MedFirst ENT Centre - Newsletter

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.

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.

2. 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.

3. 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.

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.