Q: My age is 26 years. Blood-stained cough/phlegm came out through the throat when I squeezed my nose while brushing. I have noticed this earlier too (2-3 times). I have no problem in my nose except dryness at times. Granules erupted in my throat and this also occured earlier. I was advised Chymex forte and Vitamins which I am taking. I also have cough off and on for the past 1 year and feel throat irritation when I take a deep breath. The CT scan report of throat and X-ray of chest were found normal and no pathogen was grown on culture of throat swab. Blood report - i) Haemoglobin: 14.0 g/dl; ii)Total leucocyte count-6500/cmm; iii)DLC -Neutrophils-77%, lymphocytes-20%, monocytes-01%, eosinophils-2%; iv) ESR-10 mm. I don't know from where I am bleeding. Kindly advise what investigations I need and who should I consult?

A:Yellow secretions and blood coming from the nose requires a nasal examination with instruments by an ENT specialist to make sure that there is no major problem, such as a foreign body, a tumour, a chronic infection (e.g., a fungus) or an altered immune response (e.g., Wegeners granulomatosis). A CT scan will help exclude these disorders and will reveal evidence of any sinus problem (sinusitis) or polyps. If all these concerns have been excluded, then simple treatment and time should help. Thus, increased humidity and inhalations or a spray of dilute salt solution for a couple of weeks should relieve the symptoms. It is important to avoid irritating the nose by rubbing, picking or blowing it, and no other medications should be put in the nose. Smoking and smoke exposure must be minimized. Antibiotic therapy should be avoided so as to prevent super-infection.