Allergic rhinitis (AR) is an IgE-mediated inflammatory disease of the upper airway. AR affects the patients’ quality of life, is a known risk factor for asthma and a socio-economic burden. Allergen-specific immunotherapy (AIT), comprising sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT), involves administering increasing doses of the causative allergen to induce clinical and immunologic tolerance to the allergens. It is the only currently available treatment for AR that has been proven to induce disease-modifying effects (i.e., long-term remission of allergic symptoms or potential prevention of asthma and new sensitizations). Although AIT is conventionally recommended for patients who are non-responsive to symptom-relieving pharmacotherapy, it is presently recommended as a first-line treatment for patients with moderate to severe AR who prefer a treatment with the potential for long-term remission. In light of the relatively recent implementation of AIT in Malaysia, guidelines on its appropriate indication and application are important to attain optimal outcomes. This consensus statement was developed by an expert group formed by the Malaysian Society of Allergy and Immunology to provide evidence-based recommendations for the practice of AIT in Malaysia. Patient and product selection, choice of AIT, and strategy towards an effective treatment outcome in AIT are presented.
Allergic rhinitis (AR) is a disease that presents with symptoms like nasal discharge, blockage, and itchiness, which impair the quality of life of most patients depending on its severity. The most common symptom in AR patients is a persistent bilateral nasal blockage, which may indirectly and potentially affect the airflow into the lung. However, the symptoms can be controlled using intranasal steroid spray (INS). This study investigated the role of nasal obstruction in lowering blood oxygenation and how INS improved blood oxygenation. This study included 33 patients with AR. Subjects with moderate-to-severe nasal obstruction were recruited based on the Visual Analogue Scale (VAS), and mometasone furoate nasal spray (MFNS) – two puffs twice a day for two weeks was given. Pre- and post-medication parameters compared included nasal obstruction VAS, partial oxygen arterial pressure (PaO2), partial arterial carbon dioxide pressure (PaCO2), and oxygen saturation (O2 saturation). All parameters were substantially different between pre- and post-medication. VAS, PaO2, PaCO2, and O2 saturation were significantly different before and after medicine (p<0.01). A comprehensive treatment of nasal obstruction using MFNS helps improve blood oxygenation and nasal obstruction in AR patients.
Hemangiomas are common, benign tumors which arise from the proliferation of endothelial cells surrounding blood-filled cavities. Cavernous hemangioma of the nasal cavity is a rare clinical entity but it should be considered in the differential diagnosis of the nasopharyngeal mass and in cases with epistaxis. This lesion is usually found on the lateral wall of nasal cavity and are more common in elderly with no sex preponderance. We present a case of cavernous hemangioma arising from the sphenopalatine area in a 54-year-old female. The tumour was successfully excised by trans-nasal endoscopic approach with pre-operative surgical embolization.
Paranasal sinus mucocele commonly involved fronto-ethmoidal region rather than other due to its narrow anatomical drainage outflow, which put them at a higher tendency to get obstructed. Usually, it arises from an identifiable cause such as a history of endonasal surgery, facial trauma or background of nasal allergy or rhinosinusitis. Rarely patient presented with primary frontal mucocele, and its presentation depending on the mucocele location and extension with surrounding mass effect. Treatment is based on restoration of frontal sinus drainage and ventilation or towards a more radical and definitive approach which is sinus obliteration. Risk and benefits between these two need to be taken into consideration. We present a case of primary frontal mucocele with gradual onset of unilateral eye proptosis which first presented solely with ophthalmic symptoms.International Journal of Human and Health Sciences Vol. 05 No. 03 July’21 Page: 366-371
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