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MedFirst ENT Centre - Newsletter

Newsletter - Issue 1 Volume 3

Welcome to this edition of the MedFirst Ent Centre Newsletter! In this issue, discover the groundbreaking potential of nasal injections in treating long-term loss of smell. Learn essential tips on fall prevention with a comprehensive list of ten actionable measures. Explore the fascinating connection between the timing of allergy symptoms and specific allergens. Additionally, uncover surprising insights into the various factors that can contribute to bad breath. Stay informed and empowered on matters of health and well-being with our curated content.

Nasal Injections could treat long term loss of smell

Loss of sense of smell or Anosmia is a disabling symptom which is often under reported and in the absence of robust treatment protocols treatment remains a challenge.

Losing smell has been linked to higher death rates in older adults. It also affects people’s sense of well-being.

People with Anosmia are also know to suffer from depression and it is also a cause of weight loss- since the patient cannot taste food there is loss of appetite leading to weight loss.

Though Anosmia as a symptom has existed since long, and though the mechanisms of this disorder are well understood, the onset of Covid-19 brought fresh interest into this vexatious problem.

Mechanism of Anosmia in Covid-19

Loss of sense of smell and taste are very common symptoms of Covid-19.

The sense of taste is closely interlinked with smell – in fact a large majority of taste sensation is largely dependant upon an intact sense of smell and most of it happens in the back of the nose.

Smell is the result of the following chain reaction

Odorant Molecules stimulate

Olfactory receptors deep and superiorly placed in the nose. These activate the

Olfactory Bulb via nerve fibres from the receptors.

In the absence of presence of nasal polyps, sinusitis, features of allergic rhinitis it is postulated that Covid-19 causes sensorineural Anosmia – in that the Olfactory receptor cells, Olfactory neurons or Olfactory pathways are damaged during the process of infection. It is postulated that the virus damages the supporting cells of the nerve fibres.

Treatment of Anosmia

  1. Medical management – Intra nasal steroids, oral steroids, treatment of concomitant sinusitis or nasal obstruction.
  2. Smell therapy – Aroma therapy where a series of odours is introduced to the patient to help recover function faster.
  3. Stem Cell therapy – Basal cells, Sustentacular cells, and other supporting cells can be used.
  4. PRP injection therapy – in a great new development workers at Stanford have successfully injected Platelet rich plasma into the affected nasal cavities in order to treat long standing Anosmia.

Procedure – Once the plasma is enriched the extract is taken into a syringe. The patient lies down and under Nasal endoscopic guidance the area is anaesthetized with 2 or 4 &% Xylocaine.

The PRP is then injected superiorly – over the septum as well as superior aspect of the Middle Turbinate. This has shown promising results with gratifying results.

Fall Prevention - Ten things you can do to prevent from Falling

A Fall is a catastrophic event in any one’s life, more so in the weak and the elderly. A fall may lead to a fracture, bruising, head injury etc and incapacitate a person for a long time. It may also re3quire frequent hospitalization and surgical intervention.
A fall leading to a fracture of the femur is like a death knell for the very elderly because apart from seriously hampering their mobility they may never leave the bed again.

What are some easy things we can do to prevent ourselves from falling?

–              Stay in well-lit surroundings – avoid darkness since that can disorient you and affect your stepping. If required install motion sensor lights in the room- for that time in the dark when you need to get out of bed.

–              Avoid Slip rugs and loose carpets – these may slip while walking and cause a fall.

–              Use handrails in bathroom- washrooms are wet and slippery and a potential hazard for falling. Use handrails and nonskid floors to prevent from slipping. Sit on a chair while bathing.

–              Check your vision and hearing regularly – failing vision is a common cause of falling – get regular eye checkups in case you have visual issues.

Surprisingly, untreated hearing loss is an important reason for falling and you must have your hearing checked- this is because the ear is responsible for hearing as well as balance and a weakness in the organ can cause imbalance and unsteadiness.

–              Keep your floor dry and free from clutter – wet floors make you much more susceptible to a fall- ensure the floor is dry before you walk on it. Avoid unnecessary clutter on the floor because you may slip over it.

–              Use a walking stick in case you have instability or chronic imbalance.

–              Keep your blood sugar under control- fluctuating blood sugar levels can cause unsteadiness and long-standing diabetes may also be a cause for postural hypotension.

–              If you use sedatives at night be sure to get up carefully in case you need to use the toilet – your coordination may be affected.

–              If you have episodes of giddiness or are unsteady– have those checked out and treated because giddiness is a common cause for falling. Chronic unsteadiness can be evaluated, a cause found and it can be treated in many cases.

–              Take supplements for good bone health if needed – specially Vitamin D3 and calcium.

The timing of your Allergy symptoms indicates your Allergen

Allergy symptoms include Sneezing, clear watery nasal discharge, nasal congestion, nasal itching, watering from the eyes, etc.

When are you the most Allergic? The month and timing of your peak allergy symptoms is an indicator of what you are allergic to. Let’s take a look

–              Early morning allergy – this is typical of house dust mite allergy. If you wake up sneezing in the morning it is because you disturbed the mites which caused your allergy symptoms to flare up.

–              Tree pollen allergies typically present in spring season – so March and April would be bad months.

–              Allergic all the year round, specially inside the house- this could indicate house dust mite , fungus (mould), dog dander or insect allergies since they reside inside the house and are present all year round.

Did you know these things can cause bad breath?
  1. Gastric ulcer – stomach ulcers caused by H Pylori can sometimes cause a bad breath.
  2. Late night drinking- alcohol is partly excreted through the lungs – late night drinking and excessive drinking will cause your mouth to smell.
  3. Tonsil stones – Tonsilloliths can cause a bad smell because of putrefaction of food particles inside the crypts of the tonsils.
  4. Sinusitis/ a bad cold- a bad cold with a secondary sinus infection causes foul smelling postnasal drip – this leads to halitosis.
  5. Reflux- laryngopharyngeal reflux can lead to a choking sensation and a bad breath.
  6. Medication – some drugs, including commonly prescribed anti-depressants can cause dryness in the mouth due to reduced salivary flow- this can lead to a secondary infection in the mouth causing a bad smell.

Newsletter - Issue 1 Volume 2

Welcome to the latest edition of the MedFirst Ent Centre Newsletter! In this issue, we explore effective strategies to minimize allergies, shed light on the intricacies of primary headaches, and delve into the correlation between Obstructive Sleep Apnea (OSA) and cognitive decline. Stay informed for a healthier you!

How to reduce your allergies?
  1. Keep Doors and Windows closed. If you want to open for airing or cross ventilation then the late afternoon is a better time when air quality is better.
  2. Use Air purifiers/ HEPA filters. Air Conditioners also help, specially the newer ones
  3. Avoid Furry animals inside the house. If unavoidable because of sentimental reasons keep them off you bed. Furry animals carry ticks and dust and can cause severe allergies. Humans are quite often allergic to Dog dander.
  4. Keep a strict watch on Seepage/ Soakage, specially next to bathroom walls. Wet walls promote the growth of mould and humans are very commonly allergic to it.
  5. Avoid pollinating or strong-smelling plants within the house. Such plants cause intense reactions and the soil can grow mould. If fond of plants in the house try using artificial ones.
  6. Avoid carpets, rugs. Use good wooden flooring that is easy to maintain. Keep floors dry and clean since dust that is swept off the floors can cause allergies.
  7. Wet wash and Vacuum clean rather than dusting and sweeping.
  8. Avoid lighting Agarbatti, Dhoop batti or any strong smell inside the house; if holding Havan do it outside or let it be a ‘virtual’ Havan.
  9. Stay away from the house during periods of renovation or construction activity, especially woodwork and painting jobs.
  10. Keep humidity low since high humidity promotes growth of mould/fungus.
  11. Be especially careful in basements. Use drying agents to prevent mould formation and circulate the air to prevent mustiness.
  12. Linen – be very careful with linen since house dust mite is the commonest human allergen – cover pillows, quits, mattresses with dust proof covers.
  13. Use non allergenic material for linen.
  14. Wash linen thoroughly and frequently in boiling hot water and put up in the hot sun to dry- to kill house dust mites.
  15. Wash/ Dry clean curtains frequently – use blinds or drapes instead of curtains since they are easier to maintain in a clean state.
  16. Use kitchen chimneys with efficient filters over the stove to remove the smoke and smell of cooking. Wash and clean the filters frequently.
  17. When cleaning the house wear a mask- preferably a triple layered mask which has adequate filtration.
  18. Make sure everything you store – specially your clothes -is dry – moisture promotes fungus growth.
  19. Avoid cleaning agents that are ‘strong’ – specially if they are strong smelling- this may set off an allergic reaction.


In case of severe recurrent allergy symptoms contact your allergy specialist – You will be tested to check for your allergy levels and if required a skin prick test may ne done to identify some common allergens.

What are primary headaches?

Primary headaches where the headache is the primary condition and there is no other cause for it (as in Secondary Headaches – due to Hypertension, Vascular bleeds, Post traumatic, Infective etc).

  1. Tension type Headache

These are the commonest form of headache and most of us experience them some time in our lives. There is tight squeezing sensation over the head. The person can continue to do physical activity during the headache and there is no accompanying nausea or vomiting.

  1. Migraine

 This is a severe throbbing headache, usually on one side of the head. There is usually accompanying nausea or vomiting and the headache lasts for hours to days. Patients may have photophobia (dislike of bright lights) or phonophobia (dislike for loud sounds). Patients who have had episodes in the past may experience an ‘Aura’ or premonition of an attack.

  1. Cluster Headaches

Headaches, usually in males, most often early in the morning and they happen in clusters – a few weeks of headache and then headache free for a few months. The pain is unilateral and there are accompanying eye symptoms like watering from the ipsilateral eye. The headache lasts from minutes to a couple of hours only to reappear the next day. Alcohol intake or stress can bring about an attack though there may be other factors.

HOW TO PREVENT A MIGRAINE ATTACK FROM OCCURING?Migraine is one of the commonest causes of Primary Headaches and one of the most debilitating.

It should be understood that Migraine is caused when there is excessive sensory input to the body – may it be in the form of bright lights, loud sound etc. There are some preventive measures against getting an attack –

  1. Eat well and regularly – do not fast and do not overindulge – specially on highly processed or preserved food.
  2. Stay hydrated.
  3. Avoid going out in the hot bright sun- so avoid mid-day travel. If you have to go use dark glasses.
  4. Avoid exposure to loud sounds or bright lights.
  5. Reduce screen time and take frequent breaks from the screen.
  6. Indulge in moderate regular exercise- group therapy, satsang etc are good.
  7. Learn to meditate to quieten the mind.
  8. Avoid the usual food and drink triggers like red wine, chocolate, processed cheese, food additives and preservatives. Yours may be specific to you and you will have to identify those.
  9. Avoid too much coffee.
  10. If attacks are debilitating and frequent use disease modifying agents as prescribed by your doctor.
  11. In the event of an impending attack take medication immediately- do not delay. If the attack progresses and the headache becomes worse it will take longer to return to normal.
  12. Be ready during your periods – this is a precipitating factor – be prepared and avoid other triggers during this time
  13. Do not overmedicate with pain medication – this can be counterproductive – if attacks are becoming more severe or more frequent seek medical help and start yourself on prophylactics – they really help.
  14. Start with the simplest pain medication. Avoid strong medication in the initial stage.

Migraine, though a debilitating illness, can be kept under good control by following the above precautions and lifestyle modifications.

Osas Causes Cognitive Decline

Snoring is a fairly common problem, specially in men above 45 years of age.

Factors which largely contribute to Snoring are Obesity, sedentary lifestyle, alcohol use, smoking, certain anatomical configurations like a short thick neck, and certain medical conditions like Nasal Polyps, enlarged Tonsils etc.

When snorers stop breathing in between their bouts of snoring due to upper respiratory passage obstruction – a period called Apnoea (no breathing) – snoring gets converted into OSAS – obstructive sleep apnoea syndrome.

OSAS has been linked with multiple health problems including long term cardiac and pulmonary issues, increased risk of stroke, risk of accidents while driving or operating machinery, sudden death etc.

There is a recent study which has linked OSAS with cognitive decline (deterioration of our mental functioning).

Published this year in the Journal ’Frontiers in Sleep’ the study found that men with OSA experienced

  1. poorer short-term memory
  2. poor executive functioning – ability to plan and execute
  3. Deficits in vigilance,
  4. Deficit in sustained attention
  5. Reduced movement and impulse control.

The participants were non smokers and did not consume alcohol.

Surprisingly, not only did the study participants display early cognitive decline based on their response to simple tests but they also showed poorer communication and their social interactions were also impaired.

The authors speculate that the cognitive deficits are due to intermittent low oxygen and high carbon dioxide in the blood, changes in blood flow to the brain, sleep fragmentation, and brain inflammation in people with OSA.

During sleep, people with OSA may have a partial or full collapse of the upper airway in the neck because the airway is looser during sleep due to muscle relaxation, which then leads to drops in blood oxygen and other blood gas abnormalities.

Frequent arousals at night related to episodes of apnoea prevent the patient from having a sound sleep and this also impacts intellectual functioning.

OSAS has deadly consequences and if you are a snorer the first measure you should take is to undergo a sleep study.

This will assess the severity of the problem and then solutions can be discussed.

Newsletter - Issue 1 Volume 1

Welcome to this edition of the MedFirst Ent Centre newsletter! In this issue, we delve into groundbreaking research suggesting that hearing aids may play a crucial role in reducing the risk of dementia. Additionally, discover practical tips to bolster your immune system for a healthier body, and gain insights into the common occurrence of ear infections in children. Stay informed and empowered with our comprehensive coverage on vital health topics.

Hearing Aids May Protect Against a Higher Risk of Dementia: A Study

According to a study published in the Journal of the American Medical Association (JAMA), hearing aids may help protect against a higher risk of dementia. The study found that people who used hearing aids had a lower risk of developing dementia than those who did not use hearing aids. The researchers believe that hearing loss may contribute to cognitive decline, and that using hearing aids may help to prevent or delay the onset of dementia.

Understanding the Link Between Hearing Loss and Dementia

Hearing loss is a common condition that affects millions of people around the world. As people age, they may experience a gradual decline in their ability to hear, which can impact their quality of life. In recent years, researchers have become increasingly interested in the link between hearing loss and cognitive decline. Studies have shown that people with hearing loss may be more likely to develop dementia than those with normal hearing.

The exact mechanism behind this link is not fully understood. However, it is believed that hearing loss may contribute to cognitive decline in a number of ways. For example, hearing loss can make it more difficult to communicate with others, which can lead to social isolation and depression. It can also lead to a decrease in cognitive stimulation, which is important for maintaining cognitive function.

The Study

The study published in JAMA involved analyzing data from over 114,000 people aged 66 and older. The participants were divided into two groups: those who had been diagnosed with hearing loss and used hearing aids, and those who had been diagnosed with hearing loss but did not use hearing aids. The researchers then tracked the participants over a period of 10 years to see who developed dementia.

The results showed that people who used hearing aids had a lower risk of developing dementia than those who did not use hearing aids. Specifically, the risk of dementia was 18% lower in people who used hearing aids compared to those who did not. The researchers believe that using hearing aids may help to improve communication, reduce social isolation, and increase cognitive stimulation, which could all contribute to a lower risk of dementia.

Other Benefits of Hearing Aids

In addition to potentially reducing the risk of dementia, hearing aids offer a number of other benefits for people with hearing loss. For example, hearing aids can improve communication, which can lead to better relationships with family and friends. They can also improve job performance and increase earning potential. Additionally, hearing aids can help people to participate in social activities and maintain an active lifestyle.


The link between hearing loss and dementia is complex and not fully understood. However, the recent study provides evidence that using hearing aids may help to protect against a higher risk of dementia. If you or someone you know has hearing loss, it is important to seek treatment as soon as possible. In addition to potentially reducing the risk of dementia, hearing aids offer a number of other benefits that can improve quality of life.

Boosting Your Immune System: Tips for a Healthy Body

The immune system is the body’s natural defense system against harmful pathogens such as viruses, bacteria, and parasites. It plays a crucial role in protecting the body from diseases and infections. A healthy immune system can help prevent illness, while a weakened immune system can increase the risk of infections and other health problems. Here are some tips to keep the immune system healthy:

  1. Eat a healthy diet: A balanced diet that is rich in fruits, vegetables, whole grains, lean protein, and healthy fats can help support the immune system. Foods that are high in antioxidants, such as berries and leafy greens, can also help protect the body against damage from harmful free radicals.
  2. Stay hydrated: Drinking plenty of water and other fluids can help keep the body hydrated and support immune system function. Dehydration can weaken the immune system and make it more difficult for the body to fight off infections.
  3. Get enough sleep: Adequate sleep is essential for immune system health. During sleep, the body produces cytokines, which are proteins that help fight infection and inflammation. Lack of sleep can decrease the production of cytokines, making it more difficult for the body to fight off infections.
  4. Get Vaccinated – make sure your child’s and your vaccines are up to date including the annual Flu Vaccine.
  5. Manage stress: Stress can have a negative impact on the immune system. Techniques such as meditation, yoga, and deep breathing can help reduce stress and promote immune system health.
  6. Exercise regularly: Regular exercise can help boost the immune system by increasing blood flow and the production of antibodies and white blood cells. Exercise can also help reduce stress, which can have a positive impact on the immune system.
  7. Practice good hygiene: Good hygiene practices, such as washing hands frequently and avoiding close contact with others who are sick, can help prevent the spread of germs and reduce the risk of infections.
  8. Avoid smoking and excessive alcohol consumption: Smoking and excessive alcohol consumption can weaken the immune system and increase the risk of infections and other health problems.

In summary, a healthy immune system is essential for overall health and well-being. Eating a healthy diet, staying hydrated, getting enough sleep, managing stress, exercising regularly, practicing good hygiene, and avoiding smoking and excessive alcohol consumption are all important strategies for supporting immune system health.

Health supplements – There is no credible medical evidence that health supplements offer any additional benefit on individuals who are otherwise not malnourished.

Ear Infections in children

Children are very prone to ear infections- in fact ear pain is one of the commonest reasons that children are taken for emergency visits. This is mainly due to the developing immune system in children along with an Eustachian Tube that is wide and short, thus causing infections to travel easily from the nose and throat to the ears.

There are several steps parents can take to help keep their children safe from ear, nose, and throat problems:

  1. Keep vaccinations up to date: Make sure your child receives all recommended vaccinations, such as the flu shot and the pneumococcal vaccine, which can help prevent infections that can lead to ear and sinus infections.
  2. Practice good hygiene: Teach your child to wash their hands frequently and avoid touching their face. This can help prevent the spread of germs that can cause infections.
  3. Protect your child’s ears: Use protective ear plugs while swimming – this prevents water from going into the ears and so protects from Swimmer’s ears.
  4. Manage allergies: If your child has allergies, work with their doctor to develop a management plan to help control symptoms. Allergies can contribute to ear and sinus infections.
  5. Avoid sharing personal items: Encourage your child to avoid sharing utensils, cups, and other personal items with others to reduce the risk of spreading infections.
  6. Seek medical attention promptly: If your child develops symptoms of an ear infection, seek medical attention promptly. Early treatment can help prevent complications and more serious problems.
  7. Unsafe practices – avoid putting oil in the child ear and do not use Q-tips to clean the ears. Do not use any ear drops lying at home to instil in the child’s ears – there are different problems which need different medication.