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Flu

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The nasal cavity is the usual starting point for the flu. This is produced by viral invasion of the nasal lining, successfully attacking it when local resistance is reduced. This is common following or during chills, being in crowded surroundings with others soughing and sneezing germs about in profusion. A slight burning or itching is soon followed by a thin watery discharge, which generally becomes infected with secondary invaders to produce the typical thick, yellowish nasal discharge.

As toxins spread to other parts of the body, general feelings of malaise, elevated temperatures, aches and pains take place. The virus rapidly becomes established in other parts of the respiratory tract, and advances quickly to the pharynx (throat), larynx, bronchi and lungs. It can also travel into the sinuses on either side of the nasal passageways, and along the Eustachian tubes into the idle ear, setting up infections in each cc, together with a further set of symptoms.

The flu is the most common of all infectious disorders, and can account for the discomfort and disability, as well as tune loss in industry.

Chronic rhinitis sometimes will not completely disappear, and a long-standing chronic swelling of the nasal linings will occur. Also obstruction to the airways, due to mechanical blockage, or due to injury or allergy, may develop. There may be a chronic sinus infection, and the nasal passages may swell along with this. Fumes, dust, the ubiquitous house-dust mite, and an unsuitable climate have all been incriminated.

Flu Symptoms

There is swelling and redness of the mucosal lining of the nasal passages, and often respiratory difficulty. In the early stages it may be intermittent, or only on one side, but this may become more persistent, sometimes affecting both nostrils. There may be a thick, sticky discharge, with much hawking and nose blowing to gain freedom.

If the Eustachian tubes become blocked, hearing reduction may occur. Often there is a headache, with a feeling of fullness in the head, the voice becomes nasal, and mouth breathing and snoring may occur. The patient probably uses nasal drops to excess, and in due course this may aggravate the condition.

These are usually those of nasal obstruction, generally in a person prone to hay fever or other systemic allergies. Generally it affects both sides and there is some discharge. It may be colorless and mucoid in nature. If infections occur, this will become JW, will contain pus and probably be A. Often there are few other symptoms; headaches are unusual. Frequently the most troublesome symptoms are from the allergies that produced polyps in the first place, for these can persist.

Most patients tend to overuse nasal drops, but these give little if any relief, for usual polyp is far too large to be reduced by drops aimed at causing blood vessel walls to contract.

Sometimes the polyps can be seen when inspecting the internal part of the nose from the outside.

Flu Treatment

This consists of finding a possible underlying cause, such as foreign bodies, infections, septal deviations, environmental factors etc, and rectifying these where possible. Ceasing smoking, stopping the overuse of nasal decongestants, and getting out in the fresh air may help.

Antihistamines and the corticosteroid inhalants (such as beclamethasone dipropionate inhalant for nasal use) may give relief if there is an allergy basis. If these simple measures are unsuccessful, the ENT doctor may resort to submucosal diathermy. When this heals, the surface tissues will contract and reduce the swelling. In severe cases, resort to surgery may be necessary.

Nasal allergy. This is common, especially in young adults and children, although anybody may be affected. It simply means the body is allergic to various substances (called antigens) it contacts. An immediate reaction may occur, producing the typical set of symptoms.

The condition is more common in spring and early summer, when pollens from flowering grasses arc about in profusion. But many other allergens arc around. Each person will have a well-defined series of items to which he is allergic. These may include inhalants, items that are eaten or contacted. Moulds, feathers, pollens, house-dust (or more accurately the house-dust mite), some foods, most notably fish, milk and egg products, and certain drugs are well-established for causing trouble with many patients. Once sensitized to a substance, this tendency will remain. Symptoms are frequently widespread through the body.

There may be sneezing, with an itchy, watering nose that often blocks up. In severe cases, the allergic response may extend to the lungs, causing mild breathing difficulties and even a wheeze. This condition is widespread and important, and in recent times a significant advance has been made in treatment. It is now possible to gain very satisfactory results, even in cases that were once severe and sustained considerable degrees of disability.

Nasal polyps. Nasal polyps are grayish masses of tissue that can occur anywhere in the nasal passageways. They resemble a tiny bunch of grapes, having narrow stalks by which they are attached to the walls of the nasal passages. Almost always they are due to swelling of the nasal canal linings. In sonic areas the lining becomes waterlogged (oedematous) and as the tissue may be loose, it tends to sag. Constant nasal blowing, the addition of more fluid from infections, or more commonly allergies, produces further swelling. Gravity helps the downward movement, and finally a polyp is born.

This is usually carried out by the ENT surgeon. Diagnosis is made by a thorough inspection of the nasal passages, both from the front as well as from behind. Mirrors are used that give a good of the back parts of the nasal canals, and often large polyps are seen there.

Surgical removal of the polyps gives the best results, and this is carried out with a flu wire “snare” that grasps the polyp at its stalk and severs it. Results are A, and immediate normal nasal airway function is again possible. However, it is essential that any basic underlying cause is treated at the same time, otherwise recurrences are almost inevitable. Allergies, sinus infections and septal deformities should all be attended to, for unless this occurs, the operation may be redundant as the polyps make reappearance later on, producing identical symptoms.

Causes of Vertigo

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Vertigo, which means dizziness usually accompanied with nausea, is a multifactor symptom that can occur with various ear disorders.

Normal equilibrium depends on the interrelationship of sensations coming from many different organs: from the eyes, muscles, tendons, skin receptors and also from the balance mechanism of the labyrinths of the ear. If these signals are at variance with one another (as interpreted by the higher centres of the brain), and there is a consequent interference with coordination, then vertigo may result.

There are many causes, and there are several conditions in which this symptom is prominent.

Meniere’s Disease

This has already been considered, and is probably the most dramatic disorder involving balance problems.

Benign Postural Vertigo

This can take place when the head is in a particular position. There is usually no obvious cause, or conversely it may follow on from some form of head injury. Symptoms often abate with or without treatment within three to six months.

Toxicity

Some medicinal preparations arc well-known for their ability to destroy or interfere with vestibular function. Streptomycin, medications used for epilepsy, mental depression and hypertension, come into this category. The symptoms may not be clear-cut. If possible, altering medication may bring relief.

Epidemic Vertigo

This strange disorder may occur in young people who have had a simple viral infection. Often many persons with a similar infection about the same time will report sensations of vertigo and vomiting. The cause is unknown but it is probably a toxic effect from the invading germ on the vestibular mechanism. Prochlorperazine may assist, although the condition is probably self-limiting.

Psychogenic Vertigo

Some neurotic patients will describe their vertigo symptoms in striking terms. The level of authenticity is hard to determine, as it is more likely to be one symptom in a maze.

Ischaemia Vertigo

Some patients suffer from vertigo as part of a definite pathological vascular deficiency of the blood supply to the brain. It is referred to as vertebrobasilar ischemia and is really one symptom in a series of others. It is more probable in the person, and treatment is usually satisfactory.

Vertigo

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What is Vertigo?

Vertigo is a fairly common symptom, and means a subjective sensation of rotary movement, either to the person or of the environment. Often there is inability of the upright body to remain so, and there may be a falling to one side. Sometimes the patient may fall to the floor. but the subjective sensation is that the floor has come up and hit the patient. Disorientation occurs.

Vertigo comes from a word meaning a turning, and the sense of rotation that takes place is an apt description of symptoms. The so-called eighth cranial nerve (the auditory nerve) has two parts. One, the auditory component, is concerned with the appreciation of sound. The other, called the vestibular part, supplies the balance mechanism located within the inner part of the ear.

Often infections of the labyrinths (commonly in association with an upper respiratory tract viral infection – often called URTI) may adversely affect the vestibular nerve and mechanism. So an acute labyrinthitis may occur.

Vertigo Symptoms

Intense vertigo, usually with a marked tinnitus (ringing sensation in the ears), a staggering gait, and possibly irregular eye movements may occur.

Vertigo Treatment

Bed rest for a few days is essential, for it may be impossible to carry on normal activities in the upright position. It is worth treating any intercurrent infection (such as an URTI). Antibiotics are usually useless, for this is often viral in nature, and antibiotics will not kill viruses.

Treatment is entirely symptomatic. A darkened room with peace and quiet is often preferable. Sedation or the use of tranquillisers may he ordered by the doctor. Prochlorperazine, either in tablet form (Stemetil) or injection, may assist in alleviating the dizziness. But such treatment must be ordered by the physician. As the URTI or intercurrent infection subsides, the symptoms of the labyrinthitis usually decline and phase out with no aftermath. Any persisting form, of course, needs adequate medical investigation.

Blood Cancers

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There is a group of diseases considered to be the cancers of the blood system. They are generally referred to as leukaemias and lymphomas, or malignant diseases of the lymphoreticular system.

White blood cells are produced in bone marrow and in lymphoid tissue, which means the spleen and the lymphatic glands located in various parts of the body. This is collectively referred to as lymphoreticular tissue.

Just as cancers can occur in any system, the regions producing blood cells are not immune. For a variety of reasons (many now clearly understood. others as yet unknown), these cell-production sites may suddenly begin to produce cells at a rate far in excess of normal. It is due to a disorder of the basic structure of the cell-producing material. As increased numbers of cells are poured into the blood system, more and more immature forms find their way into the circulation.

Under normal conditions blood cells reach maturity and, only when they are in a finished fully developed state, capable of carrying out their appointed duties.

Blood cells go through a distinct routine of development, and the very early cell is called a blast cell. As disease of these systems progresses, more immature blast cells appear in the circulating blood, and this, plus the great augmentation in gross numbers, often leads to the diagnosis of the disease.

There is an extensive classification of these diseases. Once they were considered to be individual disorders. But with greater knowledge and more work being carried out in research centers, it is now quite evident that they are all closely interrelated.

There are two main types:

(1) Malignant disease affecting the bone marrow.

This interferes with production of the cells normally produced here. It may be an acute form, giving rise to the disease known as acute leukaemia when the white cells are affected, or an erythraemia when the red-cell system is affected.

It may be a slower type of disorder, producing chronic forms of disease, such as chronic leukaemia, affecting the white cells, or polycythaemia vera that affects red-cell production, or essential thrombocythaemia (producing excessive platelets).

(2) Malignant disease affecting the lymphoid tissues.

This may produce the well-known disorder called Hodgkin’s disease, as well as many other, less frequently occurring, subclassifications.

In comparison to simple iron-deficiency anaemia, these diseases are rare, and in comparison to cancers in general, the proportion of mortalities attributed to them is also small. In Australia, no more than 1200 deaths annually are due to leukaemia, a small fraction of the 30,000 annual deaths due to cancers in general.


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