Diagnosis of asthma  in  children - মায়া

Diagnosis of asthma  in  children

    
Asthma is a chronic disease for which cough, wheezing sound during expiration & respiratory distress occurs. The severity of which differs from person to person but the disease is preventable.
What is asthma?
Asthma is kind of disease which attacks the respiratory tract. The function of respiratory tract is the inhalation of air from outside & exhalation of bad air. A asthmatic person has more sensitive airway than others.
When the children come in contact with such things which can irritate their airway which creates inflammation there, the wall of the airway becomes edematous, circular muscle of the airway becomes constricted & mucous secretion occurs in the respiratory tract. All of these cause the narrowing of the airway. For this difficulty in breathing occurs & following problem creates:

  • Wheezing sound during expiration.
  • Cough.
  • Unable to take proper breathe.
  • Chest tightness.
    Who are at risk of asthma?
    • The person who has history of asthma from paternal & maternal side or who has allergic disease such as eczema hay fever or history of food allergy.
    • The children who have allergy to some foods or eczema,hay fever present.
    • The children who have bronchitis.
    • Those who are exposed to secondary cigarette smoking.
    • The premature children.

 

  • The children whose birth weight was less than 2 kg.

 
When asthma starts?

  • When infection occurs in the lungs or respiratory tract which may occurs from common cold or virus.
  • Contact with the allergic substance such as dust,pollens,feathers or animal hairs.
  • The environmental particles which irritates the respiratory system of the asthmatic patient such as smokes of cigarettes,chemical fumes & other aznospheric pollution.
  • Non steroidal anti inflammatory drugs such as aspirin,ibuprofen ingestion.
  • Emotional factors like mental stress or excessive laughing.
  • The foods full of sulfide like fruits juice,jam,prawns & processed foods.
  • Environmental factors such as-sudden temperature change,cold wind,storm,increase in air temperature & humidity,polluted air.
  • Indoor factors: wet house,dusty carpet,chemicals,little insects.
  • Exercise:during exercise the oxygen demand of the body increases so it can aggravates the asthma.
  • Food allergy:differs from person to person.

How to evaluate asthma:
  For the children it is difficult to confirm the asthma.
Because the main symptoms like difficulty in breathing & wheezing may also occur in common cold or any kind of infection in lungs. Common cold in children usually occurs 6 to 8 times in a year. In winter or at the beginning of spring or sometimes in the summer cough & cold commonly occurs in children. Most of the time these are not asthma. But if these kind of attacks occur frequently & there is positive history of genetic predisposition then asthma can be suspected.
 The confirmatory test of asthma in less than 6 years of age children has not been discovered yet. So the evaluation of asthma in children is much more difficult than adults.So evaluation in children is based on the clinical features & the response of bronchodilators on the respiratory system. There is a test called spirometer is available for more than 6 years of children.
Symptoms of asthma in newborn & 1 to 3 years of children:
All the child does not show the same features but the features like cough,difficulty in breathing & wheeze are common.
In this case important points are:

  • Frequency of attack or every year variations present or not.
  • Symptoms are more in the night or morning or not.
  • The factors responsible for aggravation of asthma present or not such as exercise,emotions,excessive laughing.
  • For the children cough may be the only symptom.

Attack of asthma:
       Severe attack of asthma may occur suddenly. Those who have chronic asthma suddenly may present with acute features. This is then called acute severe asthma. Sometimes it may be life threatening. In this case patient should be hospitalized.
      Usually it takes 6 to 48 hours to take the formation of acute severe asthma from acute asthma. But it takes less time in some children.
      If your child has asthma then you should keep on eye that it is becoming the acute attack or not. In this case you should look for:

  • Difficulty in breathing present or not.
  • Wheeze increased or not.
  • Chest tightness present or not.

The drugs such as inhaler which he takes if that does not work properly or when you feel that the attack of asthma is going to be a serious one you should consult with a doctor.
Other symptoms of asthma:

  • Regular medications are not working.
  • The main symptoms such as cough,wheeze & chest tightness do not improve rather remain the same.
  • The rate of respiration will be increased. When talking can not complete a sentence in one breathe rather has to take frequent breathing.
  • So much restless & irritable feeling.
  • Cyanosis of lips & pulp of the finger occur sometimes.

The examinations for evaluation of asthma:
Spirometer test:
  It is a breathing test by which the respiratory functions can be measured whether the functions are good or not. It can be done for more than 5 years of age children.
   In this test the patient is asked to exhale a deep breathe in the spirometer. Sometimes it is done in a condition when the patient is sick and then after administration of the drug. If lung function becomes improve after getting the drug then make sense that the child have asthma. The cost of this investigation is 1200 to 15OO tk & available in every specialized hospitals.
Allergy test:
   It can be done by a blood test or skin sensitivity test for allergy to the foods or other particles like dust,mites,pollens etc. Asthma is for that allergy or not that is tested by this test.
 
Peak respiratory flow rate test:
    A handy machine is used for this test. Whether the airway become narrow or not it can be evaluated by this test. The total volume of air which we exhale during exhalation it can be measured by this test.
Sometime the patient is provided by such machine so that he can do this test at home and record the everyday reading. By this recorded reading a assumption can be done that asthma is becoming severe or not.
This test is only applicable for the children above the age of 5 years.
Image Source: mayaclinic.in

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