Airway Disorders

Upper airway disorders are frequently encountered in the primary care setting and present in both adults and children. This review covers earache, sinusitis, sore throat, peritonsillar abscess, sialolithiasis and sialadenitis, parotitis, epiglottitis, epistaxis, foreign body in the ear, nose, or throat, and Ludwig angina. Figures show right-sided peritonsillar abscess demonstrating swelling and distortion of the anterior and posterior tonsillar pillars and uvular deviation, peritonsillar abscess demonstrated by an ultrasound image of a hypoechoic fluid collection, ultrasound imaging of sagittal view of the tonsillar pillars, lateral radiograph of the neck demonstrating a swollen epiglottis and widened vallecula, photographs of brawny swelling of the submandibular region of the neck in Ludwig angina, and a patient with peritonsillar abscess with extension to the base of the tongue. Tables list criteria for diagnosing acute sinusitis, and clinical presentations that best identify patients with acute bacterial versus viral rhinosinusitis. This review contains 7 figures, 17 tables, and 66 references Keywords: Epiglottitis, epistaxis, parotitis, peritonsillar abscess, pharyngitis, sialolithiasis, sinusitis