Mouth breathing in children is not an uncommon condition. Parents and clinicians have not giving the importance it deserves to correct the same. If not corrected early these children from habitual mouth breathing become compulsive mouth breather. Nose breathing is difficult than mouth breathing. Hence once a child becomes compulsive mouth breather, reversal is a difficult process needing lots of effort and time.

The immediate harm of mouth breathing is foul smell in mouth which leads to personal and psychological handicap. Long term effect is on the lungs as the air reaches the lung by bypassing the nasal air conditioners.

Correction of the nasal airway compromise if any is the first step in the management. For success the long term cooperation of the child and parents is a must. Parents should always ensure they do not hurt the child in public in their enthusiasm to help the child revert to nose breathing.

The best option to cure cancer is by early detection. ENT cancer is the commonest form of cancer seen in India. It includes, Lips, Cheeks, Tongue, Mouth /oral cavity, Throat [Hypopharynx], Nose, Nasopharynx and larynx [Voice box].

It is also the easiest to detect early, by a simple OPD procedure with proper protocol. Awareness is poor hence most of these cancers are detected late with poor prognosis. Symptoms are late hence the best option to detect early is by regular routine ENT check up. Some symptoms of ENT [Head and Neck] Cancers are:

• A Sore throat that does not go away
• Change of voice of more than 6 weeks
• Hoarseness of Voice
• Difficulty in Swallowing
• Pain or difficulty in Chewing, swallowing, or moving the Jaws or Tongue
• Red or White Patches in the Mouth
• Foul Mouth Odour not explained by Hygiene
• Trouble while breathing or speaking
• Non Painful, Lump / Bump / Mass in head neck area
• Frequent nose bleeding and or unusual Nasal discharge
• Ringing in Ears or difficulty in Hearing
• Giddiness / swaying off and on
• Bleeding nose in adult
• Referred pain to ears.
• Persistent Head ache

The above mentioned symptoms can be sign of less serious conditions.

Avoid Smoking, Alcohol, chewing betel, paan or guthka as they can cause Cancers.

This subject has evoked lots of interest in the last two decades. Sleep deficiency to heart attacks are blamed. The concern seems to be exaggerated, nevertheless when suspect it is wise to get an examination and evaluation by an ENT specialist. Commonest cause is Obstructive sleep apnea. The priority in management hence should be to identify the nature of obstruction and correction of the same. CPAP in obstructive sleep apnea should be considered only if surgery does not give adequate results.

World Health Organisation [WHO] defines health as physical, mental, emotional and Social well being. Hearing handicap and giddiness are two ENT conditions which has a direct bearing on the health of the senior citizens.

Hearing Handicap will vary, depending on the attitude and perception of the affected individual, as well as the demands placed on one’s ability to hear and understand speech in everyday life. Deafness affects the person, his family, social circle, and his employment situation. Frequent, erratic, and misunderstood communication breakdowns results in psychosocial problems, stress, anxiety, and conflicts. A feeling of inadequacy sets in resulting in self isolation and withdrawal from family and society. We call this DEAF sentence. There are many senior citizens who sentence themselves to this DEAF sentence and lead a life of self isolation.

Hearing loss is a silent / invisible disability hence we more importance to this hidden handicap in geriatric care. Due to the hidden nature care givers / society too are not sensitized. We need to help these individuals. Shravan gives top priority to identify the hard of hearing and rehabilitate them to lead a healthy life.