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Cysts Removal Procedure
Treatment of Tonsils (Tonsillitis)
Hearing Aid Fitting
Treatment of Throat and Voice Problems
Earlobe Repair Procedure
Treatment of Sleep Disturbance
Nose Reshaping Procedure
Hearing Testing Techniques
Nasal And Sinus Allergy Care
Cochlear Implant Procedure
Ear Micro Surgery
Treatment Of Hearing Deficiency
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Sir I am 44 year old, from last one yera I feel sudden weakness in legs and I fell I am going to fall. Bp 115 155, 90 to 93 pulse rate. Ifell dizziness also because of this.
Recent Health check I found that am suffering from Sinus, Apart from taking medicine, what are the other cure I should follow. I heard there is no permanent cure in Allopathy but what should I do to keep away myself from Sinus problem. Do we have permanent cure in Ayurveda/Homeopathy.
I am 23 yr old male having problem in my left ear while cleaning it. After cleaning their is severe pain and I hear less please help me
How to differentiate between on and off spinning movements caused by cervical spondylosis and middle ear issues.
I am having sneezing problem during waking up and after taking bath. I sneezes for about 8 to 10 times. How to cure this?
I have a serious sinus problem. When I go to bed in the night both my nostrils get choked and I am not able to breathe. What is the treatment for this problem in Ayurveda and Homeopathy? Mukesh.
I have recently started getting swelling on my face. Reason is unknown, though I have cold, sinus as I can feel it at my eyebrows. The first time I had my half face swelled completely. Of late it is at places like between eyebrows then next day it moves to the left side. I can't understand what problem and disease it is exactly. Please guide and advise.
Hi, I am 20 years old and I am suffering from severe throat sore! Can you please suggest me some immediate solution.
My throat is acidic .i have visited many doctors and had many medicines but there is no improvement at all. I am 19 years old girl. Will it turn to cancer?
Hello Doctor, I am Atul Mittal, aged 44 yrs. Male. I am getting throat problem in every changing season from last winter. Now also I have the same problem and not getting rid of Khansi. Please suggest Regards Atul Mittal.
Hello. am 18 years old. I was smoking cigarettes by one and half years. I am not a chain smoker I will smoke two cigarettes per day but one day I found some small amount of blood in my mucus I got scared and I am suffering from tonsillitis infection also. I will be gettingtreatpain some days. So what is the cause for getting blood in mucus. Is this happened because of tonsillitis infection or by smoking. Now from three months I had quitted smoking.
I am suffering from severe period throat infection. I had consulted many ENT doctors but no relief, they will give antibiotics (pentids 400, azithral.) when taking this for some days it will go but after a few weeks it's come again. I am suffering from this for about 2 years. Once every month I need to take antibiotics for this. When throat infection occur fever also comes. Pls help me.
My head is getting numb when it's too hot the climate. I took a CT scan already and the diagnose is only a sinusitis but until now my head is still getting numb every time I stay outside the house.
I'm 66 years old. In 1986 I met with an accident, jumping down from 4' upper side from motorcycle while crossing unnoticed many speed breakers.& I got multiple fracture with one head crack along with blood comes out from left ear & remain 2 days unconscious. After recovery since I' suffering from tinnitus in left ear & hard of hearing alongwith not understanding the conversations of meetings. What to do?
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
● 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
● bad breath
● symptoms of chronic sinusitis (may or may not be present)
● nasal or postnasal discharge
● facial pain or pressure
● nosocomial sinusitis is typically seen in patients with nasogastric tubes or nasotracheal intubation.
● 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
● foreign bodies
● congenital choanal atresia
● other entities that cause obstruction of sinus drainage
● dental infections lead to maxillary sinusitis.
● viruses recovered alone or in combination with bacteria (in 16% of cases):
● 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
● migraine headache
● cluster headache
● dental infection
● trigeminal neuralgia
● 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
● 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.
● 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.
● 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
● 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.
● 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