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Thursday, June 24, 2010

A Family Doctor's Tale - THE COMMON COLD


Who has never have the common cold? The code words are "Ah Choo" or sneezing, dripping of nose, pain in the throat and occasional fever. Cold weather, rain, snow, freezer, air conditioner are the precursor of a common cold. Once one person gets the common cold, every one in a closed environment gets it. That is why they called it the common cold.

The Common Cold (A Simple Guide to Coryza(Common Cold))is one of the most common infections seen by the family doctor.

Unlike Influenza, the patient suffer more from inflammation of the mucous membranes of the nose and throat, with sneezing, sore throat, and usually mild coughing. 

There are over 200 different viruses which can cause a common cold: rhinovirus, respiratory syncytial virus (RSV), corona virus, rotavirus.

Generally the common cold viruses produces mild but uncomfortable symptoms which seldom last more than 1 week:

1.Runny nose
3.Nasal congestion
5.Headache especially around the eyes and forehead
6.Fever - low grade rare

Usually a common cold runs its course without complications in one week. Because there is no cure for a viral infection, I usually aim at relieving the symptoms:

1.Rest is the most important part of treatment. 
A rested patient will recover faster.

2.Adequate warm fluids keep the mucus membranes moist to allow infected mucus to flow better and also to replace wet mucus lost during the runny nose.

3.If there is any fever, headaches and pains, paracetamol can be given to relieve symptoms.

4.Oral (tablet or syrup) decongestants may also relieve nasal symptoms. 
Antihistamines may help to reduce mucus production.

5.Decongestant sprays can relieve block nose temporarily, but should not be used for more than three days. 
Longer use can lead to rebound congestion with more symptoms of congestion.

6.Antibiotics and vitamin C are not helpful in relieving symptoms of the common cold.

Very rarely young children may develop complications such as bronchitis, viral pneumonia, and croup.  
I would check the lungs of young children carefully to make sure there is no breathing problem.

Acute otitis media ( A Simple Guide to Otitis Media) , an infection of the middle ear occurs in 2% of patients with a cold. 
I would ask all patients with cold whether there is pain in the ear or blockage in the ear.

Bacterial Sinusitis (A Simple Guide to Sinusitis) occurs in 0.5% of people with a cold. I would ask them for pain in the cheek and forehead area. If necessary an X-ray of the Sinuses should be done.

People with chronic obstructive pulmonary disease ( A Simple Guide to Chronic Obstructive Lung Disease) who have a rhinovirus infection are more likely to have a more serious or longer duration of illness.

Prevention is by :
1.Proper hygienic care of the hands and body
2.Well balanced diet with enough fluids
3.Adequate exercise

It is important to distinguish a Common Cold from Influenza which is usually more serious.

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