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Asthma - Symptom, Treatment And Causes

What is Asthma ?

Airways become narrow and get constricted and there is excess mucus production in asthma. It makes breathing difficult and also triggers wheezing and coughing. For some asthma is just a minor ailment. Others might not be able to function and may have near fatal experiences. Even though it can’t be cured. The symptoms are manageable. As it can change with time, it is necessary that your doctor tracks your symptoms and signs and adjusts treatment as required. It isn’t known as to why some people have asthma while others don’t. Genetic and environmental factors are thought to play a role in this.

What trrigers Asthma?

  • Being exposed to various substances and irritants that might trigger allergies or the asthma symptoms and signs.
  • Airborne particles like dust mites, pollen, pet dander, cockroach waste and mold spores.
  • Common cold
  • Exertion induced
  • Chilly air
  • Emotional overload and stress
  • Irritants and air particles like smoke
  • Certain medicines like aspirin, ibuprofen, beta blockers and naproxen
  • Preservatives and sulfites
  • GERD or gastro esophageal disease, an acid reflux condition

The chances of asthma increase for a number of reasons. These are:

  • Having a relative with asthma
  • Having other allergic conditions like allergic rhinitis or atopic dermatitis
  • Smoking excessively
  • Having a high BMR
  • Being exposed to passive smoke
  • Being exposed to pollution or fumes
  • Having an occupation which involves dealing with chemicals

Diagnosis and Treatment

It is necessary to do a physical exam to rule out other possibilities like COPD (chronic-obstructive pulmonary disease) or respiratory infections. The doctor will conduct these tests and question about your symptoms and signs.

  • Lung Function Tests- Pulmonary or lung function tests can determine the amount of air moving out and in during breathing. They may include: Spirometry- This tests for the widening of the bronchi by seeing how much air is exhaled after deep breathing.
  • Peak flow- A peak-flow meter is quiet a simple instrument that checks the intensity of the exhalation. A low reading on the meter might indicate that the lungs aren’t working to their best efficiency and that the asthma is deteriorating. A doctor will instruct you on how the peak flow measurements are to be interpreted and tracked.
  • A medicine called bronchodilator is taken after or before a lung function test, to open the airways up.
Can't be cured, but treatment helps Self diagnosable Lab test not required Chronic: can last for years or be lifelong Non communicable
Symptoms
Pain in the chest Troubled breathing Wheezing Irritated or inflammed throat Mouth breathing Tightness of chest

Popular Health Tips

Difficult Asthma - All You Should Know!

Gynaecologist, Faridabad
Difficult Asthma - All You Should Know!

Asthma is the most common chronic condition for women in pregnancy. While Asthma control can affect pregnancy, pregnancy too can affect Asthma. Yet while pregnancy does not beget Asthma, neither does it abate.

Nevertheless, Asthma management during pregnancy is very important. Improper Asthma management, especially in difficult Asthma, during pregnancy may imperil both the mother and the child.

Along with taking the right medications, Asthma patients also need to avoid exposure to Asthma triggers.

Avoiding Asthma Triggers

Asthma triggers may be different for different people. In general, one or a few of the following act as Asthma triggers:

  1. Allergens like pollen, dust mite etc.

  2. Smoking

  3. Certain exercises

  4. Certain occupational exposure

  5. Pollution

  6. Certain drugs like β‐blockers, aspirin etc.

  7. Alcohol, dairy products, orange juice, peanuts etc.

  8. Additives like tartrazine, monosodium glutamate etc.

  9. Certain medical conditions like gastric reflux, rhinitis etc.

Apart from avoiding these Asthma triggers, she would also need to follow the instructions of her gynecologists. She should always be concerned that if the treatment is not working or if she is experiencing any trouble, she must consult with the gynecologists. She can also do some exercises to stay active and healthy.

However, she should always consult a doctor before doing any exercise, especially for those who have experienced Asthma attacks in the past.

Effects of Asthma on Pregnancy

Poor Asthma management and difficult Asthma before pregnancy are associated with increased risk of hypertension during pregnancy, which can beget Preeclampsia. Studies have also shown that women with Asthma tend to undergo Caesarean sections more than others. It has also been observed that Asthma may restrict the growth of the fetus leading to low birth weight.

However, this is more due to poor Asthma control such as persistent breathing difficulty or poor lung function etc., than Asthma per se.

Effects of Pregnancy on Asthma

Certain physiological factors during pregnancy do affect Asthma. In difficult Asthma, control usually deteriorates between 24 and 36 weeks of pregnancy, mainly due to poor adherence to corticosteroids. This is why pregnant women with Asthma should be monitored closely irrespective of the severity of Asthma.

Breathlessness in Pregnancy

Breathlessness during pregnancy is common. In fact, even pregnant women with no Asthma symptoms may feel breathless at times. It reflects some normal physiological and anatomical changes during pregnancy. Even anxiety may precipitate breathlessness. This indicates that pregnant women with difficult Asthma may feel breathless, not just because of Asthma, but also because of normal changes during this period. However, new incidents of Asthma can also be a cause of breathlessness.

Respiratory Distress in Pregnant Women

Respiratory distress in pregnant women may not always be due to asthma. There may be a whole host of reasons that include Anxiety, Hyperventilation, chest infection, dysfunctional breathing, pneumonia, interstitial lung disease, thromboembolic disease, amniotic fluid embolism, pneumothorax, ischemic heart disease, arrhythmias, cardiomyopathy and a variety of endocrine, hematological and renal disorders.

Preventing Respiratory Distress During Pregnancy

Apart from avoiding Asthma triggers, pregnant women with Asthma or difficult Asthma need to strictly adhere to Asthma control. This indicates that they need to adhere to their corticosteroids religiously. However, before that, they also need to make sure that the corticosteroid is safe to be taken during pregnancy.

Asthma may or may not affect pregnancy. However, it is always a great idea to go for Asthma management. This will help women deal with complications related to Asthma during pregnancy.

Apart from that, always consult a doctor before going for any medication related to Asthma control, or actual treatment of Asthma.

4030 people found this helpful

Respiratory Complications During Pregnancy - Tips To Avoid Them!

Gynaecologist, Faridabad
Respiratory Complications During Pregnancy - Tips To Avoid Them!

Pregnancy brings with it a slew of changes in the physiological parameters of women. Women are susceptible to a number of complications, including respiratory complications during this stage. An abnormal chest X-ray or a complaint regarding some kind of respiratory trouble guides doctors to explore the possibility of pregnancy leading to respiratory complications.

Respiratory Complications During Pregnancy

Let us explore the likely respiratory complications during pregnancy. 

Though studies do not indicate any increase in risk of pneumococcal infection during pregnancy, it has been observed that complications arising out of pneumonia are increased during this time. Anemic or asthmatic women are more susceptible to this infection, and the risk of complications is also more common in such women. It entails risk for both the mother and the child. While the child can be born preterm or low in weight, the mother can even suffer respiratory failure.

It is a kind of fungal infection that affects the respiratory system, especially in the last trimester of pregnancy. It is a respiratory tract infection that is self- limiting in nature. However, owing to reduced immunity during pregnancy, this fungal infection may turn out to be severe. It may cause a variety of complications, including pneumonia, fever, chest pain, difficulty in breathing, etc.

However, timely diagnosis and administration of antifungal therapy has reduced maternal mortality to a large extent.

There is a risk of formation of blood clots during pregnancy due to hypercoagulability of blood during this stage. This leads to an enhanced risk of embolic pneumonia, where blood clots may block an artery in the lungs. It is an emergency condition where patients usually have difficulty breathing, chest pain, cough, etc.

Pregnancy is not a risk factor for asthma, but asthma during pregnancy may exacerbate the risk of complications such as premature birth, restricted growth, preeclampsia, etc.

Tips to Avoid

These and other respiratory complications during pregnancy, if any, increase the risk of complications for the mother as well as the fetus. However, there are ways that pregnant women can adopt to get over these problems and give birth to a healthy baby.

  1. Avoid Crowded Place in Pregnancy: Pregnancy enhances the risk of Pneumonia, and Pneumonia is mostly a community acquired. Pregnant women can try to avoid Pneumonia by avoiding going to crowded places.
  2. Eat Immune Boosting Food: Coccidioidomycosis is a fungal infection that is mostly diagnosed during the third trimester. However, it is usually a self-limiting infection. Along with avoiding going to crowded places, she also needs to take immune-boosting food such as citrus fruits, green vegetables, etc.
  3. Walk Regularly: Pulmonary Embolism is the result of being immobile for a long time. This happens during pregnancy and this is what makes pregnant women susceptible to the problem. One can tide over the problem by taking regular strolls at home or outside and doing regular chores.
  4. Consult with Gynecologist in Case of Asthma: If she is suffering from asthma, she must discuss it with the gynecologist. Most asthma medications are safe to be taken during pregnancy.
  5. Take Care of Infant Breath: Pregnant women should regularly visit gynecologists for checkups. They should also take a balanced diet and stay happy for the healthy life of the child.
4240 people found this helpful

Pulmonary Function Tests - Types And Reasons To Undergo Them!

MBBS, MD - Respiratory Medicine , Trained In Treating Sleep Disorder , Trained In Interventinal Bronchoscopy , Trained In Medical Thoracoscopy , Trained In Rigid Bronchoscopy
Pulmonologist, Delhi
Pulmonary Function Tests - Types And Reasons To Undergo Them!

Lung function is a major indicator of health since it determines the amount of Oxygen that a body is getting. Doctors resort to Pulmonary Function Tests if there is a problem with breathing or the lungs. Pulmonary tests show how the lungs are functioning. These tests measure parameters like lung capacity, lung volume, gas exchange, rate of flow, etc.

Armed with information from these tests, a doctor can decide whether a person has some issues with lungs or not. And if there’s some issue, doctor will be able to easily decide the line of treatment for accelerated recovery.

Type Of Pulmonary Function Tests

There are two common types of Pulmonary Function Tests: Spirometry and Plethysmography

Spirometry Test

● This test measures how much air a person can inhale and exhale, as well as how fast one can empty the lungs.
● It may also be done to monitor the lung condition periodically to measure the outcome of a treatment a person may be undergoing.
● In this test, a person needs to breathe into a tube. The tube is attached to a Spirometer.
● Before the test, nostrils will be closed with a clip. The person will also need to create a seal around the tube, so that there is no leakage of air.
● Patient will be asked to take a deep breath and then breathe out as hard as possible through the tube.
● The doctor may ask the person to repeat the effort three times so that he gets consistent result.

Plethysmography Test

● This measures how much air is actually in the lungs after a deep inhalation.
● During the test, one needs to sit in a plastic box, wear a clip on the nostrils, wrap lips around a special mouthpiece and breathe in and out through it.

Why To Undergo Pulmonary Function Tests

Doctors may conduct Pulmonary Function Tests even on healthy people. If a person works in certain hazardous environments like graphite factory, coal mine, etc., the employer may order such tests on a regular basis. People working in such places are at risk of developing Pulmonary problems.

However, the most common condition when a doctor may advise a PFT is when someone faces health problems like:

● Respiratory infections
● Allergies
● Breathing problem after injury
● Chronic lung problems like Bronchiectasis, Asthma, Chronic Bronchitis, Emphysema, etc.
Tumors in the lungs or scarring or inflammation of the lungs

Diseases That May Precipitate The Need For A PFT

Sarcoidosis, a disease characterised by the formation of lumps of inflammatory cells around the lungs, spleen, eyes, skin, etc.
Asbestosis, a disease that results from inhalation of Asbestos particles.
Scleroderma, which causes thickening of connective tissues.

One of the Pulmonary Function Tests may be advised by a doctor for a variety of reasons. These tests do not always mean that Lungs have a problem. They are just a way to measure the parameters of working of the Lungs so that a Physician can treat a problem effectively if found.

2573 people found this helpful

Pollution - How Different Masks Can Help You Protect Yourself?

MBBS, MD - Pulmonary Medicine, FNB-Critical Care, Europeon Diploma In Adult Respiratory Medicine, Europeon Diploma In Intensive Care, Fellow
Pulmonologist, Delhi
Pollution - How Different Masks Can Help You Protect Yourself?

The air that we breathe in has become a cauldron of harmful and poisonous gases, particulate matter, chemical fumes and a host of similar toxic substances. Pollution, especially of the air is at an all-time rise. The quality of air is deteriorating with each passing day, triggering a plethora of health problems. Chronic and severe lung and respiratory disorders (such as COPD, Chronic Bronchitis, Asthma, Emphysema), heart and kidney problems, headache, burning eyes, are affecting people (irrespective of their age and sex) like never before. As per WHO, nearly 6.5 million premature deaths worldwide are reported yearly due to pollution, a depressing statistics indeed! Thus, necessary preventive measures should be followed to keep ourselves and our loved ones protected from the deleterious effects of pollution.

The use of Anti-pollution masks to deal with pollution

  • The anti-pollution masks come as a blessing for millions of desperate souls who have been frantically looking for a solution to tackle pollution.
  • The anti-pollution masks act as a shield against the harmful pollutants that often finds its way into our bodies.
  • The different face masks work by filtering out the hazardous particulate matter from the air.
  • Though industrial air masks and the surgical masks are available, most people prefer to go with the more superior quality anti-pollution masks such as N95, N99, and P95 masks.
  • The surgical masks seldom provide any protection from the air pollution as toxic air can pass through the masks without any difficulty.

N95, N99 and P25 Air Masks

  • The particulate matter (PM) in the air can be PM 2.5 or PM 10. PM 2.5 implies that the diameter of the particulate matter is 2.5 micrometers or less.
  • Increased exposure to PM10 (the diameter of the particulate matter is 10 micrometers or less) can result in severe bronchial and respiratory problems (coughing, wheezing, breathing problems, asthma), heart ailments and stroke, a shoot in the blood pressure.
  • As compared to PM 10, PM 2.5 remains suspended in the air for a longer time and can adversely affect the lungs (lung irritation and inflammation), heart (result in plaque formation in the arteries), throat and nose.
  • As indicative of the name, the N95 Air Masks come with superior grade filtration technology that can filter about 95% of the PM 2.5 from the inhaled air. However, when it comes to oil-based pollutants, the effectiveness of N95 air masks takes a downslide.
  • The N99 Air Masks comes with a better filtration rate and can filter out the PM 2.5 from the air with close to 99% efficiency. As seen in N95, the N99 air masks also fail to deliver against oil-based pollutants.
  • The P25 masks come with an added benefit. Unlike the N95 and N99 air masks, the P25 masks are effective against oil-based pollutants and are used to remove PM 2.5 with 95% efficiency.
  • However, be it N95, N99 or P25, one cannot use the masks for more than 40-42 hours (the filter loses its efficiency).
1240 people found this helpful

Asthma - What Precautions Should You Take?

MBBS, MD - Pulmonary Medicine, FNB-Critical Care, Europeon Diploma In Adult Respiratory Medicine, Europeon Diploma In Intensive Care, Fellow
Pulmonologist, Delhi
Asthma - What Precautions Should You Take?

Living with asthma can be tough, but not necessarily unmanageable to the point that it interferes living your life to the fullest. It all boils down to being aware of the triggers, signs and all the other relevant details and taking the necessary precautions to keep the asthma attack at arm’s length.

Here is an insight.

  1. Keep your home dust free: Dust which contains irritants like dust mite collect in your beddings, old rugs, and curtains and they cause severe allergic reactions. Wash your bedspreads and pillow covers weekly once with hot water to kill the dust mites. Wear a mask and gloves while dusting the interior of your home. Keep the interior of your house dry so that molds do not form in the dark and damp places like faucets and toilets.
  2. Keep your pets at bay: Pet dander triggers problems of asthma when they enter your respiratory system through breathing. If you have any asthma patient in your home, it is best to keep your home free from pets. You can make a separate accommodation outside your home for your pets. They should not be allowed inside the room of the family member with the asthma problem.
  3. Be aware of your warning signs: Signs such as nose block, running nose, wheezing, coughing and shortness of breath are the common symptoms which trigger an asthma attack. You can measure your peak airflow with the help of a meter right at home. Thus, you can have an assessment of your lung function and take necessary precautions to prevent an attack. Keep your anti-allergic medicines and inhalers during the season you are susceptible to asthma attacks.
  4. A healthy diet keeps the doctor away: Your diet is directly related to your asthma problem as certain foods have an immediate allergic reaction in our body even before we understand clearly. Also, there are certain foods that have a magical effect on the prevention of asthma. Recent studies have shown Vitamins C& E, Beta-carotene, magnesium, selenium, flavonoids and Omega 3 fatty acids play a vital role in improving lung function and preventing asthma. Eat as much fresh fruits and vegetables as possible.
  5. A strict no-no to sulphites: Foods that are rich in potassium bisulphite or sodium sulphite may trigger your asthma attack. Both these ingredients are the used for preserving foods for a long time e.g., wine, beer, pickles, tinned or frozen berries, shrimps, etc. Due to the presence of potassium bisulphite, an asthmatic patient may suffer from bronchospasm and other symptoms of asthma attack. Dried fruits like raisins or apricots are also on the list.

Apart from the preventive measures mentioned above, regular exercises and yoga will strengthen the capacity of lungs and help you fight asthma with ease. A healthy diet and stress-free lifestyle is the key to keep this problem at miles away from you!

1878 people found this helpful

Popular Questions & Answers

My husband is suffering from asthma for a month. He has been a heavy smoker for 3 decades. What can be his treatment? He has seen a doctor who advised to take salbair, odimont, defcort, azifine and budamate. Is there any medication without serious side effects and steroids?

M.D - Respiratory Medicine
Pulmonologist, Hyderabad
He appears to be suffering from copd rather than asthma smoking to be given up other drugs such as roflumilast deriphyllin bambuterol news inhalers with tiotropium or glycopyrronium may be considered by your pulmonologist.
1 person found this helpful

Table of Content

What is Asthma ?

What trrigers Asthma?

Diagnosis and Treatment

Play video
Asthma In Kid
Asthma is a painful pulmonary disease that is usually caused due to inflammation of the air passages. The tubes that help us breathe in and out can get contaminated with pollutants and allergens like dust, smoke, pet hair, pollen and nettle, amongst various other substances. This can lead to coughing, shortness of breath, chest pain due to breathing difficulties and wheezing as the lungs try to get more oxygen which cannot pass through the swollen airways. This is usually at least as asthma.
Play video
Asthma
Hello!

I am Dr. Rahul Roshan, consultant pulmonologist. Asthma which is a very common problem is a serious condition. It is a long-lasting condition. It is usually defined as a chronic inflammatory disease of the airways. It presents as breathlessness, cough, wheezing.

It can develop in childhood but can occur at any age. The diagnosis of asthma includes some clinical evaluation along with Pulmonary Functional Test (PFT). The treatment of asthma is the self-management and along with that usage of bronchodilators with an inhaled corticosteroid. The patient needs to inhale regularly and be compliant with the treatment. Along with that self-education of the patient is very important while controlling asthma.

Thanks!
Play video
Things To Know About Asthma
Hi,

I am Dr. Pawan Gupta, Pulmonologist. Me apko aaj asthma ke bare me btaunga. Ye bhut hi common hai pure world me. Airway tract me swelling aa jane se tract narrow ho jata hai. Islia oxygen ki kami ho jati hai and carbondioxide ka badhne ka khtra rehta hai. Asthma curable nhi hai but treatable hai. Iske symptoms hain chest tightness, coughing, breathing difficulty. Asthma can happen at any age group. Asthma causes are air pollution, indoor allergens. Indoor pollution ke causes hain pets, dust, smoking. Diagnosis of asthma basically depends on the clinical history along with the clinical examination and spirometry. It is a lung function test.

You should avoid smoking. How to manage the asthma? Consult the doctor timely as he will prescribe the medications. Myth hai ki medications lene se adat paad jati hai but aisa nhi hai. Inhaler medications are safe than the oral medications. Agar patient ke symptoms medications se control nhi ho rhen hai to immunotherapy di jati hai. Asthma is generally associated with allergic rhinitis. Nasal allergy ko control krna jruri hai. Iske lia nasal spray use kia jata hai. Next allergy jo asthma ke sath associated hai vo hai skin allergy. You should know that what are the risk factors of the asthma and how to manage and how to prevent. Inhalers are very useful and not addictive. They have very minimal side-effects and can be used for long term. Asthma is long term disease. So, basically knowledge and awareness of the asthma and well educated asthma plan is the most essential part of the asthma management.

Thank You!
Play video
Inhalation Therapy In Respiratory Disorder
Good afternoon!

I am Dr. Hemant Kalra. I am a pulmonologist. Today our talk will be about inhalation therapy in respiratory disorders. So what is inhalation? Inhalation is when we give drugs or solution of drugs by nasal or oral respiratory route. Inhalation is also called inspiration. What is the inspiration? Inspiration is movement of air from external environment by our breathing pipes into our lungs. This is inhalation and inspiration also. In which conditions we use inhalation therapy? Inhalation therapy is used in Obstructive Airway Disorders. What are these disorders? These are Asthma, COPD, Bronchitis and some cases of Sarcoidosis. You may ask me why tablets and syrups are not used in such disorders?

Why inhalation therapy is preferred over tablets and syrup in such disorders because- tablets and syrup are in high doses, they are very toxic, very costly, they reach systemic blood circulation, they have got adverse side effects. When you give a drug, tablet or syrup it first enters your stomach, then via your blood stream it enters your airways where inflammation is there and where these types of drugs are required. So why to give a drug in oral or syrup form when inhalation therapies are available. Inhalation therapies takes drugs directly where it is required. Inhalation therapy can be given in various forms. First is metered dose inhaler. You might have seen inhaler people using in movies.

Dry powder inhalers are also available in market and other forms like nebulation is also available. What drugs can be given in inhalation therapies? We can give bronchodilators, which can open up the airways. We can give Cortico-steroids. Mucolytics and some antibiotics can also be given via inhalation route. Nowadays insulin is also given in inhalation route. Inhalation therapy is very very effective in certain disorders. I started this topic because I felt that we in India do not use inhalation therapy because of various myths in our society. So what are the myths? Firstly, inhalers are very costly- absolutely wrong. Secondly, inhalers are addictive- absolutely wrong. Thirdly, inhalers have got side effects- also absolutely wrong. Inhalers do not have any side effects. I can assure you this that inhalers can be given in pregnancy from day 1 to 9th month when very few drugs are recommended in pregnancy.

It can be given in any age group from 1 year to 90 years. Fifthly, inhalers are always given when disease is very severe- it is also wrong. On the contrary inhalers are recommended or should be given as early as possible in the disease. So inhalation therapy is the best option for any kind of obstructive airway disorders. I can proudly say that we have got the best inhalation technique or inhalers available in India. You must use them as advised by the doctor. Do not say no when the doctor writes an inhaler for you. It is the best option for obstructive airway disorders because it is most effective with no side effects, very cheap and can be given for many years. Thank you very much! In the nutshell please use inhalers as adviced by a doctors. Do not hesitate to take inhalers. Inhalers are best option for obstructive airway disorders, very safe, very effective, no side effect and very cheap.

Thank you very much!
Play video
Know More About Asthma
I am Dr. M.C Gupta. Practicing at Jeevan Jyoti Hospital, Faridabad. I am a pulmonologist and going to talk about asthma.

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.

For further queries or any follow up treatments you can contact me at my hospital.
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