Wednesday, April 28, 2021

OTBBA Enema Bulb Clean Anal Silicone Douche for Men Women Certificate Comfortable Medical Kit

 OTBBA Enema Bulb Clean Anal Silicone Douche for Men Women Certificate Comfortable Medical Kit

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What is the Glycerin Enema for and how to do it


The glycerin enema is a rectal solution, which contains the active ingredient Glycerol, which is indicated for the treatment of constipation, to perform radiological examinations of the rectum and during intestinal lavage, as it has lubrication and humidifying properties of the feces.

The glycerin enema is usually applied directly to the rectum, through the anus, using a small applicator probe that comes with the product, specific to the application.

Glycerin is stored in packs of 250 to 500 mL of the solution, with each mL generally containing 120 mg of the active ingredient. This medicine can be purchased at major pharmacies, with a prescription.

What is it for
The glycerin enema works by helping to eliminate feces from the intestine, as it retains water in the intestine by stimulating bowel movements. It is indicated for:

  • Treatment of constipation;
  • Bowel cleansing before and after surgery;

Preparation for an opaque enema exam, also known as an opaque enema, which uses x-ray and contrast to study the shape and function of the large intestine and rectum. Understand what it is for and how to take this exam .
To treat constipation, glycerin is usually indicated when there is a recurrent constipation and difficult to treat. Check out the ills of using laxative remedies frequently .

How to use
The glycerin enema is applied directly rectally, and the concentration, the amount of the product and the number of applications will depend on the doctor's recommendation, according to the indication and the needs of each person.

In general, the recommended minimum dose is 250 mL per day up to a maximum of 1000 mL per day, for a standard 12% solution, and treatment should not exceed 1 week.

For application, the product does not need to be diluted, and must be made in a single dose. The application is made with an applicator probe, which comes with the packaging, which must be used as follows:

  • Insert the tip of the applicator probe into the tip of the enema package, making sure that it is inserted into the base;
  • Insert the flow tube from the applicator probe into the rectum and press the ampoule;
  • Carefully remove the material and then discard it. Check out more application tips on how to make an enema at home .
  • An alternative to the enema is the use of glycerin suppository, which is applied in a more practical way. Check when the glycerin suppository is indicated .

In addition, glycerin can be diluted with saline solution for an intestinal lavage and, in these cases, a thin tube is inserted through the anus, which releases drops in the intestine, over a few hours, until the intestinal content is eliminated and the intestine is clean.

Possible side effects
As the glycerin enema is a locally acting medication, not being absorbed into the body, side effects are uncommon. However, bowel cramps and diarrhea are expected to arise from increased bowel movements.

Other possible side effects are rectal bleeding, anal irritation, dehydration and symptoms of an allergic skin reaction, such as redness, itching and swelling. In the presence of these signs and symptoms it is necessary to seek medical attention immediately.

Tuesday, April 27, 2021

Summer's Eve Freshening Spray | Ultra | 2 oz Size | Pack Of 3 | pH Balanced, Dermatologist & Gynecologist Tested

 Summer's Eve Freshening Spray | Ultra | 2 oz Size | Pack Of 3 | pH Balanced, Dermatologist & Gynecologist Tested

  •     5 Fresh Benefits in 1 Freshening Spray: Neutralizes Odor, Absorbs Moisture, Won't disrupt natural pH, Talc-Free, Clinically Tested Safe Scents
  •     Gynecologist-Tested, Hypoallergenic, and formulated with Vitamin E for smooth-feeling skin
  •     Available in 5 fragrances: Tropical Rain, Island Splash, Baby Powder, Ultra, and Tahitian Sunset
  •     Summer's Eve Freshening Spray meets our Safe Scents quality standards that ensure that the fragrances you love are gentle enough for your most delicate skin
  •     Spray some on in the morning for a fresh start, or carry a can with you for a little PM pick-me-up.


12 natural deodorants to take care of your body and the environment


Until recently, natural deodorants - often in novel formats such as creams, sticks and lozenges - were manufactured and sold for people with delicate skin who were looking for the least aggressive product possible. However, in recent years, the evolution of the cosmetic market, social changes and that tendency to lead a life as sustainable as possible, have made a product like the deodorant we use every day no longer just that.


If before we only asked it to smell good and eliminate sweat, now we are looking for much more ... and, among all those new features, that it be ecological, natural and in accordance with our zero-waste philosophy that respects the environment. Also, of course, that it is not antiperspirant, that it is not aerosol and that it does not contain aluminum salts.

Fortunately, there are more and more natural deodorants that cover all these needs. These are natural, toxic-free, ecological and 100% healthy formulas that are made from essential oils. And there is to choose: in format, in texture and, of course, in price. Here are 12 of the best options on the market.

ON ROLL-ON
Users' favorite format. Perhaps because it is the best known and to which we were accustomed before this new type of deodorants. As always, they are applied directly to the armpit by rolling the application ball on the skin.

Weleda Citrus
The winning option from one of the most natural cosmetic firms on the market. In 50 ml size. (ideal to also take on a trip), offers 24-hour protection and neutralization of bad odors. In addition, its citrus fragrance provides an energizing and refreshing effect.

Natural Hydrothelial
One of the leading brands in this type of product and its roll-on version: ideal for sensitive or irritated skin and formulated with plant extracts. It offers 24 hour efficacy and is also suitable for children.

Hemp Oil by Dr. Organic
In balm texture and roll-on format, this version is formulated with organic hemp oil, aloe vera, Irish moss and other essential oils with antiseptic and antimicrobial properties.

IN SPRAY
For the more traditional, the spray format is still available although not in aerosol. It is also applied to clean and dry skin in several sprays and, as it is an aqueous solution, it provides an extra freshness and cleanliness.

Weleda sage spray
The best-selling brand in this format, with more than 1,000 opinions on Amazon. Totally natural and with a herbal aroma, it provides a long-lasting refreshing fragrance and does not alter the body's natural regulatory functions. It can be used, as well as a deodorant, as a refreshing body spray.

24h Basis Sensitive de Lavera
An ecological brand of organic products and one of its star products. With active and effective deodorant ingredients and organic essences of witch hazel and roses. It offers 24 hour protection against the formation of bad odors.

Thyme from Corpore Sano
Same spray format, this time made from thyme, which provides a delicate aroma and a refreshing sensation on the skin. Suitable for the whole family and also as a refreshing body spray.

Natural Hydrothelial
The same product as the one described in the roll-on section, but this time in spray format. Ideal for sensitive or irritated skin and formulated with plant extracts.

Coconut Unbeatable
The most advertised deodorant in recent weeks. In an innovative format and brand used by celebrities. It is assuming a complete revolution, since it is a cream that is applied only once to obtain several days without a bad smell (from 2 to 7, as indicated by the brand). It stays on the skin and activates every time you sweat, inhibiting microbial growth, absorbing sweat and eliminating bad odor.

SANON Alum stone
The natural remedy against excess sweating par excellence and one of the best sellers on Amazon. It is applied in a roll-on way and creates an invisible film of mineral salt microcrystals on the armpit that eliminates bad odors and acts as a natural bactericide.

Biork stick
The true organic deodorant, as its name says on Amazon, where it is always one of the best sellers. With over 350 ratings, it provides a neutral scent and protects against sweat. Formulated with natural potassium crystal. A plus: its completely organic packaging made of cork.

Cedar Stick by L'Occitane
The firm's most natural deodorant version, in a stick format that glides easily on dry skin. It fights against odors and bacteria and perfumes the skin with fresh and energizing notes without leaving the skin sticky or using harsh ingredients.

IN PILL
The most sought after when we talk about natural deodorants: an alum stone in pill format that is applied directly to the skin (always on the polished side) as if it were a stick.

Pure Mineral from Lynpha Vitale
An alum stone deodorant, available in various sizes and weights, that is applied directly to the skin. It accumulates more than 1,000 reviews on Amazon that guarantee its effectiveness. In addition to eliminating the bad smell generated by bacteria, it has soothing properties against inflammation caused by shaving or waxing the underarm area. It also works against hand and foot odor and is suitable for children.

Sunday, April 25, 2021

Systane Ultra Lubricant Eye Drops, Twin Pack, 10-mL Each,packaging may vary

Systane Ultra Lubricant Eye Drops, Twin Pack, 10-mL Each,packaging may vary
 

  •     #1 Dr Recommended Brand of Artificial Tears*, packaging may vary
  •     Extended Protection
  •     Fast Long-Lasting Dry Eye Symptom Relief
  •     Reduces both the signs and symptoms of dry eye
  •     Quickly soothe irritated eyes wherever you are


10 ways to fight dry eyes when humidity is low


Those who live in regions where the drought is prolonged know that low humidity can bring a series of discomforts, such as difficulty in breathing, some diseases and, of course, dry eyes. This last one, in fact, can be a big problem, since it hinders the vision and causes discomfort such as the sensation of sand in the eyes.

But, while the rain does not arrive and if you do not intend to change the region, you must learn to deal with the dryness of time and the whole body. In the list below, as you will see, there are some tips that can help in this mission.

Most of them will help not only to fight dry eyes, but to keep the body properly hydrated to face the low humidity. These tricks should even be learned by people from Brasília and the region, where the weather is so dry that the government declared a state of attention.

Now, be alert: if the tips below are not effective in fighting your discomfort, seek an ophthalmologist. Although low humidity contributes a lot to dry eyes, some diseases can also cause this effect.

Discover how to fight dry eyes:

1. Apply the 20-minute technique

Throughout the day, if you are connected to work with computers, smartphones and other displays, take breaks every 20 minutes, on average, and look at some other point further away, such as a window or a painting, for example.

This serves to prevent the eyes from drying out too much since as we look at the illuminated electronic screens the tendency is for us to blink less.

2. Use humidifiers

It sounds like a silly tip, but the daily use of humidifiers on low humidity days doesn't just improve breathing. Dry eyes also benefit a lot from this habit, as it makes the environment more humid and reduces the dryness of the skin, eyes and even hair.

3. Drink water

Keeping your body hydrated is one of the most efficient ways to avoid dry eye problems. To do this, drink 8 to 10 glasses of water a day. This will keep your whole body grateful on days of low humidity.

4. Consume omega-3

Fish, avocado and even supplementation of this nutrient will help a lot to fight dry eyes at any time of the year.

5. Reduce sugar consumption


Not only do the drinks you sweeten have sugar, did you know? Soda, sweet foods and even pasta made with white flour contribute to the increase in blood sugar. The result of this, among other negative consequences, is the lack of hydration in the eyes.

6. Make hot compresses

Using warm compresses on your eyes is also a great way to combat dry eyes. To do this, place a warm cloth over your eyes, or tea bags (which already help to soothe your skin and fight dark circles), for at least 1 minutes.

This helps to melt the oils that can clog the tear glands, for example.

7. Use eye drops

Neutral eye drops, indicated to lubricate the eyes, are a very efficient way against dry eyes, at least when it comes to immediate relief. But, do not overdo the use, as the eye drops are still a medicine.

8. Wash with baby shampoo

It seems strange, but this type of shampoo does not irritate the eyes and still cleans the eyelashes and all this region of the residues that dry weather leaves on the skin.

9. Avoid fans

Although they help against the heat, fans and other devices that cause directed winds are terrible for the eyes and tend to make them dry out.

10. Blink more

A natural way to fight dry eyes is to police yourself to blink more. Unless you suffer from an eye problem, when you blink more often the moisture in your eyes increases and cleans impurities that can cause irritation, for example.

Eye Wash by Bausch & Lomb, Eye Relief Solution that Cleans, Refreshes, and Soothes, 4 Fl Oz (Pack of 6)

 Eye Wash by Bausch & Lomb, Eye Relief Solution that Cleans, Refreshes, and Soothes, 4 Fl Oz (Pack of 6)

  •     Eye-irrigating solution cleans, refreshes, soothes
  •     For daily or emergency eye cleansing
  •     Sterile isotonic solution contains boric acid, purified water, sodium borate, sodium chloride
  •     Sterile eye cup enclosed
  •     Please read all label information upon delivery

7 expert tips to clean your eyes properly


Did you know that improper cleaning of the eye region can cause disease and impair vision? Many people believe that washing your face is enough to keep your eyes clean. However, some details, such as removing the makeup completely and not putting dirty fingers in the eyes are essential to maintain health.

Some daily care must be taken to avoid problems. See below the tips from the ophthalmologist Ibraim Viana Vieira on how to properly clean your eyes:

1 - Wash eyelashes and eyelids with water, eye cleaning solutions or neutral shampoo
External eye hygiene is important to remove excess oil produced by the glands, as the accumulation of fat leads to local inflammation, risk of obstruction of these glands and increase the number of bacteria. The ophthalmologist recommends only the use of specific eye solutions or neutral shampoo, as they harm the eye tissues less.

2 - Always remove all makeup
Sleeping from makeup or keeping it in the region for very long periods facilitates the obstruction of the eyelid fat glands and can generate local inflammation, irritation of the conjunctiva and cornea. The removal must be carried out with suitable products so as not to affect the eyes.

3 - Avoid placing your hands on your eyes, especially without washing them or after using alcohol gel.
The hand can bring several foreign bodies to the eyes, such as dust, animal hair, viruses and bacteria. Not scratching your eyes with dirty hands is an important factor in decreasing the risk of infections.

4 - Eye drops can maintain the lubrication of the ocular surface, but only the ophthalmologist can identify the appropriate type and frequency
It is essential to consult an ophthalmologist before using any type of eye drops, whether the lubricant type without preservatives, lubricant with preservatives or vasoconstrictors. Self-medication and the indiscriminate use of these eye drops can lead the patient to have chemical conjunctivitis and medicated keratitis. More serious effects such as chronic red eye due to rebound effect and arterial hypertension can also be observed.

5 - Avoid sharing personal hygiene objects, such as handkerchiefs and face towels.
There are diseases that can be transmitted in this way, such as viral and bacterial conjunctivitis, in which transmission occurs by contact, and the sharing of personal objects, including eye drops, favors contagion.

6 - Avoid the application of boric acid water and saline.
The ideal is always to opt for the most tear-like products possible. Boric water should not be used, as it contains boric acid in its composition and may cause worsening of inflammation symptoms in some patients. The saline, although it looks more like the tear, can still be harmful to the eye mucosa and the cornea, with the use of lubricating eye drops being preferable.

7 - Be careful when handling contact lenses
. Wash them only with suitable solutions and respect the change time.
There are specific products for lens hygiene that allow the removal of residues that cause eye irritation and eliminate bacteria, fungi and protozoa that can cause serious infections.

Saturday, April 24, 2021

Refresh Optive Mega-3 Lubricant Eye Drops For Dry Eyes, Preservative-Free, 0.01 Fl Oz Single-Use Containers, 30 Count

 Refresh Optive Mega-3 Lubricant Eye Drops For Dry Eyes, Preservative-Free, 0.01 Fl Oz Single-Use Containers, 30 Count

  •     Preservative-free moisture-rich formula; On-the-go single use vials
  •     Designed to relieve eye dryness that may be due to Meibomian Gland Dysfunction.
  •     Delivers advanced hydration and lubrication
  •     Supports all three tear film layers
  •     Helps prevent tears from evaporating
  •     The only eye drop in the U.S. with Carboxymethylcellulose Sodium, Glycerin, and Flaxseed Oil (an inactive ingredient)
  •     Hydrocell technology enables hydration and maintains the volume of cells on the ocular surface
  •     The Number 1 selling brand in preservative-free artificial tears; IRI Artificial tears preservative-free dollar and unit sales by manufacturer, 52 weeks ending 11/29/20

Dry eye


What is dry eye?
We say that we are facing a dry eye when there are no tears in sufficient quantity and quality to keep the eyes lubricated, and the problem may affect only one eye (unilateral) or, then, both eyes (bilateral). In most cases, the problem affects both eyes.

In certain occasions or circumstances, the eye may be dry without any eye problem or eye disease. Pollution, overexposure to the sun, wind, exposure to air conditioning or environments that somehow make the air drier, are factors that can act as facilitators in the evaporation of tears and, in this way, cause dryness in the eyes. .

Watching television for long periods or frequent use of a computer, mobile phone, tablets, and other digital devices also causes dry eye. This fact is related to the difference between the number of times that we “blink” our eyes in a usual way and when we use this type of devices. In addition to these, other factors may be at the root of the problem. See more information on factors that contribute to dry eye and prevention.

In some patients there may be an eye problem (pathology) that causes dry eye, as we will see below.

Dry eye syndrome
In dry eye syndrome or dry eye disease, there is not enough tears produced, or even though the tears are sufficient, they do not have the quality necessary to keep the eyes lubricated.

Tears also aim to protect the eye surface from infections and harmful effects of the environment. These contain vitamins, minerals, proteins and lipids. The presence of all these substances allows to obtain quality tears to hydrate, feed and lubricate the cornea.

Tears are produced by the tear glands, located behind the upper eyelid. With blinking, they spread and make the corneal surface shiny and transparent, forming the tear film.

The tear film consists of three layers: lipid, aqueous and mucin. The lipid layer is the outermost layer and prevents the evaporation of the tear, the innermost layer is the mucin and allows the tear film to stick to the cornea, in turn, the thickest layer is the watery layer and consists of water.

The eye can be considered dry not only due to the lack of sufficient quantity of these constituents, but also when the quality is altered. The eye may be dry not only due to the quantity of these constituents but also if the quality is altered.

Thus, if the diagnosis of dry eye syndrome is confirmed, the patient, as he has poor eye lubrication, the eye suffers a kind of aggression, even trauma, with blinking.

When dry eyes occur upon waking up, this problem is likely to be related to dry eye syndrome or disease, that is, there is a decrease in the amount of tears, essentially in the basal production, or deficiency in the quality of the same, namely, alteration of the lipid layer or the mucin of the tear film.

Dry eye symptoms
In dry eye, one of the most frequent symptoms is redness and burning or itchy eyes . The p excessive tears roduction ( " watery eyes "), al excessive eye rritação (smoke or wind) eod esconforto and complications with the use of contact lenses are also the most frequent signs and symptoms in dry eye.

Patients typically report that their eyes are dry and red, accompanied by burning. Blurred or "blurred" vision can occur , fundamentally, at the end of the day. In some situations there may be pain in the eyes that can be more severe in the most severe cases.

Patients who suffer from dry eye syndrome experience several signs and symptoms that can cause a lot of discomfort, fundamentally, in the presence of severe dry eye.

Causes of dry eye
The most frequent causes of dry eye are: age, menopause, use of a computer in a continuous or excessive way, air conditioning, use of contact lenses and some medications (diuretics, antihistamines, benzodiazepines, antidepressants, analgesics, contraceptives, in some eye diseases and in some systemic diseases, etc.). Dry eye can occur in people of both sexes and at any age, although the female sex is the most affected.

The diagnosis must be made by an ophthalmologist through tests that measure the quality and production of tears. The tests are quick, painless and non-invasive.

Is dry eye curable?
Dry eye syndrome has no cure . However, there are effective ways of controlling the disease that allow patients to restore their lives to a perfectly normal life. Next, learn how to treat dry eye.

Dry eye treatment
The treatment for dry eye essentially involves the use of artificial tears in drops ( eye drops ) placed in the eyes several times a day, as needed. Sometimes, the use of eye drops is not enough and it may be necessary to use anti-inflammatories, antibiotics, among others, for an effective control of the disease. In certain situations, the occlusion of the tear points is useful, avoiding the drainage of tears through the tear pathways, allowing their maintenance on the ocular surface.

The ophthalmologist, based on the observation and exams performed, will make the decision about the treatment for dry eye most appropriate for each patient.

Patients, in addition to medical treatment, should avoid contact with the risk factors mentioned above, such as prolonged and excessive use of the computer (taking breaks for example), avoiding air conditioning, etc.

Eye drops for dry eye
In the treatment of dry eye, several types of artificial tears ( eye drops ) are used , it is important to choose the best eye drops for an effective treatment. In these eye drops it is essential that no preservatives are present, since their use can cause serious eye allergies ( conjunctivitis ).

Counseling with the ophthalmologist (specialist in ophthalmology), on the correct use of eye drops for dry eyes, or other medication, is essential for an effective treatment.

Dry eyes - what to do?
In addition to the consultation with an ophthalmologist in order to make a possible diagnosis of dry eye syndrome, it is also necessary to take some preventive measures or "natural treatment" for the health of your eyes.

Changing habits when using a computer or other digital devices, choosing a monitor, adapting lighting in the workplace and at home, routines during the day or night, among others, are all measures that can help prevent or treat the problem of dry eyes.

Xlear Nasal Spray with Xylitol, All-Natural Saline Nasal Spray for Sinus Rinse & Sinus Relief 1.5 fl oz

Xlear Nasal Spray with Xylitol, All-Natural Saline Nasal Spray for Sinus Rinse & Sinus Relief 1.5 fl oz
 

  •     NATURAL SALINE SOLUTION & NASAL RINSE: Our nasal saline spray will gently clean and moisturize the sinus tissues. Unlike other normal saline nasal sprays our spray can also decongest the sinuses by targeting the primary causes of nasal congestion. Our nose spray will help reduce tissue swelling from pollen, pollution, bacteria, and other irritants.
  •     SAFE NASAL RINSE & SPRAY: Our all-natural nasal cleaner is safe for kids, non-addictive, Non-GMO Project Verified and is effective without the use of steroids, drugs, or chemicals. It is the ideal daily sinus medicine that will reduce swelling and open your airways. Using our saline nose spray before bed may reduce snoring.
  •     IMPROVED FORMULA WITH XYLITOL: Our patented saline nasal spray solution may reduce tissue inflammation and naturally open airways. Xylitol's powerful oral and upper respiratory health benefits come from its unique five-carbon structure. Xylitol may help reduce swelling and allergy symptoms by reducing bacterial adhesion on your nasal tissue.
  •     EASY TO USE DIRECTIONS: Clear the nasal passageway by gently blowing your nose before using Xlear. Prime the pump by holding the sinus rinse bottle upright and pumping one or more times until the saline solution is dispensed. Insert nozzle into nostril and depress pump completely while breathing in through your nose. Spray each nostril 2-4 times and use at least twice daily.
  •     WASH AWAY POLLUTANTS: Our natural saline nasal spray can wash away pollutants and help to bring sinus relief. Use our sinus spray daily to protect and keep your nasal passages clean. Each 1.5 oz bottle delivers approx. 240 fine mist Sprays so you can find fast and quick relief.

SYNUSITIS - SYMPTOMS, CAUSES AND TREATMENT


WHAT IS SINUSITIS?
Sinusitis, or sinusopathy, is the name given to inflammation of the paranasal sinuses, also known as the sinuses.

Sinusitis can result from viral, bacterial or fungal infections, allergies or immune system problems, including autoimmune diseases .

Sinusitis is usually accompanied by rhinitis , which is inflammation of the nasal cavity, causing a condition called rhinosinusitis. In most cases, rhinosinusitis is caused by respiratory viruses, such as rhinovirus, influenza virus and parainfluenza virus.

WHAT ARE PARANASAL SINUSES?
Paranasal sinuses, also called nasal sinuses or sinuses, are air-filled cavities within the skull and face bones, which communicate with the nasal cavity.

There are four number of paranasal sinuses, namely:

  • Frontal sinus.
  • Ethmoidal sinus.
  • Sphenoid sinus.
  • Maxillary sinus

The sinuses are important anatomical structures, as they perform the following functions:

  • Humidification and heating of the air breathed through the nose.
  • Increased voice resonance.
  • Balance of intracranial pressures when there are variations in atmospheric pressure (dives, plane trips or high altitude climbs).
  • Mucus secretion for protection of the upper airways.
  • Impact absorption in cases of trauma (hollow materials absorb more impact than solid materials).
  • The paranasal sinuses are bilateral and symmetrical, connected to the nasal cavity through small holes through which the mucus produced is drained.

Allergies or flu, for example, cause edema of the nasal mucosa and increased secretions, easily obstructing the drainage of the sinuses. The inability to drain the mucus produced leads to sinus congestion and, consequently, sinusitis.

TYPES
Sinusitis can affect any of the 4 paranasal sinuses, and can be bilateral or unilateral.

Sinusopathy can be classified into:

  • Acute sinusitis : when symptoms last less than 4 weeks.
  • Subacute sinusitis : when symptoms last between 4 and 12 weeks
  • Chronic sinusitis : when symptoms last more than 12 weeks.
  • Recurrent sinusitis : when there are 4 or more episodes of sinusitis during the year.
  • The vast majority of acute sinus infections are of viral or allergic origin, but it is not uncommon for them to turn into bacterial sinusitis.

It turns out that the obstruction and stasis of mucus in the sinuses favor the proliferation of bacteria that live quietly in the airways. The patient, therefore, may have an initial case of allergic or viral sinusitis that after a few days can turn into a bacterial sinusitis.

Bacterial sinusitis that is not completely cured can progress to chronic sinusitis.

SYMPTOMS
The main symptoms of acute sinusitis are:

  • Nasal congestion .
  • Purulent nasal discharge (yellowish coryza).
  • Headache .
  • Pain in the face.
  • Pain in the upper dental arch.
  • Pain around the eyes.
  • Feeling of pressure when the head is lowered.
  • Clogged ears,
  • Cough (mostly nocturnal).
  • Decreased taste and smell.
  • Pain is common when pressure is placed on the sinuses with the fingers, especially in the frontal and maxillary sinuses, which are the most superficial.

Most cases of viral or allergic sinusitis improve spontaneously within 10 days. Mild bacterial sinusitis can also be self-limiting, but in the most symptomatic cases, with high fever and a purulent runny nose, the cure usually only comes with antibiotic treatment.

Bacterial sinusitis
When there is contamination of sinusitis by bacteria, fever is common. However, as the flu can trigger sinusopathy and also develop a fever, it is not always easy to distinguish between viral sinusitis and bacterial sinusitis. As already pointed out, sinus disease can start as a viral infection or an allergic condition and after a few days it turns into bacterial sinusitis.

In many cases it is not possible to distinguish between viral sinusitis and bacterial sinusitis in the first 10 days of illness.

The existence of an acute bacterial rhinosinusitis should be suspected in patients with any of the following characteristics:

  • Signs or symptoms of acute sinusitis lasting 10 days or more with no clinical improvement.
  • Onset of the condition already with more severe symptoms, such as fever above 39ºC and purulent nasal discharge, lasting at least three consecutive days.
  • Acute sinus disease that improves after a few days, but suddenly worsens again, with fever, pain in the face and a purulent runny nose.


COMPLICATIONS

As the sinuses are closely related to noble organs, such as eyes, ears and brain, bacterial sinusitis can lead to serious complications.

It is important to seek medical attention whenever there are the following signs of complication listed below:

  • Fever above 39ºC.
  • Edema or redness on the face.
  • Edema and redness around the eyes.
  • Double vision or any other visual change.
  • Mental confusion.
  • Very severe headache.
  • Neck stiffness.
  • Intense prostration.

Bacterial sinusitis, despite having a low mortality rate, is an infection that should not be overlooked, especially when there are the signs described above.

Among its possible complications we can mention the infection of the eyes, meningitis , brain abscess, infection of the bones of the face, otitis and labyrinthitis .

DIAGNOSIS
The diagnosis of sinusitis is almost always clinical, obtained through history and physical examination.

If the doctor you are attending is an otorhinolaryngologist, he can perform a rhinoscopy (nasal endoscopy) to try to directly view the paranasal sinuses and confirm the clinical suspicion.

X-ray of the sinuses
In case of doubt, imaging tests may be used. The radiography of the sinuses, widely used in the past, is no longer considered a good exam, as its sensitivity is low.

When the result is positive, as in the photo below, which shows sinusopathy of the left maxillary sinus, the diagnosis can be confirmed. The problem is that if the radiograph is normal, you cannot rule out the existence of sinusitis, as the test cannot detect up to 40% of cases.

Computed tomography of the sinuses

The most used imaging exam today is computed tomography (CT). Compare the images below with two CT scans of the sinuses and see how the quality of the images is much higher.

Sinusitis
The CT on the right is normal and the paranasal sinuses are filled only with air (black image). On the left, we can see a CT scan of the sinuses showing bilateral sinusopathy, more evident in the right maxillary sinus, which is completely filled with liquid (gray image).

The images provided by TC are much better defined. Contrary to what happens in the simple radiography of the sinuses, a computed tomography scan with normal results is able to exclude the diagnosis of sinusitis.

TREATMENT
Most cases of acute sinusitis improve spontaneously in 7 to 10 days. Treatment, therefore, is basically symptomatic. Even bacterial sinusitis usually has a good prognosis, as complications are uncommon.

For the treatment of acute non-bacterial sinusopathy, it is indicated to wash the nasal cavity with saline solution (saline) and spray nasal corticosteroids . Warm compresses on the face can bring relief, and vigorous fluid intake helps to dilute secretions.

During attacks it is important to avoid contact with cigarette smoke, as this is an important irritation factor in the airways. In addition to smoke, it is important to try to identify other stimuli that may be irritating to the airways, such as cold or strong odor-producing chemicals.

Apart from these guidelines, nothing else is very effective. Contrary to what most people think, it is not necessary to fill up with medicines to treat sinusitis.

Nasal decongestants
Nasal decongestants are often used excessively and unnecessarily. When necessary, its use is indicated for a maximum of 3 days, since these drugs are associated with relapses, caused by rebound nasal congestion. The patient uses the decongestant, has temporary relief of symptoms, but when he suspends it, nasal congestion returns quickly, thus creating a vicious cycle.

Antihistamines
The use of antihistamines (antiallergic), despite being widely prescribed, does not present evidence of benefits in sinusitis. If there is no allergic process behind it, it is unlikely that this class of remedies will bring any benefit.

Antibiotics
Antibiotics should only be used when there is evidence of bacterial sinusitis. The most used are amoxacillin with clavulanic acid , Bactrim® , levofloxacin, moxifloxacin, clarithromycin or azithromycin .

Care must be taken not to use antibiotics indiscriminately so that there is no selection of resistant bacteria. If sinus disease does not have characteristics of bacterial origin, there is no reason to use antibiotics.

CHRONIC SINUSITIS
Chronic sinusitis is one that remains for more than 12 consecutive weeks despite treatment.

The chronic form is very associated with the presence of deviated nasal septum and / or nasal polyps . Both provide chronicity because they cause communication obstruction between the paranasal sinuses and the nasal passages.

Other causes of chronic infection are fungus sinusitis, gastroesophageal reflux disease , recurrent respiratory allergy, HIV , asthma and cystic fibrosis.

While acute sinusitis usually resolves on its own in a few days, chronic sinusitis is an inflammation that is more difficult to control and should always be evaluated by an otolaryngologist. Despite being difficult to cure, it can be controlled with appropriate treatment.

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Breathing through your mouth and 5 more signs that you don't breathe properly


What is Breathe Well?

This may seem like an easy question, but in practice it is not always. The thermometer can accurately measure our temperature. We can easily measure blood pressure, heart rate and even breathing, but there is no simple and definitive way to measure the quality of breathing .

There are some old tests like the Glatzel mirror (photo) and others more sophisticated like the computerized rhinomanometry, but both are just a way to see the respiratory restriction. While many people are uncomfortable with the way they breathe and seek help in our offices, others are not even aware that they have a serious problem. Some take their lives to breathe through their mouths, with their chronically blocked nose due to allergies, infectious, inflammatory changes and anatomical deformities.

When the problem gradually sets in, this mouth breathing can gradually be considered “normal”. That is why we often treat patients who simply do not breathe through their nose, but came to us for other issues, be it a hearing loss or a sore throat. Only when asked about the quality of their breathing that they begin to be aware of the problem ...

Our oxygen every second

Breathing provides us with access to one of our fundamental “foods”:  oxygen . Although nitrogen represents almost 80% of the composition of the air we breathe, it is the 20% of oxygen that most interest the proper functioning of our cells. Without it, there could be no physiological reactions that transform fats and sugars into energy, in a phenomenon known as cellular respiration.

For oxygen to get there in the cells, we need to draw room air into our lungs through inspiration . It is in the pulmonary environment that, inside the alveoli, oxygen is exchanged for carbon dioxide, produced by breathing. After this exchange (oxygen for carbon dioxide), the air is expelled from the lungs back to the atmosphere by exhalation , completing the respiratory cycle that is repeated an average of 15 times every minute in adults, or 21,600 times a day! Most of the time, especially during all sleep, breathing happens automatically and unconsciously.

However, we need to assume it consciously for some important physiological acts such as speaking (and singing), playing sports, sneezing, yawning, laughing or playing a wind instrument. Some meditation techniques, such as Yoga, are also based on voluntary breathing control.

The wing opener
For oxygen to start its way to the lungs and cellular respiration, ambient air must first pass through the nose. Located right in the middle of our face, the nasal pyramid and its nostrils are the entrance gates of this journey. More than that, inside the nasal cavities the ambient air is tempered (heated or cooled), humidified and partially filtered, through an efficient cleaning and drainage system, with the participation of hair cells and mucus producers.

Cellular cilia act as a "conveyor belt" capable of carrying away trapped particles, viruses and bacteria, while antibodies present in the mucus begin to attack and destroy them. Thanks to this protective role the nose is known as the guardian of the lung .

Breathe through your mouth
Chronic nasal obstruction leads to a picture that is already well known to doctors, dentists and speech therapists: mouth breathing. Nasal airflow is essential for the development of facial anatomy. When a chronically obstructed nose is established, the nasal airflow starts to generate a series of deformities, especially in children: tapering face, short upper lip without closing the mouth, dental malocclusion, high and deep palate (roof of the mouth) that reduces the size of the nasal cavity.

Some of these deformities are irreversible and will affect respiratory quality for the rest of your life. The fight against mouth breathing should be intensive and as soon as possible.

Other Signs
Although most people who do not breathe well through their nose are aware of this, some secondary signs can help to suspect a nasal breathing problem.

Breathing discomfort
Many people report “bad” breathing, but without being able to explain how and why. Although breathing also occurs consciously, it is not expected to be uncomfortable. When you have to focus your attention repeatedly on your breathing or nasal obstruction, it is best to go and see what is going on. We used to say that " a good nose is one that we don't even remember that we have ".

Snoring at night

Snoring often cannot be considered normal. The breathing noise that generates snoring is a clear sign that something is obstructing the flow of air and preventing good breathing during sleep. This phenomenon often leads to sleep apnea , a disease that can become serious and fatal.

Short of breath for physical exercises
When we are quiet or at rest, our demand for oxygen is low. By putting the body in motion, especially in aerobic activities, our muscle cells greatly increase their demand for energy and the oxygen needed to create it in cellular respiration. As a consequence, we need more "air" entering the nose. In this situation, it is common for people who have already become accustomed to poor breathing at rest to perceive their restriction more clearly, getting tired more quickly than normal. It is a frequent complaint in patients with deviated nasal septum .

Decreased sense of smell and taste
The sense of smell is the result of the reception of chemical particles by receptors of olfactory cells, present in the roof of the nasal cavity. When the flow of air through the nose is blocked to some extent, these receptors stop receiving the chemical signals necessary for their detection. The reduction of smell, and consequently of taste, is frequently seen in cases of nasal polyposis.

Constant nasal discharge
The passage of air through the nasal cavity, in addition to providing comfortable breathing and the correct development of facial anatomy, also helps to keep you “dry”. Clogged noses also tend to produce phlegm, since the internal swelling of its mucous surface increases mucus production and becomes a culture medium for bacteria, making rhinitis and sinusitis frequent  .