I AM A 25- YEARS-OLD WORKING WOMAN. SINCE LAST SIX MONTHS I am suffering from dryness of the nose, headache, sensation of nasal obstruction and sometimes epistaxis. I have consulted an E.N.T. surgeon for the problem. He told me that you are suffering from atrophic rhinitis. I want to know about the disease in detail.
Atrophic rhinitis is a condition in which the nasal mucosa and turbinates undergo atrophy. It is commonly found in females of the younger age group. It is the result of the local disease in one or the other of the praranasal air sinuses. Owing to some disturbances of the endocrine system the disease is very common at the age of puberty and menopause. The accepted view is that the disease is due to some hereditary or endocrine factor. Symptoms of the disease are dryness of the nose, headache, a sensation of nasal obstruction due to the formation of crusts, anosmia (inability to smell), epistaxis (bleeding from the nose) after separation of the crust, a foul odour is the outstanding symptom and it may be so severe as to render the sufferer an outcast from society. The nasal cavity will be widened, greenish crusts may fill the nasal cavities. Medical treatment consists of the removal of crusts by nasal douches with warm isotonic or alkaline solutions. Painting of the nasal cavity with 25 per cent anhydrous glucose in glycerin. This prevents adherence of crusts and inhibits the growth of organisms. After cleansing, a spray of oestradiol in oil has been found beneficial. Surgical treatment of sinus infection may be properly treated. Latest development in the treatment of this disease is closure of one or both nostrils by plastic surgery. The nasal mucosa becomes normal on reopening of the nostril after a few months or years but any treatment should be taken only with consultation by a doctor.
● I AM A 30- YEAR-OLD WORKING WOMAN. SINCE LAST ONE YEAR, I am suffering from itching on my skull and have dry scales or only yellowish scurf, infections are also present occasionally. I have consulted a skin specialist for this problem. He told me that you are suffering from seborrheic dermatitis and dandruff of the scalp. He advise me to use a shampoo and a solution for this problem. I want to know in detail about this disease.
Seborrheic dermatitis is an acute or chronic papulosquamous dermatitis. Seborrheic dermatitis may represent an inflammatory reaction to malassezia furfur yeasts. Pruritius (itching over skin) is an inconstant finding. The scalp (skin over skull) has dry scales or only yellowish scurf. Fissuring and secondary infection are occasionally present. Patients with Parkinson's disease, patients who become acutely ill and are hospitalised and patients with HIV infection often have seborrheic dermatitis. Scaling of the scalp due to tinea capitus may simulate dandruff or seborrheic dermatitis but alopecia (absence of hair in a particular area) is usually present in tinea capitis. Treatment of seborrhea and dandruff of the scalp contains shampoos that contain zinc pyrithione or selenium are used daily if possible. These may be alternated with ketoconazole shampoo (1 per cent or 2 per cent) used twice weekly. A combination of shampoos is used in refractory cases. Tar shampoos are also effective for milder cases and for scalp psoriasis. Topical corticosteroid solutions or lotions are then added if necessary and are used twice daily. MY DAUGHTER IS 19 YEARS OLD AND OBESE. I WANT TO KNOW about the health consequences of obesity.
Obesity is associated with significant increases in both morbidity and mortality. A great many disorders occur with greater frequency in obese people. The most important and common of these are hypertension, type II diabetes mellitus, hyperlipidemia, coronary artery disease, degenerative joint disease and psychosocial disability. Certain cancers (colon, rectum and prostate in men and uterus, biliary tract, breast and ovary in women), thromboembolic disorders, digestive tract diseases (gallstones, reflux Oesophagitis) and skin disorders are also more prevalent in the obese. Surgical and obstetric risks are greater. Obese patients also have a greater risk of pulmonary functional impairment endocrine abnor - malities, proteinuria and increased haemoglobin concentration. The relative risk associated with obesity, however, decreases with age and weight is no longer a risk factor in adults over age 75. I AM A 35- YEAR- OLD HOUSEWIF., SINCE LAST ONE YEAR I FEEL pain and difficulty during sexual intercourse. I want to know about this problem in detail. Pain or difficulty with intercourse is known as dyspareunia. Its causes may be briefly summarised as any painful obstructive lesion at the vaginal introitus or in the vaginal canal, painful inflammatory conditions in these two situations and deeper seated lesions such as endometriosis of the uterosacral ligaments and retroversion of the uterus with tender prolapsed ovaries. When the history of pain is being taken, these points must all be borne in mind. The patient must first be asked if she has any pain and if so the relation of the pain to menstruation must be investigated as must also be the situation, severity and date of development of the pain. It is always instructive to request the patient to point out with her finger the exact situation of the spot of maximum pain. Quite often she is able to do this with anatomical exactitude – eg in ovarian pain – she will indicate a spot one inch above the mid point of pupart's ligament. A vague gesture which encompasses the upper abdomen usually indicates an extra genital origin and suggests the possibility of functional overlay. – Dr Sanjay Teotia.