Medicine Hack

  DEFINITION  Chronic sinusitis refers to inflammation the paranasal sinuses for a period of at least 12 weeks. The most important cause of chronic sinusitis is failure of acute infections to resolve.   PATHOPHYSIOLOGY  Acute infection destroys the normal ciliated epithelium, thus impairing drainage from the sinuses. There is pooling and stagnation of secretions in the sinuses which favours infections. Persistence of infection causes mucosal changes, such as loss of cilia, edema and polyp formation. We eventually have a vicious cycle.   CLINICAL FEATURES  Patients may complain of blocked nose, runny nose, headache and a reduced sense of smell (hyposmia). Foul-smelling discharge suggests anaerobic infection. Some people will also have nasal polyps.   TREATMENT  1) We should always search for underlying aetiological factors which obstruct sinus drainage and ventilation. 2) A work-up for nasal allergy may be required. 3) Culture and sensitivity of sinus discharge helps in t

  DEFINITION   It is an upper respiratory tract illness that comprises of rhinorrhea and nasal obstruction as the main symptoms.   EPIDEMIOLOGY   5- 7 times/ year in children and 2-3 times/ year in adults. most commonly seen between the early fall and late spring in temperate climates. Transmission of the virus may occur via direct contact, large-particle aerosol, or small-particle aerosol.   MICROBIOLOGY   The rhinoviruses are usually responsible for the majority of cases. Coronavirus, respiratory syncytial virus and metapneumovirus may also be associated with the common cold syndrome.   DIAGNOSIS   The diagnosis of the common cold is a clinical diagnosis. Polymerase chain reaction assay can determine the responsible pathogen but this is rarely useful in the management of the patient.   THERAPY   Management is mainly directed towards the bothersome symptoms as no specific antiviral agents are useful in the treatment. First published on: 10 June 2016