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Dr. Gumaste Anupama

ENT Specialist, Pune

0 - 300 at clinic
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Dr. Gumaste Anupama ENT Specialist, Pune
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I believe in health care that is based on a personal commitment to meet patient needs with compassion and care....more
I believe in health care that is based on a personal commitment to meet patient needs with compassion and care.
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Dr. Gumaste Anupama is a popular ENT Specialist in Pune Railway Station, Pune. He is currently practising at Sahyadri Hospital - Bibwewadi in Pune Railway Station, Pune. Don’t wait in a queue, book an instant appointment online with Dr. Gumaste Anupama on Lybrate.com.

Lybrate.com has a number of highly qualified ENT Specialists in India. You will find ENT Specialists with more than 36 years of experience on Lybrate.com. You can find ENT Specialists online in Pune and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Sahyadri Hospital - Bibwewadi

Plot No.13, S.No. 573, City No.281, Swami Vivekananda Marg, Bibwewadi. Landmark: Near Suhag Mangal Karyalaya & Pune Railway Station, PunePune Get Directions
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Sahyadri Hospital - Bibwewadi

Plot No.13, S.No. 573, City No.281, Swami Vivekananda Marg, Bibwewadi. Landmark: Near Suhag Mangal Karyalaya & Pune Railway Station. Landmark : Near HDFC Bank ATMPune Get Directions
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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

6 people found this helpful

Pain in stomach, gas, always thirsty, dizziness, loose stools Taking metrogyl 400 pantosec d Ciprodec 500.

BHMS
Homeopath, Vadodara
Pain in stomach, gas, always thirsty, dizziness, loose stools
Taking metrogyl 400
pantosec d
Ciprodec 500.
Hello stop all those medications. As metrogyl itself can cause acidity n gas. You can take Homieopathic medicine Arsenic alb 200 (4 pills) twice a day for 2 days. Tab Mag Phos 12X (2tabs) after 15 minutes of meal. You will get cure. Along with it *Have light food. Dal rice. Curd khichdi. *Avoid spicy in any form. *take more water *Have mlre fruits. Glucose.
2 people found this helpful
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I feel like tired and dizziness always .im really depressed. Is this cause due to regular masturbation or some other problem .kindly help me to rule out this situation.

Bachelor of Ayurvedic Medicines and Surgery(BAMS), Post Graduation Diploma in Emergency Medicines And Services(PGDEMS), MD - Alternate Medicine
Ayurveda, Ghaziabad
I feel like tired and dizziness always .im really depressed. Is this cause due to regular masturbation or some other ...
You should take chandraprabha vati 1-1 tab with milk twice a day. And pranacharya dhatupaushtik churna with milk twice a day. Avoid tea and coffee.
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I am 21year boy every time I am getting throat infections on tongue and beside area. What should I do.

ENT Specialist, Vijayawada
I am 21year boy every time I am getting throat infections on tongue and beside area. What should I do.
u r too young to get any disease but for ur unhealthy habits, so practice oralhygene+lidocam gargles.forever
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Is it advisable to do a tonsils operation because the doctor says that the tonsil is the size of a golf ball?

MS - ENT(Gold Medalist), MBBS
ENT Specialist, Delhi
Yes, if tonsils are enlarged and causing recurrent sore throat, fever difficulty in swallowing/breathing. Surgery in this scenerio will be perfect solution.
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Sir, I am Sandip 34 year old, I have big sound snoring problem, that why very irritating to me. So kindly suggest me.

MD - Homeopathy, BHMS
Homeopath, Vadodara
Snoring can occur for different reasons... And to give treatment we need to find out the accurate cause like obesity, adenoids, deviated nasal septum etc... So if you can consult with details for proper treatment then it will be better..
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I wish a surgery to my nose to make it small. I heard that some surgeries may fail. So is there any danger for me when any failure takes place. Or whether my nose becomes too bad when any failure takes place. Which doctor can I trust?

MS - ENT
ENT Specialist, Delhi
You need to see a plastic surgeon doing cosmetic nose surgery. No surgery can guarantee 100% cure or results, you have to be prepared for some unfortunate post operative events. Discuss with the doctor carefully and seek complete advice.
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Whenever I travel in AC bus or car with all window panes closed and AC on, my head starts paining a lot. I get a nausea feeling and it feels like my ears are going to burst out. However I don't feel the same in an Air conditioned room. Kindly suggest whom to consult.

MBBS
General Physician, Ahmedabad
Whenever I travel in AC bus or car with all window panes closed and AC on, my head starts paining a lot. I get a naus...
You are likely to have motion sickness. Ie getting symptom while traveling by road. You need to take antiemetic and antihistamines 30 minutes before traveling.
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I am having a stomatitis for the past two weeks it is increasing more and more how can I control and what type of food should I need to take.

BDS
Dentist, Hyderabad
I am having a stomatitis for the past two weeks it is increasing more and more how can I control and what type of foo...
lybrate-user stomatitis is of different types but they stay upto 2 weeks and they repeat but to the reason you need to consult physician coz it will be also related with systemic conditions. Coming to food -avoid hot beverages, salty, spicy,citrus based foods. Drink more water ,rinse mouth with salt water or peridex mouthwash. Suck an ice pop when your mouth is burning. Pain relief medicine is Tylenol or ibuprofen.
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