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Breathe a sigh of relief

Many asthma sufferers would like to reduce their dependence on their inhalers.Vicky Frost looks at the 'natural' options from herbs to breathing exercises. There are 5.2 million people in the UK currently receiving treatment for asthma, come in two types: preventers, which are taken daily to control inflammation in the airways long-term and usually contain low-dose steroids; and reliever inhalers, which instantly relax the muscles if something triggers symptoms. Most asthmatics agree it's no big deal having to take them.And yes, it's great that they work. But as with anyone with a long-term reliance on drugs, many asthmatics would like to reduce their reliance on inhalers without increasing the likelihood of a potentially dangerous attack."Lots of people are very keen to know what they can do about their asthma other than take drugs to control it," says Dr Mike Thomas, a GP. There's a large amount of information out there about "natural" treatments, from avoiding cow's milk to eating more shilitake mushrooms. But as Thomas warns: "There's a fairly low amount of evidence for many of these things because lots of the research is based on drug treatments.It's basically much harder to fund non-drug research-but that has been increasing in the last 10 years, so the evidence is growing." So what are the alternatives, and how effective are they? Breathing exercises Buteyko is the best know of these-and proponents claim it can be beneficial to mathmatics (and those with emphysema or bronchitis). You normally attend a workshop, may be over a couple of days, but it isn't available on the NHS. So is it worth it? "Quite a lot of people do breathe abnormally," says Thomas. "We think breathing is instinctive, but it's very complex and need coordination of many muscle groups." Quiet breathing-ie, when you are at rest should come from the diaphragm, with little movement of the chest. But some people will breathe largely from their chests. "If people can be encouraged to use quiet natural diaphragmatic breathing, this may led to improvements in their asthma control," says Thomas. "There are some extravagant claims made about Buteyko, but good-quality studies do show that it can help people, and mean they are less reliant on their reliever-although there's no evidence that it can cure asthma. Breathing normally is probably why it works. "But Buteyko isn't the only breathing exercise regime that might help."It could be the same with yoga- and there are some people who say that singing is very helpful,"says Thomas. A recent study published in the journal Thorax also showed success in controlling asthma with the Papworth technique a series of breathing and relaxation exercises which may reduce symptoms by as much as a third. The technique encourages breathing from the abdomen, using the diaphragm, rather than taking rapid, shallow breaths.

Diet

There is evidence to suggest that asthmatics may benefit from antioxidants such as vitamins E and C, as well as the mineral selenium, which can be found in foods such as brazil nuts, cereals, dairy products, fish and meat. Antioxidants help combat free radicals, which are throught to damage the airways. But Dr. Seif Shaheen, a senior lecturer in epidemiology at Imperial College and senior research fellow for Asthma UK who works in the area of asthma and diet, says: "In our selenium trial, a lot of the asthma sufferers had quite good selenium levels so extra selenium would n't be expected to have any benefit, but it still might have an impact for people with really low selenium. However, the test relied on people taking supplements rather than changing their diets, which might also have an effect on the results.

"To derive maximum benefit from antioxidants, they may need to be consumed in food rather than as pills, although trying to change people's diets is notoriously difficult." It might be worth eating more apples, which are a rich source of antioxidants. Research by Dr.Shaheen suggests that adults who eat two or more apples a week are almost a third less likely to have asthma than those who eat them less than once a month.

Poor diagnosis, care worrying asthmatics

Pune:Blaming the country's health ministry for not implementing asthma treatment guidelines prescribed by the Global Initiative for Asthma (Gina), Arvind Bhome, city-based chest physician and asthma expert points out that Indians spend a whopping Rs. 7,600 crore on asthma treatment every year, when the out flow should have been under Rs. 2,500 crore. He is not surprised with the CRF findings that as many as 62 percent of the 240 astma patients surveyed in Pune recently do not have their asthma under control. Quoting the 205 report of the 'National commission on macro economics and health -the economic burden of the asthma in India,' Bhome. According to Bhome, India was suffering from a triple tragedy as per as asthma was concerned: poor diagnosis, poor monitoring and poor treatment."Most general practitioners do not use simple, inexpensive asthma diagnostic equipment like peak flow meters to measure lung function in patients. Government hospitals and health programmes too, do not have this diagnostic equipment, as a result of which asthma is not detected early." Bhome was of the opinion that a strong national advocacy campaign for asthma was the need of the hour He said readers could visit the site:http//www.ginaindia.com, an Indo-Gina initiative and has a patient guide in 10 Indian languages with answers given to more than 90 frequently asked questions.

What is asthma?

Asthma:is a chronic disease that affects your airways. The airways there the tubes that carry air in and ut of your lungs. If you have asthma, the inside walls of your airways are inflamed(swollen). The inflammation makes the airways very sensitive, and they airways very sensitive, and they end to react strongly to things that you are allergic to or find irriating. When the airways react, they get narrower, and less air flows through to your lung tissue. This causes Asthma symptoms like wheezing(a whistling sound when you breathe), coughing, chest tightness, and trouble breathing, especilly at night and in the early morning. It cannot be cured, but most people can control it so that they have few and infrequent symptoms.

Antibiotics linked to asthma

Pune:If you are suffering from a common clold, headache or other seasonal ailments, consuming antibiotics might make you susceptible to asthma. This, and many such surprising facts were revealed at a press conference orgainised by Cipla on the ev of World asthma day, which fails on May 6.Revealing the shocking reality, leading chest physician Nitin Abhyankar said, one out of twenty persons in Pune are affected by asthma. Besides the number of child asthmatics is twice that of adults. Conservative estimates peg child asthmatics at 10 per cent; but the actual numbers might be many times higher, Abhyankar said. The alarming prevalence of asthma is largely attributed to rapid urbanisation and adoption of western lifestly. "As we move towards sterilised no-bacteria zones, the exposure to natural enviornment reduces to nill. The body then reacts violently to even

natural phenomena

like dust, causing asthma. 'Are we too clean for our own good?' is now a question being asked by experts globally. Over-dependence on medication is another issue that warrants serious attention, feels Abhyankar. Rushing to the doctor for every sniffle and sneeze weakens the natural immune-system of our body, making it more susceptible to diseases like asthma, he feels. Abyankar said that while asthma is reversible, it causes life-threatening, irreversible damage to the lungs, if left untreated for upto five years. Up to 10 percent of the patients from Pune are now in the irreversible zone, and the fingures are only moving upwards. Inadequate knowledge among patients as well as doctors is the major reason for this rise. Echoing this need for awareness, the theme for this year's World asthama day is"You can control your own Asthma."

Asthma suffocating Pune

Pune:Even as the world observes the 'World Asthma Day'on May 6, an astounding 62 per cent of the 240 asthma patients surveyed in Pune recently do not have their asthma under control. This was revealed to TOI by citybased Chest Research Foundation (CRF)that carried out the survey in five clinics and two leading hospitals in the city. The study, which was carried out on a cross-section of 240 asthma patients, has been submitted to the Eurpoean Respiratory Society Congress to be held in Berlin in October 2008. If that is not all, city-based asthma expert Nitin Abhyankar's recent study on 316 patients in Pune and Ahmednagar shows that poorly controlled chronic asthma led to chronic obstructive pulmonary disease(COPD) in 76 per cent of the cases. Abhyankar's report, too has been submitted for the Berlin Congress. Acording to Abhyankar, in a COPD situation, the patient severely compromises his/her life expectancy because of increasingly weak lungs. "I sincerely hope my report wakes up people and keeps them away from emergency situtations." Says Bill Brashier, leader of the CRF research team,"While the failure to take the right medicine at the right time in the right manner was the major reason for this lack of control, our study revealed that the lack of control also depended on factors beyond medicines

Myths about asthma

Ayurvedic cure for Asthma?

The incidence of Asthma has increased considerably because fo today's stressful living and Ayurveda holds the key to its cure, saysDr.S.S.Hiremath. Asthma is a chronic disease of the lungs, which inflames your airways(bronchi). It is characterised by

In today's stressful living, the incidence of asthma has increased considerably. Asthma in Childrens suffer more than adults and the disease is more common in boys than in girls. Asthma attacks are not all the same. Some are worse than other. Many people with asthma have problems only occasionally, but others struggle with it every day. It can be life threatening particularly if it is not treated adequately and promptly. Asthma attacks are not all the same. Some are worse than other. Many prople with asthma have problems only occasionally, but others struggle with it every day. It can be life threatening particularly if it is not treated adequately and promptly. Ayurvedic insight into asthma has a broader perspective. It classifies asthma as an acutely Kaphic disorder with simultaneous accumulation of ama(toxin which is produced by undisgested and uneliminated food particles) at respiratory system brought on by excessive mucous and phlegm.Although the human body has a great intelligent, natural healing system that is capable of rejuvenating itself, the formation of toxins reduces this natural capacity. So, the versatile approach of Ayurveda helps in treating asthma as the focus is on the root cause of the disease. Hence, the therapy does not focus on the disease but the cause. Ayurveda Treatment Ayurveda emphasizes on treatments to eliminate such toxins and balancing the Dosha. Some such treatments are: 1)Vamana(Therapeutic vomiting), 2)Virechana(Purgation therapy)

Vamana is the procedure in which we eliminate the waste product (Kapha toxins)which are collected in the body and respiratory track from its roots(stomach) through the mouth.The course of treatment involve loosening and mobilizing the toxins in an effort to finally eliminate them. After vomiting, the patient feels very confortable as most of the congestion, wheezing and breathlessness will disappear along with the clearing of sinus. As the process of purification is done from the roots, the chances of sudden asthma attacks is brought under control.After Vamana, the Virechana therapy and internal medicines plays a role to stop further production of toxins and strengthen the immune system, make the respiratory system more resistant, enhance self-reliance, vitality and mental clarity. Treatment for children below 14 years and aged people should be only through internal medicines.

Bandra based doctor practices acupuncture without needles Dr.Alka Tandon began taking the method seriously when she herself was cured of asthma a few yers ago. Bandra-based Dr. Alka Tandon makes use of a unique method called psychological acupuncture without needles to treat her patients. This new concept also known as the emotional freedom technique(EFT) cures ailments without any side-effects. “There is an EFT manual with points which can be used to cure headaches, backaches, spondilytis, arthritis, grief, psychological fears, phobias, allergies and accidental traumas,” informed Dr. Tondon who practices at Diamond House on Linking Road began taking this method seriously when she herself was cured of asthma. When queried about the method in which it works, Dr. Tondon said, “All that we need to do is cap lightly at the end of energy meridian lines. One needs to follow the same recipe given in the EFT manual for different emotional, physical and psychological problem.” Explaining further about the method she adds, “ The basic premise is in the disturbance in energy body. But by tapping it we get the energy system into balance. Bodies know how to heal and get energy blocks out of the system, without using any medicines and without any side effects.” There is an EFT manual with points which can be used to cure headaches, backaches, spondilytis, arthritis, grief, psychological fears, phobias, allergies and accidental traumas” Breathe free and easy.

Tips to help people with respiratory problems

cope with the deadly winter cocktail of rain, smog, pollen and pollution. As the scorching heat of summer gives way to dry wintry breezes and early mornings with a nip in the air, the most festive trimester of the calendar year spells mega-excitement for party hoppers. But for those prone to respiratory disorders, it’s another story altogether. The residue of Diwali fumes combined with dust, smog, pollen and pollution form a deadly winter cocktail.

“The influenza virus thrives in winter and, as a result, we see an alarming rise in chest infections, asthma attacks, chronic obstructive pulmonary disease and bronchitis. In fact, with the cold weather providing flourishing conditions for certain strains of bacteria, we are dreading being hit by another bout of swine flu,” says Mumbai based cardiologist and consulting physician, Dr. Anil Ballani.

Advice:

His advice is to avoid outdoor activities early in the morning when thick smog settles low. Instead, he encourages exercise freaks to choose evening hours for jogging/walking or opt for indoor activities. For those with chronically weak lungs, he strongly recommends chest physiotherapy and regular steam inhalation, which helps prevent cumulative congestion. “Keep away from pollution of all kinds,” is his constant advice to respiratory patients in winter while simultaneously informing them about the availability of two new vaccines (the influenza vaccine and the pneumococcal vaccine), which – if taken around October-November-appreciably reduces the intensity of flu attacks. He recommends these vaccines to those who wish to arm themselves against influenza in winter. The importance of diet can never be over-emphasised and the ancient adage ‘you are what you eat’ continues to hold good for respiratory patients, particularly in winter.

Avoid some food diet in Asthma patient

“Steer away from cold foods like yoghurt, cold salads, ice cream, sherbets and smoothies, Instead, opt for hot soups, ginger tea, spicy curries and rasam. Strong black coffee sipped steaming hot works wonders during an attack of asthma.

Asthma cure

on foods rich in vitamin C, as these boost immunity and prevent cold, cough and the sniffles,” says nutritionist Vinita Aran. She recommends incorporating tomatoes, capsicum, red pumpkin citrus fruits and gooseberries into the regular diet .Traditional remedies Traditional kitchen remedies continue to be popular in keeping chest infections at bay and are generally taken along with prescribed drugs in most homes. Dr.kamlesh Tripathi has deep respect for the therapeutic qualities of herbs and claims that the antiseptic powers of tulsi,neem and turmeric are incredibly high while dried ginger, black pepper and cardamom combined with honey make the best decongestants ( besides being free of undesirable side-effects). He believes that spasm of the trachea and bronchus is often due to allergens in the atmosphere and it is of prime importance to keep the surroundings clean, dry and sunny. Besides certain foods, mould, damp dust mites and fungus are allergens that could bring on a serve attack of respiratory distress and should be avoided at all costs, cautions Dr. Tripathi. A few decades back, patients had to resort to pills and injections to get relief; but now advances in medical science have put the healing process in fast-forward mode. Steroids may get their share of bad publicity but they continue to be life-savers. When used in inhalers and inhaled under the doctor’s guidance, they constitute very effective maintenance measures for good respiratory health. “I was joining my sailor husband on sea and was stranded in a hotel in Korea when I felt a major attack of asthma coming on. Nobody around spoke English and I panicked till I discovered a strip of steroid tablets in my purse. A couple of those pills saved me that night,” recalls Lavinia Ghose, young asthma patients. The doctors, however, warn against self-medication, as steroids need a tapering does that can only be prescribed by an exert physician. Dr. Sanjeev Mehta, a chest specialist in Mumbai, feels that lifestyle changes are of utmost importance, along with proper medication. “Install chimneys in the Kitchen to draw away cooking fumes, stay away from cigarette smoke and oil fumes (generated during deep frying). Avoid carpets and heavy draperies at home, all dust traps. Avoid over-exertion, learn to say no to demands, when an attack of asthma seems imminent. Even if as you have to cancel a party you are hosting at the last moment, do so; but give top priority to your health,” he says firmly.Positively helps. Often, patients are pleasantly surprised at the sympathy and support they receive on going public. Psychosomatic factors play a huge role in many cases of respiratory distress and a positive frame of mind is a major help. “Join a hobby class or a support group head for a mountain hike with fellow respiratory patients (you won’t feel apologetic about huffing and puffing on your way up!), learn salsa, walk the green side with bare feet(nothing like having fresh grass squelch underfoot) or simply join a laughter group and laugh yourself silly and out of breath, the best exercise for your lungs,” says Anup Biswas who over-came crippling asthma by incorporating radical changes in his lifestyle. He also attributes his present good health to yogic exercise, “As asthmatics, we tend to breathe shallow and, in our old age, we run the risk of suffering from atrophy of the lower lungs, Simple pranayam and Kapalbhaati exercise, if done regularly, can increase lung capacity to an amazing degree,” says Anup. Prevention, education and medication in the right combination can enhance the quality of life for those weak of chest say the experts. The bottom line, however, is loud and clear: Take charge of your ailment before it takes charge of you.

Dos and don’ts

  • Nip a respiratory problem in the bud, Do not let it get out of hand.
  • Religiously follow maintenance medication prescribed by the doctor.
  • If a problem seems to getting out of control, immediately consult the doctor.
  • Keep a stock of emergency medication at home.
  • Keep spare inhalers handy. You may need them in the middle of the night.
  • Carry prescription medicines and inhalers when going out (specially when travelling to remote places) .
  • Keep your doctor’s phone number handy at all times.
  • Follow a healthy diet, exercise moderately and have a mission in life.
  • When down in the dumps, remember you are in august company….Mohammad Azharuddin and Amitabh Bachchan are two celebs who did not let respiratory problems interrupt life! .

Keep your lungs healthy.

Answers to some frequently asked questions on pulmonary disease DR.R.NARASIMHAN

Chronic Obstructive Pulmonary Disease(COPD) is crippling because it is a progressive disease. We have been endowed with such reserves that we do not realise the damage caused to the lungs by smoking. Smoking attacks the lungs from day one and studies have shown that complete cessation is the only way to arrest the decline of the accelerated fall in lung function. Here is some more information on COPD What is COPD? COPD encompasses two important diseases: Chronic bronchitis and Emphysema. Chronic bronchitis is inflamed and narrowed airways that make breathing difficult; so that the patient is left breathless. In emphysema the lungs are enlarged but not working. Take the example of a balloon. A balloon can be inflated up to a point where you can see the expansion. Beyond this, you cannot see the balloon growing though you continue to blow. Your lungs in emphysema are like an inflated balloon that cannot be blown any further without becoming breathless. What causes it? Smoking is the single most important cause. Other causes are increasing pollution -both outdoor and indoor pollution cooking with coal; cooking exposure to industrial dust and congenital enzyme deficiency. How can smoker met develop COPD? Simple. Stop smoking. It is never too late. The benefits start immediately. Once the smoker stops, the decline of the lung function reduces immediately and it approaches that of the non-smoker. Can COPD patients exercise? The patient will feel breathless but if he rests it will disappear and the exercise can be scary but the worst things is to stop exercising. Some tips: start using the stairs. Whenever you feel breathless rest for a while and continue. This will make your walk on plains easy. If you don’t, you will eventually become breathless even for simple tasks. Sometimes breathing through the pursed lips can help you overcome breathlessness. Regular walking for 30 minutes is a good way to keep your lungs healthy. Do diets play a role in COPD management? Yes diets can complement your management. Eat lots of vegetables and fruits. Avoid foods that are hard to digest like oily and spicy foods, onion, ice cream with nuts etc. If you are not well eat short small soft foods, Foods rich in carbohydrates like pasta and proteins like chicken and fish are preferable. But if you are overweight it can add to your problems. Is there a role for home oxygen therapy? If one winds up in hospital too frequently there is a need for home oxygen treatment. Oxygen should be given for a minimum of 16 hours a day. In severe cases. This can be delivered by various means. Oxygen cylinder: This may need regular refills and is ideally used at night and after meals. Oxygen concentrator:Concentrators take in normal air, remove some nitrogen and deliver oxygen. But if the oxygen requirement is more than five litres this won’t help. Oxygen should always be delivered via Vent mask and not via nasal canulas or routine masks. Will vaccines help prevent infections? There are two kinds of vaccines. One is a pneumococcal Vaccine to be given once in five years to prevent pneumococcal Infections. The other is an influenza vaccine that has to be given once in a year. Now there is an oral vaccine that is given sub-lingual to prevent bacterial infections. Reducing infections in COPD prevent long-term morbidity. Can I monitor my illness myself? Yes , Use a pocket spirometer that with measure the pulmonary function and a oxygen pulse meter, which measures one’s oxygen saturation. If you notice a difference in the values visit the doctor. Although COPD is different from asthma don’t be alarmed. The patient’s quality of life will be good if he follows his physician’s advice. When to see the doctor? . • Coughing out blood . • More phlegm and change in colour. • Fever. • Getting more breathless, worsening of spirometry values and decrease in oxygen saturation. • Swollen legs and face. • Excessive day time sleeping’s . • Mood swings. Make things worse . • Continued smoking . • Not taking recommended treatment. • Being irregular with inhalers . • Not dealings with other illnesses. • Not keeping regular appointments with physician. • Limited interaction with friends. • No exercise. General advice. • Holidays: One can go on a holidays. If you are flying inform the airlines about your problem. It is better to avoid extremely cold places as they increase exacerbations. • Sleep: It is very important to have a good night’s sleep. Avoid sleeping too much in the afternoon as that will reduce night’s sleep. • House work: Avoid dust and strong chemicals in rest rooms and bathrooms as they will worsen symptoms. ‘I FOUGHT ASTHMA FOR 14 YEARS…AND WON’. It started with ‘simple’ cold. After marriage, I shifted to Mumbai from Ajmer. Barely a few months here, cold became a constant companion. I didn’t do much except pop pills, once in a while. I was always the tough one in the family, hence it was difficult to swallow that having survived on ghee and butter all my life, an occasional cola caused such trouble! The cold persisted for over a year; then I started getting asthma attacks. BUT WHY NOW. It was tough to pinpoint the exact cause, my dad being asthmatic, heredity perhaps played its role. Some doctors blamed Mumbai’s humid weather unlike the dry climate up north, while I personally felt it has also to do with the struggles of adjusting to a new marriage, lack of support from in-laws and the result ant stress. Who knows? . THE CURE….OR WAS IT? . Then began a long tryst with doctors. First, our local GP, who after having given up, forwarded me to a chest specialist. He, in turn, asked me to get allergy tests done, which forbade me from having certain daals and oils.Strength, considering, I had been having them all my life! Still, anything to get better, I thought. Not that it helped. I was still getting attacks, with increasing frequency. Ayurveda and Homeopathy came next. But with no benefits. DRUGS Worse than asthma was my dependency on allopathic drugs. Some capsules kept me awake all night. If I didn’t take them, asthma would do the needful. Regular, popping resulted in those tablets being rendered ineffective, following which I would be put on a stronger dosage. All this, played at a psychological level too. And when your mind starts doubting your are recovery, only God can help you. Due to constant illness, I lost out on quality family time, especially with my son. FIGHT BACK For a change of weather, I shifted to Kota for two years. Surprisingly, I started getting attacks, though milder ones, there too. Then I found naturopathy which started the process of correcting all the wrongs of the past years. Naturopathy believes in natural healing, and getting rid of the body toxins. My diet was completely over hauled and treatments such as enema and kati-snaan meant that my body was cleansed off the cough and toxins. My health improved, so did my immunity. I had plenty of honey those days. The asthma stokes reduced though they didn’t completely stop. MEDITATION My naturopathy doctor, also a vipassana student, vouched that my asthma attacks had nothing to do with being ‘unhealthy’ She recommended that I go for a vipassana course. The first 10-days vipassana course changed my life. I didn’t come out enlightened, rather it was extremely difficult. Firstly, I realised my breathing technique was wrong. Trying to gasp for breath all these years, I had almost forgotten to breathe with my nose. The first course reconditioned me to breathe right-a pre-requisite for dealing with asthma. As I practiced vipasana daily, I saw a pattern-stress and friction made me breathless, and all I had to do was concentrate on my breath and let the moment pass. That same stress would have otherwise resulted in an attack. With every course, I learned to control my mind. Vipassana says every thought shows on your body- the good and the bad. In many case, it manifested itself largely as asthma. Whether, the constant cold etc. were only add-ons. I changed my thoughts to change my health. No, I didn’t turn saintly. I still lost my temper, felt stressed out, but I didn’t dwell over it. Instead, I shut up, concentrated on my breath and ‘observed’ the negative vibrations simply fade away. Almost like a miracle, my attacks stated disappearing. Sounds simple? But our mind is where most of our health problems originate. An hour of vipassana every day helps me keep my stress levels under control. The patience has helped me in every aspect of life including relationships. To date, I have attended many course, primarily to brush up, and each time, it benefits me further. THE PRESENT After two years in Kota, I came back to Mumbai. The city weather is the same, but my asthma is nowhere. My doctors find it impossible to believe, to see their regular customer not dependent on medication. Had I found vipassana earlier, the 14-year-long struggle could have been cut short, but that’s okay. Today, I have the key to healthy life. Cure for cough is in lungs, not throat London: A cure for coughing is in the offing, thanks to scientists who have identified the process that leads to the reflex. Coughing has largely remained a mystery to science. Now, a team in Britain has found that the problem actually lies in receptors on nerve endings in the lungs which react to irritants. For victims persistent coughing in which no useful purpose is being served, the receptors on these nerve endings are repeatedly prompting the cough reflex. If those receptors are blocked, coughing could be stopped, according, to scientists from Britain’s National Heart and Lung Institute, Imperials Collage London and Hull University. Lead scientist Maria Belvisi of the National Heart and Lung Institute and imperial Collage said: “For some people, chronic coughing can be annoying and duncomfortable, but for others it can be distressing and can have a server impact on their quality of life. “Many people say that certain things in the air can make them cough and we are very excited that we have shown, for the first time, exactly what is probably happening inside the lungs. “Now that we think we have cracked the mechanism, we can start investigating whether we can stop people from coughing excessively by blocking the receptor protein that triggers it” In their research, involving guinea pigs and human volunteers the scientists showed that irritants in the air—including cigarette smoke and air pollution---switch on receptor proteins in lung nerve endings called TRPAI. This in turn causes the cough reflex, the Daily Mail reported. When the TRPA1 receptors were blocked in guinea pigs, using drugs, their coughing response to stimulants including a key compound in cigarette smoke was reduced. Nerves taken from mice, pigs and humans were also used to back up the research, as were reactions by human volunteers. OUT OF BREATH Awareness and lifestyle changes are the only way to counter respiratory diseases, says chest physicians. Is development taking a heavy toll on Mumbaikars? While enough has been said about sedentary lifestyles leading to ailments, a recent BMC survey showed that deaths due to respiratory tract infections have increased by 20.17 per cent, pushing even heart problems and cancer aside. The new killer diseases are bronchial asthma and chronic obstructive asthma and chronic obstructive pulmonary disorders (COPD). Not surprising, given the dust, pollution and erratic lifestyles. Also WHO ranks Mumbai among the top 10 polluted cities in the world. Here are some of the commonest respiratory ailments to watch out for: ASTHMA The big daddy of all respiratory problems. In its most serious manifestation, asthma is a debilitating disease, but even the milder forms are problematic. Has your occasional wheeze turned into a regular affair? Or do you get frequent nocturnal coughs? It might be the beginning of asthma. Breathlessnes after climbing a few storeys is the biggest sign. Or if you feel out of breath trying to catch the 5.10 local, know what it’s not merely your lack of fitness that’s responsible. Treatment Asthma needs a multi-pronged approach where medication apart, you should overhaul your lifestyle. Firstly, become more active. Take up a sport or go for brisk walks. Practice pranayam and breathing techniques. Go completely off canned or unnatural foods, stick to seasonal vegetables and local food, and drink lots of water. Also, late night meals should be strictly avoided. Maintaining a strict schedule and sticking to it is the key. Simply put: go back to the basics. COPD It’s similar to asthma but an irreversible condition, hence more dangerous. Primarily caused by smoking, pollution and other factors are only add-ons. Here, patients’ breathing capacity goes down with time and they suffer from severe breathlessness and coughing sputum. Treatment While a permanent cure is difficult, quitting smoking and following afore mentioned lifestyle changes are a must. CHRONIC COLD A common cold is a bi-annual affair where you might feel sick for a week and get back on track. But chronic cold is a condition where some or the other problem-cough,blocked nose, sneezing- are persistent. It’s directly related to pollution. Though dismissed as trivial, chronic cold can affect your normal functioning. It also releases a chemical Histamine that makes you feel very sluggish. Treatment It requires medication for at least six weeks. Dietary changes can help. Have more vegetables and fruits. CHRONIC CONJUCTIVITIS It affects cab and rickshaw drivers the most and those who have field jobs are equally vulnerable. Mostly it’s symptomised by red eyes and itchiness. Treatment Wash your eyes often. Putting saline drops in your eyes (even if you are not suffering from the disease) helps. PHARYNGITISNoticed how some people constantly seem to have an itchy throat and constant cough? Pharyngitis suggests redness and infection in the throat. Being stuck in traffic and inhaling polluted air is a direct invitation to pharyngitis. Treatment Salt water gargling is a good way to clear your throat. Especially if you have to travel through dusty roads, make this a daily habit. Also have lots of water , and among dietary changes, include more turmeric. Why Worry Forget grave statistics, you should be worried also because the environment has a direct link with respiratory organs. While the liver, heart etc are well protected, it’s often the lungs that take the brunt of changes in the atmosphere, first. But it’s the indirect effects that are a cause for concern. Take for instance, the increasing incidents of road rage. High carbon monoxide levels irritate the nerves. All that’s needed then is a small trigger to burst. Similarly, high nitrous oxide levels emitted by vehicles lead to watery eyes. Such factors add fuel to the existing health problems. One may not be able to prevent these conditions, but being aware of the disorders can go a long way in controlling them. The TB Scare Tuberculosis (TB) is an increasing public health concern world-wide with about eight million new cases reported every year. Co-infection with HIV (that is, it can strike even while you are HIV positive), immigration of infected persons from high-risk areas to developed countries and drug resistance due to inadequate treatment are reasons enough to be concerned. But the most common form of infection is the pulmonary infection (that of the lungs). Genital TB is a form of extra-pulmonary TB. It represents about 20 percent of all extra pulmonary infections. About 12 per cent of lung infections can spread, causing a genital infection. (A genital infection is mostly secondary to lung infection.) However, increasingly, cases are being seen where it has been spreading through blood from kidneys, bones or intestines, other common sources of primary infection. WHO (World Health Organisation) estimates that in cities such as Mumbai, one in every four individuals is exposed to the infection. In tertiary referral hospitals, the incidence can be high. In infertility centres, Genital TB can be a cause of infertility in about 16-18 per cent of cases. RISK ACROSS SEXES The actual incidence of a genital TB infection is very difficult to determine since some patients can be asymptomatic and can go undiagnosed. Hence a high index of suspicion is required to investigate people. In women, menstrual irregularities, recurrent miscarriages, ectopic pregnancies (abnormal position of an organ at the time of birth) and infertility can lead physicians to investigate. In men, testicular masses and male infertility due to low sperm count or abnormal sperm can be the basis for investigations. Conception can be difficult in cases of genital TB and when it occurs, it is complicated with miscarriages or pregnancy in the fallopian tubes (pair of tubes conducting the egg from the ovary to the uterus) which can be life-threatening. It is reassuring that genital infection is not known to be contagious to the partner. However, it is wise to investigate the partner in cases of genital TB. TREATMENT Since the disease is not preceded by any symptoms in most people, diagnosis can be difficult. However with the availability of ophisticated tests, it is easy to pick up cases very early so that treatment can be offered before the devastating effects occur. *In women, ‘endometrial biopsy’ i.e. biopsy from the lining of the uterus can be easily done as an out-patient procedure to diagnose the infection. *In men, testicular biopsy or even semen samples can be tested for the infection. Treatment is medical with multi-drug therapy which can run for six to nine months. Patients need to be monitored during the treatment to avoid its side-effects. It is very important that the treatment is completed properly since inadequate or incomplete treatment can lead to a drug-resistant form of the infection. In some cases, in women where the infection has caused adhensions or tubo-ovarian masses, surgery is necessary. In cases of infertility, uterine TB may need endoscopic surgery to increase the cavity area or make it better for pregnancy. The PCR (Polymerase Chain Reaction) technique is the most advanced test to diagnose TB. It can pick up infection with only a few bacilli and the results are available in four days. Previously, tests were not so sensitive and it often took upto six weeks to confirm the infection. BE AWARE Poverty, malnutrition, smoking, alcohol and drug abuse, diabetes and co-infection with HIV are pre disposing factors for TB. But proper sanitation, good ventilation and regular, healthy eating habits go a long way to reduce the chances of catching the infection. In 4 years, single shot for all allergies Jab will Protect Against Number of complaints, Including Asthma And Hay Fever London: Scientists have developed a “one-size-fits-all” jab to cure allergies, including hay fever and asthma, which they claim would be available in market in just four years. The team behind the injection claims it would be the “holy grail” of vaccines as a single dose would protect against a number of allergies and ward of reactions to cat fur, dust and peanuts. Wolfgang Renner, from Cytos Biotechnology, which developed the jab, said:”We think it is a one-size-fits-all mechanism. We are very excited about it.” At the jab’s heart are pieces of synthetic DNA similar to those found in the bug that causes tuberculosis or TB. The DNA fools the body into thinking it is under attack from a dangerous bug, kick-starting a multi pronged immune response. Recent trials showed the jab was as effective as taking steroids when used to fight asthma. It found that when comparing 63 asthma suffers who were given the jab or a fake drug over two or three months, the new vaccine slashed asthma attack by a third, the Daily Express reported. In another trial, the drug-CYT003-QBG10-was given as a jab once a week for six weeks. The scientist found this cut runny noses and weepy eyes-symptoms caused by an allergic reaction to house dust mites and reliance on other medicines-by 39%. The jab also boosted quality of life by 42%, according to Renner who said larger trials could start next year and the vaccine could on sale within four years. Experts have welcomed the jab. An Allergy UK spokesman said: “It does sound a very promising treatment, giving hope for those with severe asthma/allergy symptoms for whom the usual treatments aren’t enough but there is still a long way to go before it will be available.” Leanne Metcalfe, director of research for Asthma UK, added: “We are excited about the potential of this vaccine to make a real difference.” Britain’s NHS currently estimates around 10 million people suffer symptoms of hay fever-such as sneezing, runny nose and itchy eyes-in the spring and summer as grasses and trees release their pollen into the air. But that number could reach 30 million within 20 years as city living, pollution and climate change exacerbate symptoms. Aerobic exercise may improve asthma symptoms Brazilian researchers have found that regular aerobic exercise may help improve respiratory symptoms and psychological distress in adult patients with asthma. Researchers evaluated the outcomes of an asthma program in patients with asthma. In the control groups, 50 patients received educational programming and underwent breathing exercise; in the aerobic training group, 51 patients underwent additional aerobic training beyond educational programming and breathing exercise. After three months, quality of life scores asthma symptom free days, anxiety and depression levels improved only in the aerobic training group. Furthermore, there was a linear relationship between improvement in aerobic capacity and days without asthma symptoms.

I FOUGHT ASTHMA FOR 14 YEARS... AND WON’

Her doctors had given up on her. Today, they marvel at her recovery. Leaving sleepless nights and never-ending medication cycles behind, Meeta Hotwani recounts her battle with asthma

It started with a 'simple' cold. After marriage, I shifted to Mumbai from Ajmer. Barely a few months here, cold became a constant companion. I didn’t do much except pop pills, once in a while. I was always the tough one in the family, hence it was difficult to swallow that having survived on ghee and butter all my life, an occasional cola caused such trouble! The cold persisted for over a year; then I started getting asthma attacks. It was tough to pinpoint the exact cause. My dad being asthmatic, heredity perhaps played its role. Some doctors blamed Mumbai’s humid weather unlike the dry climate up north, while I personally felt it had also to do with the struggles of adjusting to a new marriage, lack of support from in-laws and the resultant stress. Who knows?

THE CURE...OR WAS IT?

Then began a long tryst with doctors. First, our local GP, who after having given up, forwarded me to a chest specialist. He, in turn, asked me to get allergy tests done, which forbade me from having certain daals and oils. Strange, considering I had been having them all my life! Still, anything to get better, I thought. Not that it helped. I was still getting attacks, with increasing frequency. Ayurveda and Homeopathy came next. But with no benefits.

DRUGS



Worse than asthma was my dependency on allopathic drugs. Some capsules kept me awake all night. If I didn’t take them, asthma would do the needful. Regular popping resulted in those tablets being rendered ineffetive, following which I would be put on a stronger dosage. All this, played at a psychological level too. And when your mind starts doubting your recovery, only God can help you. Due to constant illness, I lost out on quality family time, especially with my son.

FIGHT BACK



For a change of weather, I shifted to Kota for two years. Surprisingly, I started getting attacks, though milder ones, there too. Then I found naturopathy which started the process of correcting all the wrongs of the past years. Naturopathy believes in natural healing, and getting rid of the body toxins.

My diet was completely overhauled and treatments such as enema and kati-snaan meant that my body was cleansed off the cough and toxins. My health improved, so did my immunity. I had plenty of honey those days. The asthma strokes reduced though they didn’t completely stop.

MEDITATION



My naturopathy doctor, also a vipassana student, vouched that my asthma attacks had nothing to do with being ‘unhealthy’. She recommended that I go for a vipassana course.

The first 10-day vipassana course changed my life. I didn’t come out enlightened, rather it was extremely difficult. Firstly, I realised my breathing technique was wrong. Trying to gasp for breath all these years, I had almost forgotten to breathe with my nose. The first course reconditioned me to breathe right — a pre-requisite for dealing with asthma.

As I practised vipassana daily, I saw a pattern — stress and friction made me breathless, and all I had to do was concentrate on my breath and let the moment pass. That same stress would have otherwise resulted in an attack. With every course, I learned to control my mind.

Vipassana says every thought shows on your body — the good and the bad. In my case, it manifested itself largely as asthma. Weather, the constant cold etc were only add-ons. I changed my thoughts to change my health. No, I didn’t turn saintly. I still lost my temper, felt stressed out, but I didn’t dwell over it. Instead, I shut up, concentrated on my breath and ‘observed’ the negative vibrations simply fade away.

Almost like a miracle, my attacks started disappearing. Sounds simple? But our mind is where most of our health problems originate. An hour of vipassana every day helps me keep my stress levels under control. The patience has helped me in every aspect of life including relationships. To date, I have attended many courses, primarily to brush up, and each time, it benefits me further.

THE PRESENT



After two years in Kota, I came back to Mumbai. The city weather is the same, but my asthma is nowhere. My doctors find it impossible to believe, to see their ‘regular customer’ not dependent on medication. Had I found vipassana earlier, the 14-year-long struggle could have been cut short, but that’s okay. Today, I have the key to a healthy life.

Out of breath



he new killer diseases are bronchial asthma and chronic obstructive pulmonary disorders (COPD). Not surprising, given the dust, pollution and erratic lifestyles. Also, WHO ranks Mumbai among the top 10 polluted cities in the world. Here are some of the commonest respiratory ailments to watch out for:

Asthma



The big daddy of all respiratory problems. In its most serious manifestation, asthma is a debilitating disease, but even the milder forms are problematic. Has your occasional wheeze turned into a regular affair? Or do you get frequent nocturnal coughs? It might be the beginning of asthma.

Breathlessnes after climbing a few storeys is the biggest sign. Or if you feel out of breath trying to catch the 5.10 local, know that it’s not merely your lack of fitness that's responsible.

Treatment



Asthma needs a multi-pronged approach where medication apart, you should overhaul your lifestyle. Firstly, become more active. Take up a sport or go for brisk walks. Practise pranayam and breathing techniques.

Go completely off canned or unnatural foods, stick to seasonal vegetables and local food, and drink lots of water. Also, late night meals should be strictly avoided. Maintaining a strict schedule and sticking to it is the key. Simply put: go back to the basics.

COPD



It's similar to asthma but an irreversible condition, hence more dangerous. Primarily caused by smoking, pollution and other factors are only add-ons. Here, patients’ breathing capacity goes down with time and they suffer from severe breathlessness and coughing sputum.

Asthma needs a multi-pronged approach where medication apart, you

Treatment



While a permanent cure is difficult, quitting smoking and following aforementioned lifestyle changes are a must.

Chronic cold



A common cold is a bi-annual affair where you might feel sick for a week and get back on track. But chronic cold is a condition where some or the other problem — cough, blocked nose, sneezing — are persistent. It’s directly related to pollution.

Though dismissed as trivial, chronic cold can affect your normal functioning. It also releases a chemical Histamine that makes you feel very sluggish.

Treatment



It requires medication for at least six weeks. Dietary changes can help. Have more vegetables and fruits.

Chronic Conjunctivitis



It affects cab and rickshaw drivers the most and those who have field jobs are equally vulnerable. Mostly it’s symptomised by red eyes and itchiness.

Treatment



Wash your eyes often. Putting saline drops in your eyes (even if you are not suffering from the disease) helps.

Pharyngitis



Noticed how some people constantly seem to have an itchy throat and constant cough? Pharyngitis suggests redness and infection in the throat. Being stuck in traffic and inhaling polluted air is a direct invitation to pharyngitis.

Treatment



Salt water gargling is a good way to clear your throat. Especially if you have to travel through dusty roads, make this a daily habit. Also have lots of water, and among dietary changes, include more turmeric.

Dr Pramod Niphadkar is hon. secretary, Asthma and Bronchitis Association of India

Why worry



Forget grave statistics, you should be worried also because the environment has a direct link with respiratory organs. While the liver, heart etc are well protected, it’s often the lungs that take the brunt of changes in the atmosphere, first. But it’s the indirect effects that are a cause for concern. Take for instance, the increasing incidents of road rage. High carbon monoxide levels irritate the nerves. All that’s needed then is a small trigger to burst. Similarly, high nitrous oxide levels emitted by vehicles lead to watery eyes.

Such factors add fuel to the existing health problems. One may not be able to prevent these conditions, but being aware of the disorders can go a long way in controlling them.

Asthma is a common long-term condition that can cause a cough, wheezing, and breathlessness. The severity of the symptoms varies from person to person. Asthma can be controlled well in most people most of the time.

What is asthma?



Asthma is caused by inflammation of the airways. These are the small tubes, called bronchi, which carry air in and out of the lungs. If you have asthma, the bronchi will be inflamed and more sensitive than normal.

When you come into contact with something that irritates your lungs, known as a trigger (see below), your airways become narrow, the muscles around them tighten and there is an increase in the production of sticky mucus (phlegm). This leads to symptoms including:

  • 1) difficulty breathing
  • 2) wheezing and coughing
  • 3) a tight chest
Read more about the symptoms of asthma.

A severe onset of symptoms is known as an asthma attack or an 'acute asthma exacerbation'. Asthma attacks may require hospital treatment and can sometimes be life-threatening, although this is rare.

For some people with chronic (long-lasting) asthma, long-term inflammation of the airways may lead to more permanent narrowing.

If you are diagnosed with asthma as a child, the symptoms may disappear during your teenage years. However, asthma can return in adulthood. Moderate to severe childhood symptoms are more likely to persist or return later in life. Although asthma does not only start in young people and can develop at any age. Read more about childhood asthma and how asthma is diagnosed.

What causes asthma?



The cause of asthma is not fully understood, although it is known to run in families. You are more likely to have asthma if one or both of your parents has the condition.

Common triggers



A trigger is anything that irritates the airways and brings on the symptoms of asthma. These differ from person to person and people with asthma may have several triggers.

Common triggers include house dust mites, animal fur, pollen, tobacco smoke, exercise, cold air and chest infections.

Read more about the causes of asthma.

Asthma can also be made worse by certain activities, such as work. For example, some nurses develop asthma symptoms after exposure to latex. This is often referred to as work-related asthma or occupational asthma.

Treating asthma



While there is no cure for asthma, there are a number of treatments that can help effectively control the condition. Treatment is based on two important goals:

  • * relieving symptoms
  • * preventing future symptoms and attacks from developing
Treatment and prevention involves a combination of medicines, lifestyle advice, and identifying and then avoiding potential asthma triggers.

Read more about living with asthma.

Who is affected?



In the UK, 5.4 million people are currently receiving treatment for asthma. That is 1 in every 12 adults and 1 in every 11 children. Asthma in adults is more common in women than men.

What causes asthma?



The cause of asthma is not fully understood, although it is known to run in families. You are more likely to have asthma if one or both of your parents has the condition.

Common triggers



A trigger is anything that irritates the airways and brings on the symptoms of asthma. These differ from person to person and people with asthma may have several triggers.

Common triggers include house dust mites, animal fur, pollen, tobacco smoke, exercise, cold air and chest infections.

Asthma can also be made worse by certain activities, such as work. For example, some nurses develop asthma symptoms after exposure to latex. This is often referred to as work-related asthma or occupational asthma.

Treating asthma While there is no cure for asthma, there are a number of treatments that can help effectively control the condition. Treatment is based on two important goals:

  • * relieving symptoms
  • * preventing future symptoms and attacks from developing
Treatment and prevention involves a combination of medicines, lifestyle advice, and identifying and then avoiding potential asthma triggers.

Who is affected? In the UK, 5.4 million people are currently receiving treatment for asthma. That is 1 in every 12 adults and 1 in every 11 children. Asthma in adults is more common in women than men.

Well fit until the age of 60. developed asthma, and had several bad bouts before full diag. Now stable

Asthma suffocating Pune



PUNE: Even as the world observes the 'World Asthma Day' on May 6, an astounding 62 per cent of the 240 asthma patients surveyed in Pune recently do not have their asthma under control.

This was revealed to TOI by city-based Chest Research Foundation (CRF) that carried out the survey in five clinics and two leading hospitals in the city. The study, which was carried out on a cross-section of 240 asthma patients, has been submitted to the European Respiratory Society Congress to be held in Berlin in October 2008.

If that is not all, city-based asthma expert Nitin Abhyankar's recent study on 316 patients in Pune and Ahmednagar shows that poorly controlled chronic asthma led to chronic obstructive pulmonary disease (COPD) in 76 per cent of the cases. Abhyankar's report, too, has been submitted for the Berlin Congress.

According to Abhyankar, in a COPD situation, the patient severely compromises his/her life expectancy because of increasingly weak lungs. "I sincerely hope my report wakes up people and keeps them away from emergency situations."

The CRF study was administered to the patients using the 'asthma control test', a set of internationally accepted standardised questions.

Says Bill Brashier, leader of the CRF research team, "While the failure to take the right medicine at the right time in the right manner was the major reason for this lack of control, our study revealed that the lack of control also depended on factors beyond medicines.

What is asthma?



Asthma is caused by inflammation of the airways. These are the small tubes, called bronchi, which carry air in and out of the lungs. If you have asthma, the bronchi will be inflamed and more sensitive than normal.

When you come into contact with something that irritates your lungs, known as a trigger (see below), your airways become narrow, the muscles around them tighten and there is an increase in the production of sticky mucus (phlegm). This leads to symptoms including:

  • * difficulty breathing
  • * wheezing and coughing
  • * a tight chest
  • * What causes asthma?
  • * The cause of asthma is not fully understood, although it is known to run in families. You are more likely to have asthma if one or both of your parents has the condition.
  • * Common triggers
  • * A trigger is anything that irritates the airways and brings on the symptoms of asthma. These differ from person to person and people with asthma may have several triggers.
  • * Common triggers include house dust mites, animal fur, pollen, tobacco smoke, exercise, cold air and chest infections.
  • * Antibiotics linked to childhood asthma rise

  • * The epidemic in childhood asthma and allergies could be caused by women taking antibiotics during pregnancy, British scientists have found.
  • * A study concluded that mothersto-be who took antibiotics greatly increased the risk of their youngsters developing asthma, eczema and hay fever later in life.
  • * Experts found that babies born to women prescribed two or more courses of the drugs were 60 per cent more likely to be asthmatic.
  • * The findings could help explain the huge rise in respiratory complaints and allergies in the last decade. Asthma now affects one in five children and one in ten adults in the UK.
  • * Scientists at Nottingham University looked at GPs' records of 24,690 children.
  • * Team leader Dr Tricia McKeever said they found a 'clear link' between antibiotic use by the youngsters' mothers and asthma and allergies.
  • * The survey discovered that a third of all pregnant women had been given antibiotics by their doctor, mainly to treat urinary tract or respiratory infections.
  • * For asthma, the increase in risk was 60 per cent if the mothers had been prescribed two courses,' said Dr McKeever, whose findings are published today in the American Journal of Respiratory and Clinical Care Medicine.
  • * She added: 'There was a 12 per cent increase in eczema among these children and a 43 per cent increase in hay fever.
  • * 'There is a huge increase in allergic disease and we are trying to find out why. But we were very surprised to find this effect.'
  • * Even one course of antibiotics was enough to raise the risk of asthma, though not so significantly. Dr McKeever said it was not clear exactly how antibiotics would increase asthma risk.
  • * She went on: 'Antibiotics clear out bacteria in the gut and there is evidence that these are important in the way the immune system works.
  • * 'Antibiotics can cross the placenta and have the potential to affect the foetus.' .
  • * The effect was the same for any kind of antibiotic.
  • * Dr McKeever said she believed the research offered 'one part of the answer' to why cases of childhood asthma and allergies had soared.
  • * There has been mounting concern on the over-prescribing of antibiotics, even in cases where they are extremely unlikely to do any good.
  • * It is not just doctors,' said Dr McKeever. 'Patients historically have expected that if they went to their GP with a cold, they would be given antibiotics to make them feel better.
  • * 'It's too early to advise mothers not to take antibiotics during pregnancy, and clearly the consequences of a serious infection could be far worse. We need further studies.
  • * 'But doctors are changing their minds on when they should prescribe antibiotics, particularly in children. It may be that pregnancy is another instance in which they should think twice.'
  • * An estimated eight million Britons have been diagnosed with asthma at some stage in their lives.
  • * The coughing, wheezing and shortness of breath that characterise the condition result from airways in the lungs over-contracting when stimulated by factors such as exercise, cold air, fumes and allergy triggers.
  • * Some scientists say the rise in childhood asthma is due to the fact that today's youngsters live 'sterile existences' compared to previous generations.
  • * Because they are exposed to less dirt and micro-organisms, they do not build up immunity.
  • * Other experts believe changes in diet have caused the epidemic, while there is mounting evidence that particles caused by traffic pollution can penetrate the lungs and trigger or exacerbate asthma.

Antibiotics linked to childhood asthma rise



The epidemic in childhood asthma and allergies could be caused by women taking antibiotics during pregnancy, British scientists have found.

A study concluded that mothersto-be who took antibiotics greatly increased the risk of their youngsters developing asthma, eczema and hay fever later in life.

Experts found that babies born to women prescribed two or more courses of the drugs were 60 per cent more likely to be asthmatic.

The findings could help explain the huge rise in respiratory complaints and allergies in the last decade. Asthma now affects one in five children and one in ten adults in the UK.

Scientists at Nottingham University looked at GPs' records of 24,690 children.

Team leader Dr Tricia McKeever said they found a 'clear link' between antibiotic use by the youngsters' mothers and asthma and allergies.

The survey discovered that a third of all pregnant women had been given antibiotics by their doctor, mainly to treat urinary tract or respiratory infections.

'For asthma, the increase in risk was 60 per cent if the mothers had been prescribed two courses,' said Dr McKeever, whose findings are published today in the American Journal of Respiratory and Clinical Care Medicine.

She added: 'There was a 12 per cent increase in eczema among these children and a 43 per cent increase in hay fever.

'There is a huge increase in allergic disease and we are trying to find out why. But we were very surprised to find this effect.'

'Even one course of antibiotics was enough to raise the risk of asthma, though not so significantly. Dr McKeever said it was not clear exactly how antibiotics would increase asthma risk.

'She went on: 'Antibiotics clear out bacteria in the gut and there is evidence that these are important in the way the immune system works.

'Antibiotics can cross the placenta and have the potential to affect the foetus.'

The effect was the same for any kind of antibiotic.

Dr McKeever said she believed the research offered 'one part of the answer' to why cases of childhood asthma and allergies had soared.

There has been mounting concern on the over-prescribing of antibiotics, even in cases where they are extremely unlikely to do any good.

'It is not just doctors,' said Dr McKeever. 'Patients historically have expected that if they went to their GP with a cold, they would be given antibiotics to make them feel better.

'It's too early to advise mothers not to take antibiotics during pregnancy, and clearly the consequences of a serious infection could be far worse. We need further studies.

'But doctors are changing their minds on when they should prescribe antibiotics, particularly in children. It may be that pregnancy is another instance in which they should think twice.'

An estimated eight million Britons have been diagnosed with asthma at some stage in their lives.

The coughing, wheezing and shortness of breath that characterise the condition result from airways in the lungs over-contracting when stimulated by factors such as exercise, cold air, fumes and allergy triggers.

Some scientists say the rise in childhood asthma is due to the fact that today's youngsters live 'sterile existences' compared to previous generations.

Because they are exposed to less dirt and micro-organisms, they do not build up immunity.

Other experts believe changes in diet have caused the epidemic, while there is mounting evidence that particles caused by traffic pollution can penetrate the lungs and trigger or exacerbate asthma.

Sinusitis patients can now breathe a sigh of relief



CHENNAI: In December 2007, a gynaecologist walked into the Madras ENT Research Foundation with a stuffy nose and headache. It was diagnosed as sinusitis. Doctors slated her for the balloon sinuplasty. The surgery was a success and the next day, she was back attending to her patients.

Doctors say the procedure is a breakthrough offering hope to 40 million people with sinusitis. "It is a procedure that opens the sinuses without invasive surgery," said Dr Mohan Kameshwaran, Madras ENT Research Foundation.

Throat infections lay Mumbaikars low



MUMBAI: The sudden spike in humidity levels and temperature over the week has seen a corresponding and drastic rise in throat and respiratory tract infections. Asthma patients, particularly the elderly, are having a tough time coping with the erratic weather.

A 60-year-old south Mumbai resident has been hospitalized for nearly a week at Bombay Hospital after she suffered a near fatal asthma attack. Worse, said the doctors, it is taking longer than usual for her condition to settle. Asthma is a lung disease where the airways get swollen, clogged and squeezed. Chest physicians told TOI that there has been a visible increase in number of respiratory infection cases in the city. The rise is evident. It has been there for the past one week. At least 50% of the patients coming to our outpatient department have respiratory tract infections or problems, such as breathlessness, caused by congestion of lungs, and sleep problems. People with hypersensitive lungs are also having a tough time to deal with the weather," said Dr S Jayaram, dean and professor of chest medicine, Bombay Hospital. "Many of those who are battling respiratory problems are morning walkers," he added.

Dr Falguni Parikh, internal medicine consultant, Kokilaben Ambani Hospital, said, "The weather is erratic and more so during early morning or late at night. Morning walkers should delay their usual hours or protect themselves by wearing warm clothes."

Girgaum physician Dr Krishnakant Dhebri said that many patients complain of sore throat that persists for over a couple of days. "Sore throats are usually caused by viruses and sometimes accompany a cold," he said, adding that antibiotics don't work against viruses and can be harmful if taken without proper supervision. "One should not delay seeing a doctor."

BMC figures suggest that nearly 2,500 people had to be hospitalized for fever in the past three weeks. But the number is less compared with the last two months when 8,000 people required admission for fever. Malaria and fever cases, too, have been brought under control with less than 200 and 30 reported cases respectively.

Ayurveda Home remedies for asthma



Home remedies

  • * Honey is very effective to cure asthma.
  • * Figs can be a very good remedy in the treatment of asthma.
  • * Lemon juice drunk with water also has a positive effect on asthma.
  • * Mixture of 5 gm of Indian Gooseberry with 1 tablespoon of honey to control asthma.
  • * The roots of bitter gourd are also useful in the treatment of asthma.
  • * Soup of drumstick leaves can treat asthma effectively.
  • * A mixture of ginger and fenugreek decoction along with honey act as an effective means to control asthma.
  • * In the initial stages, garlic mixed in milk works as a tonic against asthma.
  • * Bishop's weed is another means to cure asthma. It should be taken twice with buttermilk.
  • * Safflower seeds are also very useful in curbing bronchial asthma
Milk processed with fresh ginger and palm sugar is an effective remedy to prevent the bouts. In India, most of the traditional and tribal practitioners give fresh juice of Vasa (Adathoda vasica) with honey in empty stomach for asthma. These remedies are clinically proven effective for asthma and also improve general health and metabolic system of the child. Regular practice of yoga and Pranayama, with some Ayurvedic medicines and proper diet and nutrition follow ups can minimise the asthmatic attacks and the same time may help in establishing self confidence against asthma. Intake of dates syrup, grape, wine are widely recommended to improve metabolism and digestion. Many practitioners suggest regular intake of juice of amla (Emblica officinalis)/aloe vera/noni to help improve digestion and metabolism and increase the bio assimilation of essential nutrients which in turn can reduce the bouts of the disease. Avoiding non-vegetarian foods and drinks, alcohol, completely avoiding citrus fruits etc may be helpful.

Asthma - Treatments, Prevention and Cure



Asthma Treatment - Ayurvedic asthma treatment and cure

Know as Shwas Roga in Ayurveda, Asthma is a chronic condition involving the respiratory system in which one experiences shortness of breath.

Causes of asthma



The cause of asthma is unknown till date. Also it is not fully understood as to why asthma occurs in some but not in others. Asthma symptoms vary over time, and also differ from one individual to another. Some common causes of asthma are allergens from nature like house dust mite and cockroach, grass, pollen, foods, climatic changes, animals like cats, dogs etc.

Ayurveda classifies the causes of asthma into three based on the causative factors - Diet related factors, Work related factors and Other Factors

Dietary Treatments for Asthma



  • * Avoid fried and processed foods
  • * Avoid food such as rice, curds, buttermilk, sugar, lentils, heavy milk products like cheese, paneer etc...which has natural tendency to produce the phlegm or to accumulate the mucus
  • * Drink boiled water in plenty
  • * Avoid over eating . Take light dinner one hour before going to bed
  • * Avoid fruits such as guava, papaya, watermelon and banana

Home remedies for asthma treatment



  • * Take a mixture of 1 tablespoon of water and 2 tablespoon of fresh lemon juice twice a day.
  • * Take a teaspoon of fresh ginger juice mixed with a cup of fenugreek decoction and honey to taste.
  • Drink a glass of 2/3 carrot juice, 1/3 spinach juice, 3 times a day.
  • Mix 10 - 15 drops of garlic juice in warm water and take internally.
  • Grind to powder form - 2 gms each of Nagar (Nut grass, Cyperus rotundus) and Bharangi and mix them in water to prepare a paste which should be taken, with warm lukewarm water, twice daily.
  • Mix 1 teaspoon honey with 1 teaspoon of Indian bay leaf (Cinnamomum tamala) powder and have it before going to bed at night. This will help you in preventing the attack of asthma at night.
  • Take 10 cloves of garlic boiled with 30 ml of milk once a day.
  • Make paste of Black resin, dates, long Pippli (Piper longum) and honey, in equal quantity. Take one teaspoonful of it morning and evening with warm milk.
  • Answers to some frequently asked questions on pulmonary disease.
  • Chronic Obstructive Pulmonary Disease (COPD) is crippling because it is a progressive disease. We have been endowed with such reserves that we do not realise the damage caused to the lungs by smoking.
  • Smoking attacks the lungs from day one and studies have shown that complete cessation is the only way to arrest the decline of the accelerated fall in lung function. Here is some more information on COPD.
  • What is COPD?
  • COPD encompasses two important diseases: Chronic bronchitis and Emphysema. Chronic bronchitis is inflamed and narrowed airways that make breathing difficult; so that the patient is left breathless. In emphysema the lungs are enlarged but not working.
  • Take the example of a balloon. A balloon can be inflated up to a point where you can see the expansion. Beyond this, you cannot see the balloon growing though you continue to blow. Your lungs in emphysema are like an inflated balloon that cannot be blown any further without becoming breathless.
  • What causes it?
  • Smoking is the single most important cause. Other causes are increasing pollution -both outdoor and indoor pollution; cooking with coal; exposure to industrial dust and congenital enzyme deficiency.
  • How can a smoker not develop COPD?
  • Simple. Stop smoking. It is never too late. The benefits start immediately. Once the smoker stops, the decline of the lung function reduces immediately and it approaches that of the non-smoker.

Keep your lungs healthy



  • * The patient will feel breathless but if he rests it will disappear and the exercise can be continued. Breathlessness can be scary but the worst thing is to stop exercising.
  • * Some tips: start using the stairs. Whenever you feel breathless rest for a while and continue. This will make your walk on plains easy. If you don't, you will eventually become breathless even for simple tasks.
  • * Sometimes breathing through the pursed lips can help you overcome breathlessness. Regular walking for 30 minutes is a good way to keep your lungs healthy.
  • * Do diets play a role in COPD management?
  • * Yes diets can complement your management. Eat lots of vegetables and fruits. Avoid foods that are hard to digest like oily and spicy foods, onion, ice cream with nuts etc.
  • * If you are not well eat short small soft foods. Foods rich in carbohydrates like pasta and proteins like chicken and fish are preferable. But if you are overweight it can add to your problems.
  • * Is there a role for home oxygen therapy?
  • * If one winds up in hospital too frequently there is a need for home oxygen treatment. Oxygen should be given for a minimum of 16 hours a day in severe cases. This can be delivered by various means.
  • * Oxygen cylinder: This may need regular refills and is ideally used at night and after meals.
  • * Oxygen concentrator: Concentrators take in normal air, remove some nitrogen and deliver oxygen. But if the oxygen requirement is more than five litres this won't help.
  • * Oxygen should always be delivered via Vent masks and not via nasal canulas or routine masks.
  • * Will vaccines help prevent infections?
  • * are two kinds of vaccines. One is a pneumococcal vaccine to be given once in five years to prevent pneumococcal infections.
  • * The other is an influenza vaccine that has to be given once in a year. Now there is an oral vaccine that is given sub-lingual to prevent bacterial infections. Reducing infections in COPD prevent long-term morbidity.
  • * Can I monitor my illness myself?
  • * Yes. Use a pocket spirometer that will measure the pulmonary function and a oxygen pulse meter, which measures one's oxygen saturation. If you notice a difference in the values visit the doctor.
  • * Although COPD is different from asthma don't be alarmed. The patient's quality of life will be good if he follows his physician's advice.
  • * The writer is a Respiratory Physician based in Chennai. E-mail: drrnarasimhan@gmail.com
  • * When to see the doctor?
  • * Coughing out blood
  • * More phlegm and change in colour
  • * Fever
  • * Getting more breathless, worsening of spirometry values and decrease in oxygen saturation
  • * Swollen legs and face
  • * Excessive day time sleepiness
  • * Mood swings
  • * Make things worse
  • * Continued smoking
  • * Not taking recommended treatment
  • * Being irregular with inhalers
  • * Not dealing with other illnesses
  • * Not keeping regular appointments with physician
  • * Limited interaction with friends
  • * No exercise

No morning walks: Try evenings or opt for indoor workouts.



As the scorching heat of summer gives way to dry wintry breezes and early mornings with a nip in the air, the most festive trimester of the calendar year spells mega-excitement for party hoppers. But for those prone to respiratory disorders, it's another story altogether. The residue of Diwali fumes combined with dust, smog, pollen and pollution form a deadly winter cocktail.

"The influenza virus thrives in winter and, as a result, we see an alarming rise in chest infections, asthma attacks, chronic obstructive pulmonary disease and bronchitis. In fact, with the cold weather providing flourishing conditions for certain strains of bacteria, we are dreading being hit by another bout of swine flu," says Mumbai-based cardiologist and consulting physician, Dr. Anil Ballani.

His advice is to avoid outdoor activities early in the morning when thick smog settles low. Instead, he encourages exercise freaks to choose evening hours for jogging/walking or opt for indoor activities. For those with chronically weak lungs, he strongly recommends chest physiotherapy and regular steam inhalation, which helps prevent cumulative congestion. “Keep away from pollution of all kinds,” is his constant advice to respiratory patients in winter while simultaneously informing them about the availability of two new vaccines (the influenza vaccine and the pneumococcal vaccine), which — if taken around October-November — appreciably reduces the intensity of flu attacks. He recommends these vaccines to those who wish to arm themselves against influenza in winter.

The importance of diet can never be over-emphasised and the ancient adage 'you are what you eat' continues to hold good for respiratory patients, particularly in winter.

"Steer away from cold foods like yoghurt, cold salads, ice cream, sherbets and smoothies. Instead, opt for hot soups, ginger tea, spicy curries and rasam. Strong black coffee sipped steaming hot works wonders during an attack of asthma. Also, step up on foods rich in vitamin C, as these boost immunity and prevent cold, cough and the sniffles,” says nutritionist Vinita Aran. She recommends incorporating tomatoes, capsicum, red pumpkin, citrus fruits and gooseberries into the regular diet.

Traditional kitchen remedies continue to be popular in keeping chest infections at bay and are generally taken along with prescribed drugs in most homes.

Dr. Kamlesh Tripathi has deep respect for the therapeutic qualities of herbs and claims that the antiseptic powers of tulsi, neem and turmeric are incredibly high while dried ginger, black pepper and cardamom combined with honey make the best decongestants (besides being free of undesirable side-effects). He believes that spasm of the trachea and bronchus is often due to allergens in the atmosphere and it is of prime importance to keep the surroundings clean, dry and sunny.

Besides certain foods, mould, damp, dust mites and fungus are allergens that could bring on a severe attack of respiratory distress and should be avoided at all costs, cautions Dr. Tripathi.

A few decades back, patients had to resort to pills and injections to get relief; but now advances in medical science have put the healing process in fast-forward mode. Steroids may get their share of bad publicity but they continue to be life-savers. When used in inhalers and inhaled under the doctor's guidance, they constitute very effective maintenance measures for good respiratory health.

"I was joining my sailor husband on sea and was stranded in a hotel in Korea when I felt a major attack of asthma coming on. Nobody around spoke English and I panicked till I discovered a strip of steroid tablets in my purse. A couple of those pills saved me that night," recalls Lavinia Ghosh, young asthma patient. The doctors, however, warn against self-medication, as steroids need a tapering dose that can only be prescribed by an expert physician.

Dr. Sanjeev Mehta, a chest specialist in Mumbai, feels that lifestyle changes are of utmost importance, along with proper medication. “Install chimneys in the kitchen to draw away cooking fumes, stay away from cigarette smoke and oil fumes (generated during deep frying). Avoid carpets and heavy draperies at home, all dust traps. Avoid over-exertion, learn to say no to demands when an attack of asthma seems imminent. Even if as you have to cancel a party you are hosting at the last moment, do so; but give top priority to your health,” he says firmly.

Often, patients are pleasantly surprised at the sympathy and support they receive on going public. Psychosomatic factors play a huge role in many cases of respiratory distress and a positive frame of mind is a major help.

"Join a hobby class or a support group, head for a mountain hike with fellow respiratory patients (you won't feel apologetic about huffing and puffing on your way up!), learn salsa, walk the green side with bare feet (nothing like having fresh grass squelch underfoot) or simply join a laughter group and laugh yourself silly and out of breath, the best exercise for your lungs," says Anup Biswas who overcame crippling asthma by incorporating radical changes in his lifestyle. He also attributes his present good health to yogic exercises. “As asthmatics, we tend to breathe shallow and, in our old age, we run the risk of suffering from atrophy of the lower lungs. Simple pranayam and kapalbhaati exercises, if done regularly, can increase lung capacity to an amazing degree,” says Anup.

Prevention, education and medication in the right combination can enhance the quality of life for those weak of chest, say the experts.

Dos and don'ts



  • * Nip a respiratory problem in the bud. Do not let it get out of hand.
  • * Religiously follow maintenance medication prescribed by the doctor
  • * If a problem seems to getting out of control, immediately consult the doctor
  • * Keep a stock of emergency medication at home
  • * Keep spare inhalers handy. You may need them in the middle of the night
  • * Carry prescription medicines and inhalers when going out (specially when travelling to remote places)
  • * Keep your doctor's phone number handy at all times
  • Follow a healthy diet, exercise moderately and have a mission in life

Asthma inhalers increase risk of prostate cancer



London: A new study has found that drugs used by thousands of men to treat asthma may increase the risk of prostate cancer.

The study,conducted by a team of scientists in Melbourne,Australia,has shown that men who regularly take inhaled steroids to keep their asthma under control are almost 40% more likely than men without asthma to develop a tumour. Those who regularly use another type of inhaler a bronchodilator to relieve wheezing are 36% more at risk of the disease.

But the biggest danger appears to be among men with severe asthma who frequently need treatment with steroid tablets or injections.

According to the study,among this group,the risk of cancer increases by up to 70%,reports the Daily Mail.

Cancer experts,however,stressed findings were preliminary,from a small study,and needed to be confirmed by much bigger studies before any change in asthma drug use could be considered.

The results have been published in the journal Cancer Epidemiology,Biomarkers and Prevention.ANI

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