Cough & Dyspnoea in a child with Asthma

Chief Complaint A 15 y/o female presents with cough, wheezing, dyspnoea & chest discomfort. It increases in this weather and at night. History She has h/o childhood asthma. She is n inhalers. She has family history of asthma. Vitals All the vitals are wnl Examination She is a healthy child with up to the mark growth parameters. B/l expiratory wheezes noted on lung auscultation. Investigations FEV1/FVC: 66% FEV1: 51% FVC: 60% Treatment What should be advised to this child?

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do cbc look for eosinophils . peak expiratory flow meter reading spirometry . family history of asthma / eczema . seems already a established case of asthma on inhaler . poorly controlled . use step up therapy . budecort inhaler 200 mcg 2 puffs twice daily with tab montair 5 mg once daily . at the time of exacerbation 10 puffs of asthalin inhales stat can repeat after 20 minutes . supplementing with vit d n zinc helps too .

Low FEV1 suggest obstructed airway Step wise escalation of treatment medication to treat bronchospasm Inhaled beta agonist - sorry acting better in acute episode - salbutamol Inhaled acetyl choline receptor antagonist - ipratropium/ tiotropium Inhaled steroid Montelukast Oral theophylline Finally oral/ intravenous steroid

Needs further investigation and evaluation to conclude particularly ig E, Allergy test.. 2D ECHO ,E CG or Cardiac enzymes. Till reports complied. Symptomatic treatment.

Thanks Dr Kute Ankush
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NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. HEMOGRAM.. IgE.. ALLERGY TEST .. ECG 2D ECHO STUDY.. CARDIAC ENZYMES.. CXR.. MEANWHILE TREAT SYMPTOMATICALLY..

A case of bronchial asthma Needs inhalers in a step fashionable 1) Salbutamol as rescue medicine 2) LABA like salmeterol, as maintenance 3 ) Steroid inhalers like budesonide, along with LABA 4) Ipratropium Oral steroids if above are not effective. Xray chest and sinuses, CBC, PFT needed to rule out triggers .

Hrct must Pft is low Ige allergic skin testing Inhaler with ipatronium Laba lama steriod Check spo2 must be more then94

congenital asthma sitopaladi churan, swas kas chinta mani ras, abhrak bhasma, tankan bhasma,shring bhasma,pippali churana,kaf ketu ras,somlata churan,shila sindoor are the drug of choice for asthma

Eosinophilic count clinical examination cardiac hemoglobin cxr

Acute exacerbation asthama See hrct N treat accordingly Nebulisation qds

I am agree with@Dr. Mansukh Shah Sir.

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