Articles on occupational asthma

Children Control Asthma Better With Home Monitoring of Pefr

Dr. Lalit Mohan Kaushik, Pediatrician
Asthma's the most prevalent chronic disease in children  and is proclaimed to be the third ranking cause of non-injury-related hospitalization among children less than 15 years of age. Asthma is a chronic inflammation or swelling of the airways and is characterized by reversible airway obstruction ---this simply means that the blockage of the airway tubes can be reversed by using medications like salbutamol which are beta2 agonists.A reversal which is more than 12% is diagnostic but can be done using a spirometer only.   During the past two decades, many scientific advances have improved our understanding of asthma and our ability to manage and control ineffectively. However, only a part of the patients reach the goals of control set out by the Global Initiative for Asthma(GINA).  Management of bronchial asthma is conventionally guided by objective clinical and spirometric assessment. These criteria, though reproducible and time tested, fail to address the quality of life (QoL) of children afflicted with this chronic disease. Besides, children with similar symptoms and pulmonary function tests ( PFT) may experience different levels of distress and dysfunction in their lives.  This makes a case for a multi pronged approach to childhood asthma management that addresses qualitative issues like symptom monitoring by patients and their parents, thereby ensuring active participation in the assessment and improvement of their Quality of life of the asthmatic child.Several studies conducted in the past have explored this idea and come up with convincing results. Self monitoring of symptoms and keeping a record of symptoms like cough,wheezing{the whistling rhythmic sound of breathing in and out} ,sleep time cough or sleep disturbance , inability to play or getting exhausted easily,any visit to emergency room or need for inhaled medication.Along with these measurement of peak flow expiatory rate i.e: the force with which the child expires air .Doing a peak flow monitoring at home and recording it helps to control asthma better.  study published in 2014 in Indian journal of allergy and immunology conducted at 2 centers Agra and Aligarh reflected on the scope of improvement of childhood asthma symptoms when home monitoring of symptoms was done by parents using peak flow meter and symptom diary.Children(n =125) were divided into two age groups (6-10 years and 11-15 years)and were classified into intermittent, mild persistent, and moderate persistent grades of severity. Parental and child reporting of quality of life (QoL) scores were recorded on a pretested questionnaire on the initial visit and at 4 and 8 weeks. At each session, appropriate counseling regarding the disease and its primary management at home was done. The change in scores from first and second follow-up visits was statistically correlated with changes in symptom score recorded on symptom diary, peak expiatory flow rates(PEFR), and spirometry.The study concluded that home monitoring of symptoms using a peak flow meter and asthma questionnaire are important tools to maximize control over asthmatic symptoms..Health education has a positive impact on treatment outcome. Self monitoring of symptoms at home fosters more patient involvement and promotes better management at all levels of care.After seeing the results of this study I have shifted my asthma practice from didactic and instructional to educational and inclusive encourage every parent to maintain a symptom diary and a peak flow rate recording using a peak flow meter -it’s a cheap tool about 370 rupees and very easy to use.it shifts the focus of asthma from a disease of perception to a disease of numbers teach every parent and child and advise them to maintaining a recording as best of 3 readings in morning and evening ;and when done over a period of time it reveals lot of information regarding the child symptoms . since the last 2 years the asthmatic children have been faring better;they stick to therapy better and there are less exacerbation in symptoms and the parents feel better as they are an integral part of the therapy.Including the parent as the monitoring angel hands the control in hands of parents and they feel more confident of the therapy.

Why Do We Need a World Asthma Day?

Mrs. Anju Chandna, Yoga and Naturopathy
History is a witness to the fact that the human race comes together as one in unity whenever a problem of magnitudinal proportion like a war, an epidemic or a natural calamity befalls it. It is not surprising then that people of the world have come together on many platforms to fight the menace of various diseases together, diseases that overwhelm us with their intensity and their universality. One such disease is Asthma. World Asthma Day is one such big event observed for an ailment that has vast demographic proportions in the world. According to the American Academy of Allergy Asthma and Immunology (AAAAI), more than 300 million people the world over suffer from asthma with 250,000 annual deaths because of asthma. Estimate that another 100 million people will get added to this number by 2025 points toward a grim future. In India, the burden of asthma is more than TB and HIV put together.The first Tuesday of May every year is observed as World Asthma Day by the foundation called Global Initiative for Asthma or GINA as they call it. Cynics often claim that all such ‘days’ are just a marketing gimmick to enhance sales of relevant drugs or promote brands. I’m sorry I beg to differ. And I can validate my stand.Why does an earthquake in Nepal send the entire world into a ‘helping frenzy’. Aids start flowing in, volunteers from the Red Cross and innumerable other organisations bend backwards to be of help. Somewhere in our hearts we all think that this could happen to any of us any day and at that moment we don’t want the world around us to be a mere spectator.So it is with asthma. The increasing numbers, the worsening pollution levels in the world, increased dependence on medication are factors that are cause for concern and immediate action.We have to contain the phenomenal increase in the number of asthma sufferers by understanding the underlying causes of the disease, involving medical professionals, health professionals, medical researchers, community health groups and health workers. Such increased awareness among public about precautions and preventions can go a long way in treating asthma patients without too much dependence on medication. The need of the hour is to look for holistic methods of treatment that address not just the symptom-part of the disease but the cause-part too. Such holistic methods can help to boost body immunity to fight the disease in its nascent stage without resorting to too much medication especially for kids and young adults.Asthma is treatable, this World Asthma Day lets strive to spread the awareness about Asthma to everyone who needs it! 

10 Tips To Keep Your House Asthma Proof

Dr. Shilpa Nayak, Allergist/Immunologist
Like many people you probably have a deep emotional connect with your home. It is a place to relax, after long hours at the work. That is why it is important that this place is not only comfortable, but safe to live in.If you are suffering from Asthma, there is nothing worse than aggravating your condition simply by stepping inside your front door. This is why it is essential to ensure your home is Asthma-proof. With the 10 tips found below, you can make your home safe and Allergy free:1. Clean your pillow and mattress regularly - More than 50 percent Asthmatics experiencing symptoms occur from exposure to Dust Mites.  Dust mite particles are often found in pillows, mattresses, carpeting and upholstered furniture. Cover your mattress and pillow with dust mite proof case, wash your bed sheets alternate day in hot water. 2. No Smoking in the house- With second hand smoke containing Tar,Carbon mono oxide,nicotine and other harmful chemicals;it does not matter who smokes,everyone suffers. So take it out side the house.3. Choose the correct flooring- Chose the hard flooring as regular carpets trap dust and allergens.Daily wet mopping help to reduce the exposure to common Allergens.4. Avoid upholstered Furniture- Animal dander and dust mites can get into the furniture and trigger attacks.Avoid upholstered furniture and opt for wood, vinyl, plastic and leather. Dust regularly.5. Keep your house dry- Moisture leads to growth of mold (fungus); open windows while cooking and use exhaust fan. Keep an eye on laundry and make sure that you move wet laundry immediately. Keep the plants outside. Use a dehumidifier.6. Keep an eye on your ceiling- Mold grows on damp surfaces for ex. ceiling and walls of your bathroom. Make sure that you clean and dry all wet surfaces including ceilings.7. Check your pipes- Go through your house and fix any leaking plumbing that could lead to mold on surfaces. If your walls have molds you have to replace it.8. Put away, always- Keep your kitchen neat and tidy. Wash dishes regularly; do not leave dirty dishes overnight in the sink as it not only promotes the growth of molds, but attracts cockroaches as well.9. Keep the pet outside- Animal dander from skin and saliva can have bad effect on asthma sufferer. If pet is indoor,vacuum everyday10. Regular pest control- Measures should be taken to keep the cockroach population under control

5 Common Myths About Asthma.

Mrs. Anju Chandna, Yoga and Naturopathy
Anything that is open to public discussion gets its share of myths and mysteries. A chronic disease like Asthma has long been a subject of debate and discussion and also several myths that people have created around it along the way.Let me enumerate some of these myths for you:1. My child who is suffering from asthma will outgrow it in his older years. This is both true and false. In about 50% of children, the ailment may become inactive in teenage years and symptoms of asthma may subside as they grow older. But symptoms may re-occur anytime during the adult years with or without exposure to any external triggers. The pattern remains largely unexplained. But increased body immunity does help in fighting asthma in both adults and kids alike. Proper treatment taken in the childhood years with decreased dependence on inhalers can go a long way in keeping your child asthma free once he grows up. 2. Asthmatics have a low life expectancy.This could not be anymore far from the truth. Asthmatics have the same life expectancy like any other normal person. What more can an asthmatic as for? All you have to do is to take great care of your health, never let your disease escalate (believe me it is possible) and with a few basic lifestyle changes you can outrun any normal person in the race for life.3. Asthma can be fatal. This is not entire false yet not true. Fatality related to asthma in most cases is caused by severe lack of oxygen in the lungs. Also people who have not been taking proper medication or I would say who have been abusing medicines by over-use are more prone to such near-fatal conditions. At times like these quick medical aid with supply of oxygen can save a precious life. Basically your lungs should get the oxygen when they need it. Keeping your lungs clean with natural treatments can ensure that your lungs get the oxygen they need.4. Asthmatics should not exercise.With proper care and treatment, people with asthma can exercise normally and often vigorously. As long as their asthma is controlled, there is no reason children with asthma can’t be physically active. In fact, doctors encourage children to stay active to prevent obesity, which can trigger asthma and make symptoms worse. 5. Asthmatics should move to dry climates.Not true at all. No matter where you move, your asthma will move with you. New location might help for some time but it will have new asthma triggers and some triggers like dust mites are present everywhere. The solution is to enhance body immunity to fight allergens and not run away from them6. You will surely ‘catch’ Asthma if someone in your family has it. Asthma is not contagious like common cold. You have a only - 6% chance of getting asthma if neither parent has it- 30% chance if one parent has it and - 70% chance of getting asthma if both parents have it. So the fight to keep asthma at bay is not lost even if both your parents suffer from it!The best bet against asthma is to fight it from the root, by enhancing body immunity by cleansing your lungs so that more oxygen can be inhaled into the lungs.By Anju Chandna Co-Founder SRT India – The Salt Room Therapy ChainSalt therapy is a 100% natural drug-free treatment for all kinds of respiratory problems with no side effects.

Let Homeopathy Help to Fight Asthma

Dr. Anubha, Homeopath
An estimated 300 million people worldwide suffer from asthma, with 250000 annual deaths attributed to the disease. In fact, it is estimated that the number of people with asthma will grow by more than 100 million by 2025. Asthma is a condition in which the patient suffers from a respiratory problem and it is not something which we know of recently. It is certainly not confined to our epoch – Seneca the younger, a powerful Roman leader and historic figure, described his asthma as his “last gasp”. However, he was something of a celebrity during his age and his demise was certainly not due to asthma! What is this last gasp that Seneca was referring to? Here are more details on understanding asthma.TYPES 1. Allergic (extrinsic/ atopic)Asthma 2. Infective or Intrinsic Asthma 3. Emotional Asthma 4. Occupational asthma CAUSES Allergen Irritants Respiratory infection Anxiety or stress In Children: Due to house dust mites and pets in the child’s bedroom Others: Medicines such as aspirin and beta-blockers, sulphites in food or beverages Acid reflux and heartburn SYMPTOMSCoughing, especially at night Wheezing Shortness of breath Chest tightness, pain, or pressure.Asthma has often been labelled as incurable and chronic but it can be treated with homoeopathic medicines. Case so frequent origin and those affecting children have shown encouraging curative results on the use of homoeopathy to stem the disease. Homoeopaths study not only the symptoms but also try and find out the cause and precipitating factors to prevent it from causing more harm to vital organs (like lungs, heart, brain etc.) and the medicine is administered according to the patient's condition. For those who are heavily dependent on inhalers, homoeopathic treatment will help you fight the precipitating factors (allergen), thereby reducing your dependency. Conditions such as poor resistance to climatic changes, recurrent colds / sinusitis and atopic dermatitis (skin infection) can be effectively treated during the course of the treatment. This individualistic approach helps in overall improvement of the condition and relieves any other condition associated with asthma.

The Lion Who Had asthma..

Mrs. Anju Chandna, Yoga and Naturopathy
At times the most complex of things are said in the simplest of ways and this simplicity is what stays with us for a lifetime. One such incident happened with me during the course of my interaction with our little patients suffering from asthma who come for taking therapy to our centre.This was in August last year. A little girl Angel (name changed to protect identity) was a frequent visitor to our salt therapy centre. She was suffering from asthma since birth and now at 9 years was on heavy medication when she first came to the clinic. A petite girl with pale complexion but very bright eyes, she immediately caught my attention. I stepped out of my room to chat with her. After the initial hesitation to relent, she quickly started talking while her parents were busy with the doctor discussing the course of treatment for their daughter. Upon inquiring about her hobbies, she told me that she loved to read since her mom had restricted her outside play hours owing to her medical condition. I casually asked her as to what she liked to read. Like any girl her age, her reply was ‘I like reading fairy tales”. I’ll be a writer one day and write such stories”. I turned around and said “And what will you write?” There came the answer I had not expected. “The lion who had asthma” she answered unassumingly. The confidence in her voice said a thousand things. It was as if she had already scripted the book in her young mind. It took me a while to respond. “What will you write in the book” I asked. Pat came her answer “I’ll write how the brave lion suffered because of asthma, he coughed instead of roaring and all the other animals made fun of him. But one day he got a magic potion in the forest, he drank it and his asthma was gone”. I was dumbfounded. I hope one day Angel’s dream to have her asthma gone becomes a reality. Lets all hunt for this magic potion for her. By Anju ChandnaCo-founder SRT India - The Salt Room Therapy Chain

Learning to Live With Your Asthma Is Your Key to Fighting It!

Mrs. Anju Chandna, Yoga and Naturopathy
We all know what Asthma is. Medically speaking, Asthma is a chronic inflammatory disease of the airways. It is a condition in which your airways narrow, get inflamed and produce extra mucus. This clogs your airways making breathing difficult and triggers coughing, wheezing and shortness of breath.That is the medical explanation. The real problem here is not restricted to the confines of medicine alone. For some people, asthma is a minor nuisance. Some medication accompanied with some basic lifestyle changes does the trick. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. So an asthmatic needs not just medicine but understanding, empathy, support and encouragement from family and friends to tackle this tricky problem. It is hard for an asthmatic to learn and accept that like any other allergy, asthma too has no cure. It can be worse when your doctor tells that your small kid who has seen barely four or five summers of his life, are at the mercy of inhalers and steroid, that which would last him or her for a lifetime, and the sufferers are left wondering with just a question in mind “Can we really ever lead a normal life with asthma?”Can you? The answer is YES you can! However, this normal life doesn’t come that easy and the road to normalcy won’t be a cakewalk!The key to the problem lies in early detection of the ailment and learning to cope with symptoms. With a bunch of adjustments, changes and lifestyle modifications, it is possible to make it through life without too much dependence on medicines. But the first step towards fighting this menace comes from the first emotion that needs to be handled: Denial. Most patients spend a lot of time coming to terms with the fact that they have asthma.All chronic diseases test your patience making you frustrated, angry or depressed because they are a limiting factor in your day-to-day activities. You may also feel embarrassed by the symptoms of the disease and by complicated management routines.So the first prerequisite of any successful therapy is that you get out of denial mode and take an active part in your care and follow-up plans. Instead of being a patient, be a participant in your treatment. Resorting to heavy medication is the shortest way to treat all such ailments but remember short cuts always leave dirty trails. So instead of grabbing the inhaler every time you feel a shortness of breath, reach out to nature for treatments. One such powerful natural treatment is Salt Room Therapy. It is a scientifically proven natural, safe and drug free therapy for patients of all ages. It involves the inhalation of dry aerosol particles in an hour long session in the salt room where the natural mucolytic, anti-inflammatory and anti-microbial properties of salt do the healing on reaching the deepest level of lungs. This therapy not only relieves asthmatic patients’ of their suffering but also helps boost up their immunity to withstand future attacks or allergen encounters.

Does Asthma Control You or Have You Controlled Your Asthma?

Dr. Rajesh Swarnakar, Pulmonologist
Asthma is a chronic disease which is affecting all age groups. It’s a hyper responsiveness of the airway to certain stimulus such as allergens, stress etc. It starts early in childhood and has symptoms of cough, breathlessness and chest tightness. Most important investigation being spirometry that guides for diagnosis as well as treatment.There is rise in the incidence of asthma in school going children which is of concern as its symptoms leads to absentees in school. This affects the social and psychological development of the child. Lack of awareness in parents let the symptoms to get worsen. The best available treatment is inhalation therapy which is safe as needed in micrograms and almost devoid of any long term side effects. Because of lack of awareness about availability of a very effective treatment in asthma people continue to suffer blaming their fate. While truth is that by controlling your asthma one can lead a normal active life.But how to find out whether your child’s asthma is under control? Well, take the following Asthma Control Test and find out now:How to take the test?Step 1:  Let the child respond to the first four questions (1 to 4). If your child needs help reading or understanding the question, you may help but let your child select the response. Complete the remaining three questions (5 to 7) on your own and without letting your child’s response influence your answers.Step 2:   Do scoring of the responses.Step 3:  The total score is to be added.Step 4: The score is to be discussed with the concerned doctor.Childhood Asthma Control Test (For children 4 to 11 years old)How is your asthma today?Very Bad - 0Bad - 1Good - 2Very good - 3How much of a problem is your asthma when you run, exercise or play sports?It’s a big problem; I can’t do what I want to do - 0It’s a problem and I don’t like it. - 1It’s a little problem but it’s ok. - 2It’s not a problem.          Do you cough because of your asthma?Yes, all the time – 0Yes, most of the time – 1Yes, some of the time – 2No, none of the time – 3Do you wake up during night because of Asthma?Yes, all of the time – 0Yes, most of the time – 1Yes, some of the time – 2No, none of the time – 3During the last 4 weeks, how many days did your child have any daytime asthma symptoms?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0During the last 4 weeks, how many days did your child wheeze during the day because of asthma?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0During the last 4 weeks, how many did your child wake up during the night because of asthma?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0Interpretation of score:19 or less:If your child’s score is 19 or less, it may be a sign that your child’s asthma is not controlled as well as it could be. Make an appointment to discuss the results obtained on this Childhood Asthma Control Test with your child’s doctor and ask if your child’s asthma treatment plan should be changed. Ask your child’s doctor about daily long term medications that can help control airway inflammation and constriction, the two main causes of asthma symptoms. Many children may need to treat both of these on a daily basis for the best asthma control.20 or more:If your child’s score is 20 or more, your child’s asthma may be under control. There are other factors that your child’s doctor may consider when assessing your child’s asthma control. Asthma is unpredictible.Your asthma symptoms may seem mild or nonexistent but they can flare up at any time. Have your child take the Childhood Asthma Control Test periodically no matter how good your child feels. Continue to have your child see the doctor on a regular basis to make sure your child’s asthma is treated as we as it can be.Every child has right to effective asthma treatment that can control their asthma. If not the treatment your child is receiving needs to be changed. You should go and talk to your doctor about this. If not contact an asthma specialist.With the help of above test one can know the status of the child. As of today many recent medications are available to keep asthma under control.  It’s important “to have your asthma under control than to have your asthma control you.”                          

7 Ways to Find Out if Your Child’s Asthma Is Under Control

Dr. Rajesh Swarnakar, Pulmonologist
Asthma is a chronic disease which is affecting all age groups. It’s a hyper responsiveness of the airway to certain stimulus such as allergens, stress etc. It starts early in childhood and has symptoms of cough, breathlessness and chest tightness. Most important investigation being spirometry that guides for diagnosis as well as treatment.There is rise in the incidence of asthma in school going children which is of concern as its symptoms leads to absentees in school. This affects the social and psychological development of the child. Lack of awareness in parents let the symptoms to get worsen. The best available treatment is inhalation therapy which is safe as needed in micrograms and almost devoid of any long term side effects. Because of lack of awareness about availability of a very effective treatment in asthma people continue to suffer blaming their fate. While truth is that by controlling your asthma one can lead a normal active life.But how to find out whether your child’s asthma is under control? Well, take the following Asthma Control Test and find out now:How to take the test?Step 1: Let the child respond to the first four questions (1 to 4). If your child needs help reading or understanding the question, you may help but let your child select the response. Complete the remaining three questions (5 to 7) on your own and without letting your child’s response influence your answers.Step 2: Do scoring of the responses.Step 3: The total score is to be added.Step 4: The score is to be discussed with the concerned doctor.Childhood Asthma Control Test (For children 4 to 11 years old)How is your asthma today?How much of a problem is your asthma when you run, exercise or play sports?Very Bad 0Bad 1Good 2Very good 3It’s a big problem; I can’t do what I want to do. 0It’s a problem and I don’t like it. 1It’s a little problem but it’s ok. 2It’s not a problem. 3Do you cough because of your asthma?Yes, all the time – 0Yes, most of the time – 1Yes, some of the time – 2No, none of the time – 3Do you wake up during night because of Asthma?Yes, all of the time – 0Yes, most of the time – 1Yes, some of the time – 2No, none of the time – 3During the last 4 weeks, how many days did your child have any daytime asthma symptoms?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0During the last 4 weeks, how many days did your child wheeze during the day because of asthma?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0During the last 4 weeks, how many times did your child wake up during the night because of asthma?Not at all – 51-3 days – 44-10 days – 311-18 days – 219-24 days – 1Everyday – 0Interpretation of score:19 or less:If your child’s score is 19 or less, it may be a sign that your child’s asthma is not controlled as well as it could be. Make an appointment to discuss the results obtained on this Childhood Asthma Control. Test with your child’s doctor and ask if your child’s asthma treatment plan should be changed. Ask your child’s doctor about daily long term medications that can help control airway inflammation and constriction, the two main causes of asthma symptoms. Many children may need to treat both of these on a daily basis for the best asthma control.20 or more:If your child’s score is 20 or more, your child’s asthma may be under control. There are other factors that your child’s doctor may consider when assessing your child’s asthma control. Asthma is unpredictable. Your child’s asthma symptoms may seem mild or nonexistent but they can flare up at any time. Have your child take the Childhood Asthma Control Test periodically no matter how good your child feels. Continue to have your child see the doctor on a regular basis to make sure your child’s asthma is treated as we as soon as it can be. Every child has right to effective asthma treatment that can control their asthma. If not, the treatment your child is receiving needs to be changed. You should go and talk to your doctor about this and discuss result of this questionnaire. If the score doesn’t improve contact an asthma specialist who specialise in lung diseases called Pulmonologist.With the help of above test one can know the status of the child. As of today many recent medications are available to keep asthma under control. It’s important “to have your asthma under control than to have your asthma control you.”