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Allergy

Dr. S. P. S Bakshi

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The signs and symptoms of chronic tonsillitis are:
  • Recurrent cough
  • Increased susceptibility to other respiratory infections.
  • Poor health and growth
  • Lack of usual vigour
  • Development of changes in temperament such as tantrumsand bouts of crying for little or no reason.
  • Difficulty in swallowing
  • Enlarged cervical lymph nodes.
Thus it is an erroneous idea that the surgical removal of tonsils decrease the individual's susceptibility to infections. Experience shows that such a drastic measure increases the susceptibility and the allergic patients suffer from allergy all the more specially in diseases like sinusitis, allergic rhinitis and bronchial asthma.

Diet chart for patients with recurrent respiratory infections
Avoid

  • Cold aerated drinks
  • Fruit juices
  • Curd
  • Buttermilk
  • Sour food: Tomato soup, vinegar, pickle, water balls, sambhar, rasam, ketchup.
  • Fruits: Banana, orange, lime, lemon, guava, pomegranate, sour grapes, pineapple, water-melon, mangoes
  • Starchy food: Rice noodles, kurchi, sweet corn soup, and urad dal.
  • Vegetables: colocasia, potato, beans, sweet potato, spinach, tapioca, radish, tomato
  • Oily and heavy food: fried food, samosa, sweets, pastries, ham, pakora, puri, omlette, dry fruits, chocolates, parantha, vada, kheer, halva.
  • Irregular and off-time meals should be avoided.

Avoid Exposure to
Cold wind, Dust, Rain, Smoke

Bronchial Asthma
The essential feature of asthma is episodic difficulty in breathing (dyspnoea). Generally associated with wheezing and cough. The main feature in asthma is of narrowing of the airways, which causes the symptoms. The airways in an asthmatic person are very irritable and go into spasms at the slightest stimulation, be it mechanical, chemical or emotional. These stimuli cause airway narrowing through the nervous mechanism as well as by liberation of chemicals called mediators ( Histamine, Serotine) and other chemicals which are powerful agents capable of producing a spasmodic condition of the smooth muscle in the bronchioles. Other factors that cause narrowing of the bronchi and bronchioles are oedema of the mucous membranes as well as the accumulation of the bronchial secretions in the interior of the airways. The bronchial narrowing interferes with pulmonary ventilation and dyspnoea which is often intense and is chiefly expiratory in character. Expiration therefore becomes more laborious than inspiration.

The attack usually begins in the early hours of the morning. There may be some warning signs like restlessness, mental depression, sneezing or cough with a sense of suffocation as dyspnoea increases. The patient is compelled to sit up in bed panting and grasping for breath.

There is often, irritable, unproductive cough, which aggravates the dyspnoea. In severe cases cyanosis or pallor with increase pulse may be present. The attack may end abruptly with the coughing up of tough, viscid expectoration. Sometimes the paroxysm continues for several hours or days, which is known as 'status asthmaticus'.

The sputum may contain numerous eosinophil leucocytes and the blood may also show eosinophilia during paroxysms particular in highly allergic cases.

Asthma may begin at any age but most commonly it has been seen that it develops in early adult life. A family history of asthma or some other manifestation of allergy is traceable.

In majority of the cases endogenic allergy is the basic cause of bronchial asthma. Other exciting factors include psychological disturbance. Exogenic allergens such as inhalants, ingestants cause bronchial irritation and infection.
A damp foggy climate tends to aggravate the asthmatic condition and correspondingly a dry warm climate relieves a fair number of cases. Starchy food, citrus fruits, cold drinks, condiments and pickles should be avoided.

Diagnosis

  • Family or personal history of allergic manifestations
  • Onset at a comparatively early age
  • The attacks come in paroxysms with free intervals
  • Cough and expectoration are marked when the paroxysms are nearly subsiding
  • Sputum and blood show eosionphils
  • Relief by vasodilators.

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