Asthma & COPD

ASTHMA MANAGEMENT at CHEST CENTRE

Dr Jafrey does a tailor made management of asthma for each patient as per his need and desire. His therapy suites to all economic categories of society.
If you are looking for good control of asthma; we give medicines, PEFR meter and patient diary and every patient is monitored by ‘Spirometery’.This gives a good control of asthma.

                                                                                      ASTHMA

If you are looking for BEST out of medical science; then we have


“Asthma Profile with Allergy Testing”.

Here patient goes through complete work up and he/she need not to think again for any more investigations. Affordable, accurate diagnosis of reasons of trigger of asthma is captured and corrected by our unique management.

Here we identify patient’s nasal allergy, extent of sinusitis, atopic dermatitis and severity of disease. Allergy test tells about what kind of food and inhalant patient is allergic. Allergic food is avoided and Allergy Specific Vaccines (ASIT) are created for air allergens (Inhalant) as they cannot be physically avoided.

Vaccines are to be taken for min of three years. Immunotherapy (ASIT) is helps to reduce severity, frequency of disease and also reduces medicine use by minimum of 80%. In some patient it could be 100%. With ASIT the disease goes in remission for a long time. It could vary from patient to patient. Some patients have life time remission while some have few years. It depends on patient’s constitution.

Today World over ASIT is best added on therapy along with Inhalers.

Role of Yoga: Yoga increases airway diameter (FEV1) by only 10%. So it is add on therapy and not a sole therapy. Hence we recommend Yoga (Yom-Vilom, Kapalbharti) as add on to Inhalers and ASIT.

Role of Alternative Medicines: Not a single clinical research across globe has proved role of any other ‘pathy’ . So not only we avoid but we discourage use of any alternative therapy (pithy).

We only trust in scientific management which is possible only with ‘Allopathy’ and ASIT.

Dr S Z Jafrey Recommends:

Asthma Profile & Allergy Test followed by

  • Avoidance of allergens
  • Pharmacotherapy (Medicines)
  • Allergen Vaccines (ASIT)
 
   

BASIC'S of ASTHMA

Bronchial asthma or Asthma is a disorder that causes the airways of the lungs to swell and narrow, leading to wheezing, shortness of breath, chest tightness, and coughing

Causes, incidence, and risk factors

Asthma is an inflammatory disorder hence only bronchodilator medicines alone are insufficient. It is caused by inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the diameter of airway hence the amounts of air that can pass by get reduced causing increase in rate of respiration. In sensitive people, asthma symptoms can be triggered by breathing in allergy-causing substances (called allergens or triggers).

Common asthma triggers include:

Pet Animals hair and dander
Insect droppings (Cockroach, Mosquito, Housefly etc)
House Dust Mite
Mold (Fungal Spore) >20 verities in India
Pollen: >50 are recognised by Indian College of Allergy & Immunology
Changes in weather (most often cold weather)
Chemicals in the air or in food
Exercise (Running to catch school bus)
Respiratory infections, such as the common cold
Strong emotions (stress)
Pungent smell like Perfumes, Deo, Agarbatti, Dhoop batti, Vehicle &Tobacco smoke
Drugs: Beta Blockers, Cox I NSAIDs (Aspirin)

Many people with asthma have a personal or family history of allergies, such as hay fever (allergic rhinitis), asthma or eczema.

Symptoms

Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom.

Asthma attacks can last for minutes to days, and can become dangerous if the airflow is severely restricted.

Symptoms include:

• Cough with or without sputum (phlegm) production
• Pulling in of the skin between the ribs when breathing (intercostal retractions)
• Shortness of breath that gets worse with exercise or activity
• Wheezing
Emergency symptoms which requires urgent hospitalization are:
• Bluish color to the lips and face
• Decreased level of alertness, such as severe drowsiness or confusion, during an asthma attack
• Extreme difficulty breathing
• Rapid pulse
• Severe anxiety due to shortness of breath
• Sweating

Signs and tests

The doctor with use of stethoscope to listen to wheeze. Wheezing sounds may be heard or may not be heard. Still patient has asthma. However, lung sounds are usually normal between asthma episodes.

Tests may include:

Peak flow measurements
Blood tests to measure eosinophil count (a type of white blood cell) and IgE (a type of immune system protein called an immunoglobulin)
Chest x-ray
Arterial blood gas
Lung function tests
Allergy testing is helpful to identify allergens which can be used to have avoidance and ASIT therapy for long term remission of disease.

Treatment

The goals of treatment are:

To have near normal lung functions.
Practically no acute episodes of shortness of breath.
Asthma should not affect day to day activity of House wife, Children going to school and Husband going to job or business.
Practically zero leave in full year.
There are two basic kinds of medication for treating asthma:
Control drugs to prevent attacks : called ICS-group
Quick-relief (rescue) drugs for use during attacks : Salbutamol only used sos.
Each type is described in more detail below.
Long-term control drugs for asthma are used to prevent symptoms in people with moderate to severe asthma. You must take them every day for them to work. Take them even when you feel okay. Don’t stop them until unless your Chest Physician advices.
Other control drugs that may be used are:

Leukotriene inhibitors (such as Monteleukaste)
Anti IgE : Omalizumab
Ipratropium or Tripropium

ASIT:

Allergy Specific Immunotherapy is one of the oldest therapy which was originated in 1911 at St Mary Hospital London UK. This therapy is followed to Allergy Test. All Inhalent allergens which are positive are made in diluted extract and then in increasing concentration they are given either by Injection or Sublingually. This reduces symptoms and signs by great extent. Many patient become symptoms free for many years to many decades. This therapy is also called ‘Allergy-Shots’ or ‘Vaccines’ and must be given for more than three years.
Right diagnosis of allergen and good quality of purified allergen extract is key to success. Results vary from allergist to allergist as knowledge of Aero-biology is must.
At Dr Jafrey’s Indore Chest & Allergy Centre you can be shore to have BEST RESULTs in state of MP & CG.

Complications

The complications of asthma can be severe. Some include:
Death
Decreased ability to exercise and take part in day to day activity.
Lack of sleep due to night time symptoms.
Permanent changes in the function of the lungs
Persistent cough
Trouble breathing that requires breathing assistance (ventilator)

Prevention

You can reduce asthma symptoms by avoiding known triggers and substances that irritate the airways. • Cover bedding with "allergy-proof" casings to reduce exposure to dust mites.
• Remove carpets from bedrooms and vacuum regularly.
• Use only unscented detergents and cleaning materials in the home.
• Keep humidity levels low and fix leaks to reduce the growth of organisms such as mold.
• Keep the house clean and keep food in containers and out of bedrooms -- this helps reduce the possibility of cockroaches, which can trigger asthma attacks in some people.
• If a person is allergic to an animal that cannot be removed from the home, the animal should be kept out of the bedroom. Place filtering material over the heating outlets to trap animal dander.
• Eliminate tobacco smoke from the home.
• Persons with asthma should also avoid air pollution, industrial dusts, and other irritating fumes as much as possible.