exudates and Rhinitis

Objective To objectively compare the nasal decongestion potency of lidocaine/phenylephrine when delivered with a nasal nebulizer and a nasal spray before a rigid nasoendoscopic examination. Study Design Open-label randomized controlled trial. Setting Multicenter study. Methods This prospective clinical trial involved 106 participants with untreated chronic rhinitis. Fifty-three participants had 400 μL of lidocaine/phenylephrine administered into the right nostril with a nasal nebulizer, while the remaining 53 participants had 400 μL administered with a nasal spray. The control was the left nostril. Nasal resistance at 150-Pa fixed pressure was evaluated with an active anterior rhinomanometry at 5, 10, 15, and 30 minutes postintervention. Pain score was assessed subjectively by applying pressure to the inferior turbinate 30 minutes after intervention. Results There was an overall reduction in nasal resistance of the right nostril when lidocaine/phenylephrine was administered with the nasal nebulizer in comparison with the nasal spray. However, a statistically significant difference in nasal resistance was seen only at 5 minutes ( P = .047), 15 minutes ( P = .016), and 30 minutes ( P = .036). The examining endoscopist further supported the degree of nasal decongestion via subjective assessment of the nasal cavity ( P = .001). Pain scores obtained after the intervention showed a significant decrease in pain threshold when the nasal nebulizer was used instead of the nasal spray ( P = .040). Conclusions This study suggests that the delivery of lidocaine/phenylephrine to the nasal cavity by the nasal nebulizer provides better decongestive and analgesic potency as compared with the delivery by nasal sprays.

Topics: Administration, Intranasal; Drug Combinations; Endoscopy; Female; Follow-Up Studies; Humans; Lidocaine; Malaysia; Male; Nasal Decongestants; Nasal Mucosa; Nasal Obstruction; Nasal Sprays; Nebulizers and Vaporizers; Phenylephrine; Prospective Studies; Rhinitis; Treatment Outcome

The study aims to evaluate previous management of CRSwNP patients in Universiti Kebangsaan Malaysia Medical Center (UKMMC) against a developed CP.Chronic rhinosinusitis with nasal polyposis (CRSwNP) has high economic burden and impacts patient's quality of life. Implementation of clinical pathway (CP) can standardize care while optimizing resources.Analytical cross-sectionalThis study utilized medical records of 103 CRSwNP patients at UKMMC otorhinolaryngology clinic from 2010 to 2015. Patients were divided into groups who underwent or did not undergo surgery. Information was obtained regarding sociodemographic, follow-ups, pharmaceutical regimes, and treatment cost. Cost analysis was done using top-down analysis and activity-based costing and CP was formulated. Cost was calculated using year 2020 rates to adjust for inflation. (United States Dollars [USD]1 = Ringgit Malaysia [RM] 4.2015)Study showed non-CP patients were undertreated compared to CP. This affects clinical outcomes as optimal treatment demanded by CP was not achieved. Total cost for non-CP, non-surgery patients were lower (USD660) compared to CP (USD780) due to under treatment and shorter follow-ups. Meanwhile, total cost for non-CP surgery patients were higher (USD3600) compared to CP (USD2706) due to longer visit durations and hospital stays. Non-CP surgery group underwent lengthy follow-up duration (20.7 months) prior to operation compared to 12 months expected in CP.Study showed non-CP patients were undertreated compared to CP. We identified aspects which resulted in resource wastage and unnecessary burden to our healthcare system. This study enables development of a written CP by fine-tuning various aspects of CP which could be applied to our future practice.

Topics: Adult; Aged; Chronic Disease; Cost of Illness; Critical Pathways; Female; Humans; Malaysia; Male; Middle Aged; Nasal Polyps; Quality of Life; Rhinitis; Sickness Impact Profile; Sinusitis

To evaluate the clinicopathological and mycological manifestations of fungal rhinosinusitis occurring in the Tengku Ampuan Rahimah Hospital, in Klang, Malaysia, which has a tropical climate.. Records of patients treated from 2009 to 2016 were analysed retrospectively. Data from the records were indexed based on age, gender, clinical presentations, symptom duration, clinical signs and mycological growth.. Of 80 samples, 27 (33.75 per cent) had fungal growth. Sixteen patients were classified as having non-invasive fungal rhinosinusitis and 11 as having invasive fungal rhinosinusitis. The commonest clinical presentation was nasal polyposis in non-invasive fungal rhinosinusitis patients (p < 0.05) and ocular symptoms in invasive fungal rhinosinusitis patients (p < 0.05). The commonest organism was aspergillus sp. (p < 0.05) in non-invasive fungal rhinosinusitis and mucorales in invasive fungal rhinosinusitis.. There is an almost equal distribution of both invasive and non-invasive fungal rhinosinusitis, as seen in some Asian countries. Invasive fungal rhinosinusitis, while slightly uncommon when compared to non-invasive fungal rhinosinusitis, is potentially life threatening, and may require early and extensive surgical debridement. The clinical presentation of nasal polyposis was often associated with non-invasive fungal rhinosinusitis, whereas ocular symptoms were more likely to be associated with invasive fungal rhinosinusitis.

Topics: Adult; Aged; Female; Humans; Invasive Fungal Infections; Malaysia; Male; Middle Aged; Mycoses; Retrospective Studies; Rhinitis; Sinusitis; Tertiary Care Centers; Tropical Climate

There are few studies on fractional exhaled nitric oxide (FeNO) and respiratory symptoms among adults in tropical areas. The aim was to study associations between FeNO and selected personal factors, respiratory symptoms, allergies, office characteristics and indoor office exposures among office workers (n = 460) from a university in Malaysia.. Information on health was collected by a questionnaire, skin prick test and FeNO measurement. Temperature, relative air humidity, carbon monoxide and carbon dioxide were measured in the offices. Settled dust was vacuumed in the offices and analyzed for endotoxin, (1,3)-β-glucan and house dust mites allergens, namely Dermatophagoides pteronyssinus (Der p 1) and Dermatophagoides farinae (Der f 1). Two-level linear mixed models and multiple logistic regression were used to analyze the associations.. One-fourth (25.9%) of the office workers had elevated FeNO level (≥ 25 ppb) and 61.5% had HDM, cat, seafood or pollen allergy. Male gender (p < 0.001), current smoking (p = 0.037), height (p < 0.001) and atopy (p < 0.001) were associated with FeNO. The amount of vacuumed dust was associated with FeNO among atopic subjects (p = 0.009). Asthma and rhinitis symptoms were associated with FeNO (p < 0.05), especially among atopic subjects. In particular, a combination of atopy and elevated FeNO were associated with doctor-diagnosed asthma (p < 0.001), rhinitis (p < 0.001) and airway symptoms last 12 months (p < 0.001).. Gender, smoking, height and atopy are important risk factors for elevated FeNO levels. A combination of allergy testing and FeNO measurement could be useful in respiratory illness epidemiology studies and patient investigations in tropical areas.

Topics: Adult; Air Pollutants; Air Pollution, Indoor; Allergens; Asthma; Body Height; Body Mass Index; Breath Tests; Carbon Dioxide; Carbon Monoxide; Female; Humans; Humidity; Hypersensitivity, Immediate; Malaysia; Male; Nitric Oxide; Rhinitis; Sex Factors; Skin Tests; Smoking; Temperature; Universities; Workplace; Young Adult

This paper studied associations between ocular symptoms, rhinitis, throat and dermal symptoms, headache and fatigue in students by ethnicity and in relation to exposure to chemical microbial markers and fungal DNA in vacuumed dust in schools in Malaysia. A total of 462 students from 8 randomly selected secondary schools in Johor Bahru, Malaysia, participated (96% response rate). Dust was vacuumed from 32 classrooms and analysed for levels of five types of endotoxin as 3-hydroxy fatty acids (C10, C12, C14, C16 and C18 3-OH), muramic acid, ergosterol and five sequences of fungal DNA. Multiple logistic regression was applied. Totally 11.9% reported weekly ocular symptoms, 18.8% rhinitis, 15.6% throat and 11.1% dermal symptoms, 20.6% headache and 22.1% tiredness. Totally 21.1% reported pollen or furry pet allergy (atopy) and 22.0% parental asthma or allergy. Chinese students had less headache than Malay and Indian had less rhinitis and less tiredness than Malay. Parental asthma/allergy was a risk factor for ocular (odds ratio=3.79) and rhinitis symptoms (OR=3.48). Atopy was a risk factor for throat symptoms (OR=2.66), headache (OR=2.13) and tiredness (OR=2.02). There were positive associations between amount of fine dust in the dust samples and ocular symptoms (p<0.001) and rhinitis (p=0.006). There were positive associations between C14 3-OH and rhinitis (p<0.001) and between C18 3-OH and dermal symptoms (p=0.007). There were negative (protective) associations between levels of total endotoxin (LPS) (p=0.004) and levels of ergosterol (p=0.03) and rhinitis and between C12 3-OH and throat symptoms (p=0.004). In conclusion, the amount of fine dust in the classroom was associated with rhinitis and other SBS symptoms and improved cleaning of the schools is important. Endotoxin in the school dust seems to be mainly protective for rhinitis and throat symptoms but different types of endotoxin could have different effects. The ethnic differences in symptoms among the students deserve further attention.

Topics: Adolescent; Air Pollution, Indoor; Allergens; Asthma; DNA, Fungal; Dust; Endotoxins; Ergosterol; Humans; Hypersensitivity; Inhalation Exposure; Malaysia; Muramic Acids; Rhinitis; Schools; Sick Building Syndrome; Students

There are few studies on rhinitis and sick building syndrome (SBS) among students in tropical countries. We studied associations between levels of five fungal DNA sequences, two mycotoxins (sterigmatocystin and verrucarol) and cat allergen (Fel d 1) levels in schools and rhinitis and other weekly SBS symptoms in the students. Fungal DNA was measured by quantitative PCR and cat allergen by ELISA. Pupils (N = 462) from eight randomly selected schools in Johor Bahru, Malaysia participated (96%). Dust samples were collected by cotton swabs and Petri dishes exposed for one week. None of the schools had a mechanical ventilation system, but all classrooms had openable windows that were kept open during lectures and indoor CO2 levels were low (mean 492 ppm; range 380-690 ppm). Weekly nasal symptoms (rhinitis) (18.8%), ocular (11.6%), throat (11.1%), dermal symptoms, headache (20.6%) and tiredness (22.1%) were common. Total fungal DNA in swab samples was associated with rhinitis (p = 0.02), ocular symptoms (p = 0.009) and tiredness (p = 0.001). There were positive associations between Aspergillus versicolor DNA in Petri dish samples, ocular symptoms (p = 0.02) and tiredness (p = 0.001). The level of the mycotoxin verrucarol (produced by Stachybotrys chartarum) in swab samples was positively associated with tiredness (p = 0.04). Streptomyces DNA in swab samples (p = 0.03) and Petri dish samples (p = 0.03) were negatively associated with tiredness. In conclusion, total fungal contamination, measured as total fungal DNA) in the classrooms, Aspergillus versicolor and verrucarol can be risk factors for rhinitis and SBS symptoms among students in the tropical country Malaysia.

Topics: Adolescent; Allergens; Animals; Cats; DNA, Fungal; Dust; Eye; Fatigue; Female; Headache; Humans; Malaysia; Male; Models, Theoretical; Mycotoxins; Pharynx; Prevalence; Rhinitis; Schools; Skin; Students

A prevalence study was conducted among office workers in Malaysia (N= 695). The aim of this study was to examine associations between asthma, airway symptoms, rhinitis and house dust mites (HDM) and cat allergy and HDM levels in office dust. Medical data was collected by a questionnaire. Skin prick tests were performed for HDM allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae) and cat allergen Felis domesticus. Indoor temperature and relative air humidity (RH) were measured in the offices and vacuumed dust samples were analyzed for HDM allergens. The prevalence of D. pteronyssinus, D. farinae and cat allergy were 50.3%, 49.0% and 25.5% respectively. Totally 9.6% had doctor-diagnosed asthma, 15.5% had current wheeze and 53.0% had current rhinitis. The Der p 1 (from D. pteronyssinus) and Der f 1 (from D. farinae) allergens levels in dust were 556 ng/g and 658 ng/g respectively. Statistical analysis was conducted by multilevel logistic regression, adjusting for age, gender, current smoking, HDM or cat allergy, home dampness and recent indoor painting at home. Office workers with HDM allergy had more wheeze (p= 0.035), any airway symptoms (p= 0.032), doctor-diagnosed asthma (p= 0.005), current asthma (p= 0.007), current rhinitis (p= 0.021) and rhinoconjuctivitis (p< 0.001). Cat allergy was associated with wheeze (p= 0.021), wheeze when not having a cold (p= 0.033), any airway symptoms (p= 0.034), doctor-diagnosed asthma (p= 0.010), current asthma (p= 0.020) and nasal allergy medication (p= 0.042). Der f 1 level in dust was associated with daytime breathlessness (p= 0.033) especially among those with HDM allergy. Der f 1 levels were correlated with indoor temperature (p< 0.001) and inversely correlated with RH (p< 0.001). In conclusion, HDM and cat allergies were common and independently associated with asthma, airway symptoms and rhinitis. Der f 1 allergen can be a risk factor for daytime breathlessness.

Topics: Adolescent; Adult; Air Pollution, Indoor; Allergens; Animals; Antigens, Dermatophagoides; Arthropod Proteins; Asthma; Cats; Cysteine Endopeptidases; Dermatophagoides farinae; Dermatophagoides pteronyssinus; Female; Humans; Humidity; Interviews as Topic; Logistic Models; Malaysia; Male; Middle Aged; Odds Ratio; Pyroglyphidae; Respiratory Sounds; Rhinitis; Risk Factors; Skin Tests; Smoking; Surveys and Questionnaires; Temperature; Young Adult

This study aims to assess the association between microbial composition, biofilm formation and chronic otorhinolaryngologic disorders in Malaysia. A total of 45 patients with chronic rhinosinusitis, chronic tonsillitis and chronic suppurative otitis media and 15 asymptomatic control patients were studied. Swab samples were obtained from these subjects. Samples were studied by conventional microbiological culturing, PCR-based microbial detection and Confocal Laser Scanning Microscopy (CLSM). Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae, coagulase-negative staphylococci (CoNS) and other Streptococcus species were detected in subjects of both patient and control groups. Biofilm was observed in approximately half of the smear prepared from swab samples obtained from subjects of the patient group. Most of these were polymicrobial biofilms. S. aureus biofilm was most prevalent among nasal samples while H. influenzae biofilm was more common among ear and throat samples. Results from this study supported the hypothesis that chronic otorhinolaryngologic diseases may be biofilm related. Due to the presence of unculturable bacteria in biofilms present in specimens from ear, nose and throat, the use of molecular methods in combination with conventional microbiological culturing has demonstrated an improvement in the detection of bacteria from such specimens in this study.

Topics: Bacteria; Biofilms; Case-Control Studies; Chronic Disease; Cross-Cultural Comparison; Ear, Middle; Haemophilus influenzae; Humans; Malaysia; Microscopy, Confocal; Nasal Mucosa; Otitis Media, Suppurative; Otorhinolaryngologic Diseases; Pharynx; Polymerase Chain Reaction; Pseudomonas aeruginosa; Rhinitis; Sinusitis; Spectrophotometry; Staphylococcus; Staphylococcus aureus; Streptococcus pneumoniae; Tonsillitis

To investigate the aetiology of rhinitis occurring in pregnancy, by (1) describing the relationship between pregnancy rhinitis and serum oestrogen, progesterone, placental growth hormone and insulin-like growth factor, and (2) assessing the prevalence of pregnancy rhinitis among Malaysian women.. Prospective study involving 30 pregnant women followed at an ante-natal clinic for 14 months. Hormone levels were analysed during pregnancy and the post-partum period.. Levels of all four hormones were elevated in the third trimester, compared with first trimester and postpartum values. Rhinitis patients had higher levels of oestrogen and insulin-like growth factor 1 in the third trimester than non-rhinitis patients, although these differences were not statistically significant. The prevalence of rhinitis was 53.3 per cent, with most cases occurring in the third trimester. Patients with pregnancy rhinitis had a higher prevalence of female babies, compared with non-rhinitis patients (p = 0.003).. Pregnancy rhinitis was significantly more common in women giving birth to female babies. Women with pregnancy rhinitis had a non-significant elevation in oestrogen and insulin-like growth factor 1 levels, compared with those without rhinitis.

Topics: Adult; Estrogens; Female; Gestational Age; Humans; Infant, Newborn; Insulin-Like Growth Factor I; Malaysia; Male; Nasal Obstruction; Pregnancy; Pregnancy Complications, Infectious; Progesterone; Prospective Studies; Rhinitis; Sex Factors

The complexities of the anatomy of the nose and paranasal sinuses, as well as its variations may create technical difficulties during surgery. The significance of these anatomical variations in pathogenesis of rhinosinusitis, which is the commonest disease in the region, is still unclear.. The aims of the study were to study the anatomical variations in the osteomeatal complex in chronic rhinosinusitis (CRS) patients and to compare them with the normal population.. High resolution CT scan of paranasal sinuses images of 240 individuals were reviewed comparing 120 cases of CRS and another 120 patients without CRS problem.. The anatomical variations recorded were: Concha bullosa in 49 (40.8%) CRS cases and 57 (47.5%) in control cases, paradoxical middle turbinates in 14 (12.0%) CRS cases and 27 (23.0%) in control cases, pneumatized uncinate processes were found in 3 cases (3.3%) in both CRS and control groups, Haller's cells (infraorbital ethmoid cell) in 61 (51.0%) CRS cases and 75 (62.0%) cases in the control group, there were pneumatized agger nasi cells in 100 (83.0%) CRS cases and 95 (79.0%) in control subjects and deviated nasal septums in 67 (56.0%) CRS cases compared with 73 (60.8%) in controls.. The most common anatomical variation in the osteomeatal complex in CRS patients was pneumatized agger nasi cells and the least was pneumatized uncinate processes. However the prevalence among both groups is comparable. The detection of a single anatomical variant itself does not establish the genesis of chronic rhinosinusitis except for paradoxical middle turbinate and infraorbital ethmoid cells.

Topics: Case-Control Studies; Chronic Disease; Female; Humans; Malaysia; Male; Nasal Septum; Rhinitis; Sinusitis; Turbinates

To determine the prevalence of allergic fungal sinusitis (AFS) in refractory chronic rhinosinusitis (CRS) in adult Malaysians.. This cross-sectional study involved 30 immunocompetent CRS patients who underwent surgery. Specimens were sent for mycology and histopathologic analysis for identification of fungi. Clinical and immunological workup was performed for atopy in all patients and controls.. Fungal cultures were positive in 5 (16.7%) and 11 (36.7%) of 30 patients from nasal secretions and surgical specimens, respectively. Allergic mucin was found in 8 surgical specimens (26.7%). Hence, prevalence of AFS was 26.7%. The most common causative agent was Aspergillus sp. (54.5%). In 3 (37.5%) of 8 patients, AFS was found to be associated with asthma. Twenty-five percent (2/8 patients) had aspirin intolerance, and 62.5% (5/8 patients) had elevated total immunoglobulin E levels. All patients had positive skin test reactivity to fungal allergen.. This preliminary study suggests that AFS does exist in Malaysia. Proper handling of surgical specimens and accurate diagnosis by the pathologist and mycologist are essential.

Topics: Adult; Chronic Disease; Cross-Sectional Studies; Humans; Malaysia; Mycoses; Nasal Cavity; Prevalence; Respiratory Hypersensitivity; Rhinitis; Sinusitis; Therapeutic Irrigation

The house dust mites Dermatophagoides pteronyssinus (Der p) and Blomia tropicalis (Blo t) are the most common house dust mite species in Southeast Asia. To date, there have only been a few studies on the sensitization profile of the general populations in Southeast Asia to house dust mites. The aim of this study was to determine the profiles of Der p and Blo t sensitization among Singaporean and Malaysian subjects.. Enzyme-linked immunosorbent assay was used to detect specific IgE to Der p and Blo t mite crude extracts as well as purified Der p 1, Der p 2 and Blo t 5 allergens. Sera used were from 229 Singaporean subjects (124 with rhinitis, 105 without rhinitis) and 143 Malaysian subjects (94 adults and 49 children with asthma).. The sensitization profile of rhinitis subjects to the dust mite allergens used in this study was as follows: Blo t extract positive: 91/124 (73%); Blo t 5 positive: 62/124 (50%); Der p extract positive: 61/124 (49%); Der p 1 positive: 53/124 (43%); Der p 2 positive: 45/124 (36%). The nonrhinitis subjects' sensitization profile was as follows: Blo t extract positive: 60/105 (57%); Blo t 5 positive: 24/105 (23%); Der p extract positive: 38/105 (36%); Der p 1 positive: 14/105 (13%); Der p 2 positive: 17/105 (16%). The study of Malaysian asthmatic adults showed that 39% of them were sensitized to Der p 1, 32% to Der p 2 and 37% to Blo t 5. Among the asthmatic children, sensitization to Blo t 5, Der p 1 and Der p 2 was 90, 57 and 39%, respectively.. This study clearly revealed that dual sensitization to B. tropicalis and D. pteronyssinus is common in the general populations of Singapore and Malaysia. Sensitization to Blo t 5 is more prevalent than to Der p 1 and Der p 2.

Topics: Adolescent; Adult; Aged; Allergens; Antigens, Dermatophagoides; Antigens, Plant; Arthropod Proteins; Asthma; Child; Cysteine Endopeptidases; Female; Humans; Immunoglobulin E; Malaysia; Male; Middle Aged; Rhinitis; Singapore

The prevalence and severity of asthma, rhinitis and eczema in Kelantanese schoolchildren were determined as part of an international study of the epidemiology of asthma and allergic diseases. The international study of asthma and allergies in childhood (ISAAC) written questionnaire was administered to 7055 schoolchildren from February 1995 to August 1995. The respondents were parents or guardians of 5- to 7-year-old children (n = 3939), and schoolchildren aged 12-14 years (n = 3116). The ISAAC video questionnaire (AVQ3.0) was shown to children aged 12-14 years after the written questionnaire. The overall prevalences of 'ever wheezed' and 'wheezing in last 12 months' were 9.4 and 6.0% respectively. The prevalence of 'ever diagnosed with asthma' was 9.4%. Both 'ever wheezed' and 'wheezing in the last 12 months' were significantly higher in 12- to 14-year-old children than in 5- to 7-year-old children, with P values of 0.0006 and 0.014 respectively. No gender differences in the prevalences were observed. For the complete study group, 4.7% of children had sleep disturbed by wheezing but only 1.1% had a severe attack limiting speech in the preceding 12 months. Sleep disturbance was more common in the 12- to 14-year-old children than in 5- to 7-year-old children (P = 0.006). There was no difference between the age groups for severe attacks limiting speech. The overall prevalence of rhinitis and eczema symptoms were 27 and 12%, respectively. The prevalence of rhinitis in the 12-14 year age group (38.2%) was significantly higher (P < 0.0001) than in the 5-7 year age group (18.2%). The prevalence of eczema in the 5-7 year age group (13.7%) was significantly higher (P = < 0.0001) than in the 12-14 year age group (9.9%). These prevalence data are comparable with previous reports in Malaysian children, but are considerably lower than those reported for most developed countries.

Topics: Adolescent; Asthma; Child; Child, Preschool; Eczema; Female; Humans; Malaysia; Male; Rhinitis

In a study of 124 adult patients with bronchial asthma, 65% of them had associated rhinitis. In the asthmatics who had associated rhinitis, both diseases usually started within two years of one another but either disease might develop first. In 21% of the patients, asthmatic attacks were preceded or precipitated by rhinitis symptoms. In the patients who had asthma alone or those associated with rhinitis, no significant difference were found in terms of age and sex distribution, age of onset, and a positive family history of asthma, rhinitis or allergic diseases. Response to skin prick test using six different types of allergens also showed no difference in the two groups of patients. Sensitivity to house dust was common among both groups of patients as well as in the normal controls suggesting a common occurrence of house dust mite in our community and making the skin prick test using this allergen unsuitable as a test for atopy in our population.

Topics: Acute Disease; Adolescent; Adult; Age Factors; Aged; Animals; Asthma; Child; Dust; Female; Humans; Malaysia; Male; Middle Aged; Mites; Rhinitis; Skin Tests

Asthmatic patients constitute up to 5% of admissions to medical wards in our area. Analysis of 1099 adult asthmatic admissions over a 3-year period showed that Malays composed 31% of patients (expected 23%), Indians composed 36% (expected 31%) and Chinese only 32% (expected 46%). There was a reduced prevalence of asthma in the Chinese (P less than 0.001). Male asthmatic admissions showed a non-seasonal cyclic variation (P less than 0.01) with an increasing trend in the number of admissions (P less than 0.02). The proportion of male to female asthmatic admissions did not differ. In a sample of 50 asthmatic patients, studied in detail, the mean age of onset was 33.3 years (range 6-74) while only 14% of subjects had onset of asthma before the age of 10 years. Although the clinical features of these patients differ from those of Caucasian asthmatics, skin prick tests and other features suggest that the majority of our patients suffer from extrinsic atopic asthma.

Topics: Adolescent; Adult; Age Factors; Aged; Asthma; Child; China; Dermatitis, Atopic; Female; Humans; India; Malaysia; Male; Middle Aged; Rhinitis; Skin Tests

Topics: Chronic Disease; Ethnicity; Female; Humans; Malaysia; Male; Methods; Rhinitis; Sex Factors; Tropical Medicine

Topics: Adolescent; Adult; Age Factors; Asian People; Child; Child, Preschool; Chronic Disease; Diathermy; Ethnicity; Female; Humans; Malaysia; Male; Middle Aged; Rhinitis; Turbinates; White People