For asthma patients, household goods used everyday may make the difference between life and death
ASTHMA, commonly known as damma in Pakistan, is a chronic disease of the lungs characterized by recurrent breathing problems. The common symptoms of asthma include breathlessness, wheezing, chest tightness, and coughing.
During normal breathing, air flows freely in and out of the lungs. But in a patient with asthma, the airways of the lungs become thick, swollen and inflamed.
The airways of asthma patients are very sensitive to environmental changes. During an asthma attack, the lining of the airways swells further, muscles around the airways tighten, and mucus clogs the tiny airways in the lungs, making breathing very difficult. In some patients, particularly in children, coughing may be the only symptom of having this condition.
Asthma symptoms vary from time to time. Some patients get symptoms very occasionally, once or twice a year, during the change of weather. There are others who get symptoms everyday. There are few who have a very severe disease that almost excludes them from normal school and work activities. These symptoms are often worse at night and in the early hours of the morning.
HOW COMMON IS ASTHMA IN PAKISTAN: There has been no epidemiological study on the prevalence of asthma in adults in Pakistan but it is estimated that between five to 10 per cent of the adult population in the country is suffering from this condition. Regarding the prevalence of asthma in Pakistani children, research, done in 1997 by the Aga Khan University approximated 10 per cent of children in Pakistan were suffering from this disorder. This study was repeated last year in which it was found that the prevalence of asthma in Pakistan has increased to 18 per cent in children of 13-14 age groups.
The epidemiological studies from other parts of the world have also confirmed that asthma prevalence is increasing in the world especially in the developing countries. According to the Global Initiative for Asthma (GINA), more than 150 million people in the world are suffering from this disorder. Last year 260,000 people died as a result of this disease.
WHY IS ASTHMA ON THE INCREASE: In spite of extensive research in this field, the causes of asthma increase remain unclear, in fact the rapid increase in asthma prevalence around the world is considered as one of the biggest mysteries in modern medicine. There are several possible explanations for the increase in asthma cases.
These include changes in lifestyle e.g. increased use of carpets, changes in the dietary pattern in particular, decreased use of fruits and vegetables and increased consumption of fast-food. Increased prevalence of smoking is also being considered as an important factor responsible for the rise in asthma cases in many developing countries.
WHAT FACTORS CAN BRING AN ASTHMA ATTACK: Factors that can set off an asthma attack include inhaled allergens (such as dust mites, pollen, and cat and dog allergens), tobacco smoke, air pollution, exercise, strong emotional expressions (such as crying or laughing), chemical irritants, and certain drugs (aspirin and beta-blockers). Some colouring agents and food preservatives can also cause asthma attack. Flu and common cold are by far the most common reason responsible for worsening of asthma symptoms.
HOW TO AVOID AN ASTHMA ATTACK: Avoidance of allergens and irritants is necessary in order to avoid asthma symptoms. Each person with asthma reacts to a different set of factors, and identification of these factors and how to avoid them is a major step for each individual in learning how to control their disease.
Allergen avoidance may not always be possible because most patients do not know to which agent they are allergic to, however, skin tests are helpful in this respect. House dust mite, a microscopic insect like creature is the biggest enemy of asthma sufferer. It thrives in humid and warm conditions. Their diets consist of shed scales from the human skin. At home its sources are bedroom mattress, pillows and carpets, which provide the best warm condition, humidity and food for its growth. They are also present in blankets, curtains and furniture.
Certain measures can reduce the exposure to house dust mite. This include, removal of carpets, at least from the bedrooms, discarding feathers pillow and using hypoallergenic polyester pillow, encasing the bed with a plastic cover, washing bed-clothes weekly, putting linen and blanket in the sun light at least once a week.
Apart from the above measures, children should not be allowed to bring stuffed toys in their bedroom and they should certainly not sleep with them. If the child is very keen to play with the stuffed toy, then it is advisable to keep the toy in the deep freezer from time to time in order to kill the house dust mite. Rooms should be cleaned daily with damp cloth, or vacuum; broom should be avoided. One should wear a mask or cover the mouth with a handkerchief when room is being cleaned.
Allergy from cockroaches is a common problem in Pakistan and it results from protein present in their dander and saliva. In order to avoid cockroaches, kitchen should be kept clean; avoid open food source; reduce access to water; seal all access and entry points. Boric acid powder should be sprayed under the stoves and at all the hiding areas of cockroaches. Cats and dogs should not be allowed to come in the living rooms. Allergy is caused not by their hairs, but by a protein present in their dander and saliva. Carpets, sofas and mattress will hold cat and dog allergens, even months after the animal is removed from the house.
Mold is another important allergen, which is of concern to asthma patients. Mold is a microscopic fungus. Its growth is encouraged by warm surroundings and high humidity. Garbage containers, bathroom, leaky floor and roof are their haven. Various products can be used to clean these areas. Bathroom and kitchen should not be carpeted. Excess humidity produced by showering and cooking should be removed by exhaust fan.
WHAT SHOULD ASTHMA PATIENTS EAT: Misconceptions about diet and asthma are very common in Pakistan. Scientific research has confirmed that dietary restrictions have generally no role in the management of asthma. There is not need to avoid dietary items such as rice, banana and ice-creams. Very occasionally there may be a patient who is allergic to a dietary item, for example peanuts. These patients should avoid such items in their diet. Asthma patient can also eat fish and eggs without any problem. Fruits and vegetables have certain substances which protect the lungs from damage as a result of environmental pollution. The incidence of asthma is much less in children who take fruits and vegetables regularly in their diet, compared to those children who don’t.
TREATMENT OF ASTHMA: Asthma cannot be cured but it can be effectively treated. Most patients with this condition can live a normal life. In Pakistan, asthma sufferers and their families, keep going from one health care provider to another in search of a cure from this disease. Treatment of asthma aims at control of the disease, meaning that the person with asthma does not experience asthma symptoms or acute attacks. He or she does not have to use quick-relief medication or visit the emergency room. The asthma patient is able to engage in normal physical activity, including exercise and has normal lung function. Control of asthma can be achieved in almost all patients, with no side effects from medications, through the implementation of an effective asthma management programme. The main stay of asthma treatment is in the form of inhalers (pumps).
Two types of medicine can be delivered through inhaler. The first is quick relief medicines knows as Brochodilators. These agents relax the smooth muscles of airways and the patient starts feeling better within minutes of its usage. The other group is called Preventers; these are anti-inflammatory agents, which include steroids and disodium chromoglycate. These medicines when taken regularly prevent asthma attacks. There are certain other medicines that are given in oral form. They include Aminophylline and the Tophlline. Another new group of medicine has recently come up in the market, these are called as Leukotrine antagonist. They are helpful in reducing the asthma attacks but are not superior to inhaled corticosteroids. The advantage of this group of drug is that it is available in oral from and given once in 24 hours.
Asthma is a common problem in Pakistan. For the majority, a proper understanding of the disease and using medicines appropriately can control asthma symptoms. An asthma patient can live a normal life like any other healthy person so there is no need to feel sad or depressed on having this disorder.
For asthma patients, household goods used everyday may make the difference between life and death 
