Cough variant Bronchial Asthma.

He was coughing off and on for past two months.
This  increases on lying down , on laughing and on speaking long sentences.
He visited several practitioners who treated  him  with antibiotics.
When there was no response they changed antibiotics and  added mucolytics.
Nothing improved his cough which was dry in nature and was persistent.
He was investigated  too . The blood workup was normal , the chest X ray also did not reveal any thing abnormal.
It was pulmonary function tests which showed evidence of obstructive airway disease which  reversed on bronchodilators.
Thus obvious diagnosis was Bronchial Asthma . The treatment was inhalers , the preventive inhaler of steroid and long acting bronchodilator inhaler. This comes as a combination inhaler too.
He took it  regularly and the cough was gone.
He was saved of many unnecessary medicines which cause many side effects.
Therefore its essential to keep the  entity COUGH VARIANT BRONCHIAL ASTHMA in mind. THe patients should  be diagnosed early and treated specifically.
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BRONCHIAL ASTHMA REVIEWED .

Lot of new research is being done to control this old malady, but the time tested principals still are the gold standard.
First of all the persistent nasobronchial symptoms particularly cough and definitely recurrent wheezing , breathlessness on speaking long sentences , laughing etc should be investigated for bronchial asthma.
Next most important step is to accept the diagnosis and inhalers.
It is often seen that patients or parents do not  want inhalers for the fear of addiction.
They keep children on unnecessary nebulisation , antibiotics , oral bronchdilators and even oral steroids which are certainly undesired , unscientific and dangerous modes of treatment .
cornerstone of Asthma treatment is inhaled steroids.
Patients must be demonstrated the method of inhalation so the desired salts enter the airways in desired amount.
Patients must also understand that preventive doses of inhaler is essential in fixed doses even if patient feels fine because basically it is for controlling inflammation.
Patients should also know the use of emergency inhaler salbutamol.
In difficult cases and most children Allergy triggers must be investigated which can be  done by simple allergy skin tests.
Based upon the test  results , Food allergy as a factor can be removed . Food allergy is a significant factor in bronchial asthma.
Allergy tests  also help deal occupational and environmental factors too..
Thus inspite of advances in Asthma management , majority of patients would need basic effective tretment which can be made effective with health education.

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