Asthma is a chronic inflammatory disease of the airways. Leading to hyper responsiveness of the airways, causing breathlessness, chest tightness, cough which is usually in the night or early morning hours. It should be reversible by it self or by drugs. Prevalence of asthma is in India between 1.3 to 2.5% and it is higher in the children and go even up to 10%. Type of asthma are childhood asthma, adult onset asthma, chronic asthma, occupational asthma and difficult to treat asthma. Asthma is usually genetic or environmental factors. The environmental triggers usually are allergens. Most of are, in allergens most important cause is house dust might. It can be due to stress, anxiety, obesity, drugs, infection. Infection are usually viral. It can be due to drugs like aspirin, NSIAD, or ace. The diagnosis of asthma is usually by pulmonary function test which shows the obstruction and the reversibility of the obstruction by inhaled short acting beta to agonist. If the reversibility is good then the patient is labeled as asthma. Treatment of asthma is for emergency patients or a routine patients. If a patient is unable to take proper breath, his heart rate is more than 120, he is having increased respiratory rate of 30 or having sinuses or unable to speak a single sentence then he is having a severe attack of asthma and should be rushed, patient should be rushed to the nearby health faculty for admission and treatment. Treatment for routine asthmatic is divided into certain steps. Steps 1 to 5. In the step 1, the patient is given short acting beta 2 agonist as and when required, with that the patient usually remain all right, the need for inhalation for beta 2 agonist should not be regular. Step 2 consist of inhaled corticosteroids in low doses, and the patient remain usually well controlled with that. In the step 3 of this, there is a either high dose of inhaled corticosteroids or combination of low dosed inhaled corticosteroids plus long acting beta 2 agonist. In step 4 if the patients is not controlled with the drugs in step 3 then, the patient is put on to step 4 and contain high dose inhaled corticosteroids plus long acting beta2 agonist. Most of the patients are controlled up to steep wise treatment 1 to 4. If the patient is not controlled given with that then the patient may need oral corticosteroids or anti iGE treatment.
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I am Dr. MC Gupta, a respective physician practising in Faridabad for the last 40 years. My talk is on Asthma.
Asthma is a very common disease involves 3-10 % of the population and the prevalence is gradually increasing due to increased pollution in the industrialization and environmental and occupational problems. It is characterized by chronic inflammation of the air tubes that carry oxygen and air from and into the lung. Due to chronic inflammation of the air tubes, there is a hyper responsiveness of the air tube that means if there is any trigger they react, constrict, there is an increase inflammation and that lead to the attack of asthma.
Asthma by symptom is characterized by shortness of breath, chest tightness, cough. These are the main three symptoms. Asthma is usually variable. One we have an asthma attack and the patient may go into dimensions when there are no symptoms at all.
There are many risk factors and if we control the risk factor we can avoid or control the asthma attack. The risk factors are a family if any one of the parents is having asthma then there are twenty-five percent chances of children getting asthma or if both the parents are having asthma then fifty percent of children can develop asthma. Other risk factors are repeated viral infections, stress obesity, rhinitis, reflex, some medicines which can aggravate the symptoms of asthma, even in some exercise can induce asthma which is called exercise induced asthma. Tablet aspirin commonly taken as disprin and in some persons can induce the attack of asthma.
Treatment of asthma depends upon the character of asthma, rather it just mild intermittent or it is persistent. In persistent is mild moderate and severe. If the asthma is just mild and intermittent one needs only rescue medicine that shorts acting beta 2 taken during the time of the attack and after that, the patient usually goes into remission and does not require the treatment. In persistent asthma, in mild asthma long acting beta 2 with an inhaled corticosteroid in minimum doses that control asthma and keep under control. Moderate asthma and severe asthma the bowls of inhaled corticosteroid can be increased from 800mg to 2000 microgram and it should be given in a combination of long acting beta 2. In the fourth stage of asthma, these inhaled corticosteroid plus long acting beta 2 agonists may be added with LAMA that is long acting muscarinic acids agents or taken orally or steroids. The oral steroids should not be taken continuously for the treatment of asthma because they can cause osteoporosis diabetes, hypertension and obesity.
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Understanding what causes COPD and what are the signs that a person might be suffering from it.
Clinical diagnosis of COPD is usually made by presence of symptoms that is cough, sputum production, breathlessness and spirometry. Assessment of COPD is also made by spirometry and rate of excess exacerbation. With each exacerbation there is increased breathlessness, increase in the sputum production, increase in cough, there is sputum may be dark in color which shows infection. For each excess exacerbation there is permanent damage of a lung and severity of the COPD may increase.
Treatment of COPD is by pharmacotherapy which aims to control the symptoms of the patient and prevent exacerbation. If you prevent the exacerbation then the patient health improves and prevent further damage to the lungs. If a patient is Breathless on walking at ground level, then the patient may be helped by rehabilitation and by increasing the day to day activities. Exacerbation can be prevented by adult vaccination that is vaccination for non invasive pneumococcal infection and flu vaccination. This disease is gradually progressive. Symptoms can be controlled with pharmacotherapy. But the disease cannot be cured. The main aim of the diseases to prevent and to prevent is hundred percent. If one avoid smoking, exposure to occupational gases and inter Biomass exposure. Patient of COPD should consult a chest physician or respiratory physician.
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Management of Bronchial Asthma
I’m Dr. M. C. Gupta, practicing at Jeevan Jyoti Hospital, Faridabad for the last forty years in pulmonary medicine. Today, I will talk regarding bronchial Asthma. Asthma is prevalent in about 5-10 percent population. Symptoms of asthma are cough, breathlessness, chest, tightness and wheeze. It can occur at any age from an infant to old person. On examination, one may find bronchitis on chest.
Prevention of asthma is by avoiding pollution, dust, smoke, stress and sudden change of temperature.
The treatment of asthma is, if it is mild and infrequent then, only SABAs that is Short-Acting Beta-Agonists can be taken off and on as and when required. If someone is having persistent asthma then along with inhaled corticosteroids one need LABAs that is Long-Acting Beta-Agonist which is to be continued till the symptoms are controlled. After the symptoms are controlled, one can be put on controller medicine that is inhaled corticosteroids and which should be taken in the minimum possible dose to prevent any side effects of the inhaled steroids. The side effects of inhaled steroids are very less as compared to oral steroids. The treatment may continue lifelong or the patient may go into reminiscence.
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Patient Review Highlights
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Pulmonology is the branch of science dealing with respiratory problems and related medicines. Respiratory Problems have become very common among people with increased pollution and dust particles in the air. Some of the most common lung diseases are:
It is a very common disease nowadays with many people suffering from it. In this condition, people have inflamed bronchial tubes which become sensitive, causing difficulty in breathing. The problem gets aggravated by smoking, air pollution, and chemical sprays. People suffering from it, complain of a dry cough, wheezing, and chest tightening.
The condition may also be triggered by allergies and dust particles. Doctors generally recommend taking an inhaler to asthma patients. It generally develops during childhood and progresses with age.
2. Chronic Obstructive Pulmonary Disease (COPD)
It is a disease used to denote multiple respiratory problems including chronic bronchitis and emphysema. It generally affects the bronchial tubes and causes inflammation of the airways that lead to the production of sputum (excess mucus). Other symptoms include shortness of breath and coughing. The generation of mucus also leaves people more prone to having infections.
According to doctors, it is difficult to identify COPD because the symptoms are associated with old age and a general decline in health. People generally develop COPD as early as 30 to 40 years of age. Moreover, the condition is aggravated due to excessive smoking.
Treatments include quitting smoking, bronchodilator therapy and pulmonary rehabilitation. It is a very serious disease and is not reversible like asthma. It generally worsens with time.
3. Chronic Bronchitis
It is one of the types of COPD (Chronic Obstructive Pulmonary Disease) and is generally associated with the formation of excess mucus in the lungs. This results in severe coughing. It is treated the same way as COPD. However, people also may develop acute bronchitis which is an infection caused by too much mucus in airways and subsides with medications.
It is a serious respiratory illness that is one of the types of COPD and is caused by smoking. Smoking damages the lungs to the point where the patient may have difficulty in exhaling air. They may need the help of an oxygen mask to help them in breathing.
5. Lung Cancer
One of the worst respiratory problems to have and is caused by irregular cell growth that results in tumors that interferes with the functioning of the lungs. The problem is aggravated by excessive smoking and air pollution. Symptoms include coughing up of blood, change in voices, vigorous breathing.
6. Influenza and Pneumonia
These are very common lung problems occurring among people. Influenza is a viral infection that causes damages to the lungs. Pneumonia is an infection in the lungs caused by a bacteria or virus. In cases of pneumonia, there is an accumulation of mucus or fluid in the lungs that prevent air from reaching the blood. Symptoms may include coughing, fever, shaking and difficulty in breathing. Both these diseases are curable with help of medicines but people who smoke excessively may suffer more than others.
These were some of the most common respiratory problems that can be seen among people. The first step towards treatment and prevention is to go to a doctor and consult him with the symptoms you are experiencing.