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Dr. N. Narendra Kumar

Pulmonologist, Hyderabad

50 at clinic
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Dr. N. Narendra Kumar Pulmonologist, Hyderabad
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I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family....more
I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family.
More about Dr. N. Narendra Kumar
Dr. N. Narendra Kumar is a trusted Pulmonologist in Punjagutta, Hyderabad. You can visit him at Nizam's Institute Of Medical Sciences in Punjagutta, Hyderabad. You can book an instant appointment online with Dr. N. Narendra Kumar on Lybrate.com.

Lybrate.com has a nexus of the most experienced Pulmonologists in India. You will find Pulmonologists with more than 42 years of experience on Lybrate.com. Find the best Pulmonologists online in Hyderabad. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Nizam's Institute Of Medical Sciences

Panjagutta. Landmark: Near GVK Mall, HyderabadHyderabad Get Directions
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I am 27 year old female I am having sinus problem please tell the medicine for permanently.

MD PULMONARY, DTCD
Pulmonologist, Faridabad
Can be allergic rhinitis. Avoid cold, dust, smoke. Get skin prck allergt test done to know allergen to whome you are allergic.
1 person found this helpful
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Sinusitis: Management and Prevention

MBBS, Fellowship In Endocrinology
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

4 people found this helpful

I am suffering from dry cough for the last 2 weeks and I have chest pain whenever I cough hard can you suggest what should be done.

MBBS
General Physician, Chandigarh
I am suffering from dry cough for the last 2 weeks and I have chest pain whenever I cough hard can you suggest what s...
Take honitus cough syrup three times a day do warm water saline gargles several times a day and take steam inhalation regularly twice a day everyday till you recover.
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What medications are best for the treatment of asthma? what are their side effects?

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Faridabad
Ayurveda treatment is the best. But depending upon your condition, severity of disease, diet n life style, you may require different medications. Don't bother too much about s. E. Those differs with different medications. Ayurveda, if given after understanding your problem thoroughly and in right dose, there is no s. E.
1 person found this helpful
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I have headache. If I apply vicks vapour, tears come out of my eyes and relieved of head ache. Whether it is related to sinus?

ENT Specialist, Vijayawada
It is vascular headache. So avoid anxiety+tension. Use flunerazlne 10mg at night+ zerodal-mr tab 2 timesdaily. For five to ten days. Later whenever necessary.
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I have been smoking for 4 years. Have also smoked ganja for 2 years. I want to stop it. But will the tar from the lungs get removed? How much time will it take.

Ph. D - Psychology, Professional Certified Coach
Psychologist, Ahmedabad
Smoking has many adverse effect on different system in your body. Congratulations that you are thinking about quitting it. Now you need to figure out the best strategy that works for you. Following information may help you. One of the few habits which takes very systematic approach and needs lot of support and individualized strategies to quit successfully. Data such as - since how long are you smoking and how many cigarettes a day you consume are important information. Also have you tried quitting it earlier? how successful were you? and what are your personal reasons to stop smoking? all these are also important part of your success strategy. Broadly speaking your reasons for not smoking work as your motivator. The stronger the reasons behind not smoking the higher the motivation and thus higher the chances for you to be successful. Also your body will have a withdrawal symptoms and it is very important to come up with strategies and solid plan to counter these withdrawal symptoms. These strategies should be tailor-maid as per your need and situation. If you consider these and many other individualized approach and if you have a solid support throughout your journey. You would be able to make a shift from being a smoker to a non smoker. Along with this eating healthy and having a good routine for eat and sleep is also very important. Exercise plays a huge roll when it comes to staying positively motivated and managing cravings. I hope this helps,
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Hello Dr. I am having problem with my nose, actually I having sinus problem, please give me some tips for helping about it.

MD PULMONARY, DTCD
Pulmonologist, Faridabad
Avoid cold exposure, sudden change of temperature, dust, pollens, smoke, moulds, pets, furs. Can be allergic rhinitis. Skin prick test to know allergy.
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Sir I am 19 Year old I have been suffering from cough since last 2 Weeks tell me how can get relief from it.

BHMS
Homeopath, Raebareli
Please take Bryonia 200 – once daily for next 3-4 days. Drink plenty of warm fluids. Drinking warm fluids helps to loosen the secretions in your sinuses so that your mucus flows more freely, making you feel better faster. Studies show that drinking warm fluids relieves cold symptoms such as runny nose, cough, sneezing, sore throat, and fatigue.
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I have COPD and wish to increase my resistance against infections. Apart from medicines/vaccinations/and pulmonary rehabilitation are there are other ways including dietary like chicken/bone soup, micro-greens etc to improve it?

C.S.C, D.C.H, M.B.B.S
General Physician,
I have COPD and wish to increase my resistance against infections. Apart from medicines/vaccinations/and pulmonary re...
By eating good nutritious foods like you have told and dong healthy lifestyle and exercises you can increase immunity
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I am suffering from dry cough what are the safety precautions to be taken to avoid dry cough can you please tell me.

MBBS
General Physician, Chandigarh
Take honitus cough syrup three times a day and steam inhalation regularly everyday till you recover you can use lozenges also.
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I have sufferring from severe cough. The problem is I can't able to cure this issue. I have taken medications (syrups and tablets) but cant control. Any solutions.?

MD PULMONARY, DTCD
Pulmonologist, Faridabad
Cough can be due to many reasons. As no response to your basic treatment, better consult a resp phy and get inv.
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Pl prescribe home-medicine with respective doses for a 2 years 9 months baby for A) Cough n Cold, B) High Fever (101dgr, C) Pain due to Fall, D) Sudden Vomiting. She is my grand-daughter.

MBBS, Diploma in Child Health (DCH)
Pediatrician, Aurangabad
Pl prescribe home-medicine with respective doses for a 2 years 9 months baby for A) Cough n Cold, B) High Fever (101d...
As she is having fall and vomiting she may have some internal brain injury. Take her to some paediatrician and admit her for observation as sometimes it can be brain trauma.
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Dear doctor, From 1 month inside my throat exactly down to uvula 7-8 blisters which is pimple shape. It is painless and sometime cough also coming. That cough color white. I already trying some medicine along with all home treatments like salt water, honey, haritaki etc. SO please help me I'm fully scared about that.

BHMS
Homeopath, Raebareli
Dear doctor, From 1 month inside my throat exactly down to uvula 7-8 blisters which is pimple shape. It is painless a...
It could be pharyngitis and you need proper treatment for this Take Belladonna 20 - thrice daily for next 4 days. Avoid all sour/spicy/cold food-drinks etc Take home made bland diet only Do not expose yourself in direct AC for some days.
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My mouth stinks very bad. Not every time but specially when I am talking from a long time and my mouth starts getting dry slowly, that time my breathe also starts getting to stink. Also my both grinding tooth has big cavities due to which I cannot chew my food properly.

MBBS
General Physician, Mumbai
My mouth stinks very bad. Not every time but specially when I am talking from a long time and my mouth starts getting...
Dry mouth condition aggravates halitosis (foul breath. Solution is. Take sips of water in between conversations. You have cavities which need urgent filling. If deep enough you will need root canal treatment to save those vital teeth. The cavities are collecting the good when you eat. Then those get rotten and the bad smell happens. Act fast. Maintain good dental health. You are overweight also. Try reduce your weight by diet. Exercise. Give away food rich in fat. Sugar etc.
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I have sinus problem from last 12 year and continue problem of cough and cold. Also I operate two time for sinus but no relief in cough from last 4 month I have continue cough problem and cough is yellow and thick and some time fungal type and stone type. What is the best treatment for this.

MD PULMONARY, DTCD
Pulmonologist, Faridabad
I have sinus problem from last 12 year and continue problem of cough and cold. Also I operate two time for sinus but ...
Can be allergic rhinitis. Yellow secretion can be due to infection. Get nasal secretion tested for culture for pyogenic and fungal infction.
2 people found this helpful
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I am 20 year old men. What is symptoms of lungs cancer? Because I smoke more than 5 years. One day I vomit with blood. So I really scared about this. Please give any suggestions. Thank you.

MCh - Neurosurgery, MBBS
Neurosurgeon, Chennai
I am 20 year old men. What is symptoms of lungs cancer? Because I smoke more than 5 years. One day I vomit with blood...
Lung cancer usually presents with blood while coughing but it can also present with blood during vomit so please consult a physician and get yourself evaluated.
13 people found this helpful
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