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27/Sep/2022

The sinuses are inflamed when they suffer from sinusitis. In the head, there are four pairs of cavities (spaces). There are narrow channels connecting them. Nasal channels drain thin mucus from the sinuses. By draining the nose, bacteria can be kept at bay. When the sinuses become blocked, fluid can fill them instead of air. As a result, bacteria can grow and cause an infection (bacterial sinusitis). If the nasal tissue is inflamed, it is almost always swollen. The illness is also refer to as rhinosinusitis. Many organs are involve in sinus infection, which is a complicate condition. The sinuses in your head can become infected with a sinus infection. ENT specialists can identify sinus-related complications and suggest the best treatment option if you have any sinus-related complications.

What is Sinus Infection (Sinusitis): Types, Causes, Symptoms

It is called acute sinusitis when sinusitis lasts less than four weeks. Colds are most commonly the cause of these cases. Some people develop a bacterial infection after experiencing symptoms for a week to ten days. Sinusitis Chronic: Chronic sinusitis, also known as chronic rhinosinusitis, is characterized by persistent symptoms despite medical treatment. Sinusitis is more likely to occur in people who suffer from allergic rhinitis or asthma. Asthma and allergic rhinitis cause inflammation of the airways. A nasal polyp, a deviated nasal septum, an infection, fungus, or a deficiency in the immune system can also result in sinusitis.

How does sinusitis develop?

Several causes of sinusitis include viruses, bacteria, or fungi that swell and block the sinuses. There are several specific causes, including:

  • A common cold.
  • Allergies to mold, including nasal and seasonal allergies.
  • A polyp (growth).
  • Septum deviated from its normal position. Septums are cartilage lines that divide your nose. Deviated septa do not lie straight, so they are closer to the nasal passage on one side, causing blockages.
  • Illness or medication weakens the immune system.

Using pacifiers or drinking bottles while lying down and spending time in daycares could increase the risk of sinusitis in infants and young children. Sinus infections are more likely to occur in adults who smoke. Stop smoking if you smoke. Your health and those around you are at risk when you smoke.

Sinusitis symptoms and signs: what are they?

The following symptoms characterize sinusitis:

  • Mucus drips down the throat after nasal drip.
  • A stuffy nose or nasal discharge (a thick yellow or green discharge from the nose)
  • There may be facial pressure (especially around the nose, eyes, and forehead), headaches, or tooth or ear pain.
  • Bad breath (halitosis)
  • Coughing.
  • Tiredness.
  • Fever.

Conclusion

This article discussed the types, causes, and symptoms of sinus infections. Among the most renowned pulmonologists in India is Dr. Sheetu Singh. As an expert in Jaipur and Rajasthan, she provides the best and most reliable treatment. Every patient she treats receives a high level of care and treatment. Her reputation as one of the best pulmonologists in India is well known. Various lung surgeries have been performe successfully by her. Dr. Sheetu Singh is a pulmonology specialist in Jaipur who can help you if you need one.


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27/Sep/2022

Best strategy to treat asthma

There are 4 components of asthma –

  1. Develop a patient-doctor partnership
  2. Identify risk factors and reduce exposure
  3. Assess, treat and monitor disease
  4. Manage exacerbations

The goal of management – improve control & reduce risk – NAEPP guidelines 2007

Recurrent exacerbations and the requirement for emergency room or hospital care can be avoided.

●Reduced lung growth in children and loss of lung function in adults can be avoided.

●Pharmacotherapy optimization with few or no side effects

What is the best strategy to treat asthma?

Best strategy to treat asthma inhaled corticosteroids such as beclometasone are the drugs of choice for the long-term treatment of patients with persistent asthma. Although there is no discernible difference in efficacy among inhaled corticosteroids, beclometasone is the one with which we have the most expertise. Ciclesonide (Alvesco, Nycomed then Takeda), another inhaled corticosteroid, has been tested in three double-blind trials versus budesonide and six trials versus fluticasone but none versus beclometasone. These tests revealed the “non-inferiority” of ciclesonide, especially in terms of a surrogate endpoint: the difference in compelled expiratory volume in one second (FEV1) after 12 or 24 weeks of treatment (primary endpoint). 

Which inhaled steroid do you prefer, and why?

However, the doses of ciclesonide used in these trials were higher than the standard doses while doses of the comparator corticosteroids were lower than the standard doses, thus favoring ciclesonide. Local negative effects of inhaled corticosteroids include oral candidiasis, sore throat, and hoarseness.  Best strategy to treat asthma a routine review guided by a Cochrane group recommends that ciclesonide does not have a better adverse effect profile than other inhaled corticosteroids used at equivalent doses. Corticosteroid inhalation can also show systemic absorption. The practical benefit of once-daily dosing with ciclesonide appears minor. In practice, ciclesonide is neither more useful than the inhaled corticosteroids with which it has been compared nor does it have fewer negative effects. It is better to continue to use beclometasone, a medicine with which there is more experience.

What is an optimal dose for starting ICS

Treatment naïve patient – step 2

Already on treatment – step 3

Daily v/s intermittent dosing of ICS, which is better?

Daily ICS was only periodic ICS in several indicators of lung function, airway inflammation, asthma control, and reliever use. Both treatments seemed safe, but a fair growth suppression was associated with daily, compared to intermittent, inhaled budesonide and beclomethasone. The clinician should carefully consider the possible benefits and injury of each therapy option, taking into account the unknown long-term (> one year) effect of intermittent treatment on lung growth and lung function decline.

What are the advantages of adding LABA to ICS?

Bronchodilator action of LABA provides immediate relief, and ICS sustained relief improves control, reduces symptoms, Best strategy to treat asthma daytime as well as nocturnal, improves lung functions, reduces the risk of exacerbations, hospitalization we use formoterol + budesonide it acts as a controller as well as reliever medicine, also used in exercise-induced asthma

Can LABA monotherapy be used?

LABA should not be used as monotherapy because they are only bronchodilators with no anti-inflammatory effects. Monotherapy is associated with an increased risk of exacerbation and mortality. When used as add they are superior to LTRA and theo. They reduce symptoms, improve control, and use of SABA, and reduce exacerbations and nocturnal symptoms. Only a fixed-dose combination with ICS is to be used (which improves adherence and reduces the risk of monotherapy).

What is the role of LTRA in asthma as monotherapy, as add on

LTRA has a mild bronchodilator and anti-inflammatory effects. They may be used as monotherapy in mild asthma and aspirin-sensitive asthma. However, they are inferior to ICS and cannot replace ICS as monotherapy.

As added on they may reduce the dose of ICS needed to achieve control and improve control. However, they are inferior to LABA.

What is the role of theophylline as monotherapy, as an add-on?

Data on monotherapy are lacking. An add it improves control when control is lacking with ICS alone. However, it is inferior to LABA. In some patients on ICS + THEO, withdrawal of theo leads to deterioration of control. Usage of lower dosage has a full anti-inflammatory effect, with fewer adverse effects and blood level monitoring is not required.

Is doxycycline better than dyphylline?

It is a debatable issue. Various clinical trials have been done some supporting and others not supporting. However, meta-analysis has so far not found the superiority of doxo over deri in terms of safety and efficacy profile.

What are the benefits of using LAMA in the management of asthma?

Newer ATS/ERS guidelines published in April 2014 suggest the addition of LAMA to ICS and LABA 1. Improve FEV1 2. Reduce the use of SABA 3. Reduce the risk of exacerbation. No studies on children, so not to be used on children


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27/Sep/2022

Asthma Specialist Doctor in India: Asthma is a disease in which your lung airways narrow and swell. It creates excess mucus, that’s will be causing breathing difficulty and trigger coughing, a whistling sound when you exhale, and shortness of breath. For a few people, asthma is a minor issue. For others, it can be a critical issue that conflicts with everyday activities and should build a life-threatening asthma attack. During an asthma strike, the airways will swell, the tissues around them will stiffen, and it becomes dense for air to shift in and out of the lungs. Asthma is not an infection, but it is caused, by an overreaction of the human immune system. Only some people have sensitive immune systems which trigger asthma.

Asthma Specialist Doctor in India – Dr. Sheetu Singh

Asthma is a long-term condition affecting the Lungs. It involves infection and reduction inside the lungs, which reduces air supply. There are many reasons to cause asthma, like Animal hair or dander, Dust, Changes in the weather, Mold, Pollen, Respiratory infections, Tobacco smoking. Asthma can never be completely fixed, but its signs can be managed and controlled. Because asthma continually expands over time, you must handle it with your doctor to track your signs and symptoms and take your treatment as required.

Symptoms of Asthma

Asthma symptoms fluctuate from person to person. You will have infrequent asthma attacks and have symptoms only several times like when you did, exercising, running, polluted areas, dust.

Asthma symptoms include:

  • Shortness of breath
  • Chest tightness or pain
  • Wheezing when exhaling
  • Trouble sleeping caused by shortness of breath
  • Excessive Coughing or Wheezing

Asthma in Childhood

Asthma is the most common disease in children. It can occur at any age but, it is slightly more common in children than adults. Children aged 5–14 years were presumably to suffer from asthma.

Some Common Symptoms in Childhood Asthma Include – Respiratory infections and colds, cigarette smoke, including secondhand cigarette smoke, allergens, air pollutants, exposure to cold air, sudden changes in temperature, excitement, stress, exercise.

How to Diagnosis Asthma

If you think that you have asthma, visit your doctor. They will refer you to a lung disease expert, and they are called pulmonologists or a chest specialist. 

  • Breathing tests (Spirometry)
  • Health history
  • Physical exam
  • Chest X-ray
  • CT
  • Allergy tests

Asthma Treatment

Many asthma treatments can ease your symptoms and, treatments for asthma come into three main categories,

  1. breathing exercises
  2. quick-acting treatments
  3. long-term asthma control medications

Asthma can be managed by following some daily habits and daily routines. You can take steps every day to help yourself and reduce your risk for asthma attacks.

  • Maintaining a healthy weight
  • Quitting smoking
  • Managing stress
  • Eating a healthier diet
  • Exercising regularly

When to see an Asthma Specialist Doctor

If you can feel symptoms of asthma such as weakness and can not perform daily activities, have wheezing, or a cough that does not go away, then visit your doctor immediately. If you can’t find a doctor for asthma, then you can come to Dr. Sheetu Singh. She is one of the best lungs specialists and pulmonologists in India. for Thermoplasty visit, www.drsheetusingh.com


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