Jurnal Jadi Nian
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Transcript of 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