Invited as National Faculty

Its such a privilege for someone to be invited to a National Conference that too in Head & Neck Oncology 

ADHD or just Adenoidal Swelling?

Many a times I see parents who have a hyperactive child and worse they would have put the child in a special school or even taken the child to a child psychologist. What majority forget is that Adenoidal swelling mimics Attention Deficit Disorder.

One of the thing every parent should note is how their child breathes at night.

If in doubt take the child to a specialist who also specializes in paediatric ENT and paediatric sleep apnea disorders, its much easier to rule out Adenoid as the cause but the negative impact on the child once branded ADHD is too huge a price to pay.

My Typical Thyroid Incision - Nationally & Internationally - Irrespective of the Size

Its not easy to do small incision #thyroids especially in Middle East. These are technically very challenging and the space is extremely limited and one needs to be very sure about the Anatomy of the region. One mistake and you can either cut the nerve or you can injure an important blood vessel. I have been doing it for the last 15 years both in India and in International locations. The advantage is not just the non noticable scar but also early recovery since these do not need drains and patient can be discharged on the same day or utmost the next day.

Coping With Stress - Part 1

What is stress?

Stress is defined as any demand (force, pressure and strain) placed on the body and the body’s reaction to it. Stress is experienced by everyone who is living, working, and breathing at this very moment. It is a fact of life you cannot avoid. All stress is not bad. In small doses, stress can be a good thing. It can give you the push you need, motivating you to do your best and to stay focused and alert. Stress is what keeps you on your toes during a presentation at work or drives you to study for your midterm when you'd rather be watching TV. But when the going gets too tough and life's demands exceed your ability to cope, stress becomes a threat to both your physical and emotional well-being and makes you feel anxious, afraid, worried and uptight.

 

What causes stress and its symptoms?

The potential causes of stress are numerous. There are many major events that occur in our lives: moving, leaving school, changing jobs, and experiencing losses. We also face many "daily hassles". These are events that occur routinely. Daily hassles include events such as being stuck in traffic, deadlines and conflicts with family members, and dealing with bust city life. The causes of stress are highly individual. What you consider stressful depends on many factors, including your personality, general outlook on life, problem-solving abilities, and social support system. Something that's stressful to you may be neutral or even enjoyable to someone else. For example, your morning commute may make you anxious and tense because you worry that traffic will make you late. Others, however, may find the trip relaxing because they allow more than enough time and enjoy playing music or listening to books while they drive. Whether or not the source of stress causes significant emotional and physical symptoms depends in part on the nature of the stressor itself.

What are the possible signs and symptoms of stress?

Stress affects the mind, body, and behavior in many ways and has the potential to harm your health, emotional well-being, and relationships with others. 

How stress can affect your mind	How stress can make you feel
Memory problems. Difficulty making decisions. Inability to concentrate. Seeing only the negative. Repetitive or racing thoughts.  Poor judgment.	Moody and hypersensitive. Restlessness and anxiety. Depression. Anger and irritability Sense of being overwhelmed. Lack of confidence.
How stress can affect your body	How stress can affect your behavior
Headaches. Digestive problems. Muscle tension and pain. Sleep disturbances. Fatigue. Chest pain. High blood pressure. Weight gain or loss. Asthma or shortness of breath. Skin problems.	Eating more or less. Sleeping too much or too little. Neglecting your responsibilities. Increasing alcohol and drug use. Nervous habits (e.g. nail biting, pacing). Teeth grinding or jaw clenching. Overdoing activities such as shopping. Losing your temper. Overreacting to unexpected problems.

Keep in mind that the signs and symptoms of stress can be caused by other problems, so it’s important that you consult a doctor to evaluate physical symptoms.

 

Can stress hurt my health?

The stress response of the body is meant to protect and support us. When faced with a threat, the body's defenses kick into high gear. Our heart rate and blood flow to the large muscles increase, the blood vessels under the skin constrict to prevent blood loss in case of injury, the pupils dilate so we can see better, and our blood sugar ramps up, giving us an energy boost.

In the modern world, most stressors are psychological, rather than physical. Unfortunately, our bodies don't make this distinction. The problem with the stress response is that the more it is activated, the harder it is to shut off. Instead of leveling off once the crisis has passed, the stress hormones, heart rate, and blood pressure remain elevated. Extended or repeated activation of the stress response takes a heavy toll on the body. The physical wear and tear it causes includes damage to the cardiovascular system and immune system suppression. Stress compromises the ability to fight off disease and infection, makes it difficult to conceive a baby, and stunts growth in children. In an attempt to cope with stress, some people drink too much alcohol, abuse drugs, blame others (e.g. spouse or parent), and may become physically violent, most often with family members.

Health Problems Linked to Stress
Heart attack Hypertension Stroke Diabetes Depression Obesity Eating disorders	Substance abuse Ulcers Irritable bowel syndrome Memory loss Insomnia Thyroid problems Infertility

My Child Wakes Up With Pain in the Ear - What To Do

Acute Pain causing extreme discomfort to the Child will happen because of many reasons,one of  the commonest of these is Otitis media which is a build up of fluid in the middle ear, the space between the eardrum and the inner ear. The middle ear is usually filled with air. Sometimes it gets filled with fluid or mucus, for example during a cold. 

Symptoms

• severe earache, due to the pressure of the mucus on the eardrum, 
• fever; 
• flu-like symptoms in children, such as vomiting and lethargy;  
• slight deafness.

Babies with ear infections will be hot and irritable. They cannot point to the source of discomfort so it can be hard to tell what is wrong with a baby, but an ear infection is one possibility to consider if your baby is unsettled in this way.

In rare cases the eardrum will become perforated (a hole will form in it), and pus will then be seen running out of the ear.  This sometimes helps to relieve pain, by releasing the pressure on the eardrum, but can lead to reinfection.

Not all earaches are caused by ear infections - especially if there are no other symptoms. Earache may also be caused by build up of uninfected mucus after a cold, or toothache.

Causes

The infection spreads from the nose or throat through the Eustachian tube, a passage between the throat and the middle ear.

Any fluids in the ear usually run out through the nose, via the Eustachian tube. If this tube gets blocked it can lead to otitis media. Enlarged adenoids or tonsils, which are at the back of the throat, may block the Eustachian tube.

A perforated eardrum may get infected if water enters a child's ear during bathing or swimming.

Treatment

Around 80% of cases of acute otitis media clear up within three days without any treatment. Perforated ear drums also usually heal by themselves.

While antibiotics may help with the short-term symptoms, there is no evidence that they make otitis media clear up faster or reduce the chance of complications happening.

Pain killing drugs like paracetamol or ibuprofen may be used to control the symptoms of otitis media (pain and fever).

Nose drops containing decongestants or antihistamines may be used to reduce the swelling of the mucous membranes in the nose and back of the throat. In theory, this will help to keep the Eustachian tubes clear and allow mucus to drain from the middle ear, but again, this has not been proved to be an effective treatment for otitis media.

Removal of the adenoids and tonsils may help if they are blocking the entrance to the Eustachian tube.

Prevention

There is little evidence that any specific measures prevent otitis media.

If acute ear infections are treated quickly, and there is a follow up examination to check that the infection is completely cured, this reduces the chances of chronic (recurring) infection developing.

Dr.Kumaresh Krishnamoorthy, M.S (ENT)

Head and Neck Surgery Fellowship (Buffalo, USA)

Neurotology & Skull Base Surgery Fellowship (Cincinnati, USA)

Senior Consultant in ENT - Head and Neck Surgeon and Skull Base Surgeon

patients@drkumaresh.com

What is Bad Breath...

Bad breath, sometimes called halitosis, means that you have an unpleasant smell on your breath that other people notice when you speak or breathe out. The exact number of people with bad breath is not known, but it is common.
 How can I tell if I have bad breath?
A main problem with bad breath is that the only person not to notice it is the person affected. (You get used to your own smell and do not tend to notice your own bad breath.) Often, the only way to know about it is if a person comments on it. However, most people are too polite to comment on another person's bad breath. You may have to rely on a family member or a close friend to be honest and tell you if you have bad breath.
Some people suggest a simple test which you can do yourself to detect bad breath. Lick the inside of your wrist. Wait a few seconds for the saliva to dry. Then smell the licked part of the wrist. If you detect an unpleasant smell you are likely to have bad breath.
 Causes and types of bad breath
Most cases of bad breath come from problems within the mouth such as poor oral hygiene or gum disease.
Morning bad breath
Most people have some degree of bad breath after a nights sleep. This is normal and occurs because the mouth tends to get dry and stagnate overnight. This usually clears when the flow of saliva increases soon after starting to eat breakfast.
Foods, drinks and medicines
Chemicals in foods can get into the bloodstream, and then be breathed out from the lungs. Most people are familiar with the smell of garlic, spicy foods and alcoholic drinks on the breath of people who have recently eaten or drunk these. Various other foods and medicines can cause a smell on the breath. This type of bad breath is temporary and easily cured by not eating the food.
Smoking
Most non-smokers can tell if a person is a smoker by their breath which 'smells like an ashtray'. Stopping smoking is the only cure for this type of bad breath. Smoking also increases the risk of developing gum disease, another cause of bad breath.
Crash dieting or fasting
Causes a 'sickly sweet smell' on the breath. This is due to chemicals called ketones being made by the breakdown of fat.
Medical causes
Gum disease is a common cause of bad breath. Some people with nose problems can get bad breath. For example, a polyp in a nose, sinusitis or a 'foregin body' stuck in a nostril (occurs most commonly in children) can cause a bad smell. In this situation the smell tends to occur only, or more severely, when you breathe out through your nose. Lung or tonsil infections are sometimes a cause. Other causes are rare.
However, in these 'medical' cases, there are usually other symptoms that would indicate the cause. For example, a blocked nose, sinus pain, chest symptoms, etc. If you are otherwise well and have no other symptoms apart from bad breath, the bad smell is likely to be coming from the mouth and other 'medical' causes are unlikely.
 Bad breath coming from within the mouth
As mentioned, in most people who have bad breath the bad smell is thought to come from bacteria within the mouth. As the bacteria break down proteins and other debris in the mouth, they release foul smelling gases. One or more of the following may contribute to the build up of bacteria and bad breath.

• Food stuck between teeth. Normal teeth brushing may not clear bits of food (particularly tiny bits of meat) which can get stuck between teeth. The food then rots and becomes riddled with bacteria. Regular flossing can clear and prevent this problem.
• Plaque, calculus and gum disease. It forms when bacteria combine with food and saliva. Plaque contains many types of bacteria. Calculus, sometimes called tartar, is hardened calcified plaque. It sticks firmly to teeth.
• Coating on the back of the tongue. In some people, a 'coating' develops on the back part of the tongue. It is not clear why this occurs. It may be from mucus that drips down from the back of the nose ('post nasal drip'). The coating can contain many bacteria.
• Mouth tumours that ulcerate and become infected are an uncommon cause of bad breath.

The treatment of bad breath coming from within the mouth is good oral hygiene.
 Routine oral hygiene - a cure for most cases of bad breath
It is important to get into a regular habit of good oral hygiene - in particular teeth brushing and flossing.
Teeth brushing
Brush your teeth at least twice a day. Use a soft-tufted brush. The head of the brush should be small enough to get into all the areas of the mouth. Spend at least two minutes brushing, covering all areas (the inside, outside, and biting areas of each tooth). Pay particular attention to where the teeth meet the gum. Get a new toothbrush every 3-4 months.
Flossing
Floss your teeth at least once a day after brushing, and preferably twice a day. (Some people who have not flossed before are surprised as to how much extra debris and food particles can be removed by flossing in addition to brushing.)
The gums may bleed a little when you first begin to floss. This should settle within a few days. If it persists then see a dentist as regular bleeding after flossing may indicate early gum disease.
Other general tips
Other things which are important to keep your teeth and gums healthy are:

• If you smoke, try to stop. Gum disease is more common in smokers than non-smokers.
• Eat a well balanced healthy diet. In particular, you should limit the amount of sugary foods and drinks that you have. Sugars and sugary foods in the mouth are the main foods that bacteria thrive on to make acid which can contribute to tooth decay.
• Have regular dental checks at intervals recommended by your dentist (this is normally at least once a year). A dentist can detect excessive build up of plaque and remove calculus. Early gum disease can be detected and treated to prevent it from getting worse.

 Dr. Kumaresh Krishnamoorthy
Senior Consultant
Dr Kumaresh ENT Clinic

Know About Dr Kumaresh - Otolaryngologist

Priviledged to be Invited as International Faculty

It was a great privilege and wonderful feeling to be invited as an International Faculty at the recently concluded Middle East Conference. There were only about 8 faculties of which 3 were from India and I was one of them.
That my skills and knowledge is being appreciated worldwide is all thanks to my patients and those I trained.
Spoke on the Challenges of Starting a New Cochlear Implant Program and about Sudden Hearing Loss, was well received.

Send SMS for Appointment, Contact Dr and many more...

This New Year Dr Kumaresh ENT Clinic introduces many new features:

1) No it is easier to get an appointment either through SMS or through Online Appointment system

2) Know about the Senior Consultant

3) Lost on the way, get the Geo location

4) Whatsapp or Email the doctor

5) Tweet us

6) Contact the Manger for any special requests/feedback or complaints

7) Or just Connect with the Clinic on Social Media


All by just

Visiting this Page or just scan the

QR Code...

From Need for Hearing Aids to Almost Normal Hearing

This 30 plus patient had history of failed ear surgeries in the past and had come with lots of hope
He had a huge hearing loss because of his ear drum perforation and was advised
hearing aids, felt depressed and came for an opinion. He underwent Cartilage Tympanoplasty...

Post Surgery:

CV of Dr Kumaresh - Senior Consultant Dr Kumaresh ENT Clinic

Halitosis or Bad Breath

What is bad breath?

Bad breath, sometimes called halitosis, means that you have an unpleasant smell on your breath that other people notice when you speak or breathe out. The exact number of people with bad breath is not known, but it is common.

How can I tell if I have bad breath?

Since you get used to your own smell and do not tend to notice your own bad breath, often, the only way to know about it is if a person comments on it. However, most people are too polite to comment on another person's bad breath. You may have to rely on a family member or a close friend to be honest and tell you if you have bad breath.

Perhaps you could ask your dentist next time you have a check up. A dentist will normally be able to say if you have bad breath. Gum disease is a common cause of bad breath and a dentist will be able to advice on treatment if you have gum disease.

Some people suggest a simple test which you can do yourself to detect bad breath. Lick the inside of your wrist. Wait a few seconds for the saliva to dry. Then smell the licked part of the wrist. If you detect an unpleasant smell you are likely to have bad breath.

Causes and types of bad breath

Most cases of bad breath come from problems within the mouth such as poor oral hygiene or gum disease.

Morning bad breath
Most people have some degree of bad breath after a nights sleep. This is normal and occurs because the mouth tends to get dry and stagnate overnight. This usually clears when the flow of saliva increases soon after starting to eat breakfast.

Foods, drinks and medicines
Chemicals in foods can get into the bloodstream, and then be breathed out from the lungs. Most people are familiar with the smell of garlic, spicy foods and alcoholic drinks on the breath of people who have recently eaten or drunk these. Various other foods and medicines can cause a smell on the breath. This type of bad breath is temporary and easily cured by not eating the food. (However, some people eat spiced food every day and as a result will constantly have a typical smell on their breath.)

Smoking
Most non-smokers can tell if a person is a smoker by their breath which 'smells like an ashtray'. Stopping smoking is the only cure for this type of bad breath. Smoking also increases the risk of developing gum disease, another cause of bad breath.

Crash dieting or fasting
Causes a 'sickly sweet smell' on the breath. This is due to chemicals called ketones being made by the breakdown of fat. Some ketones are then breathed out with each breath.

Acidity/acid reflux is again a common cause of bad breath.

Medical causes
People with nose problems can get bad breath. For example, a polyp in a nose, sinusitis or a 'foregin body' stuck in a nostril (occurs most commonly in children) can cause a bad smell. In this situation the smell tends to occur only, or more severely, when you breathe out through your nose. Tonsil infections are also a cause. 

Bad breath coming from within the mouth

As mentioned, in most people who have bad breath the bad smell is thought to come from bacteria within the mouth. As the bacteria break down proteins and other debris in the mouth, they release foul smelling gases. One or more of the following may contribute to the build up of bacteria and bad breath.

• Food stuck between teeth. Normal teeth brushing may not clear bits of food (particularly tiny bits of meat) which can get stuck between teeth. The food then rots and becomes riddled with bacteria. Regular flossing can clear and prevent this problem.

• Plaque, calculus and gum disease. Dental plaque is a soft whitish deposit that forms on the surface of teeth. It forms when bacteria combine with food and saliva. It sticks firmly to teeth. Gum disease means infection or inflammation of the tissues that surround the teeth. If your gums look inflamed, or regularly bleed when you clean your teeth, you are likely to have gum disease. The severity can range form mild to severe.

• Coating on the back of the tongue. In some people, a 'coating' develops on the back part of the tongue. It is not clear why this occurs. It may be from mucus that drips down from the back of the nose ('post nasal drip'). The coating can contain many bacteria.

• Mouth tumours that ulcerate and become infected are an uncommon cause of bad breath.

The treatment of bad breath coming from within the mouth is good oral hygiene.

Routine oral hygiene - a cure for most cases of bad breath

It is important to get into a regular habit of good oral hygiene - in particular teeth brushing and flossing.

Teeth brushing
Brush your teeth at least twice a day. Use a soft-tufted brush. The head of the brush should be small enough to get into all the areas of the mouth. Spend at least two minutes brushing, covering all areas (the inside, outside, and biting areas of each tooth). Pay particular attention to where the teeth meet the gum. Get a new toothbrush every 3-4 months. Many people find that an electric toothbrush does a better job than the traditional toothbrush, and so they have become popular.

It is usually advised that you use toothpaste that contains fluoride. (The fluoride helps to prevent tooth decay.)

Flossing
Floss your teeth at least once a day after brushing, and preferably twice a day. (Some people who have not flossed before are surprised as to how much extra debris and food particles can be removed by flossing in addition to brushing.)

Briefly: the usual floss looks a bit like cotton thread. Cut off about 40 cm. Wind the ends round your middle fingers of each hand. Then grab the floss between the thumbs and first finger to obtain a tight 3-4 cm section which you can pull between teeth. Gently scrape the floss against the sides of each tooth from the gum outwards. This will clean the narrow spaces between the teeth which toothbrushes cannot get to. Use a fresh piece of floss each time.

Some people prefer floss 'tape' which slides between teeth more easily than normal floss. Also, some people use disposable plastic 'forks' with a small length of floss between the two prongs. The plastic fork may be easier to hold and manipulate. However, they are expensive.

The gums may bleed a little when you first begin to floss. This should settle within a few days. If it persists then see a dentist as regular bleeding after flossing may indicate early gum disease.

Other general tips
Other things which are important to keep your teeth and gums healthy are:

• If you smoke, try to stop. Gum disease is more common in smokers than non-smokers.

• Eat a well balanced healthy diet. In particular, you should limit the amount of sugary foods and drinks that you have. Sugars and sugary foods in the mouth are the main foods that bacteria thrive on to make acid which can contribute to tooth decay.

• If children need medicines, wherever possible use sugar free medicines.

• Have regular dental checks at intervals recommended by your dentist (this is normally at least once a year). A dentist can detect excessive build up of plaque and remove calculus. Early gum disease can be detected and treated to prevent it from getting worse.

Other things you can do if you have bad breath
The measures above are usually sufficient to look after your teeth. However, if you also have bad breath coming from your mouth:

• Use an antiseptic mouthwash at least once a day. Just before bedtime is probably the best time. The mouthwash aims to kill bacteria. (Young children should not use a mouthwash if they may swallow it.)

• Clean the back of your tongue at least once a day. Some people do this with a soft toothbrush dipped in mouthwash (not toothpaste). You need to place it as far back as you can and then gently scrape forward to clear the tongue of any coating.

• Some people chew gum after each meal. Chewing gum increases the flow of saliva. Saliva helps to 'flush' the mouth to help clear any debris remaining from the meal.

• If you have dentures and have bad breath, you may not be cleaning them properly. Ask your dentist for advice as to how best to clean your dentures. 
  
  
  
  

If any of these measure do not help meet with your ENT specialist and rule out nasal/sinus/tonsil as the cause of bad breath.

Dr. Kumaresh - www.drkumaresh.com
Senior Consultant- ENT, Head & Neck Surgery including cancer surgery and Neurotology
Governing Council Member - PSG Medical College, Coimbatore
Board Member – PSG Healthcare Innovation, Incubation and Development Center
Coordinator - International Healthcare Collaborations
Director - Waste2Watts, Unique Waste to Energy Environmental Healthcare Start UpDirector - International Relations - International University of RwandaDirector Tvasta Bio-Science Private Limited - 3D Bio Printer Start Up
Director - Forent Technologies - Doctor Patient Connect App
Director - KGVK Medical Technologies Pvt Ltd - Funding start ups and healthcare ventures
Innovator - Opentherapeutics - A Global Life sciences biotechnology working on a cure for Cancer using Synthetic Biology
Mentor/Advisor - Healthcare start ups 

Distinguished Alumni Awardee - PSG Medical College

Best ENT Specialist Awardee