Holding in a sneeze can be a literal pain in the neck

If you are about to sneeze -- even if you are in a quiet place -- doctors would advise you to let it rip. A 34-year-old unnamed man in Britain learned that lesson the hard way and had to spend two weeks in the hospital due to his resulting injury. That's according to a case report with the cringe-inducing title " Snap, crackle and pop: when sneezing leads to crackling in the neck".The report was published  in a medical journal.

According to the report, this "previously fit" man pinched his nose and kept his mouth closed during a "forceful" sneeze. He later told doctors he immediately felt a popping sensation in his neck. He didn't notice any problems right away, but a couple of hours later he felt pain in his throat and neck. When it became swollen and his voice changed, he went to the hospital. 

 

"This 34-year-old chap said he was always trying to hold his sneeze because he thinks it is very unhygienic to sneeze into the atmosphere or into someone's face. That means he's been holding his sneezes for the last 30 years or so, but this time it was different," case report Dr. said. She works in the department of ear, nose and throat at the Hospitals. 

 

Initially, doctors saw swelling in his neck and when they examined the soft tissue they heard popping and crackling. The Dr. said that meant there were air bubbles getting into the man's muscles and deep into his tissue. 

 

Scans confirmed the problem. The tests showed actual streaks of air in the retropharyngeal region and extensive surgical emphysema in the neck anterior to the trachea. In other words, by trying to hold in his sneeze, he actually blew a small hole in his throat.

 

"Luckily, it was a very small perforation," the Dr. said. "He didn't need any operation." 

 

When you sneeze, it's your body's protective reflex to get rid of an irritant that has gotten into your nose. With a sneeze, a significant amount of air pressure builds up in the lungs and forces its way through the nasal cavity to get rid of that irritant. 

 

A sneeze can propel mucous droplets at a rate of 100 miles an hour. If you hold a sneeze back, that pressurized air will need to go somewhere. In this case, it injured the tissue in the man's throat. In past cases, doctors have also seen a stifled sneeze cause sinus problems, middle and inner ear damage, ear infections and a ruptured ear drum.

 

The patient was given antibiotics and had to be fed through a tube, which was removed after seven days. His symptoms got better while he rested and gradually he was able to eat soft food.

 

This kind of sneezing injury is unusual, according to the report. Doctors have seen patients with similar injuries after coughing heavily or after vomiting forcefully. 

 

"It is a rare injury that we would more likely see with trauma, like if someone were to be in a car accident or was injured with a gunshot or knife, or if they swallowed something sharp," said a Dr.

 

The Dr. said if you are worried about spreading germs with your sneezes, rather than hold it in, the best thing to do to avoid injury is to let it out. If you don't have a tissue, sneezing into the crook of your elbow, rather than onto your hand, is "a good practice."

 

The good news for this patient is that there was no permanent damage. Doctors did advise the man not to pinch his nose closed for future sneezes and they advise others to heed the same advice.

 

"Halting sneeze via blocking nostrils and mouth is a dangerous maneuver," the report recommended. It "should be avoided, as it may lead to numerous complications."

 

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Monkey fever

Monkey fever, also known as Kyasanur Forest disease (KFD), is a tick-borne viral hemorrhagic fever endemic to South Asia.

Causes and transmission of the disease

The disease is caused by a highly pathogenic virus called KFD virus (KFDV), belonging to the family Flaviviridae, which also includes yellow fever and dengue fever.
The disease was first reported from Kyasanur Forest of Karnataka in India in March 1957. The virus has been detected in monkeys in parts of Bandipur National Park (Chamarajnagar) and parts of the Nilgiris.
Human infection of the disease occured in Bandipur through handling of dead monkeys that were infected.

Signs and symptoms of monkey fever

• Persons affected by the virus may show the following symptoms
• High fever with frontal headaches
• Followed by haemorrhagic symptoms, such as bleeding from the nasal cavity, throat, and gums, as well as gastrointestinal bleeding
• Other symptoms include vomiting, muscle stiffness, tremors, absent reflexes, and mental disturbances

An affected person may recover in two weeks time, but the recuperating period is typically very long, lasting for several months.

Prevention

• Wearing protective clothing
• Tick and mosquito control
• KFD vaccination

It is said that the vaccine has a 62.4% effectiveness rate for individuals who receive two doses. For individuals who receive an additional dose, the effectiveness of the vaccine increases to 82.9% for individuals who get an additional doses.

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Insulin may treat dementia

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Insulin delivered high up in the nasal cavity goes to affected areas of brain and helps improve memory, says a study that could lead to new therapies for Alzheimer's disease and similar forms of dementia.

"Before this study, there was very little evidence of how insulin gets into the brain and where it goes," said an investigator. The researchers found that insulin does not go into the bloodstream when delivered intranasally, a major concern in the medical community because it would lower blood sugar levels.

"We showed that insulin goes to areas where we hoped it would go," he noted.

The findings suggest the potential of gastrointestinal hormones like insulin to help those suffering from diseases like Alzheimer's that affect memory function.

Researchers conducted the study on a mouse model.

In the object recognition test, a test that depends on the mouse's natural curiosity for new things, old mice did not remember whether objects they are presented to play with are new or old.

After a single dose of intranasal insulin, however, they could remember which objects they have seen before, showed the findings published in the Journal of Alzheimer's Disease.