Allergic Rhinitis

Rhinitis occurs when there is inflammation of the inner lining of the nose. Allergic Rhinitis is a condition where there is hypersensitivity by the immune system to allergens. Allergic rhinitis is triggered when the body responds to allergens by producing antibodies. Histamines are released into the bloodstream leading to allergic symptoms. Allergic rhinitis is a common upper respiratory infection that affects nearly a fifth of the population. Allergic rhinitis is often associated with severe asthma, otitis media and sinusitis. This manifests in symptoms such as sneezing, nasal congestion, stuffy nose and itchy eyes. Some persons suffering from allergic rhinitis may experience frequent headaches and difficulty in hearing and smelling. This condition can bring on fatigue, sleep disorders and drowsiness.

Seasonal allergic rhinitis is also known as hay fever and is noticed during autumn. On the other hand perennial allergic rhinitis is a condition where the patient suffers rhinitis symptoms due to exposure to pet hair, carpeting, upholstery or air pollution. Patients suffering from perennial allergenic rhinitis tend to notice the symptoms irrespective of the season. Some of the common allergens are pollen, mold, animal dander, feathers, dust and grass. The symptoms are usually noticed more in winter. Certain foods and spices might increase nasal secretions associated with allergenic rhinitis. Stress and gastroesophageal reflux can trigger the symptoms of allergic rhinitis. There is post nasal drip and cough and may be accompanied by loss of smell.

Antihistamines are prescribed to block the action of the histamines created by allergy. But antihistamines tend to cause drowsiness. Decongestants can help in alleviating the symptoms of allergic rhinitis such as stuffy nose. Decongestants must be used with care on those suffering from , thyroid problems and heart conditions. Corticosteroids are useful in treating allergic rhinitis since they reduce the reaction by the body to the histamines. Steroid nasal sprays can help reduce nasal inflammation and allergy. Mucus thinning agents are prescribed for patients suffering from allergic rhinitis to make the nasal secretions less sticky so that they do not coagulate at the back of the nose and throat.

• Keep away from pets if you are extremely allergic to animal dander
  
• Use pillows made from hypoallergenic material such as dacron or polyester
  
• Use HEPA filter for your bedroom and living area
  
• Resort to vacuuming instead of dusting
  
• Drink adequate fluids
  
• Sleep with the head at a slight elevation
  
• Balanced diet
  
• Avoid nasal irritants like perfume, cigarette smoke, car exhaust and aerosol sprays
  

Asthma

Asthma is a chronic lung condition that is caused by narrowing or obstruction of the airways. This happens in persons with extremely sensitive airways. Asthma is a common childhood disease of the respiratory system. It is a chronic condition characterized by difficulty in breathing. Asthma is noticed to run in families and can develop at any age. Episodes of asthma are often triggered by pollen, cigarette smoke, mold or other air-borne allergens. Physical exertion, emotional stress or certain medications too can bring on an asthma attack.

A person suffering from an asthma attack experiences wheezing, coughing and tightness in the chest. There is shortness of breath and wheezing. In severe cases, it can be life-threatening. Blood tests and sputum studies may be conducted to aid in diagnosing asthma. Allergy prick skin testing is a diagnostic tool to confirm any allergies. Spirometers and peak flow meters are used to test and measure lung function. Spirometers measure the amount of air that passes through the airways and the rate at which they pass.

Medication for asthma can be classified as long-term asthma control and rapid relief medications. While long-term medications help in gaining control over persistent asthma, quick relief medications provide instant relief from the symptoms of an asthma attack. A bronchodilator aids in opening the airways and relieves the distress caused by an asthma attack. Corticosteroids are used to treat asthma by reducing the frequency of symptoms. But long-term use of inhaled costicosteroids may have a detrimental effect on a child's growth. Quick-relief medications include beta-2 agonists and anticholinergenic such as Atrovent. Xolair is prescribed for those suffering from severe allergic asthma.

Bronchopulmonary Dysplasia

Babies who are born prematurely experience various disorders. These disorders occur because of the underdevelopment of a particular organ. Bronchopulmonary Dysplasia is a very serious condition which occurs predominantly in premature babies. Bronchopulmonary Dysplasia was first noticed in 1976, among pre term babies suffering respiratory distress. The babies were categorized as ventilator dependent as they needed increased oxygen.

Symptoms of Bronchopulmonary Dysplasia

Chronic lung disease or Bronchopulmonary dysplasia occurs because of developmental disorders. The cellular arrangement in the lung tissue is also impaired to a large extent. Babies who are born at a gestation period of 34 weeks are prone to chronic lung disease. Studies imply that babies whose weight is less than 4 pounds during this period also experience symptoms of this condition. This happens because of the reduced development of the alveoli in the lung tissue.

These babies are often treated with positive pressure ventilation (PPV), but since they do not have enough antioxidants, there is a possibility of developing oxygen toxicity. The relation between Bronchopulmonary dysplasia and oxygen toxicity is very significant in understanding the exact cause. In many cases, ventilator associated positive pressure treatment has aggravated the condition. The classical symptoms associated are shortness of breath, cyanosis, increased breathing rate and cough.

Diagnosis of Bronchopulmonary Dysplasia

The treatment options become easier for Bronchopulmonary dysplasia, if the root cause is effectively diagnosed. The major diagnostic parameters that have to be taken in to consideration are:

• Gestation period of the baby.
  
• Underlying intrauterine infections.
  
• Duration of ventilator exposure after birth.
  
• Estimation of oxygen toxicity during positive pressure ventilation.
  

Careful analysis has to be done in differentiating respiratory distress condition and bronchopulmonary dysplasia through X-rays as both have significant appearance radiologically. One of the diagnostic identifications includes the oxygen dependency of the patient after initial treatment, as this enables evaluation of the lung functionality in the long term. Other tests that add relevance to the diagnosis include arterial blood gas estimation in case of cyanosis, pulse oxymetry and CT scan.

Treatment of Bronchopulmonary Dysplasia

One of the early ways to treat bronchopulmonary dysplasia was to administer systemic steroids. This method was practiced to minimize ventilator utilization. The only disadvantage was the onset of adrenal suppression; hence the dosage pertaining to these steroids was reduced and was given in combination with hydrocortisone to balance the cortisol levels.

Diuretics are also advised. Inflammation associated with bronchopulmonary dysplasia is treated with inhaled nitric oxide therapy as it facilitates the process of vasodilation. Other treatment options include the administration of vitamin A and E to facilitate free radical removal and enhance immunity. Nutrition is an important factor as it meets the demands of the increased energy levels in these babies and also provides the antioxidants to remove the free radicals formed during metabolic pathways.