Common Chronic Disease Patterns in Arabian Gulf, Saudi Arabia & YemenDr. O. P. Kapoor
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E.N.T. Problems

Following are my observations on E.N.T. problems :
  1. Most of the Yemenis want ear ("Edoun"), nose ("Khushm" "Aenf") and throat ("Hanjara") check up even if they have no symptoms.
  2. Atrophic Rhinitis though rare in Arabs, is found in nomadic races especially in Yemenis.
  3. The most common nose symptom heard of in Arabs is loss of smell ("Sham"—"Mush tamaam"). Often it is associated with loss of taste ("Taam"—"Mush Tamaam") as well.
    So common is this symptom of "Anosmia" especially in Yemems, that if asked as a leading question, it will be present in nearly 30 to 40 percent of population. There is hardly ever any organic cause detected. Too much use of strong perfumes and scents ("Attar") may be responsible.
  4. Hyperplasia of adenoids and tonsils is extremely common specially in Bahrain population. Nearly every second or third Bahraini visiting Bombay has hypertrophied tonsils, though some of them have no symptoms. Though excessive use of cold drinks, icecreams, drinking refrigerated water could be responsible, the other factors appear to be :
    1. Possible, hereditary predisposition.
    2. Improper and imbalanced diet.
    3. Recurrent upper respiratory tract infections. These are so common in Arab population, that they do not permit regression of this Iymphoid tissue.
  5. Otitis media and mastoiditis are very common in Arab population. This is because enlarged tonsils and adenoids result in frequent attacks of cold and infection leading to perforation of tympanic membrane which in turn leads to otitis media and mastoiditis.
  6. Sinus headache has been discussed in the chapter on "Common Symptoms".
  7. Symptom of "tinnitus" ("Sareer") is extremely common specially in Bahrainis and Yemenis. Usually no organic cause is detected.
  8. Allergic and smoker's pharyngitis ("Assassiya Hanjara") are very common especially in Bahrainis. This results in chronic cough.
    I find so many Arabs specially Yemenis, in whom uvula has been "circumcised" by their doctors, because of the symptom of chronic persistent cough!! I am convinced that these patients suffer from allergic pharyngitis (and in my opinion a pathological uvula cannot produce cough). But after discussing with the doctors who have performed these operations, I find that they are sure that the "pendulous, oedematous" uvula is often responsible for producing irritating cough. According to these doctors, excessive use of voice, recurrent pharyngitis and allergy to some food products may be some of the factors responsible.
  9. Allergic rhinitis is extremely common in all Arab countries, surprisingly more common in Bahrain. In the mild form, it presents as watering of nose and frequent sneezing.
  10. Hypertrophied turbinate ("Laaham") is very often encountered. Repeated infections and allergy have probably some role to play. Also it is possible that because of extremes of climate, dry weather, dust and sand, the nasal mucosa has to work more.
  11. Epistaxis is relatively more common in Arab population. Apart from the hot climate, dryness of the air and more exposure to dust, the habit of frequently rubbing the nose and putting the fingers in the nose is possibly responsible for the symptom. Mostly the bleeding is from the little's area.
  12. Deviated nasal septum (D.N.S.) ("Aadam Chidi") is an extremely common condition in Arab population. Past history of an accident is very common in Arabs and injury to the nose is frequent. Such patients need plastic repair of the nose along with D.N.S. surgery.
  13. Carcinoma of Oro-pharynx and larynx is very uncommon in Arab population.

Finally, it is my observation that the Arabs are very fond of undergoing E.N.T. surgery. An Indian patient seeks a second opinion if he is advised surgery by an E.N.T. Specialist. An Arab patient seeks a second opinion if he is not advised surgery.