Dr. Dhirendra Singh Kushwah

An estimated 10 to 30 percent of people across the world suffer from Allergic rhinitis. Allergic rhinitis, more commonly known as hay fever, is a condition wherein the immune system overly responds to allergens resulting in inflammation in the nose. As you might be aware, an allergen is typically a harmless substance present in the surroundings causing an uncomfortable allergic reaction.

Following is a detailed account of the condition.

Symptoms-
Some of the most common symptoms of allergic rhinitis include,

1. Sneezing
2. Stuffy and runny nose
3. Persistent coughing
4. Itchy and watery eyes
5. Sore throat
6. Frequent headaches
7. Dark circles under the eyes
8. And, symptoms associated with eczema

Further, it also results in hives and excessive fatigue. An allergic person is likely to feel many of these symptoms within a few minutes of coming into contact with an allergen. Some symptoms, such as recurrent fatigue and headaches can only happen when there is long-term exposure to allergens. There are some people, who rarely undergo any signs, and this happens when a person is exposed to the allergens in massive quantities.

Causes of Allergic Rhinitis:
When the body comes in contact with the allergen, it triggers the release of histamine which is a natural chemical that defends the body from the allergen. This histamine can lead to allergic rhinitis and the associated symptoms which may range from a blocked or a runny nose to itchy eyes. Common allergens include pollen, dust mites, animal dander, grass pollen, and mold.

There are two variants of allergic rhinitis- seasonal and perennial.

1. Seasonal- Seasonal allergies usually occur during specific seasons owing to the response to outdoor allergens. For example, during a specific time in the year such as spring, the pollen can cause allergies in a person. Also, when trees and flowers release pollens during the fall and summer, seasonal allergic rhinitis can be seen on the rise.
2. Perennial- On the other hand, perennial allergens tend to linger all-round the year, and pet dander, mold or dust mites come under perennial allergic rhinitis causing allergens.

Diagnosing and treating allergic rhinitis-
When a person is suffering from minor allergies, a physical exam may be required. But a doctor may also perform some tests for identifying the best course of treatment as well as prevention plan for a particular patient. A skin prick test is one of the best ways to determine whether you have allergic rhinitis.

This health issue can be treated in a variety of ways which range from home remedies to medications to alternative therapies. Common medications include antihistamines, decongestants and nasal sprays and eye drops.

Staying away from a known allergen is the best possible way to prevent allergic rhinitis. When diagnosed, it is necessary to consult your doctor as the condition may sometimes lead to complications.

Loss of hearing cannot be reversed or cured. However, it can be treated. Even people who have lost all hearing can hear sounds again with the help of modern medicine. Treatment for hearing loss depends on a number of factors. This includes the type of hearing loss, the severity of hearing loss, budget etc. The most common treatment options for a loss of hearing are:

Removal of Wax Blockage: Ear wax that accumulates in the inner ear canal is a common cause for temporary loss of hearing. In such cases, cleaning the ear wax can help restore hearing. This should not be attempted at home as damaging the ear canal can result in a permanent hearing loss. To remove the ear wax, a doctor will need to loosen it with oil and then suction out the softened wax.

Surgery: Loss of hearing caused due to a traumatic ear injury can be treated with surgery. This usually involves the insertion of small tubes to help fluid drain out of the ear. This surgery may also be beneficial in the case of temporary loss of hearing caused by recurrent infections.

Hearing Aids: Permanent loss of hearing is usually caused by damage to the inner ear. In such cases, a hearing aid can help. There are many different types of hearing aids available. These hearing aids work by amplifying the sound received and thus making it easier for a person to hear. Hearing aids are removable and can be taken off whenever needed. The most common types of hearing aids are:

1. Behind the ear hearing aids – These are large, powerful hearing aids that are used to treat severe loss of hearing.
2. In the ear hearing aids – These are small hearing aids that fit within the outer ear and can be used to treat mild to severe loss of hearing.
3. In canal hearing aids – These are very small hearing aids that fit inside the ear canal and are thus not visible from outside. They are used to treat mild to moderate loss of hearing.

Cochlear Implants: Severe hearing loss caused by irreparable damage to the inner ear canal can be treated with a cochlear implant. This works by amplifying sounds and transmitting them to the auditory nerves while bypassing the damaged ear canal. A cochlear implant needs to be surgically inserted behind the ear and can be used by children and adults. Cochlear implants have been successfully used to treat people who were born with a loss of hearing. In case you have a concern or query you can always consult an expert & get answers to your questions!

While a sizeable population suffers from allergy issues every year, treating them is often possible without an extensive diagnosis. However, diagnosis of the allergen becomes crucial when the problem recurs several times in a year.

The skin prick testing is a reliable means of diagnosing the IgE-mediated (immunoglobulin E) allergic disease in people who have asthma, urticaria, rhinoconjunctivitis, atopic eczema, anaphylaxis, and drug allergy.

It offers evidence for confirming the diagnosis of the type I allergy. The best aspect of allergy testing by skin prick method is that it is minimally invasive, inexpensive and the results are immediately available when carried out by trained professionals.

Why is skin prick test conducted?
Skin prick test is usually used for diagnosing the food allergy symptoms which are typically caused by the interaction between a food allergen and the IgE antibody. To diagnose a food allergy, the allergy expert may recommend you undergo a skin prick test for measuring the number of antibodies present.

What can you expect?
During the skin prick test, the allergist places a drop of solution which contains the food allergen on the back or the forearm. When testing the fruits and vegetables, food is used in place of solution. In this allergy testing method, the doctor would use a needle or a plastic probe for gently pricking or scratching the skin for allowing a small amount of solution to penetrate the skin surface. This method is not painful, and no bleeding is involved in it. Though many people think that the process would cause much discomfort, the reality is that it feels similar to a scratch caused by fingernails.

On the basis of the case history, a patient may need to be tested for just one or many foods. The results are almost immediate; You can get them within half-an-hour of the test. The positive results of the test are indicated by a wheal which causes a raised white bump encircled by a small circle of itchy red skin. Though the size of the wheal is not the accurate indicator, a large wheal generally indicates that the patient is affected by food allergy.

How accurate is skin prick testing?
The skin prick allergy testing hardly produces any false negatives which indicate that you are not allergic to a food. Having negative results is synonymous with not being allergic to the food for which you are tested. On the other hand, positive results are also not always accurate. About 50 percent of cases show false positives which mean the positive result is shown even though you are not allergic to that particular food.

This simple test can be the means of identifying the allergens which will help determine the allergy prevention plan. Consulting an allergist before undergoing the test is essential.

Sinusitis or sinus is an infection in which your nasal passage becomes inflamed and congested. The main cause of the health problem is due to a virus. But there are rare cases in which the infections are caused by a bacteria or in even rarer cases by a fungus. Some health conditions including tooth problems, allergies and nasal polyps can also result in sinus problems. Here are some of the effects of sinus on your health.

1. Headaches: Headaches are one of the primary and most common effects that sinus brings upon your health. The headaches result mainly because your nasal passage becomes completely blocked if you suffer from a sinus infection. The headaches are usually more adverse in the morning. The main reason behind this is that the fluids in your body accumulate in your sinus at night as you lay down for a long period of time. These type of headaches usually get worse when you are traveling due to a sudden change in the air pressure.
2. Facial Pain: Facial pain along with an excruciating headache sometimes becomes unbearable in people who have sinus problems. When you have an infection in your sinus and it swells, it causes an immense amount of pressure on your facial region which leads to the pain. The pain continues between your jaws, your eyes, on both sides of your nose. You may sometimes experience pain in your teeth as well. The bridge of the nose and the region under your eyes may seem puffy due to the fluid accumulation.
3. Nasal Discharge: The nasal discharge is more frequent and you will end up blowing your nose number of times than usual. You may also experience as postnasal drip. This is a special condition in which the mucus is seen dripping at the end of your throat because of which may make ticklish. This happens because of the excessive buildup of discharge in your nasal region. The postnasal drip sometimes also leads to a hoarseness in the voice and you may have to clear your throat from time to time.
4. Cough: A cough usually results from postnasal drip. Coughing usually aggravates at night as the postnasal drip goes down the throat and tickles the nerves of the nasopharynx which often triggers a cough.
5. Extreme Fatigue: The fatigue is a common side effect of sinus problem since your body employs your immune system to fight off the virus and uses up body's energy in the process leaving you tired. The postnasal drip and headaches often lead to poor sleep which makes you feel even more tired.

So, these are some of the effects that sinus problems can cause on your health. But with proper care and medical assistance, you can combat the problems effectively.

In case you have a concern or query you can always consult an expert & get answers to your questions!

While a sizeable population suffers from allergy issues every year, treating them is often possible without an extensive diagnosis. However, diagnosis of the allergen becomes crucial when the problem recurs several times in a year.

The skin prick testing is a reliable means of diagnosing the IgE-mediated (immunoglobulin E) allergic disease in people who have asthma, urticaria, rhinoconjunctivitis, atopic eczema, anaphylaxis, and drug allergy.
It offers evidence for confirming the diagnosis of the type I allergy. The best aspect of allergy testing by skin prick method is that it is minimally invasive, inexpensive and the results are immediately available when carried out by trained professionals.

Why is skin prick test conducted?
Skin prick test is usually used for diagnosing the food allergy symptoms which are typically caused by the interaction between a food allergen and the IgE antibody. To diagnose a food allergy, the allergy expert may recommend you undergo a skin prick test for measuring the number of antibodies present.

What can you expect?
During the skin prick test, the allergist places a drop of solution which contains the food allergen on the back or the forearm. When testing the fruits and vegetables, food is used in place of solution. In this allergy testing method, the doctor would use a needle or a plastic probe for gently pricking or scratching the skin for allowing a small amount of solution to penetrate the skin surface. This method is not painful, and no bleeding is involved in it. Though many people think that the process would cause much discomfort, the reality is that it feels similar to a scratch caused by fingernails.

On the basis of the case history, a patient may need to be tested for just one or many foods. The results are almost immediate; You can get them within half an hour of the test. The positive results of the test are indicated by a wheal which causes a raised white bump encircled by a small circle of itchy red skin. Though the size of the wheal is not the accurate indicator, a large wheal generally indicates that the patient is affected by food allergy.

How accurate is skin prick testing?
The skin prick allergy testing hardly produces any false negatives which indicate that you are not allergic to a food. Having negative results is synonymous with not being allergic to the food for which you are tested. On the other hand, positive results are also not always accurate. About 50 percent of cases show false positives which mean the positive result is shown even though you are not allergic to that particular food.

This simple test can be the means of identifying the allergens which will help determine the allergy prevention plan. Consulting an allergist before undergoing the test is essential. In case you have a concern or query you can always consult an expert & get answers to your questions!

The symptoms of allergic asthma, allergic rhinitis, and conjunctivitis and stinging insect allergy can often cause severe discomfort, and one can consider Allergen immunotherapy or allergy shots, as a long-term treatment option to manage the conditions.

Allergy shots reduce the sensitivity to allergens and often help in relieving allergy symptoms even when the treatment is over. This makes the process of allergy vaccination a cost-effective and beneficial treatment approach for many people suffering from various forms of allergy.

Who should consider taking allergy vaccination?
Both adults, as well as children, can receive immunotherapy and allergy vaccination but the latter is generally not advised for the children under the age of five. This is because children below the age of five are not prepared to co-operate with the treatment plan and articulating the adverse reactions that they have been experiencing. It is essential to consider the medical condition of the concerned patient such as cardiac disease and others that may interfere with the vaccinations. Another point that is worthy of mention is that allergy vaccination cannot be used for treating food allergies and the best way to avoid food allergy is to avoid the food one is allergic to.

How does allergy vaccination work?

1. Build-up phase: This is the initial phase where the injection is given in an increasing amount of a particular allergen for two or three times in a week. The duration of this phase is dependent on how often the injections are given and typically range from 3 to 6 months.
2. Maintenance phase: This is the second phase in which effective dose is achieved. The dosage and duration depend on the level of the allergen sensitivity as well as the response of the build-up phase. During this particular phase, there is typically a longer gap between the treatments ranging from two to four weeks. An allergy specialist can decide the most suitable range for you.

The patient will be able to notice a reduction in the symptoms during the build-up phase, but it may take around a year on the maintenance dose to see an improvement. In case the allergy shots are successful, the maintenance treatment is generally continued for three to five years.

As allergy shots bring about a reduction in the symptoms of numerous allergies and can inhibit the progression of allergic diseases ranging from asthma to allergic rhinitis, they can be highly beneficial for those with severe allergies that tend to be unmanageable.

In case you have a concern or query you can always consult an expert & get answers to your questions!

The human ear is divided into three parts, namely the outer, middle and inner ear. All these parts function in coherence with each other and help us in converting vibrations into sound and information. The middle ear consists of the air space between the inner ear and the outer ear and contains the bones that transmit the vibrations of the outer ear and translate them into information. This area is prone to infections, especially among children and thus may cause discomfort or pain. 

Symptoms of middle ear infections: Middle ear infections primarily tend to manifest themselves as inflammation of the tissues and buildup of fluids. Some of the symptoms are mentioned below.

Infections in children: Middle ear infections primarily occur in children although it can occur in adults as well. Some of the common symptoms could be:

• Ear pain either sitting or standing up and especially while lying down
• Irritability and crying, which in infants could translate to more than usual crying 
• Problems with sound and difficulties in hearing
• Fluid buildup causing balance related problems
• Discharge of fluid in certain cases
• Unable to sleep and also loss of appetite
• In some cases children may have high fever

Causes of middle ear infections: The primary cause of middle ear infection is due to the presence of bacteria or virus in the area. The Eustachian tube, which runs from the middle ear to the back of the throat, is connected to nasal passages as well. Any infection that affects the throat or the nose may also affect the middle ear through this tube. Primary causes for the infections could be

• Cold or flu like symptoms, which then infect the middle ear as well
• Otitis media, which is the buildup of fluid and inflammation either due to the presence of bacteria and viruses or even without it
• Seasonal infections, which are common during late autumn or winters
• Air pollution is also known to be a factor
• Infection from others, especially in the case of children when they are part of a group care
• Children from 6 months to 2 years are also susceptible to middle ear infections as their immune systems are much less developed.

Treatment of middle ear infections: Usually, middle ear infections resolve on their own within a day or so. You can try warm compress with a soft piece of cloth to ease the pain. However, if pain persists for too long then antibiotic medications may be required to fight the infection with pain relief medications to lessen the pain and discomfort. In case you have a concern or query you can always consult an expert & get answers to your questions!

Acoustic neuroma is a benign tumor that occurs in the primary nerve between the brain and the ear. The tumor progresses very slowly and can influence your balance and hearing. In certain cases, if the tumor becomes very large, then it may also impair vital functions of the body.

Symptoms-

The symptoms of acoustic neuroma tend to develop when the tumor starts to press on the nerve and its adjoining branches. The symptoms of this disorder are

1. You may experience hearing loss on one side which might worsen gradually.

2. You may have problems in balancing yourself.

3. A continuous ringing sound in the ears.

4. Persistent dizziness.

5. If the tumor is large and presses on the nearby nerves, then you may experience numbness of the facial muscles.

6. In some cases, it may impair the vital functions of the body.

This disorder is caused by a malfunctioning gene. There is no documented reason as to why the gene malfunctions.

The treatment options for this disorder are

1. Constant Monitoring: These tumors tend to grow very slowly but might spurt in some cases. In order to prevent damage to your body, they need to be monitored on a regular basis. Imaging tests are recommended on a periodic basis to determine the growth of the tumor.

2. Radiosurgery: Stereotactic radiosurgery is done to treat acoustic neuroma that is small in size. In this surgery, radiation is directed at the tumor without creating an incision. It is done to limit the growth of the tumor and preserve your hearing.

Surgery: The tumor can be removed by using surgical procedures. It involves administering general anesthesia, followed by removing the tumor through an incision on the skull or the inner ear. Surgery is used to remove the tumor and preserve your hearing abilities. This technique is suitable for a patient under 65 yr of age, moderately large or large tumor growing stage, significant hearing loss and severe headache.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Adenoidectomy is a surgical procedure to remove the adenoid. The adenoid is a lymphoid tissue which is present on the roof of the mouth; its role is to produce antibodies to protect the body against infections. Usually the adenoid lymphoid tissue diminish during your adolescence and disappear by the time you are an adult. Respiratory and throat infections that are chronic in nature, are the main causes of infection in the adenoid lymphoid tissue.

Adenoidectomy can be performed, one of any mentioned techniques:

1. Curette technique 
2. Debrider assisted adenoidectomy 
3. Coblation assisted Adenoidctomy

Reason for the removal of adenoids
Throat infections that occur frequently can lead to the enlargement of the adenoid lymphoid tissue. When these lymphoid tissue become enlarged, it results in breathing problems and blockage of the Eustachian tubes. Blocked Eustachian tubes can cause infections in the ear which, in turn, causes severe hearing problems.

The procedure
The surgical procedure is performed under general anesthesia in an outpatient mode. The removal of the adenoid lymphoid tissue takes place through the mouth. Initially, a small instrument is put inside the mouth to keep it open. After this, the adenoids are located in the mouth, following which they are scrapped off with a curette or by applying heat to the area by the process of diathermy (a technique to stimulate circulation by heating up a part of the body with the application of localized heat currents). Once the procedure is completed, you will be discharged on the same day.

Post procedure
Post-surgery, you may experience a sore throat for a few weeks. You must drink plenty of fluids to prevent dehydration. Keeping yourself hydrated also helps relieve symptoms of post-surgical pain, if any. Oily and spicy foods should also be avoided as it may cause pain inside the mouth. Applying ice can also relieve pain symptoms. However, don’t apply ice directly wrap it in a cloth and then apply it on the neck. Do not undertake any stressful or strenuous activity for 7-10 days post-surgery to further facilitate the recovery process. Post-surgery, the risks of throat and ear infections are greatly reduced. Breathing through the nose also becomes relatively easier.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Loss or impairment of hearing can happen due to a variety of causes and may be temporary or permanent in nature, depending on the type and severity of the condition. One of the most common causes of hearing impairment is age. The degeneration of one's vital organs and senses becomes a reality for many people as the advancement of age happens, and the delicate insides of the ears are no different. Noise pollution, injury to the ear drum or any other part of the ear, as well as the movement of particles inside are only a few of the many reasons for loss of hearing. One of the many ways of dealing with long term hearing impairment is by using a hearing aid.

Read on to know how you can regain your hearing with hearing aids:

1. Long Forgotten Sound: A hearing aid will help you reacquaint yourself with long forgotten and subtle sounds that you may not have been able to hear for a long time. Many times, this kind of impairment also makes us forget to notice the fact that we do not hear so many normal sounds in our everyday lives - sounds that we probably did not notice even earlier. This may include the whirring of a fan, the whoosh of the air, the pitter patter of pets' feet and so much more. A hearing aid will help in bringing about an adjustment to these sounds that you will actually end up discovering again.
2. Technicalities: The hearing aid basically works by letting your hearing and ears readjust to the various volumes, intensity and vibrations that one feels when different sounds reach the ears. This helps in hearing better.
3. Amplification: A hearing aid is basically an electroacoustic device that fits in neatly behind your ear where it is tucked away from plain sight. This device helps in amplifying sounds so that you can catch them and hear them more clearly.
4. Modulation: The ENT specialist will usually prescribe a certain kind of hearing aid based on your individual condition in terms of volume, size, power and circulation. These factors help in modulating the sounds in a certain way so that they reach the nerve pathways from the inner ear and travel to the brain in a proper and effective way. This is usually done in a customised way to cater to the specific type and cause of your hearing loss.

Using a hearing aid is a matter of retraining your hearing rather than restoring it completely. These aids will be helpful in regaining a better sense of hearing within the condition you are going through, rather than reversing the condition completely. If you wish to discuss about any specific problem, you can consult an Ent Specialist.