Dr. Varun Kumar Gupta (Indus Health)

Nosebleed is a condition wherein blood vessels burst in the nasal lining. Nosebleeds are fairly common and it is rarely a serious condition.

1. Anterior nosebleed: It is caused by the eruption of a blood vessel at the tip of the nose. Anterior nosebleeds are generally easy to control by yourself or by a doctor.
2. Posterior nosebleed: It is a rare type of nosebleed. Posterior nosebleed mostly occurs in older people. It occurs when an artery bursts behind the nose, which causes the blood to flow down the throat. Posterior nosebleeds are, thus, dangerous, and they need immediate medical attention.

Causes:

1. There are numerous causes of nosebleeds. The most common cause of nosebleeds is dry air. Dry climates dehydrate the nasal membranes (internal nasal tissues). This dryness leads to crusting which can cause irritation or itching.
2. Also, if you pick or scratch your nose too much, it can start to bleed.
3. Decongestants for allergies, sinus infection or cold and antihistamines can make the nasal membranes dry and cause nosebleeds as well.

Some other causes of nosebleeds include:

1. Some sort of foreign object stuck in the nasal cavity
2. Allergic reactions
3. Repeated sneezing
4. Nose injuries (For example, car accidents, a punch to the face, etc.)
5. Chemical irritants
6. Cold air
7. Respiratory Infection
8. Consuming high doses of aspirin-high dosage thins the blood down, thus triggering nosebleeds

There are other rarer causes as well, such as:

1. High blood pressure
2. Bleeding disorder
3. Blood clotting problems
4. Cancer

Treatment: A nosebleed can easily be treated at home. While in a sitting position, close your nostril by squeezing the soft part of your nose. Hold your nose for ten minutes, then lean slightly forward. Inhale and exhale slowly using your mouth.

Never lie down when you are trying to stop a nosebleed, as you will end up swallowing the blood which can upset your stomach. Remove your hand from your nose after 10 minutes and check if the bleeding has stopped. If it has not, repeat the steps all over again.

However, consult a doctor if the bleeding does not stop or if there is a foreign object stuck in your nose.

If you wish to discuss about any specific problem, you can consult a doctor.

The inflammatory condition of your sinuses (marked by inflammation of your nasal cavities) caused due to viral, bacterial or fungal infection; any autoimmune disorders or allergic reaction is known as sinusitis. This condition is also referred to as 'rhinosinusitis' as nose inflammation occurs. Sinusitis can be either acute, sub-acute or chronic in nature. Acute sinusitis is generally caused due to the common cold and lasts not more than four weeks. Sub-acute sinusitis is more prolonged in nature and lasts for about eight weeks. Chronic sinusitis is more severe in nature and can last for up to twelve weeks or even more.

The most common symptoms of sinusitis are as follows: 

1. Severe headaches
2. Nose blockage
3. Release of yellowish green fluids from your nose.
4. Fever
5. Difficulty in breathing
6. Painful sensation in your eyes, ears and forehead.
7. Post nasal discharge
8. Frequent cough
9. A sore throat
10. Nausea
11. Body fatigue
12. Neck stiffness
13. Tastelessness and anosmia (loss of smell)

The treatment methods available for sinusitis are as follows:

• Intake of painkillers like paracetamol can give you temporary relief from your aches. But consuming too much of these can cause side effects such as loss of appetite and drowsiness.
• Keep yourself hydrated by drinking about 2 to 3 liters of water every day and take proper rest.
• Steam inhalation can give you relief from nasal congestion.
• Using nasal sprays like Oxymetazoline can also give you temporary relief.
• Your doctor may advise you antibiotics like Amoxicillin in your sinusitis is chronic in nature.
• Immunotherapy helps to treat sinusitis if your sinusitis is caused due to allergic reactions.
• Your doctor may also recommend an endoscopic surgery of the sinus if your condition is found to be very severe. If you wish to discuss about any specific problem, you can consult an Ent Specialist.

If you hear a constant ringing in your ears without any external stimulus, it is called tinnitus. The sound can also manifest as incessant roaring, hissing, buzzing or clicking. The sound can be loud or soft, low or high pitched. Tinnitus can occur in one ear, or both the ears.

Tinnitus is primarily of two types:

1. Subjective tinnitus: This type of tinnitus is very common. In this type, only you are able to hear the ringing, or buzzing. The main cause of subjective tinnitus is ear problems, especially in the inner, middle and outer ear. Problems in the auditory nerves (hearing) or auditory pathways (the part in your brain that changes nerve signals into sound) can also cause subjective tinnitus.
2. Objective tinnitus: In this type of tinnitus, the doctor can also hear the sound when he/she performs an examination. This type of tinnitus is rare. Muscles contractions, problems in the blood vessels or conditions in the middle ear bone can cause objective tinnitus.

Causes:
Tinnitus is not a condition; it is more of a symptom of some other underlying medical condition. Tinnitus can be caused by any of the following complications-

1. Hearing loss (This happens mostly among older people)
2. Loud noises
3. Sinus and ear infections
4. Blood vessel or heart problems
5. Meniere's disease (The inner ear is affected by unknown causes which lead to deafness)
6. Brain tumours
7. Hormonal changes(This happens mostly to women)
8. Thyroid problem
9. Certain medications (antibiotics, cancer medicines, diuretics, quinine medication, some types of antidepressants, aspirin)

Symptoms:
The symptoms of tinnitus include

1. You hear noises that no one else will be able to hear
2. The sound can be depicted as chirping, whistling, screeching, clicking, static, hissing, buzzing, roaring, pulsing, musical or whooshing.
3. The sounds can vary greatly in volume and it is most prominent at night or when your surroundings are quiet
4. Loss of hearing commonly follows tinnitus. If you wish to discuss about any specific problem, you can consult an Ent Specialist.

Sleep apnea is a sleeping disorder in which you experience frequent breathing pauses while sleeping. In case of some, the pauses may last for just a few seconds, while for others, it may continue for a few minutes. Sleep apnea is generally chronic in nature. There are three types of sleep apnea, namely Central, Obstructive and Complex sleep apnea. Central sleep apnea occurs if the brain fails to transmit signals to the muscles responsible for your breathing functions. Obstructive sleep apnea occurs due to relaxation of your throat muscles. Complex sleep apnea refers to a combined condition of both central and obstructive sleep apnea.

Some of the possible causes of sleep apnea are as follows: 

1. Blockage of airway during sleep can cause sleep apnea
2. Putting on weight can cause obstructive sleep apnea
3. In some cases, large tonsil tissues can lead to obstructive sleep apnea in small children
4. Intake of certain medicines like Oxycontin or MS Contin can cause central sleep apnea
5. Male people are more prone to sleep apnea
6. Smoking is also a potent trigger for sleep apnea
7. At times, high blood pressure can induce sleep apnea
8. Suffering from sinus can also lead to sleep apnea
9. Large neck size (more than 16 inches) may cause sleep apnea

In case of some people, sleep apnea might be an inherited condition.

The most common symptoms of sleep apnea are mentioned below:

• Sometimes, obstructive sleep apnea is accompanied by choking or snorting sounds.
• You may encounter breathing trouble while sleeping, leading to a disruption of your sleep.
• Maximum times, sleep apnea is accompanied by snoring.
• Sleep apnea leads to a dry mouth, which can disturb your sleep.
• You may feel dizzy during daytime. If you wish to discuss about any specific problem, you can consult an Ent specialist.

While most noise is just in the background for us, loud noises, either in small spurts or prolonged exposure, can cause hearing loss. This has been happening more frequently as the levels of noise in an industrialized society go further up.

Noise induced hearing loss explained
Loud noises may damage the sensitive structure of your ear, which process the sound waves into information. They eventually become nonfunctional, resulting in a loss of hearing in that range. If exposure to loud noises continues, then this might extend to the entire range of hearing and may cause total hearing loss.

What may cause noise induced hearing loss?
Some of the scenarios which may cause noise induced hearing loss are as follows:
1. Listening to music on high volume: If you constantly listen to music or watch movies at your home on very loud levels, then it may result in noise induced hearing loss. In fact, listening to music or watching movies with headphones in your ears is one of the leading causes for hearing loss. Headphones have deceptively loud levels and may result in damaged hearing overtime.

2. Noise of household tools: Household tools such as drills, mixers, grinders, mowers, and saws can expose you to loud levels of noise. Even a quick exposure for a few seconds could temporarily damage your hearing. 

3. Occupational problems: Occupations such as construction, factory work and military that require the use of power tools on a constant basis can also cause hearing loss. The sound from the resulting friction might damage your hearing very quickly. Explosions and impacts are also causes of hearing loss in the military and law enforcement departments.

Prevention and treatment
Treatment: It is difficult to treat hearing loss as in most cases; it may be permanent, except sudden shocks, when your hearing might come back to normal. The only treatments for hearing loss are hearing aids or cochlear implants which can restore hearing partially.

Prevention: Prevention is the best method to avoid hearing loss and in most cases, you should wear ear protection such as mufflers or sound level reduction devices to protect your hearing. Also, practice listening to music, watching TV or movies at lower levels, especially if you are on the headphones. If you wish to discuss about any specific problem, you can consult a ent-specialist.

Sleep apnea is a potentially dangerous sleep disorder in which you stop and start breathing frequently while you are sleeping. Symptoms of sleep apnea often include loud snoring and fatigue even if you sleep uninterrupted through the night. Obesity and age are the common risk factors of sleep apnea.

The most common type of sleep apnea is obstructive sleep apnea, in which the throat muscles contract and relax while you are asleep. The other type of sleep apnea, called central sleep apnea, usually occurs in people who have been diagnosed with brain tumors, infections or heart failure, or have had a stroke.

Treatment of sleep apnea includes:

1. CPAP: The Continuous Positive Airway Pressure (CPAP) device is generally recommended in the treatment of sleep apnea. CPAP is a breathing machine that stops your airways from getting blocked when you are sleeping. The CPAP device is normally the size of a tissue box. It comes with a mask that you put over your mouth and nose. The machine attached to the mask pumps a continuous flow of air that keeps your airways clear as you sleep.
2. BPAP: The Bilevel Positive Airway Pressure (BPAP) device is used as an alternative to the CPAP device, if you find it hard to adjust to the CPAP. If you have a weak pattern of breathing, the BPAP can be helpful.
3. ASV: The Adaptive Servo-ventilation (ASV) device is used to treat both central and obstructive sleep apnea.
4. Treatment for other medical conditions: Sometimes sleep apnea can be caused by underlying health conditions. Problems such as rhinitis (nasal passage inflammation) and hypothyroidism (underactive thyroid gland) can cause sleep apnea. In such cases, your doctor needs to diagnose these conditions first before treating your sleep apnea.
5. Lifestyle changes: Excessive weight sometimes can cause sleep apnea; so losing excessive weight should be a priority. Also, alcohol and tobacco can contribute to your symptoms, so try avoiding those.
6. Medication: Usually, doctors do not prescribe any medicine, since sedatives and sleeping pills actually worsen sleep apnea. But, in case of sleep apnea in children, doctors typically suggest intra nasal corticosteroid medicine to treat the symptoms.
7. Surgery: Surgeries to increase the size of your airway or to remove your adenoids, tonsils or extra tissues in the rear of your throat or your nose can prove helpful. If you wish to discuss about any specific problem, you can consult a doctor.

Here are cause symptoms and treatment of Throat Pain

Hello, I'm Dr. Varun Gupta, a Senior ENT consultant. Dr. Bindu Kumari, our speech language pathologist and Mr. Rajesh, our audiologists. Today we are discussing in brief, a very common clinical condition, on our day to day clinical practice, which is a throat pain.

The common causes of throat pain are viral infections, bacterial infections, acid reflux, smoking and food irritants. It leads to a difficulty in swallowing, irritation and itchiness in the throat. It may lead to a swelling of lymph nodes as well. It is very important to visit your doctor, if you are having some pain in the throat, because it is a very annoying symptom and though it is not a very serious ailment and we can get it control with the use of simple antibiotics, anti-inflammatory, and anti-histamines along with if there's an acid reflux we can start with some anti-acidity medicines also.

Many times in case of throat pain it can lead to hoarseness of voice as well means the voice of the patient also deteriorates. I would like to introduce Bindu Kumari to talk about something about the voice hygiene. When you have throat pain, you need to maintain some vocal hygiene tips, don't clear throat frequently, don't whisper, take adequate amount of voice taste, don’t scream, use some humming relaxation exercises. Throat pain due to viral infection can lead to involvement of ear.

So I will request Mr. Rajesh to mention about this. Viral infection can lead to hearing loss. The symptom can be ringing sound, buzzing sound, blocking in the ear and is also is can be hearing loss. So please do not hesitate to come visit the audiologist and go for the hearing screening. As it can prevent permanent hearing loss. So regarding the management of throat pain, as you have just seen it lead to all kinds of symptoms like voice problem, a throat pain and it can affect the hearing also.

So any clarification if you want you can consult us through Lybrate by any of the methods like text consultation or your video consultation.