jurnal jadi nian

7/29/2019 Jurnal Jadi Nian

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Journal Reading

Dr. Novirianty

Tutor :

Dr. Puspa Zuleika, Sp.THT-KL,M.Kes


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Treatment of Postviral Olfactory Loss WithGlucocorticoids, Ginkgo biloba, and

Mometasone Nasal Spray

Beom Seok Seo,Hyun Jong Lee, Ji-Hun Moo,Chul Hee Lee, Chae-Seo

Rhee,Jeong-Whun Kim


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Background

Olfactory disorder mechanism is not

clearly understoodWhich viruses cause postviral olfactory

loss is unknown

The role of the olfactory neural system inpostviral olfactory loss is unknown


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Questions

Does treatment using prednisolone

plus ginkgo biloba significanly

improved for postviral olfactory loss?


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The Purpose

To analyze the efficacy of treating postviral

olfactory loss with glucocorticoid, Ginkgo

biloba and mometasone nasal spary


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There is significant difference

between the ginkgo biloba and non

ginkgo biloba group of treatingpostviral olfactory loss.

Hypotesis


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Material and method

RCT ( Randomized Controlled TrialDesign

Chemosensory Outpatient Clinic of

Seoul National University Bundang

Hospital, Seongmnam, KoreaPlace

July 1,2007 through June 30,2008Time


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Inclusion criteria

History of upper

respiratory tract infection

immediately before post

viral olfactory loss

Sudden onset of

postviral olfactory loss

Exclusion criteria

History of olfactory loss

History of head trauma

History of oral or nasal

corticosteroid use

Concurrent memory loss


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Inclusion criteria

A visit within 12 month

after onset of postviral

olfactory loss

No evidence of sinus

Inflammation on

computed tomographic

osteomeatal or

paranasal sinus view

exclusion criteria

Presence of nasal

discharge

Allergic rhinitis

Chronis rhinosinusitis


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71 patient

monotherapy

Male 10

Female 18

Combinationtherapy

Male 10

Female 33

Procedure


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monotherapyCombination

therapy

Oral prednisolon

for 2 weeks

Oral prednisolon 2 weeks

and G biloba 4 weeks

Monometasone furoat nasal spray2 puff pernostril twice daily for 4

weeks


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Result

After treatment

( score change)

Monotherapy Combination

therapy

BTT 2.2 2.9 (P=.22)

CCSIT 1.7 2.7 (P=.11)


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Result

After Therapy ( the

threatment respon)

Monotherapy Modification

Therapy

BTT Therpy 32% (9 from 28) 37% ( 16 fom 43) (

P=0,66)

CCSIT 14% ( 4 from 28) 33% ( 14 from 43)

(P= 0,08)

Odds ratio: 2,89( 95% Confidence interval 0,84-9,97)


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Discussion

This study to analyze the efficacy of treating

postviral olfactory loss with glucocorticoids, Ginkgo

biloba and mometasone furoate nasal spray

All patient underwent olfactory function test such

BTT, CCSIT

Postviral olfactory loss were treated with oral

prednisolon,Ginkgo biloba and mometasone furoate

nasal spray


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Critical apraisal

1. Is an estimate of the treatment effect given ?

yes

2. Is it of clinical importance ?

yes

3. Is the estimate of threatment effect

sufficiently precise ?

yes


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4. Was the spectrum of patients well defined?

yes

5. Was the diagnosis of the disease well defined?no

6. Were eligibility criteria suitably narrow ?yes


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7. Was assignment to treatments stated to be

random? yes

8. Was the method of randomized explained?no

9 Were all patient accounted for after

randomization? no


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10. Were loses to follow-up low ?

yes

11. Were the treatment groups similar inimportant factor's at the start of the trial?

yes

12. Were all patients otherwise treatedalike?

yes


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13. Were patients, health care workers andinvestigator 'blind' to treatment?no

14.Was assessment of outcome 'blind'?no

15. Was the main analysis on 'intention to

treat'? Yes

16. Were appropriate statistical methods used?

Yes


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Conclusion

The study is valid and

can be applied in clinicalpractice


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Thank you

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