Upcomig Lectures

Thanks all who attended my last lecture on, "Asthma & Allergic Rhinits -together in most" at Rotana hotel, Al Ain.
You may attend my following lectures as well,

 "Asthma & COPD, treat them the same way ? " 1st AKH symposia at Ain Al Khaleej hospital auditorium on 29th November 2013

 "The most common symptom, treatment of chronic cough in adults" at Ain Al Khaleej hospital auditorium on 23rd December 2013

Going for Hajj -- donot forget to pack your inhalers

Every year tens of thousands of Muslims perform the holy pilgrimage, HAJJ. This spiritual experience requires a certain amount of physical fitness and those with existing chronic diseases may face extra burden. It is very important thus for those who are on regular treatment to consult their health advisors about continuing their medicine or for any modification if required. For those who use inhalers e.g. patients with Asthma or COPD should not miss out their inhalers while packing for this important journey and might need to carry some as required inhalers for performing all spiritual rituals smoothly.

Ramadan and inhalers

All those who have been prescribed inhalers should continue to use them in Ramadan even if they are fasting by simply changing the time of inhalation to "before end of SAHOOR" and "after FATOOR".

Most of the prescribed regimens are for twice daily inhalation or once daily for some and with litle modification should be contiued.

Enjoy Ramadan without dicnontinuing your inhalers .....

Asthma and Allergic Rhinitis

In great majority of patients, Asthma and Allergic Rhinits (inflammation of nose due to allergens) exist together.
For the simple reason that as one breaths same allergens and triggers pass through the nose and airways causing almost the same reaction albiet at different sites.
Unless identified and treated, Allergic Rhinits makes Asthma control very difficult and significantly increaes the healthcare burden.

Smoking and women

As per a study recently published in a reputed medical journal (Chest – January 2013),

 Moderate and heavy smoking carry a higher risk of lung cancer in women than in men, and this difference does not seem to be explained by lung volume.

 

    " Don't start smoking if you don't and don't delay quitting if you do"

Don't let Asthma win the battle

In upto 80% cases Asthma is associated with Allergic Rhinits and unless both conditions are properly diagnosed and treated at the same time the treatment outcome is sub optimal.

It is important to obtain hisotry very carefully keeping possible allergens in mind as per patient's dynamics and local environment coupled with directed investigations followed by treatment according to the clinical impression and lab results.

Last but not the least is patient education without which it is unlikely to treat any long term medical condition including Asthma.

Chronic cough evaluation and treatment

Chronic cough is not only a bothersome symptom but a social stigma as well. If one is otherwise healthy and non smoker, it is most commonly secondary to one of the three following conditions namely,

1. Asthma (Cough variant Asthma)
2. GERD
3. Upper airway cough syndrome.

Diagnosis may be clinched with proper history taking and doing few tests usually performed under supervision of a Pulmonologist (Chest Physician). After making the diagnosis effective treatment may be offered.

Don't kill yourself with your own hands

• Chronic Obstructive Pulmonary Disease (COPD) is a     disease of lungs caused by smoking.

• Currently it is 6th leading cause of death worldwide.

• In the year 2020 it is estimated to become the 3rd leading cause of death !!!

Treatment with 90% cure rate for Lung cancer

Annual deaths have increased from 18,000 in 1950 to 158,000 in 1997 in US and roughly 900,000 deaths worldwide with >50% of those in developed countries.

More deaths than the next 3 most common cancers combined (colon/rectum, breast and prostate).

One single measure can lead to 90% cure from this sinister disease ........

"Do not start smoking"
if you do, don't delay quitting.

Asthma diagnosis and treatment during pregnancy

Possible effects on baby:

Asthma symptoms during pregnancy are not only bothersome but elevate the anxiety level as well. In case of a severe attack the developing baby, totally dependant on the mother for oxygen supply, may also be affected.

 

Difficulty in making diagnosis:

Performing the usual diagnostic test, Spiormetry may be diffcult as not only performing the maneuver is cumersome for the pregnant patient, it may cause stress especially after 2nd trimester. With the new method, Impedance Oscillometry, it is much easier to obtain objective measurements for diagnosing the problem and monitor the effects of treatment.

 

Proper follow up:

It is important to be in contact with your pulmonologist or treating physician througout the pregnancy who may help you with re assurance and education about the medications and their use.

Usual outcome:

In most of the cases, Asthma during pregnancy can be effectively treated so much so that the course of pregnancy remains essentially the same as in individuals without Asthma.

COPD / Lung cancer -- who is at the risk?

Chronic Obstructive Pulmonary Disease (COPD) is currently the 6th leading cause of death worldwide and will become the 3rd by the year 2020.

Lung cancer is the no. 1 cause of death from any cancer in both men and women.

Anyone who smokes is at the risk of deveoping COPD and Lung cancer.

Don't start smoking if you don't and don't delay quitting if you do.

Asthma FACTS

•    Long term studies suggest many children become asymptomatic by adolescence (M>F).

•    May return in some particularly in those with severe disease.

•    Severity does not vary in a given patient; those with mild asthma rarely progress to more severe disease, whereas those with severe disease usually have severe disease at the onset.

•    Deaths from asthma have declined over the years mostly attributed to widespread use of inhaled corticosteroids.

•    Risk factors for asthma deaths :

  >   poorly controlled disease with frequent use  of  bronchodilator inhalers.

  >   lack of corticosteroid therapy.

  >   previous admission with near fatal asthma.

Can I know what I am allergic to ?

Yes..
The answer invloves,

Detailed and directed history obtained from patient.
Skin allergy test and
Blood allergy test.

Treatment entails avoidance of the allergen,
General treatment which reduces the symptoms of allergy
Specific treatment that reduces body's hypersensitivity to allergens.


 

Sleep hygiene

The most common cause of un refreshed sleep is  sleep in-hygiene.

You may take following measures to improve your sleep hygiene,

• Try to take your meal at least couple of hours before going to bed.

• Avoid caffeine containing drinks late in the evening.

• Don’t use television and computers in your bedroom.

• Give yourself ample time to sleep (at least 6 hours).

If you already do it and yet have problems, consult a Pulmonologist (chest physician) with interest in sleep disorders as in case you have a sleep disorder for example sleep apnea, it may seriously affect your mental and physical health.

Crying lungs .... please don't insult them

Oxygen is our body's fuel without which we can not survive.

Soul may be defined as " the ability to use oxygen" and when our cells loose this ability (soul leaves body) for whatever reason, we die.
Lungs, one of the vital organs of the body,  have the responsiblity to receive oxygen from the atmosphere which after binding to hemoglobin is delivered to every part of the body by the circulating blood.

Fresh air is the nourishment for lungs. On the contrary, man is the only living subject that will fully smokes cigarette and causes enormous insult to the lungs inviting diseases like COPD and lung cancer.

Don't start smoking if you don't and don't delay quitting if you do.

COPD - Chronic Obstructive Pulmonary Disease

• Chronic Obstructive Pulmonary Disease (COPD) is a disease of lungs caused by smoking.

• Currently it is the 6th leading cause of death worldwide.

• In the year 2020 it is estimated to become the 3rd leading cause of death !!!

 Dont start smoking if you dont and dont delay quitting if you do.

Chronic cough - not easy to live with

Chronic cough is not only a bothersome symptom but a social stigma as well. If one is otherwise healthy and non smoker, it is most commonly secondary to one of the three following conditions namely,

1. Asthma (Cough variant Asthma)
2. GERD
3. Upper airway cough syndrome.

Diagnosis may be clinched with proper history taking and doing few tests usually performed under supervision of a Pulmonologist (Chest Physician). After making the diagnosis effective treatment may be offered.

1st three steps in Asthma management

A recently published study invloving 450 subjects showed

 

• Approximately half of the patients did not receive any

   information about bronchial asthma as a disease, and

• 40.7% did not receive any education regarding how to use

   asthma medication.

• Asthma was not controlled or partially controlled in the majority

   (97.7%) of the patients preceding the admission to emergency

   department.

• No education about asthma and uncontrolled asthma are the

  major factors leading to frequent ED visits (three or more

  visits/year).

 

Remeber the 1st three steps in Asthma mangement are,

 

1. Patient educaiton and counseling,
2. Patient educaiton and counseling and
3. Patient educaiton and counseling

 

I have Asthma - can I play?

Yes, indeed.
The goals of Asthma management are,

§Achieve and maintain control of symptoms

§Maintain normal activity levels, including exercise

§Maintain pulmonary function as close to normal levels as possible.

§Prevent asthma exacerbations

§Avoid adverse effects from asthma medications

§Prevent asthma mortality

With proper assessment, management and adherence to treatment you may lead a normal life including participating in sports activity.

Don't abuse cough syrups

Cough is one of the nature's gift given to us.
It not only draws attention towards the underlying problem but also helps clearing the secretions present in the airways which are not meant to remain inside that may happen if cough is suppressed.
At the same time proper precaution should be taken while coughing to prevent others from catching the disease particles which may possibly be there, "the cough manners".
Most of the time the treament should target the cause of the cough rather than treating the symptom only. However, there are certain conditions where your Pulmonologist (Chest physician) might prescribe a cough syrup for you especially if it is prolonged and dry.

Asthma in Al Ain, Abu Dhabi, UAE.

    Every year in the Emirate of Abu Dhabi (Abu Dhabi & Al Ain) about 150,000 individuals (0.45 million visits) require asthma care, of whom half are  males and 50% are UAE nationals. 50% of cases are under 15 years of age.

    Only few health care facilities use spirometry in assessing asthma.

    Moreover, children less than 5 years defiantly never been tested by the spirometry because it is not prepared and approved for this age group.

Impact of Asthma on daily life

•  The estimate of lost work and school time from asthma is approximately 100 million days of restricted activity.

•    Approximately 500,000 annual hospitalizations (40.6% in individuals aged 18 y or younger) are due to asthma.

•    Each year, an estimated 1.81 million people (47.8% of them aged 18 y or younger) require treatment in an emergency department.

•     For 2010 in US, the annual expenditures for health and lost productivity due to asthma are projected to be $20.7 billion.

 

       With proper diagnosis and treatment an Asthmatic person can lead a normal life.

Sleep disorder -- Do you have it ?

If you are over weight, in mid 30s or above, snore loudly, feel un refreshed after a  night's sleep and feel sleepy during the day you may have a Sleep disorder.
The possibilities include from simple sleep un hygiene to Sleep apnoea.
Whatever the reason may be, un refreshing sleep is not something to live with especially for a long time whereby it affects the quality of life significantly.
Moreover, if it is because of a disease for example, Sleep apnoea, the impact on health is far much more and grave.
If you think you may have a sleep disorder, consult a Pulmonologist with interest in sleep medicine and get yourself assessed before it affects your physical and mental health.

Acute cough in children ... What to do ?

•Simplest and cheapest advice may be home remedy.(*)

 

 * Role of  night time honey in children with nocturnal cough with an URTI. Pediatrics August 2012

What does a cigarette contain

Why cigarette cuases harm

 

The answer is in its constituents.

A cigarette is composed of the following,

 

Nicotine :  An insecticide and the main reason for addiction to cigarette smoking.

Cadmium : used in batteries

Stearic acid: found in candle wax

Acetic acid: found in vinegar

Hexamine: used in barbecue lighters

Taulene: an industrial solvent

Ammonia: toilet cleaner

Arsenic: a poison

Methane: sewer gas

Carbon monoxide: a toxic gas that makes oxygen binding to blood difficult.

 

 

               Don't start smoking if you don't and don't delay quitting if you do

90% cure rate for Lung cancer !!!

Annual deaths have increased from 18,000 in 1950 to 158,000 in 1997 in US and roughly 900,000 deaths worldwide with >50% of those in developed countries.

More deaths than the next 3 most common cancers combined (colon/rectum, breast and prostate).

One single measure can leadto 90% cure from this sinister disease ........

              "Do not start smoking"
         if you do, don't delay quitting.

Why I dont wake up fresh

Refreshing sleep is one of the gifts given to us by our creater. The consequences of non refreshing sleep are not only day time sleepiness and lethargy but serious effects on vital organs of the body including heart and blood vessels.

If along with day time sleepiness, one is overweight and also has history of choking during sleep (may be observed by partner) then the chances of having Sleep Apnoea, one of the common and most important cause of non refreshing sleep, are very high.

If present, Sleep Apnoea may lead to diseases of heart, high blood pressure which is difficult to control with medicines, Diabetes and high risk ot road traffic and  occupational accidents.

If you think you may have this condition, consult a Pulmonologist (Chest specialist) and get your self assessed. You might have to under go an overnight sleep study, to confirm the diagnosis.

The treatment of this condition is very effective and  includes life style modification especially, weight reduction and if required, mechanical assistance with a device (CPAP/BiPAP) to be used while sleeping.