Allergic rhinitis-Allergic rhinitis is an allergic inflammation of the nasal airways.
In this slide we can get info about its causes,symptoms,prevention & treatment.This slide helps people to know about this disease.
Allergic rhinitis is a very common disorder that affects people of all ages. It is frequently ignored, under diagnosed, misdiagnosed, and mistreated, which not only is detrimental to health but also has societal costs. Although allergic rhinitis is not a serious illness, it is clinically relevant because it underlies many complications, is a major risk factor for poor asthma control, and affects quality of life and productivity at work or school. Hidden direct costs include the treatment of co-morbid asthma, chronic sinusitis, otitis media, upper respiratory infection, and nasal polyp. Nasal congestion, the most prominent symptom in AR, is associated with sleep-disordered breathing, a condition that can have a profound effect on mental health, including increased psychiatric disorders, depression, anxiety, and alcohol abuse. Furthermore, sleep-disordered breathing in childhood and adolescence is associated with increased disorders of learning performance, behavior, and attention. Management of allergic rhinitis is best when directed by guidelines. At this juncture Homoeopathic system of medicine offers a safe and effective solution of the illness if followed under the guidance of expertise. This article provides an overview of the patho-physiology, diagnosis, and appropriate homoeopathic management of this disorder.
Dr. Smita Brahmachari
M.O., Dept. of AYUSH, Govt. of NCT Delhi.
Define allergic rhinitis
Pathophysiology of allergic rhinitis
Signs/symptoms of allergic rhinitis
Diagnosis
Investigations
Complications
Treatment
Non allergic rhinitis
Pathogenesis
Signs/symptoms
Treatment
“It is an IgE-mediated immunologic response of nasal mucosa to airborne allergens and is characterized by watery
nasal discharge, nasal obstruction, sneezing and itching
in the nose. This may also be associated with symptoms
of itching in the eyes, palate and pharynx”
. Two clinical types have been recognized:
1. Seasonal. Symptoms appear in or around a particular
season when the pollens of a particular plant, to whic
the patient is sensitive, are present in the air.
2. Perennial. Symptoms are present throughout the year
Allergic rhinitis-Allergic rhinitis is an allergic inflammation of the nasal airways.
In this slide we can get info about its causes,symptoms,prevention & treatment.This slide helps people to know about this disease.
Allergic rhinitis is a very common disorder that affects people of all ages. It is frequently ignored, under diagnosed, misdiagnosed, and mistreated, which not only is detrimental to health but also has societal costs. Although allergic rhinitis is not a serious illness, it is clinically relevant because it underlies many complications, is a major risk factor for poor asthma control, and affects quality of life and productivity at work or school. Hidden direct costs include the treatment of co-morbid asthma, chronic sinusitis, otitis media, upper respiratory infection, and nasal polyp. Nasal congestion, the most prominent symptom in AR, is associated with sleep-disordered breathing, a condition that can have a profound effect on mental health, including increased psychiatric disorders, depression, anxiety, and alcohol abuse. Furthermore, sleep-disordered breathing in childhood and adolescence is associated with increased disorders of learning performance, behavior, and attention. Management of allergic rhinitis is best when directed by guidelines. At this juncture Homoeopathic system of medicine offers a safe and effective solution of the illness if followed under the guidance of expertise. This article provides an overview of the patho-physiology, diagnosis, and appropriate homoeopathic management of this disorder.
Dr. Smita Brahmachari
M.O., Dept. of AYUSH, Govt. of NCT Delhi.
Define allergic rhinitis
Pathophysiology of allergic rhinitis
Signs/symptoms of allergic rhinitis
Diagnosis
Investigations
Complications
Treatment
Non allergic rhinitis
Pathogenesis
Signs/symptoms
Treatment
“It is an IgE-mediated immunologic response of nasal mucosa to airborne allergens and is characterized by watery
nasal discharge, nasal obstruction, sneezing and itching
in the nose. This may also be associated with symptoms
of itching in the eyes, palate and pharynx”
. Two clinical types have been recognized:
1. Seasonal. Symptoms appear in or around a particular
season when the pollens of a particular plant, to whic
the patient is sensitive, are present in the air.
2. Perennial. Symptoms are present throughout the year
Allergic Rhinitis ppt.
by Vishnuvardhan Thotakura [vishnutv9@gmail.com]
3yr MBBS
i have put BASICS to know all ABOUT ALLERGIC RHINITIS in this ppt. and hope you understand it!
ref: ENT books - Dhingra, Hazarika , pics and video from the internet.
Slides prepared and compiled by highly experienced ENT teacher, Dr. Krishna Koirala from Nepal , for teaching undergraduate and postgraduate ENT students in the field of otorhinolaryngology.
A clear and concise explanation of the basic concepts in the subject matter concerned.
He is the Head of department with a sound knowledge in the field of ENT to teach both undergraduate and postgraduate ENT students
Allergic rhinitis is a very much prevalent condition in the community. This presentation hopes to spread a ray of hope in treating allergic and intrinsic rhinitis.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
4. History
1. Duration ( age 20 yrs)
2. Seasonal/Perennial
3. through the day/ particular time
5. Allergic Rhinits and its Impact on Asthma (ARIA)
AR is classified by frequency and severity of symptoms.
A) Intermittent AR -- if symptoms occur < 4 days a week or 4 weeks of the
year.
B) Persistent AR -- if symptoms occur > 4 days per week and more than 4
weeks of the year.
Symptoms are classified as
a) Mild -- quality of life is not affected.
b) Moderate to severe -- if patients have at least one of the following:
sleep disturbance,
impairment of daily activities, sports, or leisure,
impairment of school or work, or
troublesome symptoms.
6. • Determine which organ systems are affected and the specific
symptoms.
• Exclusive involvement of the nose/ involvement of multiple
organs.
• Primarily have sneezing, itching, tearing, and watery
rhinorrhea
• while others may only complain of congestion.
• Significant complaints of congestion, particularly if unilateral,
might suggest the possibility of structural obstruction, such as
a polyp, foreign body, or deviated septum.
7. Trigger factors
• Determine whether symptoms are related temporally to specific trigger
factors like exposure to pollens outdoors, mold spores while doing yard
work, specific animals, or dust while cleaning the house.
• Irritant triggers such as smoke, pollution, and strong smells.
• Other patients may describe year-round symptoms that do not appear to be
associated with specific triggers. This could be consistent with nonallergic
rhinitis, but perennial allergens, such as dust mite or animal exposure,
should also be considered in this situation.
• With chronic exposure and chronic symptoms, the patient may not be able
to associate symptoms with a particular trigger.
8. Response to treatment
• Response to treatment with antihistamines supports the
diagnosis of allergic rhinitis.
• Response to intranasal corticosteroids supports the diagnosis
of allergic rhinitis,
9. Complications of this allergic rhinitis
• Acute or chronic sinusitis
• Otitis media
• Sleep disturbance or apnea
• Dental problems (overbite): Caused by excessive breathing
through the mouth
• Palatal abnormalities
• Eustachian tube dysfunction
10. Comorbid conditions
• Asthma or atopic dermatitis.
• 20 % also have symptoms of asthma. Uncontrolled allergic rhinitis may
cause worsening of asthmaor even atopic dermatitis.
• Sinusitis
• otitis media, sleep disturbance or apnea, dental problems (overbite), and
palatal abnormalities. [he treatment plan might be different if one of these
complications is present.
• Nasal polyps occur in association with allergic rhinitis, Polyps may not
respond to medical treatment and might predispose a patient to sinusitis
or sleep disturbance (due to congestion).
• Allergic rhinitis is a risk factor for obstructive sleep apnea (OSA) syndrome
and cause increased nighttime awakenings and daytime sleepiness.
• Nasal airway resistance is increased and it is intesified in the supine
position compared to the upright position.[39]
• Diseases such as hypothyroidism or sarcoidosis can cause nonallergic
rhinitis.
• Concomitant medical conditions might influence the choice of medication.
11. • Family history
• Environmental and occupational exposure
• Effects on quality of life
12. Signs/Physical examination
Nasal features include :
• Nasal crease: A horizontal crease across the lower half of the
bridge of the nose; caused by repeated upward rubbing of the
tip of the nose by the palm of the hand.
• "Allergic shiners" are dark circles around the eyes and are
related to vasodilation or nasal congestion.
13. Anterior Rhinoscopy
• The mucosa of the nasal turbinates may be swollen (boggy)
and have a pale, bluish-gray color.
• Thin and watery secretions are frequently associated with
allergic rhinitis.
• Deviation or perforation of the nasal septum.
• Examine the nasal cavity for other masses such as polyps or
tumors.
14. Other Manifestations:
• Ears: Retraction and abnormal flexibility of the tympanic membrane
• Eyes: Injection and swelling of the palpebral conjunctivae, with
excess tear production; Dennie-Morgan lines (prominent creases
below the inferior eyelid); and dark circles around the eyes
(“allergic shiners”), which are related to vasodilation or nasal
congestion
• Oropharynx: "Cobblestoning," that is, streaks of lymphoid tissue on
the posterior pharynx; tonsillar hypertrophy; and malocclusion
(overbite) and a high-arched palate
15. • Neck - Look for evidence of lymphadenopathy or thyroid
disease.
• Lungs - Look for the characteristic findings of asthma.
• Skin - Evaluate for possible atopic dermatitis.
• Other - Look for any evidence of systemic diseases that may
cause rhinitis (eg, sarcoidosis, hypothyroidism,
immunodeficiency, ciliary dyskinesia syndrome, other
connective tissue diseases).
16. Occupational allergic rhinitis
• Caused by exposure to allergens in the workplace,
• Can be sporadic, seasonal, or perennial.
• People who work near animals (eg, veterinarians, laboratory
researchers, farm workers) might have episodic symptoms when
exposed to certain animals, daily symptoms while at the workplace,
or even continual symptoms (which can persist in the evenings and
weekends with severe sensitivity due to persistent late-phase
inflammation).
• Some workers who may have seasonal symptoms include farmers,
agricultural workers (exposure to pollens, animals, mold spores, and
grains), and other outdoor workers.
• Other significant occupational allergens that may cause allergic
rhinitis include wood dust, latex (due to inhalation of powder from
gloves), acid anhydrides, glues, and psyllium (eg, nursing home
workers who administer it as medication).
18. Diagnosis
Mainly clinical
Laboratory tests used in the diagnosis of allergic rhinitis include the following:
• Allergy skin tests (immediate hypersensitivity testing): An in vivo method
of determining immediate (IgE-mediated) hypersensitivity to specific
allergens.
• Fluorescence enzyme immunoassay (FEIA): Indirectly measures the
quantity of immunoglobulin E (IgE) serving as an antibody to a particular
antigen.
• Total serum IgE: Neither sensitive nor specific for allergic rhinitis, but the
results can be helpful in some cases when combined with other factors.
• Total blood eosinophil count: Neither sensitive nor specific for the
diagnosis, but, as with total serum IgE, can sometimes be helpful when
combined with other factors.
• Nasal cytology - The presence of eosinophils is consistent with allergic
rhinitis
19. Radiology Investigations
• Radiography: Can be helpful for evaluating possible structural
abnormalities or to help detect complications or comorbid conditions,
such as sinusitis or adenoid hypertrophy
• Computed tomography scanning: Can be very helpful for evaluating acute
or chronic sinusitis
• Magnetic resonance imaging: Also can be helpful for evaluating sinusitis
20. Management
3 major treatment strategies:
• Environmental control measures and allergen avoidance: These include
keeping exposure to allergens such as pollen, dust mites, and mold to a
minimum
• Pharmacologic management: Patients are often successfully treated with
oral antihistamines, decongestants, or both; regular use of an intranasal
steroid spray may be more appropriate for patients with chronic
symptoms
• Immunotherapy: This treatment may be considered more strongly with
severe disease, poor response to other management options, and the
presence of comorbid conditions or complications; immunotherapy is
often combined with pharmacotherapy and environmental control
22. Medication
• Oral antihistamines, decongestants, or both
• Intranasal steroid spray may be more appropriate for patients with chronic
symptoms.
• The newer, second-generation antihistamines like cetirizine,
levocetirizine, desloratadine, fexofenadine, and loratadine are preferable
to avoid sedation and other adverse effects.
• Pseudoephedrine, nasal decongestant, stimulates vasoconstriction by
directly activating alpha-adrenergic receptors of the respiratory mucosa.
Induces also bronchial relaxation and increases heart rate and contractility
by stimulating beta-adrenergic receptors.
• Ocular antihistamine drops (for eye symptoms), intranasal antihistamine
sprays (azelastine and olopatadine) ,intranasal cromolyn, intranasal
anticholinergic sprays may also provide relief.
23. Leukotriene receptor antagonists
• Alternative to oral antihistamine .
• Montelukast .
• Selective leukotriene receptor antagonist that inhibits the
cysteinyl leukotriene (CysLT 1) receptor.
• Selectively prevents action of leukotrienes released by mast
cells and eosinophils.
24. Immunotherapy
This treatment may be considered more strongly with
1. severe disease,
2. poor response to other management options, and
3. the presence of comorbid conditions or complications;
Can be given
1. Injections
2. Sublingual immunotherapy
25. Patient Education
• Educate patients on environmental control measures, both
the avoidance of known allergens and the avoidance of
nonspecific, or irritant, triggers.
26. Surgical Care
• Indicated for comorbid or complicating conditions, such as chronic
sinusitis, severe septal deviation (causing severe obstruction), nasal
polyps, or other anatomical abnormalities.
• Turbinoplasty effective for persistent allergic rhinitis refractory to
intranasal steroids and antihistamines.
• Radiofrequency turbinoplasty to improve nasal congestion
• Intranasal steroids in conjunction with turbinoplasty shows greater
efficacy compared with intranasal steroids alone.
