Healthwealthbridge

Health,Wellness,Education,Mompreneurship

Healthwealthbridge Health Wellness Education Wealth

Subscribe to Blog via Email

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Join 10.1K other subscribers
Home » sore throat

sore throat

Kissing disease: The kiss of the virus (Infectious Mononucleosis)

By on 4

Kissing disease? Is there is something called that or is the self quarantine affecting my brain?

Yes, there is and it’s more common than you think. Infectious mononucleosis or kissing disease is caused by the Epstein Barr virus. It is spread by contact with oral secretions among young adults and from asymptomatic adults to infants during kissing.

The majority of asymptomatic but seropositive people shed the virus in saliva. The incubation period is long, ranging from 30-50 days(4-6 weeks).

How is the Health of the Nation: The report is an eye-opener!

Health of the Nation Report
Apollo Pro Health

Most common: Oral ulceration is what many patients present at an ENT clinic.

Other symptoms are

Fever,fatigue,malaise,myalgia

Throat pain and difficult Swallowing

Enlarged tonsils

Signs

Pharyngitis. Tonsillitis with an exudative membrane over tonsils /pharynx It has to be distinguished from Diphtheria

Rash and redness over the palate

Lymph node swelling,

Skin rash

Enlarged liver/spleen

Rare presenting features

Facial nerve palsy

Guillen Barre Syndrome and other systemic manifestations

A characteristic serological test and atypical lymphocytes in peripheral blood help in diagnosis.

KISSING DISEASE
KISSING DISEASE

The Epstein Barr virus is linked to many diseases including

NPC-Nasopharyngeal cancer

Burkitt’s lymphoma

Hodgkins disease

B cell lymphoma in those with immunodeficiencies.

EBV infections occur worldwide and, most commonly, in childhood. But IM is a disease if a young adult. Have you heard of the kissing disease? Let me know in the comments below.

Other ENT posts

Recent posts:

You can text, send audio, video or schedule an audio/video consultation and Pay through NEFT/PayTM or other modes

Difficulty Swallowing? Dysphagia in Cancer #BlogchatterA2Z

By on 8


Difficulty swallowing or dysphagia is a common ENT complaint. It’s the ENT surgeon bread -butter version complaint. Today I will tell you about the danger hidden behind such a common and innocuous symptom.

A few months back a 75-year-old man had come to my clinic with his daughter-in-law. The complaint was the inability to swallow food for one month. On detailed questioning, the initial complaint of dysphagia started almost two months back with on and off the review by quacks(you know my thoughts about that) and alternative therapy. He had never visited an ENT doctor for his complaints. He also had not been given any prescriptions for alternative medical therapy.

He was suffering so much, that swallowing his own saliva was difficult. He was severely dehydrated, hardly ate anything. But he was still smoking. Without going into too many details, I can tell you that his HRCT of the thorax(chest) showed a growth obstructing more than two-third of his food pipe. I referred them to Apollo Kolkata and Tata Medical Centre Kolkata and explained to them about the need for urgent intervention.

Time is crucial for malignancies as such and more so for your breathing tubes and food pipe.If every time you swallow saliva

It has a long list of causes and can be divided easily into acute or chronic.
The most infectious condition with pain throat also has difficulty swallowing like in tonsillitis and Pharyngitis. If you have hawking, repeated clearing of the throat and a postnasal drip, that can cause dysphagia too.

When it’s difficulty swallowing with pain, its called odynophagia.

Fear of swallowing or Phagophagia occurs in Rabies, hysteria, tetanus
Globus hystericus is a sensation of a lump in the throat often associated in chronic anemia and common in women.

Difficulty Swallowing
Difficulty Swallowing

Today I will talk about malignancy causing dysphagia and the signs you should be aware of.

The Early warnings

Its the progressively increasing painless difficulty swallowing. Most common in a smoker with a history of regular high volume alcohol intake. Presenting with maybe a hot potato voice is cause for worry /Cancer of the upper part of the throat, often present with difficulty swallowing. So does cancer of the esophagus.

There may or may not be a lump in the throat/change of voice and difficulty breathing. Sudden significant unexplained weight loss is common in cancer of food pipe.

Anything more than two weeks’ duration needs the help of diagnostic tests . A Fibreoptic laryngoscopy is an office procedure to have a peek into the pharynx/larynx and pyriform fossa. If that looks clear, you need a Barium, swallow esophagus, and a CECT Neck and HRCT thorax as further workup.


As a rule of thumb, if the malignancy arises from the vocal cords and then spreads to food pipe, hoarseness precedes dysphagia.

Malignancy causing Dysphagia

Pharyngeal malignancy
Oesophageal malignancy
Laryngeal malignancy involving food pipe.

How is the Health of the Nation: The report is an eye-opener!

Health of the Nation Report
Apollo Pro Health


Treatment depends on the site, size, spread, and type of cancer.
Prognosis is dependent on histological type, local spread, metastasis, and patient profile. In more cases, the correlation between smoking and alcohol abuse is very high in such cancers. Surgery and adjuvant therapy are planned after a full review . Nowadays Proton therapy is another modality that is considered.

Betadine Gargle Helps my sore throat get better(Review)

By on 7

Betadine for Gargle is something I advice as an ENT surgeon to most of my patients with sore throat.

But why do I love using it?

Betadine gargle is the brand name for Povidone-iodine.  It’s synonymous with “my favorite” gargle.  I have been using it myself and prescribing it for my patients for as long as I can remember.

How does Betadine work?[1,2,3,4]

Povidone Iodine gargle has proven bactericidal and virucidal action both in -vitro and in vivo. There are over sixty years of evidence of efficacy in fighting oral and oropharyngeal germs.

PVP-I gargle inactivate-adenovirus, mumps, rotavirus, poliovirus (types 1 and 3), coxsackievirus, rhinovirus, herpes simplex virus, rubella, measles, influenza, and human immunodeficiency virus.

1% gargle/mouthwash works against MERS-CoV.

Application of PVP-I with 0.23–1% concentration, for 1–2 min reduced SARS-CoV virus infectivity from 1.17 × 106 TCID50/ml to below detectable levels in a study by Kariwa et al. Studies for shorter contact times are not available.

Following the H1N1 swine flu outbreak in 2009, Japan’s Ministry of Health, Labour and Welfare recommended daily gargling as a protective hygiene measure to prevent upper respiratory tract infections.

In patients with chronic respiratory diseases, gargling with PVP-I was found to lower infections with Pseudomonas aeruginosa, Staphylococcus aureus (including MRSA) and Haemophilus influenzae by half .

Oral hygiene using PVP-I will benefit immunocompromised patients at risk of prolonged virus shedding. Prolonged virus shedding increases the potential for antiviral drug resistance and nosocomial transmission and secondary bacterial infection and hospitalization.

Ito et al. reported lowering of viral infectious titres of avian influenza A viruses (H5N1, H5N3, H7N7, and H9N2) to below detectable limits after incubation for only 10 s.

How to use Betadine gargle?

An equal volume of gargle liquid in an equal volume of water preferably warm/.  This helps the povidone-iodine to be in adequate amount to have effective action against the germs in your throat. Gargle for at least 15 seconds.

Betadine has Povidone -Iodine 2% w/v

How does povidone-iodine work?

Povidone-iodine (PVP-I) has a broad-spectrum antimicrobial activity used and known for over 60 years. It also has virucidal actions. It is used in many ways for disinfecting skin, hands, mucosal surfaces, wound treatment, oral and pharyngeal infection. Not only does it help in prevention but it also helps to lower the infectivity period and shedding of germs.

When do you use Betadine gargle for sore throat?

It’s best to start using it as soon you have a hawking sensation scratchy feel postnasal drip or itchy throat.

Sore throat

Throat pain

Together with steam inhalation, it works great in the early stages of cold to kill those viruses.

Acute and chronic pharyngitis

Acute and chronic tonsillitis

Poor oral and dental hygiene

Preoperatively before orotracheal intubation, prevents nosocomial infection.

Postoperatively for maintaining oral hygiene after surgery of oral and oropharyngeal cavity

Povidone-iodine 1% mouthwash also lowers reduces the incidence of dry socket after removal of impacted mandibular third molars.

When to avoid gargling?

When you have associated hoarseness, vigorous gargling can cause more trouble,

Who shouldn’t use it?

If you are allergic to iodine or any other components.

Children often can’t gargle and better avoided.

People with thyroid disorders.

Safety profile

If you are on lithium.

The safety profile of PVP-I is well established. In contrast to other antiseptic agents, PVP-I oral care products do not lead to any irritation or damage of the oral mucosa, even with prolonged use [44, 45]. Although measurable systemic iodine absorption may occur with the long-term use of PVP-I, its clinical manifestation as thyroid dysfunction is not very common [39].

How is the Health of the Nation: The report is an eye-opener!

Health of the Nation Report
Apollo Pro Health

Why can’t I dilute it more?

It doesn’t work in that case

Does any gargle other than betadine gargle work?

I like a hypertonic saline gargle. But efficacy studies are not comparable.

Take warm water. Dissolve table salt till you can’t dissolve anymore.  That’s hypertonic saline.  Now start gargling with it. It’s better to use betadine gargle though since its evidence-backed.

References:

1 ) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986684/

2)Inactivation of SARS coronavirus by means of povidone-iodine, physical conditions and chemical reagents.
Kariwa H, Fujii N, Takashima I
Dermatology. 2006; 212 Suppl 1():119-23. https://www.ncbi.nlm.nih.gov/pubmed/16490989

3)Ito H, Ito T, Hikida M, et al. Outbreak of highly pathogenic avian influenza in Japan and ant-influenza virus activity of povidone-iodine products. Dermatology. 2006;212(Suppl 1):115–118. doi: 10.1159/000089210.

4)Rapid and Effective Virucidal Activity of Povidone-Iodine Products Against Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and Modified Vaccinia Virus Ankara (MVA).
Eggers M, Eickmann M, Zorn J
Infect Dis Ther. 2015 Dec; 4(4):491-501.

5) Japan Ministry of Health, Labour and Welfare. Pandemic influenza preparedness action plan of the Japanese Government. 2007. http://www.mhlw.go.jp/english/topics/influenza/dl/pandemic02.pdf.

6. Silva A, Azevedo M, Sampaio-Maia B, Sousa-Pinto B. The effect of mouthrinses on severe acute respiratory syndrome coronavirus two viral load

: A systematic review. J Am Dent Assoc. 2022 Jul;153(7):635-648.e16. doi: 10.1016/j.adaj.2021.12.007.

Prevention helps. Always.

Subscribe to Blog via Email

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Join 10.1K other subscribers

Healthwealthbridge Library

Categories

Subscribe to Blog via Email

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Join 10.1K other subscribers

Podcast

Testimonials

  • Vishakha Talreja says "Amrita has immense knowledge of health-related content. Her writing style is reader-friendly and I have seen her blog posts go viral for the sheer fact that they are informative and helpful.
    As a doctor too her knowledge is noteworthy and she always gives the right consultation that is in beat interests of those consulting her. She is also hands-on on the issues faced by her own community. Having worked with her I can definitely vouch for her professionalism and punctuality."  
    Vishakha Talreja
  • Roshan Radhakrishnan says "An extremely talented doctor and author of multiple books, Dr. Amrita does a great job managing multiple roles with ease." Anaesthesiologist (Human painkiller) ¦¦ Winner #TOIWriteIndia - S01 & 02 ¦¦ Finding #HeroesOfKindness across the world
    Roshan Radhakrishnan

ORS Awareness by WB IAP

Affiliate Disclaimer

There are affiliate links in the blog post. This means I will get a small commission if you visit and buy after clicking on a link to an external site,at no extra cost to you. This also helps to sustain the website. Thank you for your help

Healthwealthbridge Disclaimer

The health -wellness information is shared on this website to improve public awareness about lifestyle diseases, products, that may help or harm us. This is in no way a replacement for professional medical advice. Please always consult your doctor for personalized medical advice.

Krishna Mishra and the Mysterious Movie Star(#Book 1) by Dr.Amrita Basu|Full Mystery Audiobook

Follow Us

error: Content is protected !!