Effect of vitamin D3 in chronic rhinosinusitis with nasal polyps

INTERVENTION: Intervention1: Standard treatment of Chronic Rhinosinusitis with Nasal Polyps AND Vitamin D3 ‐ 60,000 IU weekly: Prescribe intranasal corticosteroids for 1 month. Evaluate for surgery at the end of 1 month. Post‐op surgical care in case the patient undergoes surgery. Perform saline nasal irrigation on initial visit and follow‐up visits. Prescribe 60,000IU weekly dose of vitamin D3 for 3 months or till 8 weeks post‐op. Control Intervention1: Standard treatment of Chronic Rhinosinusitis with Nasal Polyps: Prescribe intranasal corticosteroids for 1 month. Evaluate for surgery at the end of 1 month. Post‐op surgical care in case the patient undergoes surgery. Perform saline nasal irrigation on initial visit and follow‐up visits. CONDITION: Health Condition 1: J339‐ Nasal polyp, unspecified PRIMARY OUTCOME: Change in Lund‐Kennedy Endoscopic Score.Timepoint: Baseline Day 0 and Day 90 for patients managed medically. ; ; Baseline Day 0, 1 week, and 8 weeks after FESS for patients undergoing surgery. SECONDARY OUTCOME: Change in nasal cytologyTimepoint: Baseline Day 0, Day 28 for patients proceeding to FESS, Day 90 for patients managed medically, and 8 weeks post‐operatively for patients undergoing FESS. SNOT‐22 scoreTimepoint: Baseline Day 0, Day 28, and Day 90 Surgical conversion rateTimepoint: Assessed over the 90‐day follow‐up period INCLUSION CRITERIA: Clinically confirmed cases of Chronic Rhinosinusitis with Nasal Polyps as per EPOS guidelines. The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 defines Chronic Rhinosinusitis with Nasal Polyps as inflammation of the nose and paranasal sinuses lasting for more than 12 weeks with bilateral, endoscopically visualized polyps in the middle meatus. Diagnosis requires two or more cardinal symptoms, one of which must be nasal blockage or nasal discharge, accompanied by objective evidence of mucosal disease via nasal endoscopy or CT scan.