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28/May/2022
Asthma SpecialistBlog

Do Asthma Drugs Affect Pregnancy – Dr. Sheetu Singh

Do asthma drugs affect pregnancy Asthma control may alter during pregnancy, so it’s important to keep an eye on it.

1/3 – same, 1/3 – deteriorate, 1/3 – improve

Risk to a fetus is more in poorly controlled asthma as compared to the risk of medications. Inhaled glucocorticoids, theophylline, beta-2 agonists, and leukotriene inhibitors are not associated with any fetal anomalies.

Do Asthma Drugs Affect Pregnancy | Can Heartburn be Worse Than Asthma?

Yes in many studies it has been shown that heartburn worsens asthma and proton pump inhibitors have been shown to improve asthma control. In severe GERD, surgery may also be needed to control asthma symptoms. However, routine use of PPI in asymptomatic GERD in asthmatics is not of any benefit.

What is difficult asthma?

It was in 1998 that Peter Barnes gave the concept of difficult asthma. Most asthmatics are controlled with ICS. But 5% are not controlled. Now BTS & GINA have also defined difficult asthma.

Asthma symptoms not controlled by step 4 medications (reliever + 2 or more controllers)

  1. Recheck diagnosis of asthma
  2. Adherence
  3. Smoking history – present or past
  4. Co-morbidities – GERD, sinusitis, obesity, sleep apnea

 

What is steroid-resistant asthma?

Glucocorticoids (GCs) have potent anti-inflammatory actions and are the most effective agents in the treatment of asthma. Asthmatics have 2 spectrums of disease steroid-responsive at one end and steroid-resistant at the other end. Patients with chronic asthma who are unresponsive to high doses of GCs and are without confounding factors have been termed GC-resistant.

There is no known treatment for glucocorticoid-resistant asthma. Treatment strategies include the use of higher doses of systemic glucocorticoids for a longer duration, nonglucocorticoid agents (eg, beta-adrenergic agonists, anticholinergic agents, anti leukotriene agents, omalizumab, cromolyn) and nonpharmacologic therapies (eg, trigger avoidance, bronchial thermoplasty). Small clinical trials of anti-interleukin (IL)-5 and anti-IL-13 have showed some benefit in GC-resistant asthma patients, but many of these innovative medicines require additional evidence of clinically relevant effects.

What are allergy shots?

Allergy shots are another name for immunotherapy. Subcutaneous or sublingual administration is possible. The ideal patient for IT should be more than 5 yr, with mild to moderate disease, few dominant allergens, seasonal exacerbations, patients on daily prophylactic medicines (wants to take less), and improved QOL. Not appropriate <5yr, >60 yr, h/o anaphylaxis, lack of availability of well-tested allergens.

Long-term effects of IT persist even after IT is discontinued.

SLIT: less effective than SCIT,

Safer but not totally

Shown effective as monotherapy

Dosing issues persist

Not shown to be effective in a mixture of antigens

Not yet approved in our country

Is asthma a lifelong problem or can it be cured?

There are 2 types of asthma. Half of the children who develop asthma in childhood outgrow their symptoms when they reach the age of 14-15 y. However, they may develop symptoms in later life when exposed to heavy trigger factors.

Your message for an asthmatic?

Asthma is a controllable disease and you can lead a trouble-free life with 2 Asthma Treatment strategies. 

1. KEEP PRECAUTIONS OF TRIGGER AVOIDANCE 

2. TAKE YOUR MEDICINES REGULARLY

Intrinsic (non-atopic) asthma and extrinsic (atopic) asthma)

There is no clinical or serological evidence of IgE-mediated allergy to common environmental stimuli in intrinsic asthma. When compared to controls, bronchial biopsies from such patients demonstrate increased expression of Th2-type cytokines, CC chemokines, and I/C, similar to extrinsic asthma. These data show that in this key clinically different type of the disease, there may be local IgE production directed against unknown antigens, presumably of viral origin or even autoantigens.

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What is the best strategy to treat asthma | Which Medicine your prefer | Dr. Sheetu Singh

Best strategy to treat asthma

There are 4 components of asthma –

  1. Develop a patient-doctor partnership
  2. Identify risk factors and reduce exposure
  3. Assess, treat and monitor disease
  4. Manage exacerbations

The goal of management – improve control & reduce risk – NAEPP guidelines 2007

Recurrent exacerbations and the requirement for emergency room or hospital care can be avoided.

●Reduced lung growth in children and loss of lung function in adults can be avoided.

●Pharmacotherapy optimization with few or no side effects

What is the best strategy to treat asthma?

Best strategy to treat asthma inhaled corticosteroids such as beclometasone are the drugs of choice for the long-term treatment of patients with persistent asthma. Although there is no discernible difference in efficacy among inhaled corticosteroids, beclometasone is the one with which we have the most expertise. Ciclesonide (Alvesco, Nycomed then Takeda), another inhaled corticosteroid, has been tested in three double-blind trials versus budesonide and six trials versus fluticasone but none versus beclometasone. These tests revealed the “non-inferiority” of ciclesonide, especially in terms of a surrogate endpoint: the difference in compelled expiratory volume in one second (FEV1) after 12 or 24 weeks of treatment (primary endpoint). 

Which inhaled steroid do you prefer, and why?

However, the doses of ciclesonide used in these trials were higher than the standard doses while doses of the comparator corticosteroids were lower than the standard doses, thus favoring ciclesonide. Local negative effects of inhaled corticosteroids include oral candidiasis, sore throat, and hoarseness.  Best strategy to treat asthma a routine review guided by a Cochrane group recommends that ciclesonide does not have a better adverse effect profile than other inhaled corticosteroids used at equivalent doses. Corticosteroid inhalation can also show systemic absorption. The practical benefit of once-daily dosing with ciclesonide appears minor. In practice, ciclesonide is neither more useful than the inhaled corticosteroids with which it has been compared nor does it have fewer negative effects. It is better to continue to use beclometasone, a medicine with which there is more experience.

What is an optimal dose for starting ICS

Treatment naïve patient – step 2

Already on treatment – step 3

Daily v/s intermittent dosing of ICS, which is better?

Daily ICS was only periodic ICS in several indicators of lung function, airway inflammation, asthma control, and reliever use. Both treatments seemed safe, but a fair growth suppression was associated with daily, compared to intermittent, inhaled budesonide and beclomethasone. The clinician should carefully consider the possible benefits and injury of each therapy option, taking into account the unknown long-term (> one year) effect of intermittent treatment on lung growth and lung function decline.

What are the advantages of adding LABA to ICS?

Bronchodilator action of LABA provides immediate relief, and ICS sustained relief improves control, reduces symptoms, Best strategy to treat asthma daytime as well as nocturnal, improves lung functions, reduces the risk of exacerbations, hospitalization we use formoterol + budesonide it acts as a controller as well as reliever medicine, also used in exercise-induced asthma

Can LABA monotherapy be used?

LABA should not be used as monotherapy because they are only bronchodilators with no anti-inflammatory effects. Monotherapy is associated with an increased risk of exacerbation and mortality. When used as add they are superior to LTRA and theo. They reduce symptoms, improve control, and use of SABA, and reduce exacerbations and nocturnal symptoms. Only a fixed-dose combination with ICS is to be used (which improves adherence and reduces the risk of monotherapy).

What is the role of LTRA in asthma as monotherapy, as add on

LTRA has a mild bronchodilator and anti-inflammatory effects. They may be used as monotherapy in mild asthma and aspirin-sensitive asthma. However, they are inferior to ICS and cannot replace ICS as monotherapy.

As added on they may reduce the dose of ICS needed to achieve control and improve control. However, they are inferior to LABA.

What is the role of theophylline as monotherapy, as an add-on?

Data on monotherapy are lacking. An add it improves control when control is lacking with ICS alone. However, it is inferior to LABA. In some patients on ICS + THEO, withdrawal of theo leads to deterioration of control. Usage of lower dosage has a full anti-inflammatory effect, with fewer adverse effects and blood level monitoring is not required.

Is doxycycline better than dyphylline?

It is a debatable issue. Various clinical trials have been done some supporting and others not supporting. However, meta-analysis has so far not found the superiority of doxo over deri in terms of safety and efficacy profile.

What are the benefits of using LAMA in the management of asthma?

Newer ATS/ERS guidelines published in April 2014 suggest the addition of LAMA to ICS and LABA 1. Improve FEV1 2. Reduce the use of SABA 3. Reduce the risk of exacerbation. No studies on children, so not to be used on children

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What is Asthma | How is Asthma diagnosed – Dr. Sheetu Singh

Many cells and cellular factors play a part in this chronic inflammatory condition of the airway. Chronic inflammation is associated with airway hyperresponsiveness which is responsible for chest tightness, wheezing, and coughing, particularly at night or in the early morning. What is asthma, These article are associated with widespread but variable airway obstruction within the lung that is often reversible either spontaneously or with treatment.

What is asthma? How is asthma diagnosed?

Symptomatic asthma – PFT, Asymptomatic – provocation challenge test Symptoms: episodic breathlessness, chest tightness, wheezing, cough – incited with allergen exposure, seasonal variation. There is a family history of asthma and allergy. History of variability in symptoms. Physical examination – wheezing may be present, silent chest in severe asthma, 

Lung functions – FEV1, FVC, PEFR

PEFR – 1. Confirm diagnosis of asthma (>20% or >60l/min improvement post-bronchodilator or diurnal) 2. For monitoring and control

Methacholine challenge test/ histamine challenge test/ mannitol/exercise challenge test (sensitive test – negative test rules out asthma, false-positive – allergic rhinitis, CF, bronchiectasis, COPD)

Sputum eosinophilia, Feno

Total Ig E – not diagnostic of atopy

SPT – low cost and high sensitivity through false positive is high

Rule out DD –

FOREIGN BODY INHALATION

VOCAL CORD DYSFUNCTION

LVF

COPD

CF/BRONCHIECTASIS

How do u assess the severity

 Controlled
(ALL MEASURES)		Partly controlled
(1-2)		Uncontrolled
Daytime symptoms<2 /week3 OR MORE
Limitation of activityNone
Nocturnal awakeningNone
Need for reliever<2 /week
FEV1N<80%

Assessment of future risk –

  1. Poor control of symptoms
  2. Frequent exacerbations
  3. ICU admissions
  4. Low FEV1
  5. Cigarette smoke exposure
  6. High dose medications

 

Old classification of patients – intermittent, mild persistent, moderate persistent, severe persistent

It is not only the severity of symptoms but its responsiveness to treatment.

What is an asthma attack?

Many patients have stable disease and they are relatively free of symptoms. But whenever they come across trigger factors they develop an increase in their symptoms.

Asthma attack comprises the episode of progressive increase in breathlessness, cough, chest tightness, and wheezing. Treatment comprises repeated doses of rapid-acting bronchodilators, systemic steroids, and oxygen if required. Milder exacerbations can be treated in community settings

What causes these symptoms?

Asthma is an inflammatory disease with the involvement of airway cells (like mast cells, eosinophils, t lymphocytes, and dendritic cells) and structural cells (airway epithelial, endothelial cells, smooth muscle cells). Chemokines, cysteinyl leukotrienes, cytokines, histamine, and NO are mediators that act on these cells.

Airway narrowing is caused due to – smooth muscle contraction, airway edema, mucus hypersecretion, airway remodeling.

What signs tells a person that asthma is worsening ?

1. Breathlessness

2. Talks in 

3. Alertness

4. Wheeze

5. Respiratory rate

6. Accessory muscles of respiration

7. Pulse

8. Pulsus paradoxus

9. PEFR

10. SpO2

11. PaO2

12. PaCO2

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28/May/2022
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Impact of Climate Change on Asthma patients – Dr. Sheetu Singh

Industrialization has led to many developmental changes around us, but it has induced major environmental changes in our surroundings too. Such massive change in Earth’s environment has triggered many diseases. Impact of climate change on asthma patients one such class of diseases is a respiratory disease. The rapid increase in pollution in the last century has tremendously escalated lung disorders. Lungs are the site of exchange of gases, wherein fresh oxygen from the environment is delivered into the body and carbon dioxide is collected and exhaled out of the body. Due to an increase in the pollutants in the surroundings, not only oxygen but other poisonous gases and chemicals, when gain entry into the respiratory tract, can cause disease.

Impact of Climate Change on Asthma patients and Respiratory Disease

The relationship between environmental factors and asthma isn’t new. Various anthropogenic factors have contributed to a manifold increase in the cases of Asthma over the last few decades. An increase in air pollutants and allergens in the atmosphere is contemporaneously leading to asthma prevalence lately. Several factors might contribute to asthma exacerbations, that include pollen allergies, global warming, increased vehicle emissions, and air pollution. Climate change can increase many types of breathing problems.

Effect of altered climate on increased pollen period:

The release of pollen grains into the air is a necessary event for wind-pollinated flowers, and seasonal allergies were considered moderately regulated. But global warming has increased carbon dioxide levels significantly which in turn has also risen Earth’s average temperature. This change has disrupted the occurrence and duration of pollen season. In response to high temperature and high CO2 levels, plants photosynthesize more and produce more pollens. These pollens remain in the air for quite some time. Pollen when gaining entry into the respiratory tract of humans, act as allergens. Some people are more sensitive than others, and thus start producing allergic symptoms. Prolonged pollen allergy and hypersensitivity can also induce diseases like asthma due to airway inflammation.

Dust and asthma: 

Asthma once occurs, has a variety of triggers, dust being one of them. Dust particles can cause inflammation in the airway. This is accompanied by excessive secretion of mucus which then creates difficulty in breathing. Smaller dust particles can irritate the lungs and can worsen breathing difficulties. Also, dust can’t just be an asthma trigger, it can cause asthma in young children too. Prolonged exposure to smaller dust particles can cause this disease in children at a very tender age. This asthma causing and trigger factor can simply be avoided by taking precautions if taken care of.

Air pollution and asthma: 

Particulate matter also goes by the name “particle pollution” is a mixture of extremely small particles with tiny droplets, which include chemicals, dust or soil particles, acids, etc. The particulate matter might vary in size, the smallest particles can reach up to the alveoli, directly affecting the exchange of gases inside the lungs. This environmental factor has the utmost impact on respiratory health. These substances aggravate respiratory issues, such as asthma, by blocking the airways of the respiratory tract due to increased debris and mucus. These substances are increased in the environment due to natural or anthropogenic causes. Urbanization and industrialization affect the concentration of such substances in the surroundings.

How asthmatic people take precautions

As the environmental conditions are constantly deteriorating, it is mandatory to know the triggers of your asthma conditions and impact of climate change on asthma patients. There is no precise test for the diagnosis of asthma. It is symptomatically diagnosed and is treated based on the symptoms stated. A complete cure for asthma is however not available. Prevention is the best help for asthma patients. Also, the above-mentioned causes and trigger points can be checked. Short-term relief can be provided with the help of inhalers and nebulizers. Keeping an Asthma action plan handy is a must too. If your asthma symptoms uncontrolable and trigger often in most of the day then visit top pulmonologist in Jaipur Dr. Sheetu Singh.

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COVID-19 and Bronchitis Differentiation | Causes, Symptoms, and Treatment | Dr. Sheetu Singh

Bronchitis and covid 19 both are respiratory diseases and have somewhat similar symptoms. Therefore, it is difficult to differentiate if you have coronavirus or Bronchitis. So how do you know between Bronchitis and COVID-19 Differentiation? Read till last and get full details. 

COVID-19 and Bronchitis Differentiation | Causes, Symptoms, and Treatment | Dr. Sheetu Singh

The issue begins when the airways in the lungs (known as the bronchial pipes) become infected or swollen. It makes it difficult for air to move in and out of the tubes. But, you need not worry because of Bronchitis, as it is completely treatable if the correct diagnosis is done. 

Some of the common causes of bronchitis are; bacteria, viruses, irritants, and smoking.

But First, let’s get to know about these two illnesses:- 

There are two types of bronchitis-

Acute bronchitis (normally lasts for a few weeks)

Some of the symptoms include:-

  • Cough 
  • Fever, 
  • Sore throat 
  • and wheezing, etc.

Chronic Bronchitis- 

Chronic Bronchitis is slightly more severe than acute bronchitis. It is suggestive of other lung concerns, such as COPD. And the main symptoms are cough and breathing problems (that last for months or even years). 

One important thing to remember is that bronchitis is curable with the right diagnosis and treatment.

Covid 19

Covid 19 is a respiratory infection that affects the nose, throat, airways, or lungs. 

COVID-19 is very contagious and spreads from person to person.

How does it spread? 

  • The coronavirus can travel through the air in respiratory droplets from a sneeze or cough and then into the lungs. 
  • The virus can survive on surfaces, such as phones, door handles, or countertops. 
  • If you touch something that has the virus on it, it can pass from your hands to your mouth, nose, or eyes.
  • It can also spread through direct contact (such as by shaking hands)

The disease can take a more dangerous form in aged people and patients with high blood pressure, heart problems, and diabetes. Apart from this, the virus is more easily affected by people already suffering from any disease or people who have low immunity.

Bronchitis v/s COVID-19 | COVID-19 and Bronchitis Differentiation

Anything that causes inflammation of the bronchi (tubes that carry air from the trachea to the lungs). Bronchitis starts with a common cold and is caused by the same virus that causes flu. And on the other hand, Covid is caused by the virus Sars Cov 2. Only a professional doctor can tell you that you have covid or bronchitis. Do not use any medicine and do anything without seeking a doctor’s advice. 

Causes symptoms and treatment of covid and bronchitis

COVID

  1. Fever/chills
  2. Nausea
  3. Diarrhea
  4. Smell lose
  5. Congestion
  6. Headache
  7. Ache and pain

BRONCHITIS 

  1. Tiredness
  2. Coughing (with mucus)
  3. Runny nose
  4. Low-grade fever
  5. Sore throat
  6. Chest discomfort
  7. Block nose and sinuses.

Precaution from bronchitis

  • Do not come in contact with anyone who has cold or acute bronchitis as there is a risk of infection. 
  • Bronchitis is caused by a virus or bacteria therefore, if someone sneezes or coughs, the disease can spread to others.
  • Cigarette smoke is harmful to our health so do not smoke cigarettes or tobacco. And If someone you know is smoking cigarettes then stay away from them.
  • Before going out, wear a mask or cover your mouth and nose with a cloth, especially if you are in contact with pollution, paint, or cleaning products.
  • Keep an air moistening device near you.
  • At times, you may also need to have a chest X-ray, sputum, or lung tests to rule out bronchitis. 

According to Asthma Specialist Sheetu Singh, drinking water dilutes the mucus present in the lungs. Moreover, Mullein tea also provides relief in this condition. 

Apart from that, do regular exercise to keep your lungs healthy. 

For some patients, doctors also recommend inhalers and oxygen therapy.

Sheetu Singh is a well-experienced asthma specialist. And she ensures that the best treatment is given to her patients. You can visit her if you are facing any of the symptoms, and get your treatment done. 

Read More Article Here – Can Booster Dose Help To Protect Against XE Variant

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Can Booster Dose Help To Protect Against XE Variant

Vaccines remain highly effective in preventing serious illness and hospitalization or death due to COVID-19. The recently launched booster dose is an additional dose of vaccine to offer further protection. Lungs specialist Dr. Sheetu Singh is telling, can Booster Dose help to protect against XE Variant? But before that, let’s find out when we can get a Booster dose.

When can we get Booster Dose?

  • You can have a booster dose for at least nine months after the second dose. (However, it also depends on what type of vaccine you got initially)
  • If someone caught covid-19, then it will be a minimum of 90 days after the patient’s recovery.

Can Booster Dose Help To Protect Against XE Variant- Dr. Sheetu Singh

After the XE variant, there is confusion among the public, and most probably the people; who are already suffering from a serious disease. Hence, the Booster dose, which is referred to as a precautionary dose, is beneficial for people who have a weak immune system. And also for the people who have severe diseases like Asthma, Diabetes, HIV, or cancer.

Benefits of Booster Dose for Asthma Patients

Even though there is no proof of which vaccine is beneficial for Asthma patients against the XE Variant. But a booster dose will surely decrease the chance of getting a severe coronavirus or its variant. The chances of getting severe complications from vaccines are very infrequent. However, it also depends on factors like age and how you controlled your Asthma? Or whether you have any other illness.

A booster dose is required because people are complaining that after taking two doses, the effect of the vaccine is decreasing. And apart from that, after COVID XE Variant, people fear that this will cause severe illness.

How to book a booster shot?

Booster shots are for those who have already taken two doses of the COVID vaccine. Eligible people will get the message from Covin’s website. Afterward, you have to type your registered mobile number, and you’ll get the OTP, and it will show if you completed your nine months or not.

COVID 19 VACCINE BENEFITS

COVID-19 vaccines are safe, effective, and life-saving. However, they do not ensure total protection for all vaccinated people. And we are not yet aware of how effective they are in preventing the transmission of the virus between people. For this reason, in addition to the choice to get vaccinated, you must continue to take other measures to combat the pandemic.

WHO also approves all anti-COVID-19 vaccines. And included in the list for emergency use have undergone clinical studies to test their quality, safety, and efficiency.

Also Visit: Are minors more at risk of Covid-19 than adults?

COVID 19 VACCINES BENEFITS FOR KIDS

  • As children are going to school, vaccines will help to decrease the chances of spreading the virus.
  • It helps in preventing getting COVID-19 easily.
  • They can continue their education without getting interrupted.

If you are facing any COVID-19 symptoms, and are facing any respiratory issues, you can contact Dr. Sheetu Singh, a Lung specialist in Jaipur.

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Types of Breathing Problems | Causes & Symptoms

It’s normal to be out of breath after intense physical activity. But, when you face this problem even after simple exercise, then you might need a doctor’s consultation. But you can also do a self-check of your breathing. In this article, we will tell you about the different types of breathing problems and what are the causes and symptoms of breathing problems. Types of Breathing Problems | Causes & Symptoms- Dr. Sheetu Singh

Types of Breathing Problems | Causes & Symptoms- Dr. Sheetu Singh

Hyperpnoea

In Hyperpnoea, you take your breathing deeper, And sometimes faster (i.e. during exercise). This cause does not need medical attention until and unless it’s caused without any physical activity. Hyperpnoea is the response from your body to the brain to adjust your breathing.

Dyspnea

Dyspnea is also known as Shortness of Breath. In this situation, when you can’t get enough air to breathe or you experience tightness in your chest. Tough exercise, high temperature, and obesity are the primary cause of Dyspnea.

And sometimes, Dyspnea starts because of low blood pressure, heart attack, carbon monoxide poisoning, or asthma attack.

Bradypnea

In this condition, when you breathe at a slow rate compared to your normal breathing speed. Bradypnea can cause:-

  • Dizziness
  • Tiredness
  • Lightheadedness

Kussmaul Breathing

The situation is when the body produces too much acid. Some of the Kussmaul Breathing are:

  • Organ Failure
  • Overuse of Alcohol
  • Sepsis

Cause & Symptoms of Breathing Problems

There is several cause of breathing problems

Health-Related

  • Anemia
  • Asthma
  • Lung cancer
  • Pneumonia
  • Croup
  • COPD (Chronic obstructive pulmonary disease),
  • COVID-19
  • And any other heart and lung diseases.
  • Bronchitis

Medical emergencies

  • Drowning
  • Heart attack
  • Injury to neck, lungs
  • Any allergy reaction
  • Blood clotting in lungs

Symptoms

Now talk about the symptoms of the Breathing problems

  • Suddenly trouble with breathing
  • Not able to breathe
  • Pain/discomfort in the chest
  • Not able to do even day to day activities
  • Breath rapidly
  • Dizziness or anxious
  • Difficulty in speaking
  • Cough Blood
  • Sweating
  • Whistling sound while breathing

The most important thing you should do while someone is facing any breath-related issue is to immediately dial the medical emergency number. And while waiting for the ambulance:-

  • Check the pulse of the patient
  • Loosen their clothes
  • Help the person in using an inhaler or home oxygen (if prescribed by the doctor)

And if you are facing breathing problems, then try to calm down while waiting for the ambulance. Sit straight and take someone’s help if possible.

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Types and Evaluation of Influenza | Dr. Sheetu Singh

Haemophilus influenza: characteristics, culture, pathogenesis, treatment

Haemophilus influenza is a Gram-negative, Plumorphic coccobacillus, which causes a variety of infections and some serious infections, including meningitis, septicemia, pneumonia, epiglottis, conjunctivitis, cellulitis, or arthritis. The Types and Evaluation of Influenza species represents the main pathogen of this genus. Children and the elderly are the most susceptible to serious infections caused by these microorganisms. The former suffered mostly from meningitis and later from pneumonia.

Some strains are Haemophilus influenza they are bound and others are not. Capsules are typeable according to the type of carbohydrate in the capsule. The types described by A, B, C, D, E, and F are known as different types.

Types and Evaluation of Influenza

At the laboratory level, these can be isolated with polysaccharides using antisera aggregating antibodies.

Capsulated strains are pathogenic. Type B These are the most invasive and frequently isolated in the infectious process. Non-capsulated is considered habitual microbiota and although they may be contagious, they are not usually invasive and do not represent a greater risk.

They are difficult to distinguish at the laboratory level, as they require highly enriched media for optimal development, such as chocolate agar or lethal agar.

This is why these microorganisms fall into the group of bacteria that claim to be from a nutritional point of view, although some authors prefer to call them annoying microorganisms.

Disease (pathogenesis)

These are transmitted by microbial secretions, mainly respiratory problems (saliva and mucus) excreted by sick people or carriers of bacteria.

If the patient sneezes or coughs, the bacteria are excreted in the excreta. Bacteria are spread in the environment and are inhaled by sensitive individuals.

Haemophilus influenza is a pyogenic microorganism that causes it to produce purulent secretions.

Its main pathologies are meningitis, septicemia, pneumonia, epiglottitis, conjunctivitis, and otitis, among others. Here are given different types of disease –

SepticemiaWhen bacteria enter the bloodstream it is called bacteremia and is an important step in the spread of microorganisms to other organs or tissues. When the number of microorganisms in the blood multiplies, it is called septicemia, a condition that compromises the patient’s general condition.

  1. Meningitis

Meningitis is a serious disease that causes neck, headaches, nausea, or changes in behavior and some cases leads to death. This infection is common in children.

  1. Pneumonia

It is presented as a serious complication of a previous respiratory tract infection such as bronchitis or acute fibrillar tracheobronchitis. It presents with a high fever, dyspnea, or productive cough with cauliflower chin. It can coexist with bacteremia. This involvement is more common in older adults.

  1. Conjunctivitis

Conjunctivitis presents redness, burning, swelling of the eyelids, presence of purulent discharge, or sensitivity to light (photophobia).

Diagnosis

Culture is the best way to diagnose. Samples will depend on the infectious process.

If meningoencephalitis is suspected, a sample of cerebrospinal fluid should be taken by a lumbar puncture for cytochemical study and culture. In case of septicemia, blood samples will be taken to perform multiple blood cultures.

If the process is conjunctivitis, the secretion of this mucus will be taken. In the case of pneumonia, a specimen of sputum or bronchial lavage is cultured.

Detection can also be done using manual biochemical tests or by automated systems such as VTech2.

Treatment

Types and Evaluation of Influenza Haemophilus  It can be treated with beta-lactam like ampicillin, ampicillin/sulbactam, amoxicillin / clavulanic acid, piperacillin/tazobactam. Third-generation cephalosporins, such as ceftriaxone, cefotaxime, and cefoperazone, are often used in severe infections.

It is important to note that ampicillin is no longer used because most isolated strains are currently resistant to this antibiotic, due to the production of beta-lactamase.

Macrolides and quinolones can be used.

However, the most advisable issue is to administer and treat antibiotics according to the sensitivity of the report.

Resistance

Type Haemophilus influenza E B after the introduction of the vaccine against it, this microbial cause has significantly reduced the incidence of meningitis.

Currently, capsular antigen type B (polydipsia-ribitol-phosphate) H. Influenza is included in the pentavalent vaccine which also fights against diphtheria, tetanus, pertussis, and hepatitis B.

The vaccine is given in 3 or 4 doses. The 4-dose schedule is as follows:

The first dose is started at 2 months of age. Two more doses are then given every two months (at ages 4 and 6 months). Finally, the fourth dose is placed 6 or 9 months after the third. The last dose represents a boost.

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Advantages and Disadvantages of inhaler | Inhaler technique | Dr. Sheetu Singh

Inhalers are the most useful way for people with asthma and other lung diseases to access life-saving drugs. If you suffer from asthma or you care for someone who has asthma, here’s all you need to know about inhalers, including how to use them correctly and Advantages and Disadvantages of inhaler.

Advantages and Disadvantages of inhaler

Inhalers for asthma are small, mobile devices that administer medication to the lungs. To assist control asthma symptoms, a range of asthma inhalers are available. You can receive the medication you need to prevent or treat asthma attacks if you find the right one and use it correctly.

Inhaler technique | How to Use Inhaler

Inhalers are devices to deliver medications for the treatment of obstructive airway disease including asthma and chronic obstructive airway disease (COPD). There are different types of inhalation devices primarily including dry powder inhalers (DPI) and metered-dose inhalers (MDI). It is essential to take the inhaler properly, if not taken properly the medication would not reach the proper site.

Advantages of inhaler

The dose of medication in the inhaler is almost one-tenth of the dose taken in oral form. The response to medication is quick. Since oral absorption is minimal, side effects are not significant for the inhaler. Side effects are thus minimal, the response is quick and better.

Disadvantages of inhaler 

There is some oral deposition that leads to oral ulcers, candidiasis, and dysphonia. However, all these side effects can be avoided if the mouth is rinsed thoroughly after inhalation.

Advantages of a spacer

The spacer is a device to be placed between the mouth and the MDI. The extra medicine deposits in the spacer, thereby oral deposition is very less. Thus, the above-mentioned side-effects are also very few.

How to take a DPI?

  1. First, put the capsule in the device
  2. Rotate the device till the capsule breaks
  3. Blow out completely
  4. Take the mouthpiece in the mouth and seal it with lips
  5. Fast and deep breath in
  6. Hold for 10 seconds
  7. Blow out completely
  8. Rinse mouth

How to take MDI with a spacer?

  1. Shake inhaler
  2. Fix it in the spacer
  3. Blow out completely
  4. Take the mouthpiece in the mouth and seal it with lips
  5. Slow and deep breath in
  6. Hold for 10 seconds
  7. Blow out completely
  8. Rinse mouth

Myths and facts about inhaler

  1. It is habit-forming – FALSE

Truth – It is a requirement not addicting

  1. It has many side effects – FALSE

Truth – It causes lesser side effects than oral medicines

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28/May/2022
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Are minors more at risk of Covid-19 than adults? | Dr. Sheetu Singh

Children’s lives are much more affected due to the pandemic. From schooling to playing, the complete daily routine of children is not working out. Are minors more at risk of Covid-19 than adults? This question is in everyone’s mind, every parent is worried about their children. As compared to adults, children wear less risk of severe SARS-CoV-2 infection. In addition to it, after a long period, the mild effects have been recognized in children. They could experience milder symptoms like fever, cough, fatigue, and low-grade. Only a few children can have severe complications, but they are less common. Children with some health conditions may only face some severe illness.  

Are minors more at risk of Covid-19 than adults? | Dr. Sheetu Singh

The complication that can occur in children is a multisystem inflammatory syndrome (MIS-C), which can lead to major health issues for a long time. Symptoms of MIS-C can include:

● fever for more than a couple of days

● rash

● bloodshot eyes

● stomachache

● vomiting and/or diarrhea

● neck pain

● red, cracked lips

● swollen hands and/or feet

● unusual sleepiness or weakness

How are newborns affected by COVID-19?

COVID-19 can be transferred to newborns during labor or by touching with sick caretakers after delivery. When caring for your baby during your clinic stay after labor, wear a face mask and keep your hands hygienic if you have COVID-19.

How to treat Children from COVID-19 

Dr. Sheetu Singh is one of the top Asthma Specialist in Jaipur. Along with being the best doctor, she is a well-experienced specialist. Parents are always concerned about their children. The most constant question they raise is Are minors more at risk of Covid-19 than adults? Dr. Sheetu Singh is humble to her patients. She ensures the best treatment for everyone. If your child is suffering from any symptoms of Covid-19, you can visit Dr. Sheetu Singh. 

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