1. Dr muaid I. Aziz FIMCS

2.  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

3. Rhinosinusitis allergicinfectious other

4.  Definition: Clinically defined by a combination of 2 or more of nasal symptoms Running Blocking Itching sneezing

5.  Ig E ( TYPE 1 HSR)

6.  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

7. How you classify allergic rhinitis?

8. persistant Allergic Rhinitis Intermittant

9.  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.

10.  Seasonal ( intermittent )  Sneezing  rhinorroea  Itching  Perennial ( continous)  Nasal obstruction  Poor sense of smell  Chronic inflammatory rhinosinusitis

11.  History  Examination  investigation

12.  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

13. Normal mucosaSwollen oedematous pale or bluish color

14.  Allergy diagnosis  1. skin prick test (SPT)

15. How you can control allergic rhinitis?

16. avoidancediet Medical therapy immunotherapy Control of allergic rhinitis

17. Allergen avoidance Outdoor triggers Indoor triggers

18. Indoor allergens Dust mites Animal dander CockroachMold

23. dust & dust mites Dusting Washing w hot water Animal dander& other pet allergens By restricted location Get arid of it molds Cleaning bath tube showers 

24. Outdoor triggers MoldPollen

26.  Stay inside  Closed windows & doors  Avoid fan w open window  Avoid bringing pollen back into your home

27.  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.

28. Natural allergy relieve Antihistamines OR Decongestants Steroids Leukotrienes modifiers

29.  How to prepare it ?  When to use it ?  How to use it ?  How its effect or help allergy relieve?

30.  Mix 2-3 tsp of non iodized salt + 500 cc H2O + one tsp of packing soda.

31.  Exposed to pollen outdoors ( at the end of the day)  For moisturing in dry nose in winter  Pre steroid application

32.  Neti pot  Syringe  Cupped hands

33.  Remove the pollens  Thining the mucous & relieve the obstruction  Keeping cilia healthy.

34.  For relieving running,itching,& sneezing.  Little effect on nasal obstruction  Non sedative (2 nd generation)

35.  Reduce inflammation, nasal sx., Eye sx, improve sense of smell

36.  For unblock of the nose at the start of treatment or for very sever sx,