Asthma

What is asthma?
Asthma is a chronic lung disease that affects the airways. It is characterized by 3 airway problems, reversible obstruction, caused by increased reaction of the airways to various stimuli (triggers) and inflammation. It is not an emotional or psychological disease. It can be life-threatening if not properly managed.

Can I get asthma in adulthood?
Yes. Asthma can develop at any age, though it is commoner in childhood and teenagers. Some people get asthma for the first time when they are older. More than 13 million people have asthma and 1.5 million of those are 65 years or older.

Is asthma inherited?
Yes, there is a tendency for asthma be inherited, such that asthma may seem to "run in the family". If you have a blood relative with asthma or allergies, you are at higher risk of getting asthma.

What are the symptoms of asthma?
The most commons symptoms are:
a wheezing sound when you breathe that may be triggered by a cold
chronic cough that is worse with cold or dusty environments
difficulty in breathing that comes and goes
chest tightness aggravated by cold weather or after exercise

Is there a test for asthma
The test for asthma involves a breathing test (known as spirometry) which may be done before and after administration of a bronchodilator to determine any obstruction present is reversible. In addition, a substance known as methacholine (known to induce airway narrowing), may be used to determine if the airways are hyperresponsive (typical of asthmatics). These tests are available in most major restructured hospitals.

Atopy

What is atopy?
Atopy is a genetic tendency for hypersenstivity to common allergens. This is usually manifested in the skin by a rash (atopic dermatitis). Other manifestations are allergic rhinitis and asthma.

How is asthma treated?
There are 4 main components to the treatment of asthma:
To assess the severity of asthma and to monitor the response to treatment using objective tests of lung function (for example spirometry and peak expiratory flow rate)
The use of medication to reverse and prevent airway inflammation that contributes to the airway narrowing
To take preventive measures to avoid or eliminate factors that induce or trigger asthma flare-ups
Patient education.
Can asthma be cured?
The is no cure for asthma, although the disease can be well controlled by following medical advice. Avoiding factors that aggravate asthma, learning to notice early signs of an asthma episode and knowing when to get medical attention are also important.
What are the main medications used in the treatment of asthma?
Anti-inflammatory agents control airway inflammation thereby keeping the airways open by reducing the swelling and mucus. Steroids are the most effective anti-inflammatory medications for the treatment of asthma and help to prevent asthma attacks from starting. However, oral steroids have side effects including weight gain, high blood pressure, cataracts, weakening of bones and
muscles, and swelling, and therefore should be administered for only short periods of time (when the patient's asthma is out of control). Inhaled steroids are safer and effective and are associated with minimal side effects including oral candidiasis and hoarseness of voice (usually when administered incorrectly). Examples of inhaled steroids include beclomethasone, budesonide and fluticasone.

Bronchodilators work mainly by relaxing the airway muscles to open the airway. They are used to help stop an acute attack after it has started and can be administered orally, inhaled, or by injection (mainly during emergencies). They have little or no effect on airway inflammation. Examples of bronchodilators include beta-agonists (eg salbutamol), methylxanthines (eg theophylline) and anti-cholinergics (eg ipatropium).

Asthma exercise

Can people with asthma exercise?
Yes. People with asthma should not avoid exercise as it is beneficial. Swimming is often recommended when asthma is under control. Most asthmatics can participate and excel at any sport (a number of Olympic medalists have asthma). For people whose asthma is brought on specifically by exercise, medication can be taken before exercise to help avoid an episode.
What is exercise induced asthma?
This is narrowing of the airways that is caused by exercise. It is more likely to happen when there is exposure to cold air with low humidity, and air pollutants. A specialized test that includes cycling or treadmill running is usually performed to confirm the diagnosis.
What are the factors that contribute to asthma attacks?
There are many different factors that can trigger an asthma attack. These may be found indoors and outdoors and include:
Cold air
Tobacco smoke and wood smoke
Perfume, paint and any strong odors or fumes
Allergens (particles that cause allergies) like dust mites, pollen, molds and animal dander
Infections (viral or bacterial) including common cold and influenza
What is a peak flow meter?
It is a simple device which measures airflow and therefore determines how open your airways are objectively (rather than by guessing). It is analogous to a thermometer for a patient with fever. It is used to determine the severity of an attack, to monitor response to treatment and to detect worsening in lung function in a patient who has difficulty recognizing symptoms of asthma thereby enabling prompt treatment to avoid a possible serious attack.
What is the relationship between asthma and smoking?
Smoking has a harmful effect on the airways and can trigger an asthma attack. All asthmatics should not smoke, and should also avoid passively inhaling smoke from cigarettes, cigars and pipes from family members.

What happens when an asthmatic gets pregnant?
About a third of asthmatics worsen during pregnancy. Uncontrolled asthma causes a reduction in oxygen content in the mother's blood. Since the fetus gets its oxygen from the mothers blood, this may lead to impaired fetal growth and survival. Properly controlled asthma does not increase the risk of maternal or infant complications and is essential during pregnancy.

Pneumonia disease

PNEUMONIA

What is pneumonia?
Pneumonia is inflammation of the lungs that can be caused by bacteria or viruses. The air sacs in the lungs are filled with pus and when the infection is severe, oxygen has trouble reaching the blood. More than half of the cases of pneumonia are caused by bacteria. Other causes include viruses, mycoplasma and others (parasites and fungi).

What are the symptoms of pneumonia?
Patients may complain of a recent onset of the following:
cough
fever (sometimes associated with shaking chills)
sputum production (may be rusty or greenish in colour)
chest pain that is aggravated by breathing and coughing
The patient may appear to be breathing rapidly and have rapid pulse rate. The lips and tongue may appear to have a bluish tinge due to lack of oxygen.

Is there a test for pneumonia?
Besides a clinical diagnosis of pneumonia made on history and physical examination, a chest x-ray is often required to confirm the diagnosis. Other tests may include sputum and blood tests.

Do patients with pneumonia need to be hospitalized?
Only about 15% of patients with pneumonia require hospitalization. Elderly patients, those with underlying serious illnesses and those who have serious infection may require hospitalization. Younger and relatively fit patients with 'mild' disease may be treated on an outpatient basis.

What is the treatment for pneumonia?
In the young, healthy patients, early treatment with antibiotics (usually taken orally) can cure and speed recovery from pneumonia. There is no effective treatment for viral pneumonia. In certain cases, viral pneumonias may become secondarily infected with bacteria and such cases require antibiotics as well. The type of antibiotics used to fight the pneumonia are determined by the most likely germ causing the pneumonia and the doctor's judgment.
In more severe cases, hospitalization and antibiotics given directly to the blood stream is required, in addition other supportive treatment like oxygen to increase the oxygen in the blood. Patients with severe pneumonia may require admission to the intensive care unit. With prompt treatment, most types of bacterial pneumonia can be cured within 1-2 weeks, but viral and certain other types of pneumonia may last longer.

Can one die of pneumonia?
Yes. Until 1936, before the advent of antibiotics, pneumonia was the leading cause of death in the United States. Since 1979, pneumonia and influenza combined have ranked as the sixth leading cause of death.

What are the predisposing factors for pneumonia?
People considered at high risk for pneumonia include the elderly, those with chronic illness such as chronic obstructive pulmonary disease, diabetes mellitus and congestive heart failure. Viral infections such as influenza, illness such as AIDS that impair the immune system including those undergoing chemotherapy for cancer and patients on immunosuppressant drugs post organ transplant are particularly vulnerable.

Is it possible to prevent pneumonia?
The bacteria known as pneumococcus is the most common cause of bacterial pneumonia in the community. A vaccine is available against pneumococcal pneumonia and this is usually given to people at high risk of getting the disease eg patients with chronic illnesses such as chronic lung disease, heart disease, kidney disease, or diabetes; patients who are recovering from severe illness, who are in nursing homes, and the elderly. The vaccine is generally safe and effective and is usually given once.

Quit Smoking

If you have tried to quit smoking, you know how hard it can be. It is not easy to quit smoking. It takes a little practice. Most people try to quit smoking at least once before they quit for good. Each time you try to quit, you can learn about what helps and what hurts.
Remind yourself that your first cigarette did not make you a smoker to start with, and a small setback does not make you a smoker again. Quitting takes hard work and a lot of effort, but you can quit smoking. Staying away forever takes a serious effort, involving changing behaviour and comfortable lifestyles.
If you want to stop smoking, get help. And the more help you get the better your chances of stopping for good.