Thermographic signs of certain diseases of the respiratory system (acute sinusitis, pneumonia) Thermography Atlas

The present issue focuses on the practice of medical thermal imaging in patients with paranasal sinusitis and pneumonia. The description of thermograms is based on a quantitative analysis of temperature gradients and trends in temperature of different body regions (Projection «head front» for paranasal sinusitis, «breast front» and «back», in a defined layout formed in «cloud» thermograms analysis program "Tvision" of «Dignosis», Russia) with values of thermographic markers that demonstrated their differentiating capabilities when compared with reference methods. Thus, the thermographic conclusion is formed not simply by thermal phenomenon «hot-cold», but on the basis of numerical values of markers, which indicate hypothetical nosological diagnosis and significantly simplifies the algorithm for those physicians who use this method as an additional. The publication is intended for doctors of any speciality who, in their daily clinical practice, treat the patients with suspicions disease of respiratory system

Health-Related Quality of Life Assessed in Children with Chronic Rhinitis and Sinusitis

Introduction: Quality of life (QoL) can be simply defined as an area of human life that directly affects people which they consider to be important. This can be defined in greater detail as ‘an individual perception of an individual’s life position within a cultural context, value system and in relation to their tasks, expectations and standards determined by environmental conditions’. The health-related quality of life (HRQoL) more specifically focuses on how the QoL affects health (including both medical and non-medical issues). Limitations in well-being will, by association, also occur in those children suffering with sinus diseases. Study aim: To compare the quality of life in children–adolescents suffering from some of the most commonly occurring childhood diseases of chronic rhinitis and sinusitis on a group of healthy children–adolescents. Test materials and methods: Subjects were children–adolescents with at least one of the aforementioned conditions afflicting the upper respiratory tract. Admission criteria were: ages 5 to 18 years in the presence of a chronic disease such as chronic rhinitis and paranasal sinusitis. The Child Health Questionnaire-Parent Form 50 CHQ-PF-50 (CHQ-PF50) was used, which is a general-purpose research instrument based on psychometric testing designed for assessing physical and mental well-being in children–adolescents aged 5 to 18 years. Results: Wellbeing significantly deteriorated in sick children within the following areas: current health status of the child (STAND), physical fitness (PF), social functioning resulting from behaviour or emotional state (REB), the impact of physical health on limitations in social functioning (RP), pain and discomfort (BP), behaviour (BE), mental health (MH), self-esteem (SE), general health perception (GH), influence of the child’s health condition on parental emotions (PE), limitations on parental leisure time due to the child’s health (PT) and restrictions on joint family activities (FA). Conclusions: The greatest impairment to well-being in children with chronic rhinitis and paranasal sinusitis was on the impact of the child’s health status on parents’ emotions, pain and discomfort and general perception of health. This study confirms that parents of healthy children attach great importance to their health and health-related quality of life.

A case report of frontal spontaneous epidural hematoma associated with cranial osteomyelitis and epidural abscess due to paranasal sinusitis

Background: Intracranial epidural hematoma (EDH) is frequently secondary to trauma, but in some rare cases, spontaneous EDH (SEDH) could develop without trauma. Cranial osteomyelitis is an uncommon osseous infection that most frequently presents as a postoperative complication but also rarely originates from paranasal sinusitis and can develop extracranially to form a subperiosteal abscess or intracranially to form an epidural, subdural, or cerebral abscess. Intracranial epidural abscess (EDA) is an uncommon infection that forms in the space between the cranial bone and dura mater. It is rare to have a case of SEDH associated with cranial osteomyelitis and EDA due to paranasal sinusitis. Case Description: An 18-year-old male was admitted to the hospital with headache, nausea, and vomiting for 2 days. The patient denied a history of head trauma, operation, and any other infectious and systemic diseases, and he was not taking any medication. CT scan demonstrated a mixed density lenticular mass with some air collection in the frontal region. The axial sinus CT image demonstrated opacification of the left frontal, ethmoid, and maxillary sinuses. An emergency operation confirmed the diagnosis of frontal SEDH associated with EDA and frontal osteomyelitis. The frontal EDH, abscess, and the infected bone were completely removed during the operation without opening the dura. The patient recovered well after receiving 8 weeks of antibiotic therapy, and a cranioplasty was performed 9 months after the craniectomy. Conclusion: To the best of our knowledge, SEDH associated with EDA is very rare. It is important to recognize the possibility of SEDH associated with cranial osteomyelitis and EDA due to paranasal sinusitis, and the presence of an EDA should, therefore, be considered in the differential diagnosis of cases of SEDH.

PARANASAL SINUSITIS (APEENASA/PEENASA) AND ITS MANAGEMENT IN AYURVEDA

Sinusitis is defined as the inflammation of the mucosa either of any one or all of the paranasal sinuses. In humans, there are four paired sinuses which are termed as paranasal sinuses and they are maxillary, frontal, ethmoid and sphenoid sinuses. Ayurveda being an ancient holistic science aims at alleviating the disease and protection and prevention of the positive health. Shalakya Tantra is one of the Astangas of Ayurveda that deals with the Uttamanga and the diseases related to Urdhvajatru. Paranasal sinusitis, the most common disease in Shalakya tantra can be correlated to the disease Apeenasa, Peenasa, Dusta Pratishyaya etc in Ayurveda based on its signs and symptoms. Apeenasa and Peenasa are used interchangeably for paranasal sinusitis in Ayurveda and they are managed with Deepana Pachana, Vamana, Virechana, Dhumapana, Nasya Karma or Shirovirechana. Nasya Karma, one of the Panchakarma therapy and the best therapy for the Urdhwajatrugata Rogas plays a vital role in the successful management of the sinusitis. In this therapy, the medicine is administered through nose either in the form of ghee, oil, powder, liquid or smoke. It is particularly useful in the treatment of diseases occurring in the organs situated above the clavicle but indirectly it works on the whole body by improving the functioning of the endocrine glands and nervous system.

Predominant role of Haemophilus influenzae in the association of conjunctivitis, acute otitis media and acute bacterial paranasal sinusitis in children

Haemophilus influenzae is a predominant pathogen for conjunctivitis, acute otitis media and acute bacterial paranasal sinusitis in children. We undertook this study to investigate the possible association among these diseases. Children younger than 18-year-old with a diagnosis of bacterial conjunctivitis plus acute otitis media and/or acute bacterial paranasal sinusitis during 2009–2018 were included. Sampling for bacterial cultures was obtained from the lower palpebral conjunctiva and/or ear discharge with cotton-tipped swabs. A total of 67 children were recruited and the age was 29.5 (± 22.4) months in average. Fifty-seven children had conjunctivitis–otitis media syndrome and eight of them had a concurrent diagnosis of acute paranasal sinusitis. Ten children had conjunctivitis and acute paranasal sinusitis simultaneously. Clusters in household were observed in 50.7% children. Most common isolates were Haemophilus influenzae (70%), Moraxella catarrhalis (18%), and Staphylococcus aureus (8%). Antibiotic resistance rate of H. influenzae was 80% for ampicillin, 18% for amoxicillin–clavulanate, and 11% for the second or third-generation cephalosporins. Apart from well-known conjunctivitis–otitis media syndrome, acute paranasal sinusitis may also be linked to conjunctivitis with a similar pathogenic process. Simultaneous presence of these infections may guide the choice of empiric antibiotics toward H. influenzae.

Features of the clinical course, diagnosis and treatment of paranasal sinusitis in patients with type 2 diabetes mellitus

The issue of treating paranasal sinusitis, improving the methods of their treatment and prevention remains relevant to the present. Particular attention shall be paid to patients with concomitant somatic pathology, which contributes to the chronicity of inflammatory processes in the paranasal sinuses and increases the frequency of their recurrence. Among the pathology of ENT organs, acute sinusitis is most common (5–10%). Inflammatory diseases of the nose and paranasal sinuses are fraught with various complications. Thus, the percentage of orbital rhinogenic complications ranges from 6.6 to 12.4%. Patients with a history of diabetes mellitus are more exposed to various diseases, including ENT organs, with their rapid development and subsequent complications. The clinic of purulent sinusitis in them is characterized by a prolonged course with periodic exacerbations and the involvement of nearby anatomical structures in the pathological process with atypical data of radiation studies and frequent complications. The disease proceeds against the background of pronounced changes in the immune status, which affect all links of immunity, including a significant decrease in phagocytosis indicators and an increase in the content of circulating immune complexes of small size. Prolonged exposure of the body to products of free radical oxidation, especially in excess volume, leads to metabolic disorders at all levels and also disrupts the immune status, which leads to a complicated course of diseases. The presence of a pronounced imbalance towards the production of free radicals and a weakening of antioxidant protection leads to the development of oxidative stress and destructive changes at different levels. Treatment of this category of patients is a difficult task, in the solution of which the state of immunity and antioxidant system plays an important role.