Friends I am sure u must have enjoyed green Diwali. Today I am discussing about a major problem known as Asthma. Asthma is a chronic disease of the airways that transport air to and from the lungs. No full cure is available, but management methods can help a person with asthma lead a full and active life. In a person with asthma, the inside walls of the airways, known as bronchial tubes, become swollen or inflamed. This swelling or inflammation makes the airways extremely sensitive to irritations and increases their susceptibility to an allergic reaction. In an allergic reaction, the airways swell, and the muscles around the airway tighten, making it difficult for air to move in and out of the lungs. What is asthma? asthma attack lady Asthma is a chronic respiratory disease that often leads to severe attacks of symptoms. Asthma is an incurable illness of the airways. The disease causes inflammation and narrowing inside the lung, restricting air supply. The symptoms of asthma often present in periodic attacks or episodes of tightness in the chest, wheezing, breathlessness, and coughing. During the development of asthma, the airways swell and become extremely sensitive to some of the substances a person might inhale. When this increased sensitivity causes a reaction, the muscles that control the airways tighten. In doing so, they might restrict the airways even further and trigger an overproduction of mucus. Asthma attacks The set of inflammatory events in the respiratory system can lead to the severe symptoms of an asthma attack. Worldwide, around 250,000 people die every year as a result of asthma. Asthma attacks occur when symptoms are at their peak. They might begin suddenly and can range from mild to severe. In some asthma attacks, swelling in the airways can completely prevent oxygen from reaching the lungs, which also stops it entering the bloodstream and traveling to vital organs. This type of asthma attack can be fatal and requires urgent hospitalization. At the start of an asthma attack, the airways allow enough air into the lungs, but it does not let the carbon dioxide leave the lungs at a fast enough rate. Carbon dioxide is poisonous if the body does not expel the gas, and a prolonged asthma attack might lead to a build-up of the gas in the lungs. This might further reduce the amount of oxygen entering the bloodstream. People with clear symptoms of asthma should visit a doctor. They will provide treatments and advise on management techniques, as well as identifying potential triggers for asthma symptoms and how to avoid them. The doctor will also prescribe medications to help reduce the frequency of attacks asthma. Effective asthma control reduces the impact of the condition on everyday living. Types As many different factors come together to cause asthma, there are many different types of the disease, separated by age and severity. Adults and children share the same triggers for symptoms that set off an allergic response in the airways, including airborne pollutants, mold, mildew, and cigarette smoke. Childhood asthma Children are more likely to have an intermittent form of asthma that presents in severe attacks. Some children might experience daily symptoms, but the common characteristic among children with asthma is a heightened sensitivity to substances that cause allergy. Second-hand tobacco smoke causes severe problems for children with asthma. Between 400,000 and 1 million children experience worsening asthma symptoms as a result of second-hand smoke, according to the American Lung Association. The Centers for Disease Control and Prevention (CDC) advise that children experience more emergency visits and admissions for asthma than adults. Mild asthma might resolve without treatment during childhood. However, there is still a risk that the condition might return later on, especially if symptoms are moderate or severe. Adult-onset asthma Asthma in adults is often persistent and requires the daily management of flare-ups and preventing symptoms. Asthma can begin at any age. Allergies lead to at least 30 percent of adult presentations of asthma. Obesity is a strong risk factor for adult-onset asthma, and women are more likely to develop the condition after the age of 20 years. People over 65 years of age make up a large number of deaths from asthma. Occupational asthma This is a type of asthma that occurs as a direct result of a job or profession. Symptoms will become apparent after attending a particular workplace. Industries with regular associations to occupational asthma include baking, laboratory work, or manufacturing. In this type, the work environment leads to the return of childhood asthma or the start of adult-onset asthma. Other symptoms might include a runny nose and red eyes. Difficult-to-control and severe asthma These types involve consistent, debilitating asthma symptoms and breathing difficulties. Around 12 percent of people with asthma have difficult-to-control or severe asthma. With the correct medication and effective trigger avoidance, those in this category can bring asthma symptoms back under control. Roughly 5 percent of people with asthma do not see improvements after using the standard asthma medications. These people have severe asthma, and there are several types of severe asthma depending on the cause. Newer medications are becoming available to address the different forms of severe asthma, such as eosinophilic asthma that does not link to any allergic reactions. Seasonal asthma This type occurs in response to allergens that are only in the surrounding environment at certain times of year, such as cold air in the winter or pollen during hay fever season. People still have asthma for the rest of the year but do not experience symptoms. Causes Many different aspects of a person's environment and genetic makeup can contribute to the development of asthma. Asthma is the most common chronic disease among children. The first symptoms become clear at around 5 years of age in the form of wheezing and regular infections in the respiratory tracts. The following are the primary causes of asthma. Allergies A strong link exists between allergies and asthma. One 2013 study in the Annals of Asthma, Allergy, and Immunology suggests that over 65 percent of adults with asthma over the age of 55 years also have an allergy, and the figure is closer to 75 percent for adults between the ages of 20 and 40 years. Common sources of indoor allergens include animal proteins, mostly from cat and dog dander, dust mites, cockroaches, and fungi. Smoking tobacco Research has linked tobacco smoke to an increased risk of asthma, wheezing, respiratory infections, and death from asthma. In addition, the children of parents who smoke have a higher risk of developing asthma. Smoking makes the effects of asthma on the airways worse by adding coughing and breathlessness to its symptoms, as well as increasing the risk of infections from the overproduction of mucus. Environmental factors Air pollution both in and out of the home can impact the development and triggers of asthma. Allergic reactions and asthma symptoms often occur because of indoor air pollution from mold or noxious fumes from household cleaners and paints. pollen Anything from pollen to pollution can trigger an asthma attack and inflame the airways. Other asthma triggers in the home and environment include: pollution sulphur dioxide nitrogen oxide ozone cold temperatures high humidity Heavy air pollution tends to cause a higher recurrence of asthma symptoms and hospital admissions. Smoggy conditions release the destructive ingredient known as ozone, causing coughing, shortness of breath, and even chest pain. These same conditions emit sulfur dioxide, which also results in asthma attacks by constricting the airways. Changes in the weather might also stimulate attacks. Cold air can lead to airway congestion, constricted airway, extra secretions of mucus, and a reduced ability to clear that mucus. Humidity might also lead to breathing difficulties for populations in some areas. Obesity Some studies, such as this report from 2014, suggest a link between obesity and asthma, although the American Academy of Asthma, Allergies, and Immunology does not recognize obesity as a formal risk factor for asthma. However, the report in question suggests that the inflammatory mechanisms that drive asthma also link to obesity. Pregnancy If a woman smokes tobacco or illicit substanes while pregnant, an unborn child might grow less in the womb, experience complications during labor and delivery, and have a low birth weight. These newborns might be more prone to medical problems, including asthma. Stress People who undergo stress have higher asthma rates. Increases in asthma-related behaviors during stressful times, such as smoking, might explain these increased rates. Emotional responses, including laughter and grief, might trigger asthma attacks. Genetics A parent can pass asthma on to their child. If one parent has asthma, there is a 25 percent chance that a child will develop asthma. Having two parents with asthma increase the risk to 50 percent. Many genes are involved in passing on asthma. These genes can interact with the environment to become active, although confirming these findings may require further research. Atopy Atopy is a general class of allergic hypersensitivity that leads to allergic reactions in different parts of the body that do not come in contact with an allergen. Examples include eczema, hay fever, and an eye condition called allergic conjunctivitis. During atopy, the body produces more immunoglobin (IgE) antibodies than usual in response to common allergens. The most common type of asthma is atopic asthma, and atopy plays a key role in its development. Environmental allergens lead to overproduction of IgE antibodies and trigger asthmatic reactions. The menstrual cycle One type of asthma, known as perimenstrual asthma (PMA), leads to acute symptoms during the menstrual cycle and a particular sensitivity to aspirin. The sex hormones that circulate during menstruation, such as luteinizing hormone (LH) and follicle-stimulating hormone (FSH), impact immune activity. This increased immune action can cause hypersensitivity in the airways. Diagnosis Three main components comprise an accurate asthma diagnosis: Medical history, observations during a physical exam, and results from breathing tests. A primary care physician will administer these tests and determine the level of asthma as mild, intermittent, moderate, or severe in people who show signs of the condition, as well as identifying the type. A detailed family history of asthma and allergies can help a doctor make an accurate diagnosis. A personal history of allergies is also important to mention, as many share mechanisms with asthma and increase the risk. Keep a note of any potential triggers of asthma symptoms to help guide treatment, including information about any potential irritants in the workplace. Be sure to identify any health conditions that can interfere with asthma management, such as: a runny nose sinus infections acid reflux psychological stress sleep apnea Young children who develop asthma symptoms before the age of 5 years find it more difficult to receive a clear diagnosis. Doctors might confuse asthma symptoms with those of other childhood conditions. If children experience wheezing episodes during colds or respiratory infections in early life, they are likely to develop asthma after 6 years of age. Physical exam A physical examination will generally focus on the upper respiratory tract, chest, and skin. A doctor will listen for signs of wheezing, or a high-pitched whistle on breathing out, in the lungs during a breath using a stethoscope. Wheezing is a key sign of both an obstructed airway and asthma. Physicians will also check for a runny nose, swollen nasal passages, and soft growths on the inside of the nose and check for skin conditions including eczema and hives. These are allergic conditions that link to asthma and suggest heightened immune activity that could be causing any wheezing. People with asthma do not always show physical symptoms, and it is possible to have asthma without presenting any physical maladies during an examination. Asthma tests Lung function tests are another component of an asthma diagnosis. They measure how much air a person inhales and exhales and the speed with which a person can expel air from the lungs. A spirometry test can provide an indication of lung function. spirometry A spirometry can help assess lung function. Spirometry is a non-invasive test that requires deep breaths and forceful exhalation into a hose. The hose links to a machine called a spirometer that displays two key measurements: forced vital capacity (FVC), or the maximum amount of air a person can inhale and exhale forced expiratory volume (FEV-1), the maximum amount of air a person can exhale in one second The doctor then compares these measurements against what would be normal for another person of the same age. Measurements below normal indicate obstructed airways and probable asthma. A doctor will often administer a bronchodilator drug to open air passages before retesting with the spirometer to confirm the diagnosis. If results improve after using the drug, the risk of an asthma diagnosis increases. Children under 5 years of age are difficult to test using spirometry, so asthma diagnoses will rely mostly on symptoms, medical histories, and other parts of the physical examination process. In younger children, doctors commonly prescribe asthma medicines for 4 to 6 weeks to gauge physical response. Other Tests A bronchoprovocation test, also known as a "challenge test" involves the administration an airway-constricting substance, such as cold air, to deliberately trigger airway obstruction and asthma symptoms. Similarly, a challenge test for exercise-induced asthma would consist of vigorous exercise with the aim of triggering symptoms. The doctor then conducts a spirometry, and if measurements are still normal, they are not likely to reach a diagnosis of asthma. Physicians might use allergy tests to identify substances that may be causing asthma or making it worse. These tests do not fully diagnose asthma, but they might help a doctor understand the nature of asthma symptoms. Doctors may also test for other diseases with similar symptoms, such as: gastroesophageal reflux disease (GERD) heartburn hay fever sinusitis sleep apnea chronic obstructive pulmonary disease (COPD) airway tumors airway obstruction bronchitis pneumonia a blood clot in the lung, or pulmonary embolism congestive heart failure vocal cord dysfunction viral lower respiratory tract infection A doctor may test for these using the following methods: a chest x-ray electrocardiogram (ECG) complete blood counts CT scans of the lungs gastroesophageal reflux assessment the induction and examination of sputum, or phlegm Many people with asthma will not need to visit a specialist, as most primary care physicians have training for asthma diagnosis. People who require special asthma tests or have had life-threatening asthma attacks in the past may need to visit an asthma specialist Specialists can also be useful for people who need more than one kind of medication or higher, more concentrated doses in order to control asthma. A visit may also be necessary for people with difficult-to-control asthma, or people receiving treatment for other allergies. Takeaway Asthma is a chronic, inflammatory condition that causes swelling and blockage in the airways. It can range in severity, and there are several types, depending on the cause and the age at which asthma begins. Anyone of any age can develop asthma. Women are more likely to develop the condition after the age of 20 years, and smoking and air pollution heavily contribute to the issue. The immune system and asthma share a strong link, and people with asthma often have other allergies. A young child might find that asthma seems to resolve without treatment but returns in adult life. However, moderate and severe cases often require treatment. Asthma attacks involve a sudden and severe recurrence of symptoms, and these are how younger children normally experience asthma. Adult-onset asthma tends to be more constant and persistent. Diagnosing asthma involves testing lung function and immune response, as well as assessing an individual for other condition with similar symptoms to asthma risk of asthma for young children. Can asthma develop into other harmful lung diseases, such as COPD or emphysema? Asthma is a risk factor for COPD, and people with long-standing asthma have a high risk of developing COPD, especially if they had severe asthma as children. Emphysema on the other hand, is not related to asthma even though their symptoms may be similar. Cigarette smoking almost always causes this. Homoeopathic treatment for Asthma Carbo Vegetabilis: This is a homeopathic asthma treatment which is generally prescribed when the person has violent bouts of coughing which may cause a gag reflex to set in. Extremities might be cold, but there is a need for air or breeze. Feels dyspeptic, burping gives relief. Chamomilla: This is most often prescribed for asthma attacks that are brought on by emotional stress, anxiety or over excitement. The person displays behaviour that is irritable, angry and hypersensitive. In some cases, this is accompanied by a racking cough. Arsenicum Album: A person needing this homeopathic asthma remedy may often feel a combination of exhaustion and uneasiness. Breathing problems are exacerbated when supine, better when upright. The person often finds that ease of breathing deteriorates at night, accompanied by wheezing and a constant thirst. He/she may also experience violent chills accompanied by shivering, heat may bring relief. Natrum Sulphuricum: When asthma attacks are precipitated by mould and dampness, this homeopathy remedy is especially efficacious. Nux Vomica: Persons feeling constricted in the chest and stomach, brought on by having spicy food, alcohol and sweets. Warmth and sleep along with this remedy bring relief. Pulsatilla: Excessive warmth especially indoors along with and heavily spiced food bring on wheezing as a result of exertion and chest congestion. This remedy is useful for children suffering from asthma.

Dear Dr. The patient is suffering with dry cough since 2 and half years ago. first the patient suffered from fever and cough with sputum for about 1 month and not taken treatment. after one month the cough became dry cough. -No history of allergies -No history of smoking and drinking =the cough is characterised by: -throat irritation -reddening of face while cough -No sputum -increases in night time, and after food and drinking water too. #consulted 3 doctors and done cxr. doctor told it's due to some allergies and given cough syrups and tablets. # patient is not relieved of dry since then. please kindly do dx And recommend rx.

V v v important DRUGS OF CHOICE ---------------------------------- 1. Paracetamol poisoning- :- - acetyl cysteine 2. acute bronchial- asthma :- salbutamol 3. acute gout :- NSAIDS 4. acute hyperkalemia:- calcium gluconate 5. severe DIGITALIS toxicity :- DIGIBIND 6. acute migraine :- sumatriptan 7. cheese reaction :- phentolamine 8. atropine poisoning :- physostigmine 9. cyanide poisoning :- amyl nitrite 10. benzodiazepine poisoning:- flumazenil 11. cholera :- tetracycline 12. KALA-AZAR :- lipozomal amphotericin- B 13. iron poisoning :- desferrioxamine­ 14. MRSA :- vancomycin 15. VRSA :- LINEZOLID 16. warfarin overdose :- vitamin-K (NIPER- 2009) 17. OCD :- fluoxetine 18. alcohol poisoning :- fomepizole 19.Epilepsy in pregnancy: carbamezepine safe among older epileptics & lamotrigine, levitracetam safe in newer AED! 20. anaphylactic shock :- Adrenaline 21. MRSA Infection-Vancomycin 22. Malaria in Pregnancy-Chloroquine 23. Whooping Cough or Perteusis- Erythromycin 24. Kawasaki disease-IV Ig 25. Warferin Overdose-Vit-K 26. Heparin Overdose-Protamine 27. Hairy Cell Leukemia-Cladirabine 28. Multiple Myeloma- Melphalan 29. CML-Imatinib 30. Wegner's granulomatosis-Cyclophosphamide 31. HOCM- Propranolol 32. Delirium Tremens-Diazepam 33. Drug Induced Parkinsonism-Benzhexol 34. Diacumarol Poisoning-Vit-K 35. Type-1 Lepra Reaction-Steroids 36. Type- 2 Lepra Reaction-Thalidomide 37. Allergic Contect Dermatitis-Steroids 38. PSVT- 1st-Adenosine, 2nd-Verapamil, 3rd-Digoxin 39. Z-E Syndrome- Proton Pump Inhibitor 40. Chancroid-Cotrimoxazole 41. Dermatitis Herpetiformis-Dapsone 42. Spastic Type of Cerebral Palsy-Diazepam 43. Herpis Simplex Keratitis-Trifluridine 44. Herpes Simplex Orolabialis-Pancyclovir 45. Neonatal Herpes Simplex-Acyclovir 46. Pneumocystis carinii Pneumonia-Cotrimoxazole For Nodulo 47. 47. Cystic Acne-Retinoic acid 48. Trigeminal Neuralgia-Carbamezapine 49. Actinomycosis-Penicillin 50. Plague- Streptomycin 51. Opioid Withdrawal- Methadone 2nd-Clonidine 52. Alcohol Withdrawal- Chlordiazepoxide 2nd-Diazepam 53. Post Herpetic Neuralgia- Fluphenazine 54. WEST Syndrome-ACTH 55. Diabetic Diarrhoea- Clonidine 56. Lithium Induced Neuropathy-AmilorideCommunicable Disease: 57. Tetanus: PEN G Na; TETRACYCLINE; (DIAZEPAM 58. Diphteria: PEN G K; ERYTHROMYCIN 59. Pertusis: ERYTHROMYCIN; AMPICILLIN 60. Meningitis: MANNITOL (osmotic diuretic);DEXAM ETHASONE (anti-inflammatory); DILANTIN/PHENYTOIN (anti-convulsive); PYRETINOL/ENCEPHABO L (CNS stimulant) 61. Cholera: TETRACYCLINE 62. Amoebic Dysentery: METRONIDAZOLE 63. Shigellosis: CO-TRIMOXAZOLE 64. Typhoid: CHORAMPHENICOL 65. Rabies: LYSSAVAC, VERORAB 66. Immunoglobulins: ERIG or HRIg 67. Malaria: CHLOROQUINE 68. Schistosomiasis: PRAZIQUANTEL 69. Felariasis: DIETHYLCARBAMAZINE CITRATE 70. Scabies: EURAX/ CROTAMITON 71. Chicken pox: ACYCLOVIR/ZOVIRAX 72. Leptospirosis: PENICILLIN; TETRACYCLINE;ER YTHROMYCIN 73. Leprosy: DAPSONE, RIFAMPICIN 74. Anthrax: PENICILLIN 75. Tuberculosis: R.I.P.E.S. 76. Pneumonia: COTRIMOXAZOLE; ProcainePenicillin 77. Helminths: MEBENDAZOLE; PYRANTELPAMOATE 78. Meningitis: MANNITOL (dec. ICP) ;DEXAMETHASONE ( relieve cerebral edema) ;DIAZEPAM ( anticonvulsant); PENICILLIN 79. Syphilis: PENICILLIN 80. Gonorrhea: PENICILLIN...

Friends today I am discussing about a common problem for sensitive persons known as Allergic rhinitis. What is allergic rhinitis? An allergen is an otherwise harmless substance that causes an allergic reaction. Allergic rhinitis, or hay fever, is an allergic response to specific allergens. Pollen is the most common allergen in seasonal allergic rhinitis. These are allergy symptoms that occur with the change of seasons. Nearly 8 percent of adults in the United States experience allergic rhinitis of some kind, according to the American Academy of Allergy, Asthma & Immunology (AAAAI). Between 10 and 30 percent of the worldwide population may also have allergic rhinitis. Symptoms of allergic rhinitis Common symptoms of allergic rhinitis include: sneezing a runny nose a stuffy nose an itchy nose coughing a sore or scratchy throat itchy eyes watery eyes dark circles under the eyes frequent headaches eczema-type symptoms, such as having extremely dry, itchy skin that can blister and weep hives excessive fatigue You’ll usually feel one or more of these symptoms immediately after coming into contact with an allergen. Some symptoms, such as recurrent headaches and fatigue, may only happen after long-term exposure to allergens. Fever isn’t a symptom of hay fever. Some people experience symptoms only rarely. This likely occurs when you’re exposed to allergens in large quantities. Other people experience symptoms all year long. Talk to your doctor about possible allergies if your symptoms last for more than a few weeks and don’t seem to be improving. What causes allergic rhinitis? When your body comes into contact with an allergen, it releases histamine, which is a natural chemical that defends your body from the allergen. This chemical can cause allergic rhinitis and its symptoms, including a runny nose, sneezing, and itchy eyes. In addition to tree pollen, other common allergens include: grass pollen dust mites animal dander, which is old skin cat saliva mold During certain times of the year, pollen can be especially problematic. Tree and flower pollens are more common in the spring. Grasses and weeds produce more pollen in the summer and fall. What are the types of allergic rhinitis The two types of allergic rhinitis are seasonal and perennial. Seasonal allergies usually occur during the spring and fall season and are typically in response to outdoor allergens like pollen. Perennial allergies can occur year round, or at any time during the year in response to indoor substances, like dust mites and pet dander. Risk factors for allergic rhinitis Allergies can affect anyone, but you’re more likely to develop allergic rhinitis if there is a history of allergies in your family. Having asthma or atopic eczema can also increase your risk of allergic rhinitis. Some external factors can trigger or worsen this condition, including: cigarette smoke chemicals cold temperatures humidity wind air pollution hairspray perfumes colognes wood smoke fumes How is allergic rhinitis diagnosed? If you have minor allergies, you’ll probably only need a physical exam. However, your doctor may perform certain tests to figure out the best treatment and prevention plan for you. A skin prick test is one of the most common. Your doctor places several substances onto your skin to see how your body reacts to each one. Usually, a small red bump appears if you’re allergic to a substance. A blood test, or radioallergosorbent test (RAST), is also common. The RAST measures the amount of immunoglobulin E antibodies to particular allergens in your blood. Treatments for allergic rhinitis You can treat your allergic rhinitis in several ways. These include medications, as well as home remedies and possibly alternative medicines. Talk to your doctor before trying any new treatment measure for allergic rhinitis. Antihistamines You can take antihistamines to treat allergies. They work by stopping your body from making histamine. Some popular over-the-counter (OTC) antihistamines include: fexofenadine (Allegra) diphenhydramine (Benadryl) desloratadine (Clarinex) loratadine (Claritin) levocetirizine (Xyzal) cetirizine (Zyrtec) Shop for OTC antihistamines. Talk to your doctor before starting a new medication. Make sure that a new allergy medication won’t interfere with other medications or medical conditions. Decongestants You can use decongestants over a short period, usually no longer than three days, to relieve a stuffy nose and sinus pressure. Using them for a longer time can cause a rebound effect, meaning once you stop your symptoms will actually get worse. Popular OTC decongestants include: oxymetazoline (Afrin nasal spray) pseudoephedrine (Sudafed) phenylephrine (Sudafed PE) cetirizine with pseudoephedrine (Zyrtec-D) If you have an abnormal heart rhythm, heart disease, history of stroke, anxiety, a sleep disorder, high blood pressure, or bladder issues, speak with your doctor before using a decongestant. Shop for decongestants. Eye drops and nasal sprays Eye drops and nasal sprays can help relieve itchiness and other allergy-related symptoms for a short time. However, depending on the product, you may need to avoid long-term use. Like decongestants, overusing certain eye drops and nose drops can also cause a rebound effect. Corticosteroids can help with inflammation and immune responses. These do not cause a rebound effect. Steroid nasal sprays are commonly recommended as a long-term, useful way to manage allergy symptoms. They are available both over the counter and by prescription. Talk to your doctor before starting a regimen of any allergy treatment to make sure you are taking the best medications for your symptoms. You doctor can also help you determine which products are made for short-term use and which are designed for long-term management. Immunotherapy Your doctor may recommend immunotherapy, or allergy shots, if you have severe allergies. You can use this treatment plan in conjunction with medications to control your symptoms. These shots decrease your immune response to particular allergens over time. They do require a long-term commitment to a treatment plan. An allergy shot regimen begins with a buildup phase. During this phase, you’ll go to your allergist for a shot one to three times per week for about three to six months to let your body get used to the allergen in the shot. During the maintenance phase, you will likely need to see your allergist for shots every two to four weeks over the course of three to five years. You may not notice a change until over a year after the maintenance phase begins. Once you reach this point, it’s possible that your allergy symptoms will fade or disappear altogether. Some people can experience severe allergic reactions to an allergen in their shot. Many allergists ask you to wait in the office for 30 to 45 minutes after a shot to ensure that you don’t have an intense or life-threatening response to it. Sublingual immunotherapy (SLIT) SLIT involves placing a tablet containing a mixture of several allergens under your tongue. It works similarly to allergy shots but without an injection. Currently, it is effective for treating rhinitis and asthma allergies caused by grass, tree pollen, cat dander, dust mites, and ragweed. You can take SLIT treatments, such as Oralair for certain grass allergies, at home after an initial consultation with your doctor. Your first dose of any SLIT will take place in your doctor’s office. Like allergy shots, the medication is taken frequently over a period of time determined by your doctor. Possible side effects include itching in the mouth or ear and throat irritation. In rare cases, SLIT treatments can cause anaphylaxis. Talk to your doctor about SLIT to see if your allergies will respond to this treatment. Your doctor will need to direct your treatment with this method. Home remedies Home remedies will depend on your allergens. If you have seasonal or pollen allergies, you can try using an air conditioner instead of opening your windows. If possible, add a filter designed for allergies. Using a dehumidifier or a high-efficiency particulate air (HEPA) filter can help you control your allergies while indoors. If you’re allergic to dust mites, wash your sheets and blankets in hot water that’s above 130°F (54.4°C). Adding a HEPA filter to your vacuum and vacuuming weekly may also help. Limiting carpet in your home can also be useful. Alternative and complementary medicine Due to concerns over possible side effects, more people with allergies are looking at ways to address hay fever symptoms “naturally.” However, it is important to remember that any medication can have side effects, even if it’s considered natural. Aside from home remedies, options can also include alternative and complimentary medicine. The downside to these treatments can be that there’s little supporting evidence to prove that they’re safe or effective. The correct dosing may also be difficult to determine or achieve. acupuncture nasal saline irrigation butterbur supplements honey (choose raw, organic varieties) probiotics Although these alternative treatments are derived from plants and other natural substances, they can possibly interact with medications, as well as cause reactions. Try these with caution, and ask your doctor before use. Complications of allergic rhinitis Unfortunately, allergic rhinitis itself can’t be prevented. Treatment and management are keys to achieving a good quality of life with allergies. Some complications that can arise from hay fever include: inability to sleep from symptoms keeping you up at night development or worsening of asthma symptoms frequent ear infections sinusitis or frequent sinus infections absences from school or work because of reduced productivity frequent headaches Complications can also arise from antihistamine side effects. Most commonly, drowsiness can occur. Other side effects include headache, anxiety, and insomnia. In rare cases, antihistamines can cause gastrointestinal, urinary, and circulatory effects. Allergic rhinitis in children Children can develop allergic rhinitis too, and it typically appears before the age of 10. If you notice that your child develops cold-like symptoms at the same time each year, they probably have seasonal allergic rhinitis. The symptoms in children are similar to those in adults. Children usually develop watery, bloodshot eyes, which is called allergic conjunctivitis. If you notice wheezing or shortness of breath in addition to other symptoms, your child may have also developed asthma. If you believe your child has allergies, see your doctor. It’s important to receive the correct diagnosis and treatment. If your child does have significant seasonal allergies, limit your child’s exposure to allergens by keeping them inside when pollen counts are high. Washing their clothes and sheets frequently during allergy season and vacuuming regularly may also be useful. Many different treatments are available to help your child’s allergies. However, some medications can cause side effects, even in small doses. Always talk to your doctor before treating your child with any over-the-counter allergy medication. Outlook The outcome of treatment depends on your condition. Seasonal allergic rhinitis usually isn’t severe, and you can manage it well with medications. However, severe forms of this condition will likely require long-term treatment. Preventing allergies The best way to prevent allergy symptoms is to manage your allergies before your body has a chance to respond to substances adversely. Consider the following preventive measures for the particular allergens you’re sensitive to: Pollen The AAAAI recommends starting medications before seasonal allergy attacks. For example, if you’re sensitive to tree pollen in the spring, you may want to start taking antihistamines before an allergic reaction has the chance to occur. Stay indoors during peak pollen hours, and take a shower immediately after being outside. You’ll also want to keep your windows closed during allergy season and avoid line-drying any laundry. Dust mites To reduce dust mite exposure, you can take measures to make sure your home is not a friendly environment for dust mite development. Wet mop hard floors, rather than sweeping. If you have carpet, use a vacuum with a HEPA filter. You’ll also want to dust hard surfaces often, and wash your bedding weekly in hot water. Use allergen-blocking pillows and cases to decrease dust mite exposure while you’re sleeping. Pet dander Ideally, you’ll want to limit exposure to any animals that you’re allergic to. If this isn’t possible, make sure you clean all surfaces often. Wash your hands immediately after touching pets, and make sure your furry friends stay off your bed. You’ll also want to wash your clothes after visiting homes that have pets. Tips to prevent allergies Stay indoors when pollen counts are high. Avoid exercising outdoors early in the morning. Take showers immediately after being outside. Keep your windows and doors shut as frequently as possible during allergy season. Keep your mouth and nose covered while performing yard work. Try not to rake leaves or mow the lawn. Bathe your dog at least twice per week to minimize dander. Remove carpeting from your bedroom if you’re concerned about dust mites. HOMEOPATHIC MEDICINES FOR ALLERGY Arsenic alb - There is thin watery discharge from the nose with burning sensation, recurrent sneezing one after another with runny nose. Burning and tearing of eyes . There is puffiness around eyes, stuffy nose. The person has an asthmatic tendency with breathing difficulties, and oppression of chest which is generally worse when he lies down. On sitting with a forward bending posture makes the patient little comfort from his asthmatic problem. There is marked wheezing sound during asthmatic affection. The asthma is worse in wet cold weather. Besides that the constitutional symptoms of arsenic alb are anxiety, restlessness, prostration, burning sensation. The anxiety that is found in Arsenic alb is intermingled with fear. The other prominent symptoms are debility, exhaustion, restlessness, with nightly aggravation. Great exhaustion after a slightest exertion. Sulphur – There is itching with redness of eyes in allergic condition. The itching is followed by burning sensation and relieved by cold application. sulphur patient is always irritable, depressed, thin and weak, but good vappetite. He is having forgetful nature, difficulties in thinking. He has many good ideas but cannot implement it. Selfish type person, no regards for others. very lazy person, not cleanness, never look after about his dressing and clothing. Don’t like to take bath. Having of skin diseases always. The skin rashes itch a lot generally in night and warm atmosphere. The person has a feeling congestion or oppression of chest in asthmatic condition. Natrum mur – Natrum mur is generally well indicated in case of allergic condition which gives the symptoms of more itching of nose, throat, ear with recurrent sneezing one after another. The characteristic discharge from the mucous membranes is watery or thick whitish, like the white of an egg. Natrum mur patient is very sensitive in nature. Every thing he/she takes into the heart. The person is irritable in nature and when in upset does not like any body’s present or giving of any consolation. Consolation aggravated the state of the mind - the melancholy, the tearfulness, sometimes brings on anger. The Natrum mur patient is extremely emotional. The whole nervous economy is in a state of fret (visible anxious like scratching finger on her skin in worry). Completely or desperately in love brings on complaints. The natrum mur patient desire to take extra salt in his diet. Sabadilla- it has good action on mucous membrane of the nose and the lachrymal glands, producing coryza and symptoms like hay-fever. There is spasmodic sneezing one after another. symptoms of hay-fever or allergic rhinitis with itchy nose and fluent coryza. Either nostril stuffed up, inspiration through nose labored, snoring. Violent sneezing is occurred from time to time, shaking abdomen followed by lachrymation. There is runny nose with severe frontal headache and redness of eyelids. Allium cepa: Allium Cepa is one of the most commonly used Homeopathic medicines for Allergic Rhinitis or Hay Fever. It is generally used in the symptoms of severe runny nose that drips from the tip of nose with watery eyes. There is burning of nose due to over secretion mucous. Along with the watery nasal discharge there is watery eye. There is profuse sneezing associated with runny nose and watery eyes. Tuberculinum- The patient is very susceptible to catch cold. The physical constitution is lean and thin like natrum mur, but not obese like calcarea carb. If there is family history of tuberculosis or bronchial asthma then is more suitable to give this medicines in any allergic or asthma condition. The person is very depressed, melancholic, taciturn sulky nature.

4 yrs old male child a/k/c of bronchial asthma on inhaled LABA+ICS, monteleukast 5 mg, presents with fever on and off past 6 days, cough, occasional vomiting, no c/o abd pain ,no dysuria. O/E pt very much active, hydration fair temp 102.8 R/S occasional wheeze on both sides. pt was completed 3 days amox clav. kindly suggest further management