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REVIEW OF LITERATURE:
INTRODUCTION
Asthma is a syndrome of variable airflow obstruction.
It is characterized pathologically by bronchial inflammation with prominent
eosinophil infiltration, physiologically by bronchial hyper-reactivity, and
clinically by variable cough, chest tightness and wheeze.
Asthma exacerbations are progressive increases in
asthma symptoms.
The symptoms of asthma exacerbations include coughing,
wheezing, chest tightness, and shortness of breath. Some people may also
experience rapid breathing or gasping for air during sleep.
Asthma exacerbations frequently affect people who have
severe asthma, and they usually have a trigger. Viral respiratory infections,
such as the human rhinovirus subtypes A and C, are the most common cause of
exacerbation of asthma.
Other possible triggers of asthma exacerbations
include:
•
Bacterial infections
•
Allergies
•
Defective antiviral immunity
•
Allergen exposure
•
Pollutants, such as tobacco smoke and particulate matter
•
Occupational
exposures
The signs and
symptoms of asthma exacerbations include
•
Breathlessness
•
Coughing
•
Wheezing
•
Chest
tightness
•
Agitation
•
Increased
respiratory rate
•
Increased
pulse rate
•
Decreased
lung function
Asthmatic
attack
Premonitory symptoms
“asthmatic aura” – sometimes sneezing, flatulence and drowsiness, or
restlessness and irritability. Dry irritant cough may precede or accompany
attacks of wheezy breathlessness.
Paroxysm – usually sudden
in middle of night. Sense of oppression in chest going into respiratory
distress. Patient sits up and leans forward fighting for breath, or runs to
window to relieve sense of suffocation. Anxiety, cyanosis, perspiration and
cold extremities. Wheezing may be heard at a distance. on auscultation –
inspiration short and high pitched, expiration prolonged, plenty of wheeze. Crackles
may be heard at the bases towards the end of an attack. However, in very
severe airways obstruction airflow may be so reduced that the chest is almost
silent. Tachycardia especially in children.
Termination – spontaneously
or as a result of therapy. As bronchial spasm gets less, patient is able to
cough a little and may bring out viscid muco-fibrin.
Duration of attack – Varies
from few minutes to several Hours. Sometimes paroxysms are continuous – “Status
Asthmaticus”.
EXPOSURES AND RISK FACTORS OF ASTHMA
1. Allergen exposure in those with a
predisposition to atopy
2. Occupational exposure
3. Air pollution
4. Infections - Viral and Mycoplasma
5. Tobacco
6. Obesity
7. Diet
8. Fungi in allergic airway mycosis
9. Acute irritants and reactive airway
dysfunction syndrome (RADS)
10. High-intensity exercise in elite athletes
TRIGGERS OF AIRWAY NARROWING
•
Allergens
•
Irritants
•
Viral
infections
•
Exercise
and cold, dry air
•
Air
pollution
•
Drugs
•
Occupational
exposures
•
Hormonal
changes
TYPES OF ASTHMA
1.
Extrinsic
asthma
2.
Intrinsic
asthma
Diagnosis: based on
1.
History
2.
Physical
examination
3.
Full
blood count
4.
Sputum
culture
5.
IgE
and IgE specific test
6.
Lung
function test
7.
Chest
radiograph
HOMOEOPATHIC
APPROACH:
Dr. Hahnemann explained route of administration in sec. 284- 285
Organon of medicine.
A more complete explanation of administering olfaction
can be found in the footnote to aphorism 288 of 5 th edition of Organon of
Medicine.
Hahnemann talks about the method of olfaction in
footnote to aphorism 285 of 5 th Edition of Organon of Medicine.
It is especially in the form of vapor, by olfaction and
inhalation of the medicinal aura that is always emanating from a globule
impregnated with a medicinal fluid in a high development of power, and
placed, dry, in a small phial, that the homoeopathic remedies act most surely
and most powerfully. The homoeopathic physician allows the patient to hold
the open mouth of the phial first in one nostril, and in the act of
inspiration draw the air out of it into himself and then if he wished to give
a stronger dose, smell in the same manner with the other nostril, more or
less strongly.
v Some common medicines used in a case of asthma.
Which are as follows
BLATTA ORIENTALIS: Used as an expectorant and supportive remedy
during acute attack of asthma, status asthmaticus or bronchitis to relieve
bronchospasm and expectorant. Suited to subjects with stout and corpulent
constitution< during rainy season, on lying down.
ARSENIC ALBUM: Breathing: asthmatic; must sit or bend
forward; springs out of bed at night, especially after twelve o’clock; unable
to lie down for fear of suffocation; attacks like croup instead of the usual
urticaria.
IPECAC: Cough dry spasmodic, constricted, asthmatic.
Difficult breathing from least exercise; violent dyspnea, with wheezing and
anxiety about the stomach. Cough, with rattling of mucus in bronchi when inspiring.
Threatened suffocation from mucus.
SPONGIA TOSTA: Great dryness of mucous membranes of air
passages. Cough: dry, sibilant, like a saw driven through a pine board; agg sweets, cold drinks, smoking, lying with head low, dry cold winds; agg reading, singing, talking, swallowing; amel eating or drinking warm things.
Croup: anxious, wheezing, agg before midnight. Palpitation: violent with
pain and gasping respiration; awakened suddenly after midnight with
suffocation and great anxiety.
NATRUM SULPH: Dyspnea; desire to take a deep breath during
damp, cloudy weather. Humid asthma in children; with every change to wet
weather; with every fresh cold; always worse in damp, rainy weather; sputa
green, greenish, copious.
LOBELIA INFLATA:
Dyspnea from constriction of chest; worse, any exertion. Sensation of
pressure or weight in chest; better by rapid walking. Asthma; attacks, with
weakness, felt in pit of stomach and preceded by prickling all over.
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