Objectives Anosmia is a common debilitating symptom of the novel coronavirus disease 2019 (COVID-19). Currently, there is no satisfactory treatment of anosmia. Therefore, this study was conducted to evaluate the therapeutic effect of nasal betamethasone drops in the recovery of olfaction in COVID-19-associated anosmia. Methods The study was designed as a randomised, double-blind, placebo-controlled clinical trial. In total, 276 PCR-confirmed COVID-19 patients who were presented to the outpatient clinic with anosmia were enrolled in the study. In the betamethasone group, 138 participants received nasal drops of betamethasone 3 times daily until recovery for a maximum of one month. Similar dose of 9% NaCl drops was administered to 138 participants in the placebo group. Results The median age of participants was 29 years (IQR 23–37). Among them, 198 (71.7%) were females. Ageusia was co-presented with anosmia in 234 (84.8%) of participants. In this study, 83% of participants had recovered from anosmia within 30 days, with a median recovery time of 13 days (IQR 8–18). Compared to placebo, nasal application of betamethasone drops has no significant effect on the recovery time of anosmia (hazard ratio 0.88; 95% CI 0.68–1.14; P = 0.31). Conclusion The use of nasal betamethasone to facilitate the recovery time of acute anosmia is not advised. In addition, age, smoking status, the duration of anosmia at presentation, and the co-presentation of ageusia with anosmia are important determinant covariates for the recovery time of anosmia. Further clinical trials, which take these covariates into account, will need to be undertaken. The trail has been registered at ClinicalTrails.gov , NCT04569825 .

Loss of smell and taste are common complaints in patients with the COVID-19 disease. These symptoms may present alone or with other symptoms. It is of utmost importance to know their rates of occurrence for better controlling of the infection. The aim of the study was to detect the prevalence of anosmia and ageusia in individuals with COVID-19 in Al

Although parosmia is a common problem in the era of the COVID-19 pandemic, few studies assessed the demographic and clinical aspects of this debilitating symptom. We aimed to evaluate the socio-clinical characteristics and outcome of various options of treatment of individuals with parosmia due to COVID-19 infection. The study was conducted at two main Hospitals in the Ramadi and Tikrit cities, Iraq, on patients with a chief complaint of parosmia due to COVID-19 disease. The study involved 7 months (August 2020–February 2021). Detailed demographic and clinical characteristics and treatment options with their outcome were recorded and analyzed. Out of 268 patients with parosmia, there were 197 (73.5%) females. The majority were from age group ≤ 30 years (n = 188, 70.1%), housewives (n = 150, 56%), non-smokers (n = 222, 82.8%), and associated with dysgeusia (n = 207, 77.2%) but not associated with nasal symptoms (n = 266, 99.3%). All patients have complained of anosmia (89.9%) or hyposmia (10.1%). Troposmia was reported in the majority of participants. The majority of the patients were suffering from severe parosmia (65.7%). Around 3 quarters of the cases were presented in ≤ 4 months. Altered quality of life (AQL) was presented in 91.8% of subjects, and there was a significant association with the presence of dysgeusia and type and severity of parosmia. The smoking habit didn't show a significant association with AQL, the severity of parosmia, and the recovery rate. Most of the odor group was the most triggering stimuli eliciting parosmia, while, the sewage was the response odor in above 50% of the cases. The recovery rate was poor with olfactory training plus either tonics or local and systemic steroids. Parosmia due to COVID-19 infection is a common problem with poor results in the short-term treatment and follow-up. The AQL was seen in a greater proportion of patients and strongly associated with the presence of dysgeusia, type, and severity of parosmia.

Background: Sudden sensorineural hearing loss (SSNHL) can be a feature of COVID-19. It may present alone or with other symptoms of the disease. However, there is little written in the literature about its occurrence. We aimed to evaluate the socio-clinical characteristics and outcome of confirmed mild- to moderate COVID-19 cases with SSNHL in Tikrit city, Iraq. Materials and Methods: This descriptive study was conducted at the Otolaryngology Department, Tikrit General Hospital, Tikrit city, Iraq. The period of the study was from December 1, 2020 to June 30, 2021.Mild and moderate COVID-19 subjects confirmed by real-time polymerase reaction were included in the study. Detailed demographic (age, gender, and smoking habit) and clinical characteristics (onset and duration of deafness, side, severity, associated ear, nose, and throat symptoms, and comorbidity) were recorded for every patient. Outcomes following the steroid treatment protocol were also registered. Results: SSNHL was identified in 26 patients, of whom 20 (76.9%) were women, 20 (76.9%) were in the age group ≥ 30 years, and 21 (80.8%) were non-smokers. Around three-quarters of the subjects were identified within the first week of deafness occurrence. Bilateral (18/26) was more common than unilateral deafness (8/26); therefore, the total number of deaf ears was 44. Besides, bilateral symmetrical deafness (13/18) outnumbered the asymmetrical type (5/18). Around three-quarters were of moderate severity. The most common otological symptom was tinnitus (25/26). The most common nose and throat symptom was anosmia (6/26). The mean hearing threshold before and after treatment with oral steroids ± intratympanic steroids was 50.91 ± 11.777 dB and 40.24 ± 15.693, respectively. One patient with bilateral SSNHL was lost to follow-up; the remaining number of deaf ears was 42, and half of them were partially improved. The outcome of the treatment showed no statistically significant relation with the duration, side, and severity of SSNHL (p>0.05). Conclusion: The majority of COVID-19-related SSNHL cases presented within one week of onset, with bilateral outnumbering unilateral cases. Tinnitus was the most common associated symptom. Treatment with steroids achieved partial improvement in half of the cases, and this outcome was not affected by the duration, side, and severity of deafness.

Background Dysphonia is a feature of the COVID-19 disease with different prevalence rates of occurrence among various nations. Objectives To determine the prevalence of dysphonia in hospitalized patients with COVID-19 disease. Materials and methods The study was conducted at Salahaddin General Hospital during the period from January to March 2021. Hospitalized COVID-19 patients with or without dysphonia were enrolled in the study. Demographic and clinical data were recorded. The severity, duration, laryngoscopic finding, and fate of the dysphonia were registered too. Results Out of 94 subjects, there were 21 (22.3%) with dysphonia. The age was ranged from 23 to 101 years, with nearly equal gender distribution. Non-smokers were found in 52.1% of the cases. Dyspnea (100%), fever (100%), and cough (98.9%) were the most common presenting symptoms. There was a statistically significant difference between the dysphonic and non-dysphonic groups regarding fatigue, nasal obstruction, and diarrhea (P-value<0.05). Mild dysphonia was found in 10 (47.6%) of the dysphonic cases. The most common laryngoscopic finding was the bowing of the vocal cords. Most of the patients (11/18) were with dysphonia for more than a month duration. Similar numbers were not recovered for a one-month follow-up. Conclusion The prevalence of dysphonia was 22.3%. Dyspnea, fever, and cough were the commonest symptoms. Fatigue, nasal obstruction, and diarrhea affected dysphonia. Bowing of the vocal cords was the most common abnormality. Most of the cases were with mild dysphonia, persisting for more than a month, and were not resolved during the follow-up period of one month.

Background: Loss of smell and taste are common complaints in patients with the COVID-19 disease. These symptoms may present alone or with other symptoms. It is of utmost importance to know their rates of occurrence for better controlling of the infection. Objectives: To detect the prevalence of anosmia and ageusia in individuals with COVID-19 in Al-Wajbah Primary Health Center, Doha, Qatar.Materials and methods: This retrospective study was conducted at Al-Wajbah Primary Health Center, Doha, Qatar. The study covered the two-month period -May and June 2020. The proven cases of COVID-19 by real-time PCR (Polymerase Chain Reaction) were enrolled in the study. Data regarding the age, gender, symptomatology including anosmia and ageusia, history of recent travel, smoking, past history of nasal and paranasal diseases (NPND), and severity of the disease were taken from the patients’ records. IBM- SPSS version 22 statistical software was used for the analysis of the data.Results: Out of 141, 35 (24.82%) subject presented with anosmia, ageusia or both. Most of the patients were from age group >30 year (n=104, 73.76%) with nearly equal gender. The majority of the individuals were without history of recent travel (92.2%) and smoking (80.14%). Three-quarters of the patients were asymptomatic, and 51.06% with a past history of NPND. The male sex, history of recent travel, smoking, and severe course of the disease were positive, highly significant association with anosmia or ageusia. All patients returned to their normal smell and taste sensations within a mean duration of 6.89 days.Conclusion: Loss of taste and smell were common symptomatology of COVID-19 disease. The males, recent travel, smoking, and severe course of the disease were risk factors of the anosmia and ageusia in COVID-19 cases.

Background: Chronic suppurative otitis media (CSOM) is a common otological problem in daily clinical practice. It is crucial to know the bacterial pathogens and their antimicrobial susceptibilities in patients with CSOM to achieve a good clinical outcome. Objectives: To identify the aerobic bacterial pathogens and their antibiotic sensitivities in subjects with CSOM in Al-Ramadi Teaching Hospital. Materials and Methods: A cross-sectional, descriptive study included 102 subjects with a clinical diagnosis of CSOM (aural discharge >2 weeks, eardrum perforation, and conductive deafness). Purulent discharge was obtained from the middle ear with sterile swabs and cultured for bacterial microorganisms. The sensitivity of the isolated agents to antimicrobials was evaluated by a culture and sensitivity method. SPSS version 22 was used for statistical analysis of the data. Differences were considered statistically significant at p < 0.05. Results: Out of 3634 outpatient subjects, 102 (2.8%) presented with active CSOM. The age range of the patients was 1–70 years (mean 28.90 ± 19.8). There were 58 females (56.9%). Out of 117 ear swab specimens, 107 (91.5%) yielded positive cultures. The majority (101, 94.4%) of the specimens yielded a single organism. There was a high statistically significant difference (p < 0.001) between gram-positive (n = 77, 68.1%) and gram-negative pathogens (n = 36, 31.9%). Pseudomonas aeruginosa in 65 (57.5%) cases and Staphylococcus aureus in 19 (16.8%) cases were the two most commonly isolated organisms. The drugs imipenem (93.8%), amikacin (86.1%), azteronam (83.1%), and ciprofloxacin (81.5%) were effective against P. aeruginosa (p < 0.001). Amikacin (100%), imipenem (94.7%), ciprofloxacin (68.4%), and gentamicin (63.1%) were the most effective antibiotics against Staph. aureus (p < 0.001). Conclusion: The prevalence rate of active CSOM was 2.8%. Ciprofloxacin showed high effectiveness against the two most common isolated pathogens (P. aeruginosa and Staph. aureus); therefore, it could be used as empirical therapy for active CSOM cases.

BackgroundSalivary gland diseases include a variety of conditions (inflammatory, immunological, infectious, or neoplastic pathologies). Salivary gland diseases hold the interest of clinicians and pathologists due to their varied clinical presentation and histological diversity. In this study, we aimed to assess the various aspects of clinical and pathological characteristics of salivary gland diseases. MethodologyWe reviewed the records of patients with various salivary gland diseases at