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RELIEF FROM NASAL CONGESTION - NASAL DISCHARGE - HEADACHE - LOSS OF SMELL
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How Would CRISP Help Patients of Chronic Rhinosinusitis ?

Recently, Geisinger Health System, John Hopkins Bloomberg School of Public Health, the Northwestern Medicine® Sinus and Allergy Centre, and the University of Chicago formed Chronic Rhinosinusitis Integrative Studies Program (CRISP) in the United States of America. The collective program would conduct research studies to understand the disease and develop effective methods of the treatment, benefiting the patients. CRISP received the program project grant (P01) to study the disease that is common in America but current knowledge of which is still rudimentary. The program would estimate remission, prevalence, and incidence of chronic rhinosinusitis (CRS) based on studies involving samples from general population representing the complete CRS spectrum.

Goals of Chronic Rhinosinusitis Integrative Studies Program

  • To understand genetic polymorphism associated with severity and susceptibility of CRS
  • To find costs and characteristics of the disease
  • To identify the factors exacerbating stubborn CRS
  • How do immunological factors affect CRS?
  • To study environmental risks of the disorder

Composition of Chronic Rhinosinusitis Integrative Studies Program


CRISP consists of five groups of collaborative studies and research work:
Core A focuses on administration.
Core B, Clinical, Laboratory, and Data Management Core
CRS Epidemiology Project: The Geisinger Health Systems (G.H.S.) would use new approaches to appraise epidemiology of the disease in more than 300,000 primary care patients in Pennsylvania.
CRS Immunology and Exacerbation Mechanism Project would collaborate with the epidemiology project at Northwestern University (1) to study the pathogens exacerbating the disease and (2) to define scope of autoimmunity in severity of the disease. The immunology project would also assess the role of autoimmunity and B lineage cells in the CRS etiology. 
CRS Genetics Project: The University of Chicago would conduct research studies (1) to find genes associated with the disease and (2) to understand relationship between the genetics and severity and various states of the disorder. The university would use the epidemiology project controls and samples collected from 2,000 patients to understand the genetics. 
The epidemiology and immunology projects would develop a new “systems genetics discovery platform” that would be used for identifying gene candidates.

Benefits of CRISP

The resultant improved fundamental knowledge about sub-phenotypes of CRS would help researchers in identifying cellular and molecular mechanisms and genetic susceptibilities causing and exacerbating the symptoms of the disease.  The understanding would facilitate development of therapies that are more effective than the existing ones.

Thirteen Facts about Penicillium, the Source of Modern Antibiotics

The world antibiotic consists of two Greek words “anti” and “bios” that mean “against” and “life” respectively. Antibiotics are the natural or artificial substances that can check or destroy the growth of harmful bacteria and thereby help in treating bacteria caused infections. Penicillin is probably the oldest and the most popular source of antibiotics.  But do you know?

  1. Alexander Fleming, a bacteriologist from Scotland, observed and reported merits of penicillin in 1928. He reported that Staphylococcus aureus died when came in contact of Penicillium notatum (P. chrysogenum), a green colour mould. This observation is one of the greatest feats of scientific community of the twentieth century.
  2. A decade later Ernst Chain (British), Howard Florey (Australia), and Norman Heatley worked on the observations made by Fleming. These scientists grew, extracted, and purified penicillin to use as a drug.
  3. The scientists faced three major problems while experimenting with penicillin: poor stability of penicillin at high and low pH levels, small level of production, and its fondness for surface culture.
  4. The city of Peoria in Illinois (U.S.A.) was the first place where the Northern Regional Research Laboratory (N.R.R.L.) produced penicillin at large scale.
  5. For penicillin production, locally available substances were used in both countries England and America. Yeast was used in England, whereas corn steep liquor solution was used in the U.S.A.  The liquor solution was more effective. The extract from penicillin moulds grown in the solution was successfully used in treating the World War II soldiers.
  6. The first penicillin-based injectable antibiotic for medicinal use was introduced in 1941.
  7. In 1945, Alexander Fleming, Ernst Boris Chain, and Howard Walter Florey won Nobel Prize in Medicine for discovering penicillin.
  8. Penicillium is a genus consisting of green or blue mould fungi found in asexual forms. The genus grows on fabrics, foodstuff, and leather.
  9. Penicillium is used for making cheeses, organic acid, and antibiotics. Penicillium is widely found in soil.
  10. Penicillin can be divided into two groups: natural and semi-synthetic. The natural penicillin forms during fermentation of the mould. The semi-synthetic penicillin features artificially modified six-aminopenicillanic acid.
  11. Since an antibiotic can be modified, a variety of penicillin is generated for different medicinal uses.
  12. The only natural penicillin that is still available in medical laboratories is Penicillin G. However, poor acid-stability of the penicillin limits its therapeutic use.
  13. The fungi’s conidiophores resemble a paintbrush. Therefore, the Latin word “penicillus,” which means paintbrush, is used to describe the fungi.

Thirteen Facts about Penicillium, the Source of Modern Antibiotics

The world antibiotic consists of two Greek words “anti” and “bios” that mean “against” and “life” respectively. Antibiotics are the natural or artificial substances that can check or destroy the growth of harmful bacteria and thereby help in treating bacteria caused infections. Penicillin is probably the oldest and the most popular source of antibiotics.  But do you know?
  1. Alexander Fleming, a bacteriologist from Scotland, observed and reported merits of penicillin in 1928. He reported that Staphylococcus aureus died when came in contact of Penicillium notatum (P. chrysogenum), a green colour mould. This observation is one of the greatest feats of scientific community of the twentieth century.
  2. A decade later Ernst Chain (British), Howard Florey (Australia), and Norman Heatley worked on the observations made by Fleming. These scientists grew, extracted, and purified penicillin to use as a drug.
  3. The scientists faced three major problems while experimenting with penicillin: poor stability of penicillin at high and low pH levels, small level of production, and its fondness for surface culture.
  4. The city of Peoria in Illinois (U.S.A.) was the first place where the Northern Regional Research Laboratory (N.R.R.L.) produced penicillin at large scale.
  5. For penicillin production, locally available substances were used in both countries England and America. Yeast was used in England, whereas corn steep liquor solution was used in the U.S.A.  The liquor solution was more effective. The extract from penicillin moulds grown in the solution was successfully used in treating the World War II soldiers.
  6. The first penicillin-based injectable antibiotic for medicinal use was introduced in 1941.
  7. In 1945, Alexander Fleming, Ernst Boris Chain, and Howard Walter Florey won Nobel Prize in Medicine for discovering penicillin.
  8. Penicillium is a genus consisting of green or blue mould fungi found in asexual forms. The genus grows on fabrics, foodstuff, and leather.
  9. Penicillium is used for making cheeses, organic acid, and antibiotics. Penicillium is widely found in soil.
  10. Penicillin can be divided into two groups: natural and semi-synthetic. The natural penicillin forms during fermentation of the mould. The semi-synthetic penicillin features artificially modified six-aminopenicillanic acid.
  11. Since an antibiotic can be modified, a variety of penicillin is generated for different medicinal uses.
  12. The only natural penicillin that is still available in medical laboratories is Penicillin G. However, poor acid-stability of the penicillin limits its therapeutic use.
  13. The fungi’s conidiophores resemble a paintbrush. Therefore, the Latin word “penicillus,” which means paintbrush, is used to describe the fungi.


New management guidelines for acute bacterial sinusitis in children: Part I

In July 2013, the American Academy of Pediatrics (AAP) updated “Clinical Practice Guidelines for the Diagnosis and Management of Acute Bacterial Sinusitis in Children aged 1-18.” The new guidelines were published in Pediatrics, the academy’s journal. Highlights of the guidelines are summarized in two articles.

Observations made in the new guideline document

  • Acute bacterial sinusitis (ABS) is a common complication of allergic inflammation or viral upper respiratory infection (URI).


  • Approximately seven percent of young patients getting treatment for respiratory problems have acute sinusitis symptoms.

Why ABS and viral URI are confused with each other?

The membranes lining the sinus cavities, the nose, the middle ear, the oropharynx, and the nasopharynx are continuous. These membranes are called mucosae in medical terminology.
An inflamed nasal mucosa is a main symptom of a viral URI. However, generally the inflammation is also observed in the paranasal sinus and middle ear membranes. Therefore, confusion arises and an imaging scan was recommended earlier for correct diagnosis.

Which clinical observations indicate acute bacterial sinusitis?

According to the new guidelines, a child having an acute infection of the upper respiratory channel suffers from ABS if the following sinusitis symptoms are present:
  1. Persistent illness: persistent nasal discharge, cough during daytime, or both for over ten days without any improvement,
  2. Worsening course: A new beginning or worsening of fever, daytime cough, or nasal discharge after some improvement, or
  3. Severe onset: Purulent nasal discharge and high fever (equal to or more than 102.2 degree Fahrenheit or 39 degree Celsius) for minimum of three consecutive days. Purulent discharge means colored, opaque, and thick discharge.

Do the guidelines recommend imaging of paranasal sinuses to differentiate between a simple viral URI and ABS?

The new guidelines do not recommend the imaging of the sinuses because the images of the young patients suffering from the URI would be abnormal due to overlapping in the findings associated with the two diseases. Especially, imaging is not required in case of uncomplicated ABS.
The recommendation protects children from harmful effects of exposure to radiation, saves money, and prevents false-positive diagnosis.

When to use a contrast-enhanced computed tomography (CT) and / or magnetic resonance imaging (MRI) with contrast scan of the sinuses?

A CT scan is required if the patient also have problems of the central or orbital nervous system. The scan helps in identifying the lesion and the progression, enabling to assess the surgical requirements.

10 questions about Sinuwave used for treating chronic sinus infection

What is Sinuwave™ Photodisinfection System?

Innovative and easy-to-use , a non-antibiotic treatment, uses antimicrobial photodynamic therapy (aPDT).  The system uses photodisinfection principles to treat chronic sinus infection.
The system is designed by the U.S. based Sinuwave Technologies Corporation.

What is aPDT?

aPDT is a brief process consisting of the following steps:
The therapy uses safe laser light to activate a topical photo sensitizer featuring ultra-pure Methylene Blue (MeBlue).
The custom coaxial irrigation catheter irrigates the sensitizer onto the affected paranasal sinus tissues and sticks to the pathogens residing on the membranes (mucosae).
The custom balloon catheter delivers activated light to the sinus membranes without causing any pain.

How does aPDT help?

aPDT plays multiple roles. For example, the therapy
    1. destroys various drug-resistant biofilms occupying the paranasal sinus membranes,
    2. eliminates planktonic viruses, fungi, and bacteria,
    3. removes protease and other local exotoxins,
    4. reduces inflammatory response,
    5. provides instant relief via vasoconstriction of the tissues, and
    6. improves activation of neutrophil.

Does aPDT encourage growth of “photo-resistant” bacteria?

Repeated a PDT does not make bacteria “photo-resistant” probably because the therapy uses a different mechanism than an oral antibiotic therapy to destroy the fungal and bacterial cells. In photodynamic technique, aPDT-induced oxygen radicals and singlet oxygen perforate the cell wall. The perforation damages cells and leads to protein inactivation and membrane lysis.

How are photodisinfection and antibiotics different?

Photodisinfection technique destroys microbes as soon as the light is activated. The non-antibiotic treatment therefore offers fast relief. On the other hand, antibiotics take hours or even days in resolving the symptoms.

Is photodisinfection a proven treatment?

Instant anti-inflammatory and antimicrobial effects of photodisinfection have been confirmed during testing.

How much log reduction in bacteria load did photodisinfection demonstrate during the tests?

Photodisinfection technology showed four-log reduction (99.99%) in bacteria in different systems although two-log reduction (99%) is enough for the chronic sinus infection treatment. Sinuwave would also demonstrate 4-log reduction.

When is used?

The treatment is used for the patients who do not respond to surgical and medical options.
The system reduces the sinusitis leading to formation of polymicrobial biofilms that are resistant to antibiotics. Just one treatment reduces the biofilm formation by 99.9%.

Is e an approved treatment?

Canada has approved Sinuwave. Clinical trials are in progress at the Canadian University of Montreal.

What are the benefits?

    1. Sinuwave would reduce the pain and pathogens such as fungi, viruses, and bacteria that are resistant to antibiotic.  
    2. The treatment would not require patient compliance.
    3. Sinuwave would not lead to drug interactions.

Four affordable masks, packs for sinus headache relief

A cold therapy reduces blood supply to an injured part of the body, reducing pain and swelling ascribed to inflammation and relieving discomfort. The cold therapy is generally indicated in case of arthritis, burns, muscle and joint injuries, sinus headaches, and back, neck, and post surgical pains.
Reusable hot and cold therapy masks and packs are readily available in the market. For instance, Bruder HeathCare Company, Carex Health Brands, and Southwest Technologies manufacture the affordable packs. These easy-to-use therapeutic packs are time-tested remedies for sinus headache relief. Four of these packs are reviewed in the article.


The Original Bed Buddy Cold Sinus Headache Mask, also called Thera-Med Sinus Pack, uses two-sided dual-temp technology and thus it can be placed directly on the body of the patient. The white side of the mask is used for the coldest therapy, whereas the blue side is used for coolest therapy. The mask provides four benefits: (1) reduces swelling of face, (2) relieves headaches, (3) resolves sinus pain, and (4) relaxes tired eyes.
The reusable mask, a product of Carex, is easy to use. Keep it in a freezer before applying to the body.
The Original Bed Buddy Hot and Cold Sinus Pack, a Carex product, offers moist heat with therapeutic benefits and relieves pain associated with migraine, paranasal sinus, and tension headaches. The light pack with flexible design can be used for both cold and hot therapies as a complement or substitute for over-the-counter (O.T.C.) medicines. The safe and reusable pack features natural grains.
While using the pack take the following precautions:
  • Avoid using convection function of microwave oven to heat the pack.
  • Avoid overheating the pack because excess heating may burn your skin.
  • If you have circulatory and nerve disorders, do not use the pack.
  • Do not use the pack if your skin is broken, damaged, and / or sensitive.

Elasto-Gel Hot / Cold Therapy Sinus Mask, manufactured by Southwest, reduces swelling and pain. The heat therapy relieves sinus congestion, headache, infection, pain, and pressure. The mask can also be used for cold therapy. Since it blocks out light, the mask doubles as a sleeping aid.
The mask also helps in healing bruises and providing comfort after eye surgery.

THERMALON Sinus Compress, a product from Bruder, is a moist heat mask. A twenty-minute therapy relieves pain for many hours. The compress (1) relieves sinus pressure, (2) clears nasal congestion, (3) resolves tension, and (4) ensures sinus headache relief.
Note: This article offers information about the sinus products available in the market but this is not a prescription. Please consult your doctor before using any medical product.

Sinus transillumination

What is transillumination?

Transillumination means projecting or reflecting the light through the tissues of the body part affected.  For example, the light is shown against the paranasal sinuses to identify signs of inflammation that indicates sinusitis.
This method uses principles of refraction and reflection to assess fluid accumulation in the affected part.

Why and when is transillumination used?

Transillumination is used for diagnosing sinusitis when the sinuses are tender and infected.

How is transillumination performed?

The procedure involves the following steps:
  1. Arrange for a light source that generates a high-intensity light. For example, a flashlight or transilluminator.
  2. Take the patient in a dark room.
  3. Press a flashlight or transilluminator against the cheek, the side of the nose, or the eyebrow (or on the supraorbital ring), lighting the sinuses from the outside.
  4. Observe the light patterns.

    • If the sinuses are normal i.e. filled with air, the light will reflect through the sinuses.
    • In case of swollen sinuses clogged with the mucus, the light will not reflect or reflect less.
    • The location of the resulting light patterns will depend on the place selected for projecting the light.
      • If the light is applied against the eyebrow, the light reflects on the forehead / a red glow appears above the eyebrow.
      • If the light is applied against the cheekbone below the median plane of the eye or on the side of the nose, look for the patterns on the roof of the mouth.

How are the results of sinus transillumination interpreted?

The infection reduces transillumination of the affected paranasal sinuses. The swollen sinuses reflect less light, so the red glow of the reflected light on the cheeks is absent or dim. Non-swollen sinuses reflect more light through the skin, therefore red glow on the cheeks is clear and bright.
The degree of transillumination is divided into the following three categories:
  1. Opaque: No transillumination
  2. Dull / Equivocal: Less transillumination
  3. Normal: Appropriate transillumination
The opaque and dull categories imply (1) presence of secretion in the sinus, or (2) absence of sinus development. However, interpreting the results correctly requires training and experience.

Is sinus transillumination a useful method for sinusitis diagnosis?

Sinus transillumination may or may not be useful in diagnosing sinusitis and / or sinus tumors. For instance, the procedure may facilitate identifying and assessing fluid accumulation in the frontal and maxillary sinuses. However, transilluminating the sinuses of the young patients aged less than 10 years is difficult because of poor or asymmetrical development of the sinuses.
Transillumination cannot be performed on the sphenoid and ethmoid sinuses. The procedure is also not very helpful in diagnosing chronic sinusitis owning to mucosal defects.

Non-medicated sinus cures

A number of companies develop non-medicated sinus cures to treat simple to complex sinus disorders. Some of these are discussed below:

LAVI Dead Sea Sinus Solutions

The non-medicated LAVI consists of a nasal moisturizer, nasal decongestant, and sinus wash. TriCord Pharmaceuticals LLC claims that its LAVI Dead Sea salt formula is rich in potassium chloride and magnesium chloride. The clinically tested formula contains negligible amount of sodium chloride. The formula is better than other available saline solutions used to treat sinus infections and chronic sinusitis. LAVI offers all benefits of topical nasal steroids, but it does not have side effects.  The non-addictive formula is safe for elderly, nursing mothers, pregnant women, and children.

Dr. Neuzil’s Irrigator, Herbal Enhanced Nasal Cleansing Spray


The spray contains natural essential oils with moisturizing and antiseptic properties. The non-medicated formula resolves discomfort of paranasal sinuses. According to the product website, the easy-to-use spray has no side effects.

FESS Eucalyptus Nasal Spray from Care Pharmaceuticals Pty Ltd.


The spray cleans and moistens the nasal passages. The saline solution thins and drains unwanted mucus from the sinuses. The product resolves sinus congestion ascribed to allergies. The eucalyptus aroma generates a refreshing feeling.

Nasal & Sinus Hypertonic Deep Cleansing Saline Spray


AURENA Laboratories AB’s spray relieves both nose and sinus congestion attributed to allergies, rhinitis, sinusitis, and cold. The spray contains a mild hypertonic saline solution that drains allergens, pollutants, and mucus. The hypertonic solution is more “saltier” than the standard saline solutions. Extra “salt” helps reducing sinus pressure and postnasal drip.

Antiseptic SINO Fresh Nasal & Sinus Care Spray


The homeopathic spray is non-addictive. The over-the-counter spray gives relief from sinusitis symptoms without causing any side effects. The mild antiseptic spray cleans, traps, and washes out the pollutants such as smoke, pollen, dust, bacteria, molds, and yeasts. The patented formula contains sodium chloride, purified water, mint oils, and antiseptic ingredients. All the constituents have Generally Recognized as Safe (GRAS) status.

Sinuclear™ Nasal & Sinus Congestion Relief


The hypertonic formula of Sinuclear cleans, opens blocked sinus and nasal passages and soothes the tissues. The formula consists of sterile seawater, mineral salts, and minerals that wash out extra fluid from the inflamed sinuses and repair the tissues. The natural relief does not contain any preservatives. The non-addictive product has no side effects.
All the above sinus cures are natural and non-medicated. However, you should consult the doctor before administering the products.

Six natural sinus remedies from India

The Indian Ayurveda is a well-known age-old medicine system that is still in use in the country. The leading ayurvedic drug companies offer a number of ready-to-administer natural sinus remedies. Each remedy contains several herbs and / or minerals.

Agastya Haritaki

Agastya Haritaki, a herbomineral formula from Shree Baidyanath Ayurved Bhawan (P) Limited, contains Indian herbs such as beej, kawanch, pushkarmool, shankhapushpi, apmarg, and piplamul.  The formula is used in the treatment of sinusitis and stomach disorders.

Ayurnas

Chopra Center Ayurvedic Sinus Soothing kit includes Ayurnas, a tri-doshic oil treatment. The ayurvedic formula Ayurnas relieves post-nasal drip, sinus congestion, and dryness. The product consists of basil, coconut, eucalyptus, lotus, olive, rose, sandalwood, and sesame oils.

Chitraka Hareetaki

Dabur India Limited manufactures Chitraka Hareetaki, an herbal formula for sinusitis. The formula consists of 11 herbs:
  • Cinnamomum tamala
  • Cinnamomum zeylanicum (cinnamon)
  • elettaria cardamomum (cardamom)
  • Embelica officinalis
  • Piper longum
  • Piper nigrum.
  • Pulmbago zeylanica
  • Ten roots
  • Terminalia chebula
  • Tinospora cordifolia
  • Zingiber officinale (ginger)

Dashamool Taila (Vrihat)


Dabur’s external-use oil Dashamool helps in treating sinusitis, headache, and earache. The oil consists of more than twenty herbs and oils, including
  • Adhatoda vasica,
  • Brassica compestris oil,
  • Dolicos lablab,
  • Pluchea lanceolata,
  • Plumbago zeylanica,
  • Saussurea lappa, and
  • Tamarindus indica.

Laxmivilas Ras (Nardiya)

Dabur’s Laxmivilas Ras (Nardiya) provides relief from the sinus disorders. The product contains the following herbs and minerals:
  • Argyres speciosa
  • Asparagus recemosa
  • Barringtonia acutangula
  • Cannabis sativa
  • Cinnamomum camphora
  • Dathura alba
  • Myristica fragrans
  • Pueraria tuberose
  • purified mercury, mica, and sulphur
  • Sida cordifolia
  • Sida varonicaeolia
  • Tribulus terrestris

Septilin

Septilin, a medicine manufactured by the Himalaya Drug Company, helps in treating chronic sinusitis. The medicine reduces growth of harmful bacteria and inflammation, revives mucosa cells, and expels infection, healing the sinus mucosa.
Septilin has anti-inflammatory, anti-microbial, and antioxidant properties. The formula consists of amalaki (Emblica officinalis), guduchi (Tinospora gulancha), guggulu (Commiphora wightii), yashtimadhu (licorice), and other herbs. The medicine does not have any known side effects.
Although these natural sinus remedies are made from herbs, a prescription from ayurvedic doctor is required.

Is GSE used in natural sinus relief methods?

The online literature review revealed that grapefruit seed extract (G.S.E.) is used in natural sinus relief methods. For instance, (1) Stengler and Balch (2004)  in their book “Prescription for Natural Cures: A Self-Care Guide for Treating Health Problems with Natural Remedies, Including Diet and Nutrition, Nutritional Supplements, Bodywork, and More” included the extract in the Super Seven Prescriptions-Sinusitis list. They prescribed the grapefruit seed extract nasal spray for both acute and chronic paranasal sinus disorders.

(2) The extract has both antiviral and antifungal properties as mentioned in David Rakel’s (2012) “Integrative Medicine.” The extracts are sold as liquid and capsules in health food shops. Sinus Survival Spray consists of grapefruit seed extract, yarrow leaf, calendula, and aloe.


(3) Ron Kendrick (2009) mentioned in “Peasant Remedies for Sinus Infections” that the seed extract reduces paranasal sinus inflammation. The grape seed extract contains polyphenols, linoleic acid, bioflavonoid, and vitamin E. The polyphenols with antioxidant properties work on free radicals that damage cells.  The extract liquid neutralizes viruses’ defense mechanism, making them dormant.  SinusFix pills consist of grapefruit seed extract, butterbur, peppermint extract and many other natural ingredients.

(4) Jon Barron (2008) in “Lessons from the Miracle Doctors: A Step-by-Step Guide to Optimum Health and Relief from Catastrophic Illness” cited research studies that confirmed anti-pathogenic properties of the seed extract. The grapefruit extract is therefore used externally and internally to treat various disorders, including food poisoning and sinusitis.
(5) In “Natural Prescriptions for Women: What to Do—And When to Do it—To Solve more than 100 female health problems,” Susan Berg (2000) highlighted benefits of Sinus Survival Spray containing grapefruit seed extract:
  • The spray irrigates and moistens the inflamed sinus membranes, soothing them.
  • It eliminates viruses and bacteria.
(6) Brigitte Mars (2006) discussed medicinal properties of G.S.E. in her “Beauty by Nature.” G.S.E. or citracidal is known as Citrus paradisi in botanical community.  The extract has antioxidant, antifungal, and antibacterial properties. Both capsule and liquid forms are available. The G.S.E. based remedies are prescribed for the patients suffering from sinus infections, yeast infections, and diarrhea. The seed extract is also used in cosmetics.

(7) Dr. Patrick Fratellone (2004) recommended G.S.E. for the patients having active sinus infection in his book “You’re on the Air with Dr. Fratellone: Answers to Questions Most Frequently Asked about Supplements and Herbs for the Heart.”
But never forget to consult your doctor before using natural sinus relief methods.