Results
A total of 1072 patients, 674 males (62.9%) and 398 females (37.1%), were included in the study. The age distribution, the largest proportion of participants were between 18-30 years 493 (46%) followed by those between 31-40 years 318 (29.7%), those between 41 – 50 years 198 (18.5%) and the least responses 63 (5.9%) came from participants aging more than 50 years. 384 (35.8%) lived in an urban areas and 688 (64.2%) lived in a rural areas. As for the marital status the majority 633 (59%) were married, 413 (38.5%) were single a minority of participants were divorced (1.4%) and widowed (1%).
All patients had history of chronic rhino sinusitis (nasal obstruction, mucopurulent discharge, headache, fever, post nasal discharge and anosmia) for more than 12 weeks. There was no significant association between having CRS and gender, place of residency, marital status nor educational level.
Nasal endosopic examinations revealed 718 patients (69.9%) had CRS with nasal polyps (CRSwNP) while 309 patients (30.1%) had CRS without nasal polyps (CRSsNP). CT showed opacification of at least one sinus in all of the patients and pan sinusitis was found in all of the patients.
Culture using Kirby Bauer technique for aerobic and anaerobic showed the most mixed bacterial infections in all of culture and sensitivities tests collected from middle meatus in all of the patients including Strept. Pneumoniae , Moraxeilla catarrhalis , Anaerobic streptococci , Pseudomonas aeraginosa , Haemophilus influenzae , Staphylococci , Klebsiella pneumonia , Diphtroid bacilli and Staph.pyogens.
The scores and levels of quality of life affection as well as scores of PHQ2 tool for assessing the risk of major depression and actual risk of depression. The average SNOT-22 score for quality of life affection was 69.14 ± 24.6. The level of quality of life affection was moderate in 265 (24.77%) and severe in 803 (75.23%) of participants with CRS. The mean score of PHQ-2 for assessing the risk of major depression was 4.17 ± 1.74 in participants with CRS. 216 (21.03%) were normal (not at risk of major depression) and 856 (78.97%) were at risk of major depression as showed in table (1).
The mean number of lost days of work in the preceding three months due to CRS was 3.30 and used to assess loss of productivity. 427 (66.5%) were never absent from work due to CRS, 111 (17.3%) were absent for less than 3 days due to CRS, 104 (16.2%) were absent for 3 days and more due to CRS.
The tested whether the severely impaired quality of life in CRS patients were associated with increased risk depression and lost productivity as showed in table (2). A significant difference in risk of depression was present between levels of quality of life affection (p < 0.001), where it has been observed that people with severely affected quality of life are at higher risk of depression than those with moderately affected quality of life (88% vs 12%). There was also an observed significant difference in the absences from work due to CRS within the levels of quality of life affection (p < 0.001). Higher rates of absences were found in the group with severely affected quality of life compared to the moderately affected quality of life (19.7% and 19.9% vs 10.1% and 5%).
According to the Kessler Psychological Distress Scale (10 items representing five psychological distress traits were assessed with a five-point scale) we found 759 patients (70.8%) were positive with a mean total perceived stress score of 16.92 ± 7.34, whereas 313(29.2%) were negative with a mean total perceived stress score of 6.08 ± 2.7. The difference was statistically significant (p < 0.001).