Alexander Chong asked:


Allergic rhinitis is an atopic disease, which is inherited from the parent. If both your parents have allergic rhinitis or other respiratory diseases such as asthma, tuberculosis, and emphysema, the probability that you have these kinds of respiratory diseases is 50%. If one of your parents has respiratory diseases, the probability that you inherit their diseases is 25%. If both of your parents do not have any respiratory diseases, your chances to have respiratory diseases are no more than 12.5%. Sometimes, what has happened during pregnancy can cause allergic rhinitis to the newly born baby. The immunological status of the mother during pregnancy may cause the newly born baby has allergic rhinitis. Pregnant mothers who are smoking, drinking coffee and alcohol usually have poor immunological status, which can also cause newly born infant has allergic rhinitis or other respiratory diseases. This is because all these acts can cause high IgE antibody level in umbilical blood. Apart that, using bottle-feeding to feed milk to infant, early introduction of several kinds of food and early exposure to certain allergens and pollutants can cause nasal allergy to the newly born infant.



Allergic rhinitis symptoms change with age. At the earlier stage, children are mostly sensitive to seasonal allergens. After they have grown older, they usually become sensitive to perennial allergens. Therefore, after they have got over the symptom that is caused by seasonal allergens, they may still keep on the symptoms due to the perennial allergens. When the children grow older, they may have higher risk to have bronchial hyperreactivity and asthma. 17 to 19% of them will have asthma after grow up. To protect them from getting asthma, perennial immunotherapy should be used at the early stage. Moreover, the risk of getting asthma does not depend to age when the allergic rhinitis started, family history of atopic disease, sex, severity of symptoms at the starting period and treatment.

Allergic rhinitis started when the atopic individual meets the antigens that are able to stimulate the IgE response. So, what are substances that can act as allergens? Allergens usually are airborne particles, which have molecular weight ranging from 30 to 40,000 daltons and also with diameter ranging from 2 to 60 µm. Most of them have diameter more than 15 µm, which can deposit onto the nasal, pharyngeal and ocular surface. Chemically, these particles are proteins, which link to some small unit of carbohydrate. Particles that have these kinds of characters are pollen, acarids, animal dandruff and fungi.



Pollens that are released from grams, weeds and trees during breeding season usually cause seasonal allergic rhinitis. Only light pollens that can be pollinated by wind can exist in air and cause a high natural exposure to the allergic rhinitis patient. The seriousness depends to the concentration of the pollens in the atmosphere. Individual with allergic rhinitis who lives in suburban area will be seriously affected by these seasonal pollens compared to the one who lives in city. Surrounding temperature also gives an impact to the pollens concentration in air. Usually, in warmer environment, plants release more pollens compared to cold environment. Most of the plants breed in late spring and summer that is the warmest season. Windy weather will cause the pollens scatter around in air and this will cause the most exposure to the allergic rhinitis patient. The better day is rainy day. Rain water can wash all the pollens in air and bring them down to the ground. Surrounding air becomes fresher and cleaner after raining.



The main culprit of the perennial nasal allergy is house-dust mites. The acarids that are commonly found in the house dust are Dermatophagoides pteronyssimus and farinae, Euroglyphus maynei and Blomia tropicalis. Substances that are directly responsible to the nasal allergy from these dust mites are their body and metabolic products. Usually, mites grow rapidly in damp and warm climate. Therefore, sensitization to acarids depends to where you are actually living. Nasal allergy for patients who live in tropical and equatorial regions have higher possibility causes by acarids because these regions climate is promote mites growth. House-dust mites grow at maximized concentration when surrounding humidity level is between 70 to 80 % and with the presence of high temperature. Nasal allergy symptoms will develop when the level of dust mite concentration reaches 2 µg/g in air. Conversely, in high mountains with dry and cold climate have lowest level of dust mites because this climate prevents the mite growth. Animals also are the other source of aeroallergens. These aeroallergens are present in the animal’s saliva, feces, urine and dandruff. Therefore, nasal allergy can be caused by domestic animals such as cat and dog and also wild rats and mice.

Air pollutants enhance the sensitization of the nasal allergy by the allergens. Air pollutants can be divided to two groups that are outdoor pollutants, which are released from industrial works, automobile exhaust and domestic heating, and indoor pollutants such as tobacco smoke, furnishings, wood and coal burning and heater. Chemically, air pollutants consist of oxides of nitrogen, sulfur dioxide, ozone, carbon monoxide and black smoke. How actually air pollutants enhance sensitization of nasal allergy is not completely clear. This may be due to air pollutants easily irritate the respiratory mucosa and make it prone to allergic sensitization. Air pollutants have negative impact to the nasal epithelium and ciliary beat, which are responsible to the clearance of allergens. Furthermore, some pollutants can enhance the releasing of the mediators that induce inflammation such as histamine, prostaglandins and leukotriene C-4.

Apart from that, some pollutants also can stimulate synthesis of the IgE antibody directly. When allergen binds two IgE molecules together on the mast and basophil cells surface, primary chemical mediator; histamine, will be released and it will cause nasal allergy. Therefore, we can affirm that allergens can easily enter into our blood stream through our nasal mucosal membrane if we have chronic inflammation, not enough IgA antibody, impaired ciliary beat and also with air pollutants around us. IgA antibody is very important to our body because it prevents allergens from penetrating through our nasal mucosal layer. Monounsaturated oleic acids, which can be found in cold-pressed extra virgin olive and coconut oil, hazelnut or filbert oil (or the whole nuts), green and ripe olives, and almonds can increase IgA antibody in our body. Besides oleic acids, vitamin A also can increase IgA antibody, which can be found in cod liver oil, pumpkin, cooked carrots, sweet potatoes/yams, squash and other yellow or orange vegetable.

References:

Passàli D, Mosges R. Consensus Conference of Allergic Rhinitis in Childhood. Allergy 1999;54 (Suppl 55):5–27.

Linna O, Kokkonen J, Lukin M. A 10-year prognosis for childhood allergic rhinitis. Acta Paediatr 1992;81:100–2.

Braham SS, Barrows AA, Decotiis BA, Settipane GA, Corrao WM. Airway hyperresonsiveness in allergic rhinitis. A risk factor for asthma. Chest 1987;01:671–4.

Pedvis S, Fox ZR, Bacal HL. Long-term follow-up of ragweed hay fever in children. Ann Allergy 1962;20:

569–77.

Ausdenmoore RW. Allergeni aerei e fattori ambientali. In Lawlor GJJr, Fisher TJ editors. Manuale di Immunolgia

e allergologia. Milano, Libreria Editrice Internazionale, 1990:50–62.

Taudorf E, Moseholm L. Pollen count, symptom and medicine score in birch pollinosis. A mathematical approach. Int Arch Allergy Appl Immunol 1988;86:225–33.

Krishna MT, Mudway IM, Kelly FJ, Frew AJ, Holgate ST. Ozone, airways and allergic airways disease. Clin Exp Allergy 1995;25:1150–8.

Konlee, Mark. “A Consumer’s Guide to Immune Restoration: The Search for ‘Th1′.” Positive Health News. Report No. 18. Spring 1999.

Raily Arena asked:


Hay fever, also known as Allergic Rhinitis, is a common form of allergy that people have been suffering from for many decades.  Health experts estimate that about 50 million people chronically suffer from this type of nasal allergy.  If you frequently experience symptoms such as nasal congestion, sneezing, runny nose, postnasal drip, red, swollen eyes and frequent colds, you could have Allergic Rhinitis.  Oftentimes, it takes only small particles such as pollen to affect the human body in many ways.  Some of these effects include:

- Throat itchiness that may be intermittent or continuous

- Laryngitis or hoarseness due to pollen affecting the larynx

- RAD or Reactive Airway Disease, a prolonged respiratory irritation characterized by difficulty breathing, chest tightness, wheezing and coughing

- Asthma attacks – often times, your doctor will diagnose RAD before he diagnoses asthma

- Postnasal drainage, which could lead to sore throat because of fluids flowing into and irritating the throat

- Nasal salute, particularly in young children; characterized by a red crease across the nose due to constant rubbing, wiping and scratching

- Allergic conjunctivitis, which can lead to redness, itchiness and teary eyes

- Darkened areas around the eyes

- Headaches

- General fatigue

Why symptoms occur

When exposed to foreign substances such as allergens, the immune system becomes hyper-sensitive and the body reacts.  This is the same kind of reaction that happens when the human body is invaded by microorganisms such as bacteria and viruses.  Once the body is exposed to these types of allergens, it produces substances called histamines which causes inflammation, production of mucus and other symptoms associated with hay fever.

Causes of hay fever

Although pollen is the most common cause of allergies that lead to hay fever, there are other substances that can trigger symptoms as well.  These include dust, molds, pet dander, insects and food.  Although hay fever symptoms can easily be detected, proper diagnosis by a qualified physician is the best way for correct assessment of the condition.

Testing for hay fever allergies

The most common method of determining allergies is skin testing, wherein a minuscule amount of allergen is introduced into the skin to produce a reaction.  The doctor will then try to determine if cross-sensitivity is present, such as when allergies are caused by varying substances with similar protein structures.

Controlling symptoms

As a first step, people with allergies are adviced to avoid or at least minimize contact with substances and items that may trigger an attack.  It’s also important to be aware of your environment and to perform tasks necessary to reduce allergens, avoid work that might aggravate your sensitive skin and protect your body.  With the correct knowledge and treatment regarding Allergic Rhinitis, there is no reason why it cannot be managed efficiently.

Alexander Chong asked:

Otitis media is an inflammation that occurs in the middle ear. Middle ear space contains fluid that could be easily infected and the infected middle ear is called otitis media with effusion. The cause of the chronic OME (otitis media with effusion) for most of the allergic rhinitis patients is mainly due to the IgE-mediated allergies. IgE-mediated allergy is the allergy that happens when IgE antibody (one type of the white blood cell) binds with the mast cell. IgE antibody is being produced by the plasma cell when foreign particular from outside of the body entering into the blood through nasal mucosal surface. Once the IgE antibody binds with the mast cell around the nose, histamine is secreted from this cell and it is the main chemical that causes itching and hypersensitive of the nose.

According to the publication by a group of scientists, 50% of the children who had chronic OME also had nasal allergy. Effects of the seasonal allergic rhinitis to the Eustachian tube function and middle ear pressure had been studied by a few groups of medical scientists. According to one of the studies, Eustachian tube of the pollen allergic patients become obstructed increases from 15% to 60% from the starting to the maximum of the pollen exposure. In one of the studies, ragweed pollen, which is seasonal pollen, was let it exposed to a group of people. What had been discovered is that it will cause immune reactions in the Eustachian tube and nose. Apart from this study, the other study reported that house-dust mite, which was a perennial allergen, also caused Eustachian tube obstruction. In the same study, they found out that 55% of the adults, who had nasal allergy, experienced the development of the Eustachian tube dysfunction when this group of adult was exposed to house-dust mite. In the following study, new thing that had been found out was Eustachian tube obstruction happened more frequently for the patients who had allergic rhinitis. In allergen provocation studies, scientist found out that nasal obstruction usually occurred before the development of the Eustachian tube obstruction. In allergen provocation study, individuals who took part in this study were exposed to allergen to provoke their nasal allergy symptom. In this study, researchers also discovered that various of inflammatory mediators such as histamine have been detected in middle ear effusions of the children who had OME. If Eustachian tube obstruction that was caused by perennial exposure to allergen such as house-dust mite was left it untreated for quite a sometime, it could form middle ear disease, especially, when priming phenomenon occurs in the Eustachian tube. Priming phenomenon happens when mucosa in the organ responds to lower doses of allergen with repeated exposure. Allergic rhinitis could have priming phenomenon too when the mucosa in the nasal passage responds to low amount of allergen that has been inhaled through the nostril. For the Eustachian tube obstruction that was caused by seasonal exposure to allergen such as ragweed pollen, its physiologic hyperresponsiveness could extend beyond the ragweed season.

Studies show that half of the newly occurrence otitis media are diagnosed immediately after patient had been infected by viral URTI (virus that causes flu and common cold). By using traditional standard culture techniques, it is quite rare that viruses could be isolated from the middle ear effusions in the patient with otitis media. However, with the newly developed PCR-based molecular analysis, viruses in the middle ear effusions could be detected and discovered that 53% of the middle ear effusions are positive for viruses. An experimental, which was carried out by infecting real human with rhinovirus-39, had been carried out in Children’s Hospital of Pittsburgh to study the effect of this virus to the middle ear pressure and Eustachian tube. Result of this experiment showed a substantial increase of Eustachian tube dysfunction and also abnormal middle ear in approximately 30% of the people who had been infected in this study. However, all these people who had been infected by this virus had less possibility to develop an otitis media disease. In another study, where influenza A virus was intranasally inoculated to a group of peoples, 59% of the inoculated people experienced the development of middle ear under pressure and only 25% of these people developed otitis media. In this study, one of the inoculated people developed middle ear under pressure followed by purulent otitis media. This patient middle ear effusion was taken for PCR analysis and it showed positive result for both influenza A and Streptococcus Pneumoniae. Streptococcus Pneumoniae is some kind of spherical, Gram-positive, alpha-hemolytic bacterium and it is a member of the genus Streptococcus.  In this group of inoculated people, 80% of them who had infected by this virus experienced the development of Eustachian tube dysfunction and 80% of them had middle ear under pressure. With this group of infected people, five of them had developed OME on the 4th day after the viral exposure. One of the patients had dizziness and vertigo symptoms, which is mainly due to the inner ear malfunction. All these studies support the causes of otitis media by URTIs virus and causes of otitis media starting from the development of Eustachian tube obstruction and abnormal middle ear pressure. In the recent publication about the study of a group of children with acute otitis media, micro-organisms in the fluids of the middle ears of the children were isolated by the investigator of this study. They found out that 65% of the fluid samples that had been collected contained both bacteria and viruses. These results show that virus infection in the middle ear creates an environmental that is suitable for the breeding of bacteria.

Based on the information that had been collected from a few recent publications of the studies of the relationships of the allergic rhinitis to the OME (otitis media with effusion), we could conclude that allergic rhinitis or common cold/flu will cause Eustachian tube obstruction and middle ear pressure. When the situation becomes uncontrollable, Otitis media with effusion will develop and this may could permanent hearing impairment. Therefore, allergic rhinitis and common cold/flu should be treated immediately without any delay. This is because these common illnesses may become serious and develop to chronic sinusitis disease and otitis media with effusions, which is quite difficult to cure.

Abhishek Agarwal asked:


If you are prone to sneezing problems then blame it on your genetics and your body’s lack of immunity. Allergic rhinitis or nasal allergy is bound to occur in a person if they are exposed to allergens, pollution, and cigarette smoke or happen to have a low weight at birth.

Doctors are puzzled as to why some people are allergic to certain substances while others are not, but one thing they are sure is that your body responds to these allergens. Your body’s immune system has been programmed in such a way as to react whenever a foreign body gets into the nose and these triggers off a series of reactions in the body when the immune system begins its fight to repel the substance. During this process a chemical substance called histamine is released. This is why your eyes begin to water and your nose starts running. At times more severe problems like wheezing and breathing difficulties occur in some people.

Many a times it is allergens which are present in the atmosphere that are the main cause for nasal allergies though these allergens can come from different sources. One of the main causes of nasal allergies through out the country is due to pollens, and their concentration can vary according to the places. Some places may be concentrated with flowering varieties which can generate enough pollen in the air while it may not be so in other places. Some pollen like rag weed can travel far and wide, so even if you live in a city you may still be affected by it. Flowering trees, plants, grass and bushes can also release a number of pollen grains into the air causing nasal allergies.

Though dust can cause you to sneeze it may not cause nasal allergy. But dust mites which are tiny microscopic organisms which can be found in mattresses, carpets and furniture can cause nasal allergy. You will know for sure that it is the dust mites which are actually causing you to sneeze when in the winter months the pollens in the air are at a minimal and you still find yourself sneezing endlessly.

Another serious allergic problem is caused by animal dander. Dander which comes from pets like dogs and cats easily settle down in carpets and furniture and cause you to experience sneezing problems even after you have got rid of your pets. The only way that you can get rid of dander once and for all is getting the carpet and upholstery in the sofas in your home vacuumed thoroughly and having them shampooed.

You will know that you are having a nasal allergy the moment your nose starts to twitch and you begin sneezing for no reason. It is the body’s way of trying to get rid of the allergen. The nose then starts to run and this is how the body’s mechanism tries to wash out the allergen. A little later say after a few hours you will find that you are now having a stuffy nose and you become extremely sensitive to other irritants. You will have to endure this for the duration it takes for the body to have the allergen to be cleared from your body. For some people they can develop more serious problems like asthma or sinus infections.

Alexander Chong asked:


Allergic rhinitis is an atopic disease, which is inherited from the parent. If both your parents have allergic rhinitis or other respiratory diseases such as asthma, tuberculosis, and emphysema, the probability that you have these kinds of respiratory diseases is 50%. If one of your parents has respiratory diseases, the probability that you inherit their diseases is 25%. If both of your parents do not have any respiratory diseases, your chances to have respiratory diseases are no more than 12.5%. Sometimes, what has happened during pregnancy can cause allergic rhinitis to the newly born baby. The immunological status of the mother during pregnancy may cause the newly born baby has allergic rhinitis. Pregnant mothers who are smoking, drinking coffee and alcohol usually have poor immunological status, which can also cause newly born infant has allergic rhinitis or other respiratory diseases. This is because all these acts can cause high IgE antibody level in umbilical blood. Apart that, using bottle-feeding to feed milk to infant, early introduction of several kinds of food and early exposure to certain allergens and pollutants can cause nasal allergy to the newly born infant.  

Allergic rhinitis symptoms change with age. At the earlier stage, children are mostly sensitive to seasonal allergens. After they have grown older, they usually become sensitive to perennial allergens. Therefore, after they have got over the symptom that is caused by seasonal allergens, they may still keep on the symptoms due to the perennial allergens. When the children’s age is increasing, they may have higher risk to have bronchial hyperreactivity and asthma. 17 to 19% of them will have asthma after grow up. To protect them from getting asthma, perennial immunotherapy should be used at the early stage. Moreover, the risk of getting asthma does not depend to age when the allergic rhinitis started, family history of atopic disease, sex, severity of symptoms at the starting period and treatment.

Allergic rhinitis started when the atopic individual meets the antigens that are able to stimulate the IgE response. So, what are substances that can act as allergens? Allergens usually are airborne particles, which have molecular weight ranging from 30 to 40,000 daltons and also with diameter ranging from 2 to 60 µm. Most of them have diameter more than 15 µm, which can deposit onto the nasal, pharyngeal and ocular surface. Chemically, these particles are proteins, which link to some small unit of carbohydrate. Particles that have these kinds of characters are pollen, acarids, animal dandruff and fungi.

Pollens that are released from grams, weeds and trees during breeding season usually cause seasonal allergic rhinitis. Only light pollens that can be pollinated by wind can exist in air and cause a high natural exposure to the allergic rhinitis patient. The seriousness depends to the concentration of the pollens in the atmosphere. Individual with allergic rhinitis who lives in suburban area will be seriously affected by these seasonal pollens compared to the one who lives in city. Surrounding temperature also gives an impact to the pollens concentration in air. Usually, in warmer environment, plants release more pollens compared to cold environment. Most of the plants breed in late spring and summer that is the warmest season. Windy weather will cause the pollens scatter around in air and this will cause the most exposure to the allergic rhinitis patient. The better day is rainy day. Rain water can wash all the pollens in air and bring them down to the ground. Surrounding air becomes fresher and cleaner after raining.       

The main culprit of the perennial nasal allergy is house-dust mites. The acarids that are commonly found in the house dust are Dermatophagoides pteronyssimus and farinae, Euroglyphus maynei and Blomia tropicalis. Substances that are directly responsible to the nasal allergy from these dust mites are their body and metabolic products. Usually, mites grow rapidly in damp and warm climate. Therefore, sensitization to acarids depends to where you are actually living. Nasal allergy for patients who live in tropical and equatorial regions have higher possibility causes by acarids because these regions climate is promote mites growth. House-dust mites grow at maximized concentration when surrounding humidity level is between 70 to 80 % and with the presence of high temperature. Nasal allergy symptoms will develop when the level of dust mite concentration reaches 2 µg/g in air. Conversely, in high mountains with dry and cold climate have lowest level of dust mites because this climate prevents the mite growth. Animals also are the other source of aeroallergens. These aeroallergens are present in the animal’s saliva, feces, urine and dandruff. Therefore, nasal allergy can be caused by domestic animals such as cat and dog and also wild rats and mice.

Air pollutants enhance the sensitization of the nasal allergy by the allergens. Air pollutants can be divided to two groups that are outdoor pollutants, which are released from industrial works, automobile exhaust and domestic heating, and indoor pollutants such as tobacco smoke, furnishings, wood and coal burning and heater. Chemically, air pollutants consist of oxides of nitrogen, sulfur dioxide, ozone, carbon monoxide and black smoke. How actually air pollutants enhance sensitization of nasal allergy is not completely clear. This may be due to air pollutants easily irritate the respiratory mucosa and make it prone to allergic sensitization. Air pollutants have negative impact to the nasal epithelium and ciliary beat, which are responsible to the clearance of allergens. Furthermore, some pollutants can enhance the releasing of the mediators that induce inflammation such as histamine, prostaglandins and leukotriene C-4.

Apart from that, some pollutants also can stimulate synthesis of the IgE antibody directly. When allergen binds two IgE molecules together on the mast and basophil cells surface, primary chemical mediator; histamine, will be released and it will cause nasal allergy. Therefore, we can affirm that allergens can easily enter into our blood stream through our nasal mucosal membrane if we have chronic inflammation, not enough IgA antibody, impaired ciliary beat and also with air pollutants around us. IgA antibody is very important to our body because it prevents allergens from penetrating through our nasal mucosal layer. Monounsaturated oleic acids, which can be found in cold-pressed extra virgin olive oil, hazelnut or filbert oil (or the whole nuts), green and ripe olives, and almonds can increase IgA antibody in our body. Besides oleic acids, vitamin A also can increase IgA antibody, which can be found in cod liver oil, pumpkin, cooked carrots, sweet potatoes/yams, squash and other yellow or orange vegetable.

Charlene J. Nuble asked:


Allergic rhinitis is often also called nasal allergy, pollinosis or hay fever, especially when it occurs during the haying season.

Allergic rhinitis is the occurrence of several symptoms, usually in the eyes and in the nose, after exposure to particles that may be airborne like plant pollens, dander and most especially, dust.

An oversensitive immune system is usually cited for the occurrence of allergic rhinitis. Take note that the immune system is your shield against harmful and ailment-causing viruses and bacteria. In some people, immune systems react violently to substances or allergens that are not generally harmful or disease-causing.

The most common and primary cause of allergic rhinitis is allergy to pollen. Pollens are very fine and powder-like substances produced by seed plants’ anthers. Allergic rhinitis can be similar to allergic reactions exhibited in some people by allergies to animal dander, inhaled allergens, mold and dust.

Some of the plants that usually produce pollens that cause reported cases of allergic rhinitis are deciduous and evergreen trees, flowering plants, ragweed and grasses.

Identifying allergic rhinitis

The most common manifestations or symptoms of allergic rhinitis are:

o Nasal congestion or what you call stuffy nose

o Wheezing

o Sore throat

o Sneezing

o Teary eyes

o Runny nose

o Smell impairment

o Headache

o Coughing

o Itching in the mouth, throat, nose, eyes, skin or any other areas in the body

How to treat allergic rhinitis

Remember, most allergies are treatable but not curable. Allergic rhinitis is not an exception.

Treatments or medications available or prescribed for allergic rhinitis only reduce symptoms of allergy caused by inflammation in the infected or affected tissues.

Doctors advise that the best treatment would be prevention, but if you happen to already have it, several medications may be of help.

Antihistamines are usually over-the-counter or do not require prescriptions when you buy them in drugstores. Such medicines, however, are only recommended to relieve mild symptoms or moderate symptoms. Take note that antihistamines may cause drowsiness and should not be taken when driving.

There are antihistamines that are specifically described longer-acting. Included in this category are cetirizine and fexofenadine. These types of antihistamines will unlikely cause drowsiness.

Nasal sprays are the most common form of medications taken for allergic rhinitis. They are safe and effective especially for patients whose symptoms are not reduced by antihistamines.

Decongestants are not exclusive for cough. They can also be used to treat allergic rhinitis.

In taking medications, it is important to first seek a doctor’s recommendation and prescription even if some medicines are non-prescription to ensure health and safety. Proper administration and timing is also important. No one wants to get an overdose right?

Preventing allergic rhinitis

Prevention is better than treatment, as always. To prevent the onset of allergic rhinitis, people with history should try to remain indoors or inside air-conditioned rooms especially during the pollination or hay season.

Remember that most pollinating trees produce and air-spread pollens during spring.

In the case of flowers and grasses, they pollinate during summer and ragweeds produce pollen in early autumn.

Bear in mind these trivial but interesting facts so you would know how to prevent getting another allergic rhinitis episode. It could not be that deadly, but it would really feel uncomfortable. One more thing, who says complications do not kill?