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Objective The objective of this study was to report patients’ knowledge and comfort level with CT imaging for sinus disease and evaluate patient willingness to undergo empiric medical therapy (EMT) versus CT-directed therapy (CTDT). Study Design Prospective survey study Methods A 22-item survey was administered to patients with nasal/sinus symptoms in a tertiary care rhinology clinic. Questions elicited patient demographics, imaging history, knowledge/comfort regarding imaging-related radiation exposure. Patients were presented with the theoretical choice of EMT vs CTDT, given the expected positive predictive value, in CRS management. Results Two hundred patients (52% female, age range 18–83) participated. Of these, 85% had symptoms for over three months. Only 91 patients (45.5%) were aware that CT imaging involved radiation exposure. Prior CT experience and past sinus surgery (p<0.05), but not sex or education level, were associated with increased comfort with CT imaging. Most patients (78%) preferred CTDT over EMT. If a CT sinus was recommended, 77 patients (38.5%) had concerns, of which 26% identified radiation exposure as leading concern. The majority (70%) were unsure about the relative radiation dose of a conventional CT. Conclusions Patients with CRS symptoms prefer CTDT over EMT if a diagnosis cannot be established definitively using exam findings. While most patients deferred to the physician regarding the decision to utilize CT imaging, there is low awareness of CT-related radiation exposure and a significant minority of patients have radiation–related concerns with regard to medical imaging for nasal and sinus symptoms.

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Objective This study aimed to assess the effectiveness of nasal rinsing during ablution in reducing acute respiratory tract infection among male Hajj pilgrims. Methods A quasi-experimental trial study was conducted to compare the effectiveness of nasal rinsing between two groups. The intervention group was instructed to perform nasal rinsing during ablution, while the control group was not asked to do nasal rinsing. Both groups were provided progress diaries to record the symptoms of respiratory tract infection, including cough, rhinorrhoea, nasal blockage, fever, and sore throat, as well as thick phlegm, shortness of breath, epistaxis, and changes in sense of smell. The groups were also instructed to record any visits to clinics for their symptoms throughout their stay in Makkah for the Hajj ritual. Results The study showed that nasal rinsing significantly reduced the symptoms of cough, rhinorrhoea, and nasal blockage. The intervention group had an increased number of visits to healthcare facilities for treatment, when compared to those of the control group. There were no significant differences in the groups regarding the symptoms of fever and sore throat. Conclusion Nasal rinsing can be included as part of intervention methods that include vaccination and the use of a face mask. Nasal rinsing can be easily practiced by the pilgrims, since it is a Sunnah act in ablution, which is an integral element of Muslims' daily life.

The objectives of this study were to determine the effect of a one and a half year educational intervention on the job dissatisfaction of teachers in 30 Community Based Rehabilitation (CBR) centres in Kelantan, Malaysia, and to identify the factors influencing changes in job dissatisfaction following the intervention. Method: Ten educational modules were administered to the teachers. A validated Malay version of Job Content Questionnaire (JCQ) was used pre intervention, mid intervention and post intervention. Result: Repeated Measure ANOVA revealed there was a statistically significant reduction in the mean of job dissatisfaction (p = 0.048). Multiple Linear Regression revealed that coworker support (β= 0.034 (95% CI = 0.009, 0.059)), having less decision authority (β:-0.023; 95% CI:-0.036,-0.01) and being single (β:-0.107; 95% CI:-0.176,-0.038) were significantly associated with decreases in job dissatisfaction. Conclusion: The intervention program elicited improvement in job satisfaction. Efforts should be made to sustain the effect of the intervention in reducing job dissatisfaction by continuous support visits to CBR centres.

Objectives This case-controlled study aimed to identify the association of tumor necrosis factor (TNF)α-1031 and TNFβ+ 252 gene polymorphisms between chronic rhinosinusitis (CRS) and healthy controls. Another purpose of this study was to investigate the associations of these gene polymorphisms with factors related to CRS.Methods All deoxyribonucleic acid (DNA) samples were genotyped for TNFα-1031 and TNFβ+252 genes by mean of polymerase chain reaction (PCR) and restriction fragment length polymorphisms (RFLP). The statistical analysis were carried out using chi-square test or Fisher exact test to determine the associations of these gene polymorphisms in CRS. Multiple logistic regression was performed to evaluate the associations of these gene polymorphisms in CRS and its related risk factors.Results The genotype and allele frequencies of TNFα-1031 and TNFβ+252 gene did not show any significant associations between CRS and healthy controls. However, a significantly statistical difference of TNFα-1031 was observed in CRS participants with atopy (P-value, 0.045; odds ratio, 3.66) but not in CRS with asthma or aspirin intolerance.Conclusion Although the presence of TNFα-1031 and TNFβ+252 gene polymorphisms did not render any significant associations between CRS and healthy control, this study suggests that TNFα-1031 gene polymorphisms in CRS patients with atopy may be associated with increase susceptibility towards CRS.