Q: I am a 23-year-old female. I am unmarried. A brief medical history of my cough is given below.

Two years ago, on shifting to our new house there was a lot of dust on the old carpets so we replaced them with new ones. As I got exposed to the dust, a cough started. I consulted my family doctor, but there was no relief. Then I consulted an E.N.T. specialist who advised a lot of tests. The results were normal.

At presently I have to stay awake all night because I cough continuously. Recently, I consulted a doctor who told me that there is swelling in the breathing track. Sometimes after coughing continuously, I feel like vomiting but nothing comes out. I also become weak and get a headache. I would like your advice regarding this.

A: The history that you relate about the cough beginning with exposure to dust and the exacerbations during the night point towards the allergic component of your problem.

Although you may not be overtly short of breath, the allergy may be causing what we call a ‘cough variant asthma’ because of inflammation in your airways. You definitely deserve a chest x-ray, a routine blood picture and a pulmonary function test and these should be reviewed by a pulmonologist who can examine you and take a more detailed history.

Meanwhile avoid dust, smoke and pungent odours. Also do not use cough syrups and random anti-allergy medications which could make your bronchial secretions more dry and cough worse. You can instead inhale plain stream vapour and drink a lot of water. After ascertaining the diagnosis your physician will probably prescribe you some inhaler and oral anti-inflammatory medications which may have to be taken for a while.

DR MOSAVIR ANSARI
Liaquat National Hospital


Q: I am a 16-year old girl. My problem is that I have got grey hair at this early age and I am really very upset because of this. I have not consulted a hair specialist because I feel shy about telling my Mom that I have this problem. I want to know the cause of this premature greying of hair. I have only one sister who has very beautiful black hair, my cousins who are older have black hair, so this is definitely not a family problem. Some of my grey hairs have naturally grown black again so maybe a cure is possible. Please help.

A: Early greying of hair commonly has a genetic component. Some dietary habits such as excessive intake of tea, coffee, alcohol or excessive intake of fried, oily, spicy, sour and acidic food may also cause premature greying of hair.

Deficiency of certain vitamins (A & B) and minerals (iron, copper and iodine) can also cause this condition. Stress, which inhibits vital nutrition essential for pigmentation, leads to loss of melanin from hair and can cause early greying of hair. Premature greying of hair may also be a manifestation of an underlying autoimmune disease. Since you are only 16 years old, the best advice would be to seek medical consultation to rule out the possibility of any underlying disease.

DR FIRDOUS JAHAN
AKUH


Q: I am a 47 years old male and have recently developed numbness in my right hand which comes and goes in my finger area. I have hypertension and take Cozaar 50mg.

A: From the symptoms that you have described, it appears that there is probably a pinched nerve somewhere in the wrist or elbow. But without a thorough history and neurological examination, it is very difficult to determine the cause. You need to see a neurologist as soon as possible because one of the things we worry about is transient interruption of blood supply to a part of the brain. This is called T.I.A. (Transient Ischemic Attack). TIAs are considered warning sign of stroke (falij). This needs to be excluded with the help of a proper history, neurology examination and appropriate investigations.

DR FARRUK S. KHAN
Liaquat National Hospital


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