This patient is a teacher by profession, needs , 1 ) Thorough history taking including, Family history of allergic rhinitis, hay fever, Bronchial asthma and any kind of Type 1 hypersensitivity. 2 ) StX-ray PNS OM view, Digital. 3 ) CBC, CRP, ASO titre, Serum IgE total and specific IgE estimation , TFT FPG, PPPG, HbA1C, Calcium and 25OH Vitamin D. 4 ) Throat swabs and posterior nasal swab for Gram's stain and C / S. 5 ) Lary
Do CT PNS... and laryngioscopy.... Chances of Pan sinusitis with vocal nodule or singer's nodule on vocal cord... causing hoarse voice.. Needs speech therapy with voice rest for some days Tab.Monteleucast with levocetrizine 1od Tab.Cefuroxime axetil 500mg bid for 7 days Tab.Mucolite bid Tab.Deflazecort 6mg bid for 5 days then 6mg od for 5 days.. If CT PNS suggest any obstructive pathology with pan sinusitis... patient may need FESS... and if vocal nodule is present and not resolved by Short course steroid need Laser microlaryngeal surgery.. If cough is troublesome and present with chronic bronchitis go for sputum for AFB also... Do accordingly..
Apart from Dr.Sushant advised, I will further add that patient's main problem is chronic sinusitis which leads to POST NASAL DRIP that continuously irritate his posterior pharynx causing him to cough more.Additionally his teaching job aggravates his larynx causing more hoarseness.My advise will be more STEAM INHALATION with Inhalade plus drops 5 drops to be added in hot water before inhalation EVERY 2 HOURLY & COMPLETE REST TO THE VOICE. Instead of Deflazecort TAB.PREDNISOLONE 5MG in tapering doses for 15 days (1---1---15days then 1---15days then 1 OD for 5 days ).Rest is as Dr.Sushant prescribed. I think he should be alright with this advice n medication.
X Ray PNS. Check Vit D3 level. CBC. Blood sugar levels.
It is pharyngitis complicated with laryngitis.Along with accessary measure one Homeopathic drug can do marvel and that is Causticum 30, 1 dose. Saline gurgle+ complete voice rest.
Mucous membranes are affected and the fauces inflammed. Tongue thickly coated. The patient could teach in spite of laryngitis means a prolonged sub acute condition. This condition is the result of sour food and drinks OR beer. Kali bichro 200 single dose can improve better than any other antibiotics with corticosteroid inhalers. Please give a dose Resolution should be rapid.
Story looks like poorly treated laryngitis with sinusitis and tonsillitis in professional voice user. Agress treatment of with antibiotics decongestant antiallergic analgesics steam inhalation will get him working again.needs to control sinusitis tonsillitis and speech therapy on long run to avoid recurring.
I agree with Dr Sushant.and patient required .homeopathic treatment as case is chronic and patient receive all multiple medicines. And occupationally teacher.then give stat dose nux vomica 1m stat and on every weak on Sunday bid dose. And start barita carb 30 bid for hoarseness due to overuse of voice.and I require his thirst and bowel complaint to give him constitutional remedy
Agree with Dr Gupta
@Dr. Parshant Aggarwal Could be oral candida try betadin gargle. Ask about oral sex?
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Friends today I am discussing about a very serious problem most of the peoples have on change of weather. As weather is changing in these days here value of the content is important. Topic is Allergic bronchitis. Bronchitis is an inflammation in the lining of the bronchial tubes. These tubes in the lung carry air into the lungs from the mouth and nose. The swelling narrows the airway causing a cough and may make breathing more difficult. The irritation can also lead to increased production of mucus, which blocks the airway. Bronchitis can be classified as either allergic, non-allergic, or asthmatic, depending on its cause. Although the symptoms of bronchitis are similar regardless of the cause, there may also be differences, especially in how long a person will feel the effects of the condition. What is allergic bronchitis? Allergic bronchitis Allergic bronchitis occurs when an allergen inflamed the lining of the bronchial tubes. Allergic bronchitis involves inflammation of the bronchi caused by an allergen, or something to which you are allergic. Airway irritants, such as pollen, dust, and mold, can trigger symptoms. Cigarette smoking almost always causes allergic bronchitis. The symptoms of allergic bronchitis may last for a long time or keep recurring. Allergic bronchitis that lasts longer than three months is often called chronic bronchitis. This is a type of chronic obstructive pulmonary disease (COPD). Chronic bronchitis is almost always caused by cigarette smoking. Symptoms of allergic bronchitis include: a cough that produces mucus wheezing chest tightness tiredness Bronchitis can also lead to complications. For example, lung infection, such as pneumonia, can occur. In the most severe cases, pneumonia can lead to an infection in the bloodstream called septicemia. Septicemia is often life-threatening. Chronic obstructive pulmonary disease (COPD) Chronic obstructive pulmonary disease (COPD) Click here to learn more about COPD. READ NOW Non-allergic bronchitis Non-allergic bronchitis occurs because of a viral or bacterial infection. For example, some people develop non-allergic bronchitis after a cold. Although anyone can develop non-allergic bronchitis, older adults have a higher risk of experiencing the condition. People with weakened immune systems and those who smoke also have a higher chance of developing bronchitis after an upper airway infection. Symptoms often improve within a few weeks and are less likely to recur than the symptoms of allergic bronchitis. Non-allergic bronchitis is sometimes called acute bronchitis, as symptoms may onset suddenly and are typically brief. Symptoms of non-allergic bronchitis might include: a cough that produces mucus chills fever What is asthmatic bronchitis? Asthmatic bronchitis Asthmatic bronchitis can occur in people who already have asthma as an underlying condition. Like bronchitis, asthma is a lung condition that can cause breathing difficulties. Asthma can also cause inflammation of the bronchi, but can also lead to narrowing of the muscles around the airways. When bronchitis and asthma occur together, and symptoms overlap, the condition is often known as asthmatic bronchitis. Inflammation that triggers symptoms of asthmatic bronchitis might occur in someone who has underlying asthma after exposure to certain substances, such as pollen, pollution, and cigarette smoke. Some people also develop asthmatic bronchitis because of a change in weather or exercise routine. People with asthmatic bronchitis respond to these environmental triggers by releasing leukotrienes. These are inflammatory molecules. Leukotrienes cause a series of reactions, including narrowing of the airway. Symptoms of asthmatic bronchitis may include: coughing excess mucus production wheezing shortness of breath Diagnosis A doctor will diagnose allergic bronchitis based on several factors. They will review the medical history of the individual with suspected allergic bronchitis, as well as perform a physical exam, usually ask questions to determine how long symptoms have been occurring. The physician may use a chest X-ray to rule out some other causes of breathing problems, such as pneumonia. They may also request blood tests to help determine if an infection is present. The patient may also receive a pulmonary function test. This involves the individual blowing into a special device called a spirometer. The device measures how much air a person can exhale, and how quickly. The test helps doctors to identify the presence of lung diseases, such as asthma and chronic bronchitis. Treatment Treatments for allergic and asthmatic bronchitis are often similar and may include the following: Bronchodilators Bronchodilators are medications that relax the muscles around the airways. As the muscles relax, the airways dilate or widen, often making breathing easier. People take bronchodilators through a metered dose inhaler. Both short-acting and long-acting bronchodilators are available. Short-acting bronchodilators act quickly to decrease symptoms, but the effects do not last. Long-acting bronchodilators do not reduce symptoms as quickly but control symptoms for a longer period. Steroids Steroids may also be used to treat allergic bronchitis. Steroids decrease inflammation in the bronchi. This action reduces coughing and may help air-flow in the lungs. Although steroids can be an intravenous or oral medication, a physician will often administer them through an inhaler in cases of bronchitis. This allows for quicker and more effective delivery of the drugs to the area that requires treatment. Mucolytics A mucolytic drug is a medication that makes the mucus thinner and less sticky. This making it easier to expel mucus from the lungs by coughing. People can take mucolytics either orally or through a nebulizer. A nebulizer is a device that changes a liquid medication into an aerosol. A person can then inhale this aerosol. Oxygen therapy In some instances, allergic bronchitis can interfere with the efficiency of oxygen flow into and out of the lungs. People with severe allergic bronchitis may have decreased levels of oxygen in the blood. If oxygen levels are low, a doctor may prescribe oxygen therapy. This can help restore oxygen levels to normal. Pulmonary rehabilitation classes People with chronic allergic bronchitis may benefit from pulmonary rehabilitation classes. Pulmonary rehabilitation classes involve supervised exercise, along with education on how to breathe better and manage allergic bronchitis. These classes show people how to decrease exposure to allergens that may trigger symptoms. Acute non-allergic bronchitis often does not require treatment. Doctors treat asthmatic bronchitis in a similar way to allergic bronchitis, with bronchodilators, steroids, and oxygen as needed. However, acute non-allergic bronchitis may also be treated with antibiotics if caused by a bacterial infection, though this is uncommon. In some cases, a doctor may also prescribe leukotriene modifiers to treat asthmatic bronchitis. These work by interfering with the chemical reactions that cause the symptoms of asthmatic bronchitis. Home remedies humidifier A humidifier can moisten the air and loosen mucus. Many of the treatments for allergic bronchitis require a prescription. However, there are also steps a person can take at home to reduce the effects of bronchitis. Although home remedies will not cure the underlying cause of allergic bronchitis, they may help to reduce symptoms. These steps including: Using a humidifier: A humidifier will moisten the air. This can loosen mucus and make it easier to expel. It may also decrease wheezing. People with asthma should check with their doctor before using a humidifier. Drinking plenty of fluids: Drinking enough water may help keep mucus thin. Gargling with salt water: The coughing from allergic bronchitis can lead to a sore throat. Gargling with salt water might ease discomfort. Taking a cough drop: A cough drop may keep the throat moist and can provide relief from coughing. Click here to choose online from an excellent range of humidifiers with thousands of customer reviews. Prevention Preventing allergic bronchitis usually involves avoiding irritants, such as chemical fumes, dust, and air pollution. 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