Allergic rhinitis involves inflammation of the nasal mucosa triggered by an IgE-mediated response to allergens. It is very common, affecting about 40 million people in the US, with onset typically occurring in childhood. Symptoms include sneezing, rhinorrhea, nasal congestion and itchiness. Management involves allergen avoidance, pharmacotherapy like antihistamines and intranasal corticosteroids, and immunotherapy. Allergic rhinitis can negatively impact quality of life and is associated with increased risk of conditions like asthma and sinusitis.
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.
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
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
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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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.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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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
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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2. Outline of Presentation
• What is allergic rhinitis?
• Epidemiology
• Pathophysiology
• Diagnosis and differential diagnosis
• Assessment and classification of AR
• Health effects of AR
• Management of AR
3. What is Allergic Rhinitis
• Allergic rhinitis involves inflammation of the mucous
membranes of the nose, eyes, eustachian tubes, middle
ear, sinuses, and pharynx.
• The nose invariably is involved, and the other organs are
affected in certain individuals.
• Inflammation of the mucous membranes is characterized
by a complex interaction of inflammatory mediators but
ultimately is triggered by an immunoglobulin E (IgE)–
mediated response to an extrinsic protein
5. Pathophysiology
• The tendency to develop allergic, or IgE-mediated,
reactions to extrinsic allergens has a genetic component.
• In susceptible individuals, exposure to certain foreign
proteins leads to allergic sensitization, which is
characterized by the production of specific IgE directed
against these proteins.
• This specific IgE coats the surface of mast cells, which
are present in the nasal mucosa.
• When the specific protein is inhaled into the nose, it can
bind to the IgE on the mast cells, leading to immediate
and delayed release of a number of mediators.
6. Pathophysiology
• The mediators that are immediately released include histamine,
tryptase, chymase, kinins, and heparin.
• The mast cells quickly synthesize other mediators, including
leukotrienes and prostaglandin D2.
• These mediators, via various interactions, ultimately lead to the
symptoms of rhinorrhea (ie, nasal congestion, sneezing, itching,
redness, tearing, swelling, ear pressure, postnasal drip).
• Mucous glands are stimulated, leading to increased secretions.
Vascular permeability is increased, leading to plasma exudation.
• Vasodilation occurs, leading to congestion and pressure. Sensory
nerves are stimulated, leading to sneezing and itching. All of these
events can occur in minutes; hence, this reaction is called the early,
or immediate, phase of the reaction
7. Pathophysiology
• Over 4-8 hours, these mediators, through a complex
interplay of events, lead to the recruitment of other
inflammatory cells to the mucosa, such as neutrophils,
eosinophils, lymphocytes, and macrophages.
• This results in continued inflammation, termed the late-
phase response.
• The symptoms of the late-phase response are similar to
those of the early phase, but less sneezing and itching
and more congestion and mucus production tend to
occur.[13]
• The late phase may persist for hours or days.
8. Epidemiology
Frequency: Allergic rhinitis affects approximately 40 million people in
the United States. Recent US figures suggest a 20% cumulative
prevalence rate. Scandinavian studies have demonstrated a
cumulative prevalence rate of 15% in men and 14% in women.[17]
The prevalence of allergic rhinitis may vary within and among
countries. This may be due to geographic differences in the types
and potency of different allergens and the overall aeroallergen
burden.
Mortality/Morbidity- While allergic rhinitis itself is not life-threatening
(unless accompanied by severe asthma or anaphylaxis), morbidity
from the condition can be significant. Allergic rhinitis often coexists
with other disorders, such as asthma, and may be associated with
asthma exacerbations.
9. Epidemiology
Race: Allergic rhinitis occurs in persons of all races. Prevalence of
allergic rhinitis seems to vary among different populations and
cultures, which may be due to genetic differences, geographic
factors or environmental differences, or other population-based
factors.
Sex: In childhood, allergic rhinitis is more common in boys than in girls,
but in adulthood, the prevalence is approximately equal between
men and women.
Age: Onset of allergic rhinitis is common in childhood, adolescence,
and early adult years, with a mean age of onset 8-11 years, but
allergic rhinitis may occur in persons of any age. In 80% of cases,
allergic rhinitis develops by age 20 years.
10. Diagnosis of Allergic Rhinitis
1. History & symptoms of recurrent or persistent
rhinitis and/or associated health effects
2. Signs of atopy and recurrent or persistent
rhinitis
3. Demonstration of IgE allergy
4. Exclusion of other causes of rhinitis
11. Diagnosis of Allergic Rhinitis
1. History & clinical symptoms of recurrent or
persistent rhinitis and/or associated health
effects
– Rhinorhoea
– Nasal blockage
– Postnasal drip
– Itchiness
– Sneezing
– Others: conjunctivitis, eczema, asthma, chronic
rhinosinusitis, otitis media with effusion, sleep
obstruction…
12. History
Important elements in history include an evaluation of
the nature, duration, and time course of symptoms;
possible triggers for symptoms; response to medications;
comorbid conditions; family history of allergic diseases;
environmental exposures; occupational exposures; and
effects on quality of life.
• Symptoms that can be associated with allergic rhinitis
include sneezing, itching (of nose, eyes, ears, palate),
rhinorrhea, postnasal drip, congestion, headache,
earache, tearing, red eyes, eye swelling, fatigue,
drowsiness, and malaise.
13. Symptoms and chronicity
• Determine the age of onset of symptoms and whether symptoms
have been present continuously since onset.
• Determine the time pattern of symptoms and whether symptoms
occur at a consistent level throughout the year (ie, perennial rhinitis),
only occur in specific seasons (ie, seasonal rhinitis), or a
combination of the two.
• During periods of exacerbation, determine whether symptoms occur
on a daily basis or only on an episodic basis. Determine whether the
symptoms are present all day or only at specific times during the
day.
• Determine which organ systems are affected and the specific
symptoms.
14. Trigger factors
• Determine whether symptoms are related temporally to specific
trigger factors. This might include exposure to pollens outdoors,
mold spores, specific animals, or dust while cleaning the house.
• Irritant triggers such as smoke, pollution, and strong smells can
aggravate symptoms in a patient with allergic rhinitis. These are also
common triggers of vasomotor rhinitis.
• 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.
15. Co-morbid conditions
• Patients with allergic rhinitis may have other atopic conditions such
as asthma or atopic dermatitis.
• Look for conditions that can occur as complications of allergic
rhinitis. Sinusitis occurs quite frequently
• Other possible complications include otitis media, sleep disturbance
or apnea, dental problems (overbite), and palatal abnormalities.
• Nasal polyps occur in association with allergic rhinitis, although
whether allergic rhinitis actually causes polyps remains unclear.
• Investigate past medical history, including other current medical
conditions. Diseases such as hypothyroidism or sarcoidosis can
cause nonallergic rhinitis.
16. Family history
• Because allergic rhinitis has a significant genetic
component, a positive family history for atopy
makes the diagnosis more likely.
• A greater risk of allergic rhinitis exists if both
parents are atopic than if one parent is atopic.
• However, the cause of allergic rhinitis appears to
be multifactorial, and a person with no family
history of allergic rhinitis can develop allergic
rhinitis.
17. Environmental exposure
• A thorough history of environmental exposures helps to
identify specific allergic triggers.
• This should include investigation of risk factors for
exposure to perennial allergens (eg, dust mites, mold,
pets).
• Risk factors for dust mite exposure include carpeting,
heat, humidity, and bedding that does not have dust
mite–proof covers.
• Chronic dampness is a risk factor for mold exposure.
• A history of hobbies and recreational activities helps
determine risk and a time pattern of pollen exposure.
18. Diagnosis of Allergic Rhinitis
2. Signs of atopy and recurrent or
persistent rhinitis
21. Immunoassay
• Not influenced by
medication
• Not influenced by skin
disease
• Does not require
expertise
• Quality control
possible
• Expensive
Skin test
• Higher sensitivity
• Immediate results
• Requires expertise
• Cheaper
Immunoassay vs Skin Test for
Diagnosis of Allergy
22. Other Causes of Rhinitis in Children
• Infection
– Viral, bacterial,
– Rhinosinusitis
• Foreign body in the nose
• Rhinitis associated with physical or chemical
factors
• Drug, food induced rhinitis
• NARES, aspirin sensitivity
• Vasomotor rhinitis
23. Health Effects of Allergic Rhinitis
• Social inconvenience
• Sleep disturbances/obstruction
• Learning difficulties
• Impaired maxillary growth
• Dental problems
• Infection: nose and sinuses
• Co-morbidities: conjunctivitis, asthma,
rhinosinusitis, otitis media
26. In Patients with Rhinitis:
• Routinely ask for symptoms suggestive of
asthma
• Perform chest examination
• Consider lung function testing
• Consider tests for bronchial
hyperresponsiveness in selected cases
27. Moderate-
severe
one or more items
. abnormal sleep
. impairment of daily
activities, sport,
leisure
. abnormal work and
school
. troublesome
symptoms
Persistent
. > 4 days per week
. and > 4 weeks
Mild
normal sleep
& no impairment of daily
activities, sport, leisure
& normal work and school
& no troublesome
symptoms
Intermittent
. < 4 days per week
. or < 4 weeks
AR Classification
in untreated patients
28.
29. Management of allergic rhinitis
The management of allergic rhinitis involves the following
components:
• Allergen avoidance
• Pharmacotherapy.
• Allergen immunotherapy. Of note, immunotherapy helps
prevent the development of asthma in children with
allergic rhinitis, and thus should be given special
consideration in the pediatric population.
33. • First line treatment for mild allergic rhinitis
• Effective for
– Rhinorrhea
– Nasal pruritus
– Sneezing
• Less effective for
– Nasal blockage
• Possible additional anti-allergic and anti-inflammatory effect
• In-vitro effect > in-vivo effect
• Minimal or no sedative effects
• Once daily administration
• Rapid onset and 24 hour duration of action
Newer Generation Oral Antihistamines
36. Anti-Leukotriene Treatment in
Allergic Rhinitis
Efficacy
• Equipotent to H1 receptor antagonists but with onset of
action after 2 days
• Reduce nasal and systemic eosinophilia
• May be used for simultaneous treatment of allergic
rhinitis and asthma
Safety
• Dyspepsia (approx. 2%)
38. Nasal Corticosteroids
reduction of
symptoms and exacerbations
reduction of
mucosal inflammation
reduction of
late phase reactions
priming
nasal hyperresponsiveness
1
reduction of
mucosal mast cells
reduction of
acute allergic reactions
2
• suppression of
glandular activity
and vascular leakage
• induction of
vasoconstriction
3
39. Nasal Corticosteroids
• Most potent anti-inflammatory agents
• Effective in treatment of all nasal symptoms
including obstruction
• Superior to anti-histamines and anti-leukotienes
• First line pharmacotherapy for persistent allergic
rhinitis
41. Other Management Aspects
• Manage other co-morbidities:
– Allergic conjunctivitis
– Asthma
– Sinusitis…
• Environmental manipulations:
– allergen avoidance
– Pollution treatment
• Nutritional support
• Activities and sports
42. Environmental Control
• House dust mites
• Pets
• Cockroaches
• Molds
• Pollen
1. Allergens
2. Pollutants and Irritants
43. House dust mite allergen avoidance
– Provide adequate ventilation to decrease humidity
– Wash bedding regularly at 60°C
– Encase pillow, mattress and quilt in allergen
impermeable covers
– Use vacuum cleaner with HEPA filter
– Dispose of feather bedding
– Remove carpets
– Remove curtains, pets and stuffed toys from
bedroom
44. Allergen Avoidance
• Pets
• Remove pets from bedrooms and, even better, from the entire home
• Vacuum carpets, mattresses and upholstery regularly
• Wash pets regularly (±)
• Molds
• Ensure dry indoor conditions
• Use ammonia to remove mold from bathrooms and other wet spaces
• Cockroaches
• Eradicate cockroaches with appropriate gel-type, non-volatile, insecticides
• Eliminate dampness, cracks in floors, ceilings, cover food; wash surfaces, fabrics
to remove allergen
• Pollen
• Remain indoors with windows closed at peak pollen times
• Wear sunglasses
• Use air-conditioning, where possible
• Install car pollen filter
45. To Conclude…
• Allergic rhinitis is very common and
causes considerable morbidity
• Adequate and appropriate treatment leads
to significant improvement in quality of life
• Co-morbid conditions are common and
warrants special attention and treatment
for optimal results
• Environmental manipulations is also
important in the control of disease