European Position Paper on Rhinosinusitis and Nasal Polyps 2020

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise. The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included.Peer reviewe

Control of Huanglongbing (HLB) disease with reference to its occurrence in Malaysia

The center of diversity for citrus was originally found on the northeastern India, eastward through the Malay Archipelago and south to Australia. Today citrus is produced in 140 countries, mainly between the north and south 40º latitudes. Citrus ranked first among fruit crops in the international trade based on value. Citrus production of the world is around 105 million tons per year. Orange ( Citrus sinensis) accounts for almost two thirds of the total citrus production (65%), followed by tangerine (Citrus reticulata) (21%), lemon (C. limon) (6%) and grapefruit (C. paradisi) (5.5%). Other significant commercially grown species are lime (C. aurantifolia), pummelo (C. grandis) and citron (C. medica). The largest citrus producers are Brazil (20%), United States (14%), China (12%), Mexico (6%) and the countries of the mediterranean basin (15%). Humidity and day-to-night temperature fluctuations influence which varieties are best adapted to an area. Most citrus fruits are produced for fresh market consumption and only around 30% is processed. Fresh fruits are rich in vitamin C which plays a vital role in prevention of scurvy. After extraction of the juice, the skin and fruit pulp can be used as livestock feed or making compost. The rind acid (oil) of the citrus is considered an expensive commodity in international trade (F.A.O 2003). Unfortunately, the citrus industry is threatened by 2 destructive diseases namely Witches’ Broom disease of lime (WBDL) and Huanglongbing (HLB) disease. WBDL has been known to be caused by Candidatus phytoplasma aurantifolia. It is one of the destructive diseases on citrus industry in the Middle East, India and Pakistan. It was reported in 1970 for the first time from lime orchard of Oman, united Arabian emirate (UAE) (1988), Iran (1998) and India and Pakistan (1999). WBDL is a phloem limited phytoplasma disease of lime. HLB disease causing citrus greening (Candidatus liberibacter spp.) is the second most severe disease on citrus industry all over the world. HLB has destroyed an estimated 60 million trees in Africa and Asia. More than 40 countries were infected by HLB in Africa, Asia and USA (Chau et al., 1996; Bove, 2006; Roux et al., 2006; Batool et al., 2007). The HLB pathogens are highly fastidious phloem-inhabiting bacteria in the genus Candidatus liberibacter. The bacteria have not been cultured yet in laboratory media and do not survive outside the host cells. Three types of phloem limited bacteria causing HLB disease have been described and identified (Bove, 2006). The isolate from South Africa (Candidatus liberibacter africanus) is considered heat-sensitive and found in Africa. It is vectored by African citrus psyllid (Trioza erytreae) and was described by Guercio in 1918. The isolate from Asia (Candidatus liberibacter asiaticus) is more severe and widespread; it is vectored by Asian psyllid (Diaphorina citri Kuwayama) (Garnier et al., 2000). This type of HLB is heat-tolerant (Garnier et al., 2000). It can show the symptom on humid, cool and hot temperature, up to 35ºC (Garnier et al., 2000; Bove 2006; Le Roux et al., 2006). The isolate from America has been named Candidatus liberibacter americanus; it was detected in Brazil and Florida (Coletta-Filho et al., 2005; Texeira et al., 2005)

A Critical Study of Tafsir Al-Manar (Interpretation of the Holy Quran) Regarding the Miracles of Prophet Ibrahim (PBUH) and Prophet Moses (PBUH)

The role of Intellect or Aql in the interpretation of the Holy Quran has been greatly considered by Islamic scholars through history. Some past and contemporary scholars have attempted to interpret the Quran using reason, such as Tafsir Al-Manar (the interpretation of the Holy Quran) written by Mohammad Rashid Rida. Since the perception of Muhammad Rashid Rida and his teacher Muhammad Abduh regarding the prophets' miracles are different from many commentators, it is important to examine Al-Manar's interpretive concerning the miracles of prophets including Prophet Ibrahim (AS) and Prophet Moses (AS). This article examines Tafsir Al-Manar with a descriptive-analytical method in order to assess the accuracy of Muhammad Abduh's and Rashid Rida's comments. In examining Mohammad Rashid Rida's point of view, we found that his rational interpretations are inconsistent with the Quran's appearance, Shiite and Sunni commentators. The interpretations also lack attention to the purpose of the story. The denial in their interpretations indicate their improper use of a rational interpretative method, which otherwise, would not have led to the denial of the prophets' miracles