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Dr. Payal Garg

ENT Specialist, Delhi

550 at clinic
Dr. Payal Garg ENT Specialist, Delhi
550 at clinic
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My experience is coupled with genuine concern for my patients. All of my staff is dedicated to your comfort and prompt attention as well....more
My experience is coupled with genuine concern for my patients. All of my staff is dedicated to your comfort and prompt attention as well.
More about Dr. Payal Garg
Dr. Payal Garg is a renowned ENT Specialist in Tis hazari, Delhi. He is currently associated with Dr. Payal Garg@St Stephens Hospital in Tis hazari, Delhi. Book an appointment online with Dr. Payal Garg on Lybrate.com.

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Hindi

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St Stephens Hospital

St. Stephen's Hospital Landmark : Near kashmiri GateDelhi Get Directions
550 at clinic
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Hi, I m 25 yrs old girl, I have loss my sense of smell from past 10 years and having sneezing problem continuously 7 to 10 times during waking up and after taking bath and at evening time, continuously water following from nose & eyes also nose block at sneezing time, please advise me how I can get sense of smell with also well!

MS - ENT(Gold Medalist), MBBS
Ear-Nose-Throat (ENT) Specialist, Delhi
Most likely you are having polyps in nose that is causing anosmia (loss of smell. Get a ct scan done to find out underlying pathology and review with report.
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What medicine to take for the pain in the lower ear and difficulty in swallowing.

MBBS
General Physician, Faridabad
What medicine to take for the pain in the lower ear and difficulty  in swallowing.
take 1 tab Levofloxine 500 od and 1 tab Sinarest at night for 5 days. Additionally steam inhalation, saline (salt water) gargles will help. Thank you.
1 person found this helpful
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He is having cough from last 3 or 4 days Before that fever, sore throat and cold was there But now he is only suffered from cough mostly affect at night time please tell any effective medicines for relief.

DAA, DNB
Pulmonologist, Bangalore
He is having cough from last 3 or 4 days
Before that fever, sore throat and cold was there
But now he is only suffere...
Hi. I understand your concerns. He may be having viral infection. Try steam inhalation and betadine gargle. Hope your questions were answered. Thanks.
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Sinusitis: Management and Prevention

MBBS, Diploma in Diabetology
Endocrinologist, Tumkur
Sinusitis: Management and Prevention

Sinusitis: Management and Prevention

Sinusitis is infl ammation of the mucous membranes lining one or more of the paranasal sinuses. The various presentations are as folllows:
● acute sinusitis: infection lasting less than 30 days, with complete resolution of symptoms
● subacute infection: lasts from 30 to 90 days, with complete resolution of symptoms
● recurrent acute infection: episodes of acute infection lasting less than 30 days, with resolution of symptoms, which

Recur at intervals of at least 10 days apart
● chronic sinusitis: infl ammation lasting more than 90 days, with persistent upper respiratory symptoms
● acute bacterial sinusitis superimposed on chronic sinusitis:

New symptoms that occur in patients with residual symptoms from prior infection (s). With treatment, the new symptoms resolve but the residual ones do not.
Physical findings and clinical presentation
● patients often give a history of a recent upper respiratory illness with some improvement, then a relapse.
● mucopurulent secretions in the nasal passage
● purulent nasal and postnasal discharge lasting more than 7 to 10 days
● facial tightness, pressure, or pain
● nasal obstruction
● headache
● decreased sense of smell
● purulent pharyngeal secretions, brought up with cough, often worse at night
● erythema, swelling, and tenderness over the infected sinus in a small proportion of patients
● diagnosis cannot be excluded by the absence of such findings.
● these fi ndings are not common, and do not correlate with number of positive sinus aspirates.
● intermittent low-grade fever in about one half of adults with acute bacterial sinusitis
● toothache is a common complaint when the maxillary sinus is involved.
● periorbital cellulitis and excessive tearing with ethmoid sinusitis
● orbital extension of infection: chemosis, proptosis, impaired extraocular movements.

Characteristics of acute sinusitis in children with upper respiratory tract infections:
● persistence of symptoms
● cough
● bad breath
● symptoms of chronic sinusitis (may or may not be present)
● nasal or postnasal discharge
● fever
● facial pain or pressure
● headache
● nosocomial sinusitis is typically seen in patients with nasogastric tubes or nasotracheal intubation.

Cause
● each of the four paranasal sinuses is connected to the nasal cavity by narrow tubes (ostia), 1 to 3 mm in diameter; these drain directly into the nose through the turbinates. The sinuses are lined with a ciliated mucous membrane (mucoperiosteum).
● acute viral infection
● infection with the common cold or infl uenza
● mucosal edema and sinus infl ammation
● decreased drainage of thick secretions, obstruction of the sinus ostia
● subsequent entrapment of bacteria

A. Multiplication of bacteria
B. Secondary bacterial infection

Other predisposing factors
● tumors
● polyps
● foreign bodies
● congenital choanal atresia
● other entities that cause obstruction of sinus drainage
● allergies
● asthma
● dental infections lead to maxillary sinusitis.
● viruses recovered alone or in combination with bacteria (in 16% of cases):
● rhinovirus
● coronavirus
● adenovirus
● parainfluenza virus
● respiratory syncytial virus
● the principal bacterial pathogens in sinusitis are streptococcus pneumoniae, nontypeable haemophilus influenzae, and moraxella catarrhalis.
● in the remainder of cases, fi ndings include streptococcus pyogenes, staphylococcus aureus, alpha-hemolytic streptococci, and mixed anaerobic infections (peptostreptococcus, fusobacterium, bacteroides, prevotella).

Infection is polymicrobial in about one third of cases.
● anaerobic infections seen more often in cases of chronic sinusitis and in cases associated with dental infection; anaerobes are unlikely pathogens in sinusitis in children.
● fungal pathogens are isolated with increasing frequency in immunocompromised patients but remain uncommon
Pathogens in the paranasal sinuses. Fungal pathogens include aspergillus, pseudallescheria, sporothrix, phaeohyphomycoses, zygomycetes.
● nosocomial infections occur in patients with nasogastric tubes, nasotracheal intubation, cystic fi brosis, or those who are immunocompromised.
● s. Aureus
● pseudomonas aeruginosa
● klebsiella pneumoniae
● enterobacter spp.
● proteus mirabilis

Organisms typically isolated in chronic sinusitis:
● s. Aureus
● s. Pneumoniae
● h. Infl uenzae
● p. Aeruginosa
● anaerobes

Differential diagnosis
● migraine headache
● cluster headache
● dental infection
● trigeminal neuralgia

Workup
● water’s projection: sinus radiograph
● ct scan
● much more sensitive than plain radiographs in detecting acute changes and disease in the sinuses
● recommended for patients requiring surgical intervention, including sinus aspiration; it is a useful adjunct to
 

Guide therapy:
● transillumination
● used for diagnosis of frontal and maxillary sinusitis
● place transilluminator in the mouth or against cheek to assess maxillary sinuses, and under the medial aspect of the supraorbital ridge to assess frontal sinuses.
● absence of light transmission indicates that sinus is filled with fluid.
● dullness (decreased light transmission) is less helpful in diagnosing infection.
● endoscopy
● used to visualize secretions coming from the ostia of infected sinuses
● culture collection via endoscopy often contaminated by nasal flora; not nearly as good as sinus puncture
● sinus puncture
● gold standard for collecting sinus cultures
● generally reserved for treatment failures, suspected intracranial extension, nosocomial sinusitis.

Treatment Nonpharmacologic therapy
● sinus drainage
● nasal vasoconstrictors, such as phenylephrine nose drops, 0.25% or 0.5%

● topical decongestants should not be used for more than a few days because of the risk of rebound congestion.
● systemic decongestants
● nasal or systemic corticosteroids, such as nasal beclomethasone, short-course oral prednisone
● nasal irrigation, with hypertonic or normal saline (saline may act as a mild vasoconstrictor of nasal blood fl ow)
● use of antihistamines has no proved benefi t, and the drying effect on the mucous membranes may cause crusting,

Which blocks the ostia, thus interfering with sinus drainage.
● analgesics, antipyretics.

Antimicrobial therapy
● most cases of acute sinusitis have a viral cause and will resolve within 2 weeks without antibiotics.
● current treatment recommendations favor symptomatic treatment for those with mild symptoms.
● antibiotics should be reserved for those with moderate to severe symptoms who meet the criteria for diagnosis of

Bacterial sinusitis.

● antibiotic therapy is usually empirical, targeting the common pathogens.
● first-line antibiotics include amoxicillin, tmp-smz.
● second-line antibiotics include clarithromycin, azithromycin, amoxicillin-clavulanate, cefuroxime axetil, loracarbef, ciprofloxacin, levofloxacin.
● for patients with uncomplicated acute sinusitis, the less expensive first-line agents appear to be as effective as the

Costlier second-line agents.

Surgery
● surgical drainage indicated
● if intracranial or orbital complications suspected
● for many cases of frontal and sphenoid sinusitis
● for chronic sinusitis recalcitrant to medical therapy
● surgical débridement imperative for treatment of fungal sinusitis

2 people found this helpful

Whenever I used to walk in crowded or dust full or in areas where any type of smoke is present my nose starts bleeding. What should I do?

ECFMU, MS - ENT, MBBS, Certificate in Pediatric Otolaryngology - Head and Neck Surgery, Robotic Surgery Familiarization (France)
Ear-Nose-Throat (ENT) Specialist, Gurgaon
Allergic nose. Get cauterized nasal septum and turbinate reduction, your symptoms will be suppressed fr a long time.
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I am 24 year old male and I have sinus problem from 2years please suggest some medicine.

MBBS
General Physician, Cuttack
Do steam inhalation 2-3 times daily.Take paracetamol if you have headache.Take X ray PNS TO confirm sinusitis. Consult doctor
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I am having sinusitis since past three years once I had dengue and had gone under platelets transfusion. I am chronic patient of gastritis and many a times I am OK and certain times it gets aggravated.

MBBS
General Physician, Mumbai
Apart from taking symptomatic treatment I will suggest you to buy a steam inhaler machine of crescent company and Take a flow of steam (of plain water only) over the forehead through the inhaler and can repeat the process after eight hours as and when required.
1 person found this helpful
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Hello doctor! . Doctor my problem is my ears. My ears is all time listen a sound its beep then anybody say me but I can not lessen them help me please.

MBBS, cc USG
General Physician, Gurgaon
Hello doctor! . Doctor my problem is my ears. My ears is all time listen a sound its beep then anybody say me but I c...
It seems to be due to wax and wax is removed by ear drop and if wax is not coming outside by using ear drops, a small procedure name syringing is required for removal of wax Consult ENT doctor.
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My sister met with a bike accident last month and suffered minor fracture on nose. Resulting in stitches on nose. Now she is worried about the mark on nose. Is there any tube available to remove the mark from her nose. please tell me as she is worried about her beautiful nose.

MS - ENT, MBBS
Ear-Nose-Throat (ENT) Specialist, Mumbai
My sister met with a bike accident last month and suffered minor fracture on nose. Resulting in stitches on nose. Now...
We need to assess the level of scar to suggest you any tubes. Please see a plastic surgeon and he might give after examining.
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My friend is suffering for sinus problem from yesterday, due to heat and delay in meal problems. Which is showing symptoms of migraine too, like headaches, vomit etc. She has taken paracetamol. But feeling very weak. Please suggest a proper solution ASAP.

BHMS
Homeopath, Raebareli
Please take nux vom 30 - at an interval of one hour upto 2 doses now. Also take regular meals and plenty of water.
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I can't resist Sudden weather change during monsoon it causes throat burn pain and head pain above eyes. How could I overcome it?

General Physician, Agartala
I can't resist Sudden weather change during monsoon it causes throat burn pain and head pain above eyes. How could I ...
I undertand you're visibly troubled by this seasonal illness. However, this is easily explained by a condition called acute rhinosinusitis. Altered body immunity combined with pollen in the air from plants and roadside weeds can trigger the body to respond in a defensive way leading to swelling of the membranes of your nose, throat and sinuses. These swollen membranes then secrete mucous which gets accumulated within these sinuses leading to headache. Preventing this would be possible by covering your face with a balaclava mask or a scarf when riding your bike or going out in dusty places. If inspite of preventive measures this were to occur, steam inhalation helps in opening up sinuses leading to drainage of these accumulated secretions hence relieving the headache that causes you discomfort. Hope this answers your query. Feel free to contact me if there's any query.
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I have issues with my speech. While speaking, the words that contain C or S, air blows through nose which is blocked due to tonsillitis and heavy cough. Is there a way except speech therapy to cure it. I am okay with operation if that cures it 100%.

Masters in Audiology
Speech Therapist, Jaipur
If you hv any anatomy problem in your nose than go for operation otherwise go for speech therapy only.
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I smoke and drink regular I think because of this I regularly suffer from serious throat infection Which is very painful then usually I take antibiotics tablet for that.

MD - Alternative Medicine
Alternative Medicine Specialist, Mumbai
I smoke and drink regular I think because of this I regularly suffer from serious throat infection Which is very pain...
hello, Its a better for you to stop Smoke n Drink , any antibiotics / Pain killer is not permanent solution for your case. Stay healthy - Naturally
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My frnd is having cold from many days. Even his tonsil is swollen. He gets better when medicine is taken bt cold do not get better what to do.

MBBS
General Physician, Mumbai
Few tips for cold - Avoid any triggering factor, take folic acid regularly, eat a healthy diet , always be stress free , exercise regularly
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When I record my voice and listen to that so It Sounds as I am speaking through my nose and it really pisses me off. I can't speak clearly and many words stuck im mouth pls let me how can I get over on this and I have nasal allergy problem as well.

Masters in Clinical Psychology
Psychologist, Pune
When I record my voice and listen to that so It Sounds as I am speaking through my nose and it really pisses me off. ...
Hi lybrate-user, You need build confidence, there are people speak with their nose or sound so, there is no problem in that, you have to feel good about yourself. All the above mentioned problems are due to lack of confidence. We always can work on that and for that we need to speak more, there are certain therapies and session where we can work upon your confidence and voice. Feel free to contact me Thanks,
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Am feeling like vertigo previously I have a b12 deficiencyam not able to stand constantly in one place.

MBBS
General Physician, Mumbai
Take tablet vertin 8 mg 1-1 for five days and take injection vitcofol 2cc intramuscularly every alternate days for five pricks
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While travelling by plane, I get severe ear pain. What precaution should I take as I have to travel for 20 hours by plane soon?

Master of Surgery, Post Graduate Diploma in ENT, MBBS
Ear-Nose-Throat (ENT) Specialist,
While travelling by plane, I get severe ear pain. What precaution should I take as I have to travel for 20 hours by p...
It occurs mostly while decending down. Keep chewing gum with you. Before decending, try sips of hot water. 30 minutes before, use otrivin nasal spray in both the nose. Also, keep chew chewing gum while the plane is landing. Also do Valaslva frequently when you have ear pain.
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I have a continue sound in my left ear since last 6 year. I am very worried about it. Please suggest me.

MBBS
General Physician,
I have a continue sound in my left ear since last 6 year. I am very worried about it. Please suggest me.
you may be having perforation of tympanic membrane of the ear or some defectsbin the bony structure of middle ear. consult a EN T specialist.
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