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Not paying attention to your nasal symptoms may turn your sinusitis chronic

Headache disorders Info Graphics in circle.Vector illustrationsApproximately 20% of the UAE population suffers from Chronic Sinusitis. Symptoms range from stuffy nose, nasal blockage, headache, facial pain, postnasal discharge, cough and bad breath. These are all symptoms of chronic sinusitis. The weather in UAE plays a significant role in the development of these symptoms. Fine sand in the air, humidity, allergies, sudden temperature changes too trigger it. Deviation of the nasal septum and nasal polyps too can lead to chronic sinusitis.

KNOW YOUR SYMPTOMS

When you have chronic sinusitis, the mucous membrane of the nose, sinuses and throat get inflamed, possibly from a pre-existing upper respiratory tract infection or allergies. Swelling obstructs the sinus opening and prevents normal mucous drainage, causes mucous and pressure to buildup.

Symptoms include – thick greenish post nasal discharge, nasal stuffiness, and pain around the eyes, cheeks, nose and forehead. There could be an associated reduced sense of smell and or taste.This condition if not treated on time can lead to Bronchitis, asthma or other respiratory diseases,

Many people with sinusitis either silently suffer or opt for self medication, making the problem worse leading to a chronic ailment. A common cold is usually caused by a viral infection and it gets better in approximately a week’s time. If it lasts for more than that, you need to see a Doctor.

HOW TO GET WELL

sinus-1Visual inspection, nasal endoscopy and CT scan, paranasal sinuses can help screen for chronic sinusitis. A CT scan can accurately diagnose chronic sinusitis. Once diagnosed, it is treated with nasal decongestants, steroid nasal sprays, antihistamines, antibiotics etc.
Sinus surgery may be required when conservative treatment fails. Endoscopic sinus surgery is done under local or general anesthesia. The main aim of the surgery is to enlarge the natural opening of the sinuses and to restore the normal sino-nasal ventilation and drainage.

HOME REMEDIES THAT CAN HELP

  • Steam inhalation
  • Saline spray
  • Pain in the nose and sinuses can be relieved by warm compress.

TIPS TO AVOID SINUSITIS

  • Keep yourself hydrated – Drinking water prevents mucus from thickening and blocking the sinuses.
  • Avoid smoking – Smokers are more prone to suffer from sinusitis.
  • Consult a Doctor if a cold persists for more than 10 days.
  • Complete prescribed course of antibiotics. When indicatedHeadache disorders Info Graphics in circle.Vector illustrations

Pain Management Clinic

Pain is defined by International Association for study of Pain as an unpleasant sensory and emotional experience with actual or potential tissue damage.

Conquering pain has been a major limitation for the more evolved human race. Pain imposes a burden on those who suffer from it and impairs quality of life. Most often, it is the common symptom that brings the patient to see a Physician. Pain most commonly presents as a warning sign for any pathological process in the body nevertheless may also cause agony without a specific purpose. The most common forms of pain encountered in daily medical practice are musculoskeletal pain 30-40 %, neck and back pain 30%, headaches less than 10%, and cancer pain 1-2 %.

            Pain Clinic at International Modern HospitalPain may be classified into different types based on the origin, duration, periodicity and nature of pain. Accordingly, Pain management can broadly be classified as acute and chronic pain management. While acute pain deals with perioperative pain, pain in labour, trauma, burns etc., and the latter includes a diverse group of patients in the outpatient setting. The management of acute pain is primarily therapeutic. Chronic pain management requires various pharmacological and non pharmacological approaches to tackle the multidimensional components of pain. At International Modern Hospital we take a holistic approach so as to not only treat the underlying cause but also provide psychological support and rehabilitation to ailing patient.

Pain Clinic at International Modern HospitalPain management largely comprises of pharmacological and non-pharmacological modalities, commonly being medication, counselling, relaxation techniques, electrical stimulation and local anaesthetics. Few Prescribed medications include anti-depressants and systemic local anaesthetics.

Pain Clinic at International Modern HospitalAt International Modern Hospital we undertake Interventional modalities which include diagnostic and therapeutic nerve blocks, facet blocks, epidural steroids, intra articular injections, trigger point injections for myofacial syndromesetc. Therapeutic adjuvants include Psychiatric counselling, physiotherapy and electrical stimulation. Unrelieved and inadequate relief of pain is continuing to be a global health problem and serious efforts have to be taken to provide pain treatment as it is definitely a basic human right.

Hysteroscopy

What is hysteroscopy?

Hysteroscopy is a procedure that allows a doctor to look inside the uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope – a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus.

hysteroscope

Why is hysteroscopy done?

One of the most common uses for hysteroscopy is to find the cause of abnormal uterine bleeding. Abnormal bleeding can mean that a woman’s menstrual periods are heavier or longer than usual or occur less often or more often than normal. Bleeding between menstrual periods also is abnormal. Hysteroscopy may be either diagnostic or operative.

What is diagnostic hysteroscopy?

Diagnostic hysteroscopy is used to diagnose problems of the uterus such as abnormal uterine bleeding, infertility, repeated miscarriages, adhesions, fibroids, polyps, or to locate displaced intrauterine devices (IUDs). It may also be used to confirm the results of other tests such as hysterosalpingography (HSG). Other instruments or techniques, such as dilation and curettage (D&C) and laparoscopy, are sometimes used in conjunction with the hysteroscopy.

What is operative hysteroscopy?

Operative hysteroscopy is used to correct an abnormal condition that has been detected during a diagnostic hysteroscopy, avoiding the need for a second surgery. During operative hysteroscopy, small instruments used to correct the condition are inserted through the hysteroscope.

When is operative hysteroscopy used?

 Hysteroscopy may be performed to correct the following uterine conditions:

  • Polyps and fibroids – Hysteroscopy is used to remove these non-cancerous growths found in the uterus.
  • Adhesions – also known as Asherman’s Syndrome, uterine adhesions are bands of scar tissue that can form in the uterus and may lead to changes in menstrual flow as well as infertility. Hysteroscopy can help locate and remove the adhesions.
  • Septums ­ – Hysteroscopy can help determine whether you have a uterine septum, a malformation of the uterus that is present from birth.
  • Infertility – tubal blockage at uterine end can be opened through hysteroscopy by cornual cannulation
  • Abnormal bleeding – Hysteroscopy can help identify the cause of heavy or lengthy menstrual flow, as well as bleeding between periods.
  • Postmenopausal bleeding – Hysteroscopy is also performed to determine the cause of unexplained bleeding or spotting in postmenopausal women
  • Removal of foreign body or a missing IUCD

What are the benefits of hysteroscopy?

Compared with other, more invasive procedures, hysteroscopy may provide the following advantages:

  • Shorter hospital stay
  • Shorter recovery time
  • Less pain medication needed after surgery
  • Avoidance of hysterectomy
  • Possible avoidance of “open” abdominal surgery

How safe is hysteroscopy?

Hysteroscopy is a relatively safe procedure. However, as with any type of surgery, complications are possible. With hysteroscopy, complications occur in less than 1 percent of cases and can include:

  • Risks associated with anesthesia
  • Infection
  • Heavy bleeding
  • Injury to the cervix, uterus, adjacent organs
  • Intrauterine scarring

When should the procedure be performed?

It may be recommended to schedule the hysteroscopy for the first week after your menstrual period. This timing will provide the doctor with the best view of the inside of the uterus.

What type of anesthesia is used for hysteroscopy?

Anesthesia for hysteroscopy may be local, regional, or general:

How is hysteroscopy performed?

Prior to the procedure, one may be prescribed a medication to help you relax. You will then be prepared for anesthesia. The hysteroscope is inserted through vagina and cervix into the uterus. Saline is then inserted into the uterus, through the hysteroscope, to expand it and to clear away any blood or mucus. A light shone through the hysteroscope allows the doctor to see inside the uterus and the openings of the fallopian tubes into the uterine cavity. Finally, if surgery needs to be performed, small instruments are inserted into the uterus through the hysteroscope.

The time it takes to perform hysteroscopy can range from less than 5 minutes to more than an hour. The length of the procedure depends on whether it is diagnostic or operative and whether an additional procedure, such as laparoscopy, is planned at the same time.

How will I be prepared for hysteroscopy?

If you are having general anesthesia in the hospital, you will be told not to eat or drink anything for a certain period of time (usually after midnight the night before) before the procedure. Routine lab tests may be ordered as well for women having a hysteroscopy in the hospital. You will be asked to empty your bladder and your vaginal area will be cleansed with an antiseptic

What can I expect after the procedure?

If regional or general anesthesia is used during your procedure, you may have to be observed for several hours before going home. After the procedure, you may have some cramping or slight vaginal bleeding for one to two days. However, if you experience any of the following symptoms, be sure to contact your doctor:

  • Fever
  • Severe abdominal pain
  • Heavy vaginal bleeding or discharge

Will I have to stay in the hospital overnight?

Hysteroscopy is considered minor surgery and usually does not require an overnight stay in the hospital. However, in certain circumstances, such as if your doctor is concerned about your reaction to anesthesia an overnight stay may be required.

Who is a candidate for this procedure?

Although there are many benefits associated with hysteroscopy, it may not be appropriate for some patients. A doctor who specializes in this procedure will consult with your primary care physician to determine whether it is appropriate for you.

Bedsore or Pressure Sore

What are bedsores?

A bedsore is an area of broken down skin and underlying tissue to form ulcers. Bedsores are also known as pressure sores, decubitus ulcers, pressure ulcers and pressure wounds.

What causes bedsores?

Bedsores are caused from a lack of blood flow and from mechanical stress to the skin and tissues over a bony area that has been under pressure for a prolonged period. If blood supply is cut off to an area of skin for more than 2 or 3 hours the skin is deprived of oxygen and begins to die. In addition, when slowly sliding down a bed or chair, friction to the outer skin layer such as from wrinkled bedding and clothing contribute to skin injury and ulcers. Excessive exposure to moisture such as sweat, blood, urine or faeces also increases the likelihood of bedsores.

Who is at risk of bedsores?

People whom are immobile due to illness or injury are at greatest risk of getting bedsores. These people may be wheelchair-bound or bedridden and are unable to change position without assistance. Also at risk are people whom, due to nerve damage from injury or illness such as diabetes or stroke, are unable to sense pain or signals that normally make people move. Elderly people are also at greater risk because their skin is thinner and more fragile.

Different pressure points on the human body while lying down

  1. Occiput or back of the head
  2. Both elbows
  3. Sacrum or lower back
  4. Both the gluteal regions or buttocks
  5. Both heels

What are the signs and symptoms of bedsores?

Bedsores are classified into stages according to wound severity.

Stage Features
1 ·   Skin is unbroken but shows a pink or reddened area

·   May look like a mild sunburn

·   Skin may be tender, itchy or painful

 1
2 ·   Skin is red, swollen and painful

·   Blisters that may be broken or intact may be present

·   Upper layers of skin begin to die

·   Wound is prone to infection

 2
3 ·  Sore has broken through the skin and wound extends down to deeper layers of skin tissue

·  Crater-like ulcers are present

·  Wound is prone to infection

 3
4 ·   Sore extends past the skin and into fat, muscle and bone tissue

·   Blackened dead tissue called eschar may be seen in deep opened wounds

 4

What is the treatment for bedsores?

Bedsores can be difficult to treat once they go beyond stage 2. In the early stages when the skin is still intact bedsores usually heal by themselves once the pressure has been removed. Use of special ointments can prevent further bedsore infections. Once the skin is broken the main aim is to prevent infection and protect the sore so that it can heal. Special dressings  may be used to help the healing process. Occasionally dead tissue may be removed with a scalpel (debridement, either in the ward or the patient may be required to be taken up in the operation room).

Therapeutic devices include:

  • The newest and promising mode of therapy for pressure sore is Negative Pressure Wound Therapy NPWT) also known as Vacuum Assisted Closure (VAC).
  • Hydrotherapy debridement, using saline solution in a syringe or water pressure jets.
  • Chemical debridement using special debriding agent

Deep bedsores are very difficult to treat and often require surgical treatment to remove dead and decaying tissue. Sometimes healthy skin may be transplanted to the damaged area. Infections need treatment with antibiotics. In severe or life-threatening situations amputation of limbs may be necessary.

Can bedsores be prevented?

Bedsore can be managed if proper care is given to the bedridden patient from the very beginning.

  • Correct malnutrition if present (fluid, energy, protein, vitamins and minerals)
  • Daily inspection of an immobile person’s skin to detect early redness
  • Frequent repositioning of the patient (recommendation is to turn them every 2 hours)
  • Keep the skin clean
  • Special foam, fibre and gels as padding materials used on chairs and beds to relieve the pressure on bony prominences
  • Powered alternating-pressure mattresses and overlays

Prevention of bedsores is the best approach as established bedsores can be painful and life threatening. They also lengthen hospital stays and increase medical costs dramatically.

International Modern Hospital
 
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