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RHINITISDr
muaid I . AzizFIMCS
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Rhinitis or Rhinosinusitis Definition: its an inflammation of the lining of
the nose characterized by two or more of the following symptoms
nasal obstruction Facial pain Rhinorrhoea sneezing hyposmia or anosmia nasal congestion itching headache
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Rhinosinusitis
allergic infectious other
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Allergic Rhinitis
Definition:Clinically defined by a combination of 2 or more
of nasal symptoms Running Blocking Itching sneezing
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pathogenesis
Ig E ( TYPE 1 HSR)
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Risk factors
Genetics & family hx . Environment Co – morbidities ( asthma , sinusitis ,
om ,sleep disorders, LRTI) Patients with persistent AR should be
evaluated for asthma , the converse is also true
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How you classify allergic rhinitis?
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persistant
Allergic Rhinitis
Intermittant
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Classification of allergic rhinitis Intermittent Allergy The allergy appears at certain times of year when the
pollens are carried by the wind. Examples are: tree pollen in the spring grass pollen in early to mid summer weed pollen and mold spores in autumn Persistent Allergy Perennial or “all year round” allergens give persistent
symptoms that are similar to the seasonal variety or hay fever but they are there all the time. The most important allergens are the house dust mite and animal dander . Perennial allergy can also be worse in the hay fever season if the person is also sensitive to pollen.
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Clinical presentation
Seasonal ( intermittent ) Sneezing rhinorroea Itching Perennial ( continous) Nasal obstruction Poor sense of smell Chronic inflammatory rhinosinusitis
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Diagnosis
History Examination investigation
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HISTORY
Presenting sx. , sx of co-morbidities , general medical , past ,family , ocupational , enviromental , dietry &drug hx.
As rhinorrhoea & conjunctivitis ( seasonal) While nasal obstruction is more common in (perennial rhinitis)
Frequency, severity, duration , persistance or intermittent, affecting quality of life or not
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Examination
Normal mucosa Swollen oedematous
pale or bluish color
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investigation
Allergy diagnosis 1. skin prick test (SPT)
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How you can control allergic rhinitis?
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avoidance diet
Medical therapy
immunotherapy
Control of allergic rhinitis
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Allergen avoidanc
e
Outdoor
triggers
Indoor trigger
s
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Indoor allergens
Dust mites
Animal dander
Cockroach
Mold
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Dust mite
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Mold
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dust & dust mites
Dusting
Washing w hot water
Animal dander& other pet allergens
By restricte
d location
Get arid of it
molds
Cleaning bath tube
showers
Measures to control indoor allergens
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Outdoor triggers
MoldPollen
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pollen
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Avoid pollen
Stay inside Closed windows & doors Avoid fan w open window Avoid bringing pollen back into your
home
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Avoid mold
Avoid going outside on rainy or windy days
Avoid activity as gardening Remove excess leaves from surrounding Keep rain gutters & drains clear of leaves Anti mold for car air conditioner.
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Natural allergy relieve
Antihistamines OR Decongestants
Steroids Leukotrienes modifiers
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Natural allergy relieve: saline nasal spray
How to prepare it ? When to use it ? How to use it ? How its effect or help allergy relieve?
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How to prepare it ?
Mix 2-3 tsp of non iodized salt + 500 cc H2O + one tsp of packing soda.
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When to use it?
Exposed to pollen outdoors ( at the end of the day)
For moisturing in dry nose in winter Pre steroid application
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How to use it?
Neti pot Syringe Cupped hands
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How to effect?
Remove the pollens Thining the mucous & relieve the
obstruction Keeping cilia healthy.
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Antihistamines
For relieving running ,itching ,& sneezing. Little effect on nasal obstruction Non sedative (2nd generation)
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Topical steroids
Reduce inflammation , nasal sx. , Eye sx , improve sense of smell
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Systemic steroids
For unblock of the nose at the start of treatment or for very sever sx ,
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thanks