Pusat Pengajian Sains Perubatan - Dataset

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Browsing Pusat Pengajian Sains Perubatan - Dataset by Subject "Rhinosinusitis"

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    Comparing efficacy of tapering dose vs low dose oral steroid in chronic rhinosinusitis with nasal polyp
    (2022)
    Fauzi, Mohd Zul Izzi
    Background: Chronic rhinosinusitis with nasal polyp (CRSwNP) is one of the most common chronic inflammatory diseases of sinonasal mucosa. Oral corticosteroid (OCS) is considered a mainstay of treatment in the management of the disease. However, there is significant heterogeneity existed in OCS prescribing habits for this disease among the rhinologist. This study comes with the hypothesis that a low dose steroid can have a good outcome as compared to a tapering dose. Objective: To compare the efficacy between tapering dose and low dose oral steroid in patients with CRSwNP. Method: A balanced randomisation, two-armed, non-blinded interventional parallel-group study conducted involving 58 CRSwNP patients from Otorhinolaryngology clinic of Universiti Sains Malaysia Hospital. Patients were randomly assigned in a 1:1 ratio to receive either oral prednisolone tapering dose which the starting dose of 60mg/d, or low dose oral prednisolone of 25mg/d for 2weeks. Subjective parameter of quality of life questionnaire and total nasal symptoms score as well as objective parameter of endoscopic finding were measured before and after treatment. The adverse effects of both prescribtion were also recorded. Result: The mean value SNOTT-22 after 12 weeks post treatment is 27.61 (SD 8.17) for tapering dose and 27.75 (SD, 12.22) for low dose group.(p=0.58) The mean decrease in TNSS score for the tapering dose group after 6weeks and 12weeks were 2.18 and 2.39, respectively; meanwhile, the low dose group was 1.93 and 2.22 (p=0.072). The mean decrease in modified Lund-Kennedy score from baseline to 12weeks was 2.89units for the tapering dose group and 2.29units for the low dose group.(p=0.517) The nasal polyp grading mean value for 12weeks post-treatment was 2.50units(SD, 1.29) in the tapering dose group and 2.68units(SD, 1.41) in the low dose group.(p=0.66) Conclusion: This study indicates a significant improvement in terms of quality of life, total nasal symptoms score and endoscopic findings for both prescription groups. However, there are no significant improvement outcome differences between the two prescription dose.