One third of worlds 115 million Asthma patients are in India. By 2025 there will be an estimated 100 million more asthma patients due to Environmental pollution and Lack of awareness towards the disease and its morbidity. India has second highest mortality rate of asthma in the world. Day by day the pollution levels are increasing everywhere forcing the humanity for suffocation. As with decrease in natural forests and increase in urban concrete forests, the newer spectrum of photochemical pollutants, due to combustion of petrol and diesel are on rise. Today the principal pollutants posing detrimental effects on Human lungs are the oxides of Nitrogen (NO2), Ozone (O3) and particulates.
→ Ozone levels more than 100µg/m3 is hazards to human lungs.
→No2 is emitted from unvented gas appliances and heating appliances, in indoor conditions and vehicular traffic fumes, at outdoors pose great threat to lungs. A level of NO2 more than 28.2microgram/m3 may contribute to Asthma.
→Particulate matter (PM10) consists of a mixture of particulate components including traffic and combustion generated Carbon. Particulate matter can be, Centered ultra fine particles, secondary salt particles (Nitrates & Sulfates), geological and also biological particles (Spores and pollens) of Particle size 2.5µm (PM 2.5 diameter) are capable upon inhalation of reaching, the deepest portions of the lungs and can cause irreparable damage to lungs. All these factors act as potential triggers of Asthma and make worse conditions in an already known asthmatic.
“People with Asthma are often sensitized and exposed to more than one allergen. And there also exists variability between individuals in the magnitude of response to the same levels of allergens.” Says Dr. Vyakarnam Nageshwar, Consultant Pulmonologist , Wockhardt Hospitals. He further adds “A high allergen exposure in sensitized individuals may contribute to poor asthma control. Exposure to dangerous allergens like “alternaria allergen” has been shown to cause sudden respiratory arrest leading to death in Asthmatics.
Indoor Pollutants or Domestic Allergens:-
Practical measures for Avoidance majority of exposure to indoor allergens and mite probably occurs in bed, where we spend on average a third of or lives in close contact with mattresses, Pillows and duvets.
a) Covers: - Covers of pillows, beddings and other furniture are the most common site of allergens. It is very important to cover mattresses pillows and duvet with covers that are impermeable to mite allergens. It is also must to ensure that covers are wiped at each change of bedding.
b) Washing: - All the exposed beddings should be washed at 55*c .as this temperature kills mites in beddings.
c) Feather vs. Synthetic Pillows: - Asthmatics are often wrongly told to avoid using feather pillows. In the last few decades, sales of synthetic pillows have increased enormously based on the misconception that synthetic pillows are non-allergic. But recent studies have confirmed that synthetic pillows being non allergic is just a Myth. A synthetic pillow accumulates the mite allergens more significantly faster than feather filled pillows.
Dr. Vyakarnam stresses on the fact that "People should be more aware of the fact that so called ‘Hypo allergic’ synthetic pillows and quilts are not hypo allergic at all.”
d) Carpets:-
These are important microhabitat for mite colonization and possible source of allergens.
-All fitted carpets should ideally be replaced with polished wood or vinyl flooring.
-Steam cleaning or exposure of carpets to direct sun light for at least 3 hrs will kill mites.
e) Pets at Home: -
The most powerful risk factor for severe asthma in children was pet ownership. Concentration of both cat and dog allergens are high in almost in all homes with pets. It was observed in recent studies that 62% of children are sensitized to dog and cat allergens, who had a poor control over their asthma, inspite of correct medication.
The best way to reduce exposure to cat or dog allergens is remove the animal from bed rooms and living rooms. “One should be alarmed that it takes months before reservoir allergen levels decrease and the symptoms of the patient subside, even after the animal removed from home.” Air borne allergen levels increase by 5 folds when pet is in the room.
It is an unfortunate condition that “Asthma is often severe and difficult to control in pet exposed Asthmatics.”
It is always safe to undertake an investigation of Lung Function Test (Spirometry) at the earliest sign of breathlessness, chest tightness, dry cough, nocturnal wheezing, sleeplessness at nights, which may or may not be associated with cold and sneezes. There exists a scientific way to get treated with inhalation devices to achieve an early and complete control on Asthma.
Dr. Vyakarnam further adds that “In a recent discussion with Yogic Guru Ramdev Baba we have been able to unveil a completely new dimension in the management of Asthma, which is the use of Scientific Yogic Pranayams which will benefit the Asthmatic sufferers . It is after a two hour discussion on Pranayamic postures for Asthmatic patients that we have been able to identify 4 basic Pranayamic Postures , a) Anulom Vilom, b) Kapal Bhati, c) Bhramari and lastly d) Bhastrika, these postures increase the lung capacity of the Asthmatic patient and decreases the symptoms”
How is management of Asthma different at Wockhardt?
At Wockhardt, we use a team approach which consists of a Pulmonologist , Clinical immunologist , Dietician and a physiotherapist for the treatment of our patients, providing our patients with complete comprehensive holistic treatment. We make sure that every patient is aware of his/ her condition, and there is adequate knowledge sharing with even the family members to provide adequate support to the patient. At Wockhardt we believe that we are only the facilitators in your care management and it is our patients who manage their Asthma in their individual ways. In the year 2008 Dr. Vyakarnam Nageshwar Consultant Pulmonologist, had patented a special Allergen Identification Record, which is a completely new approach for the management of Allergy and Asthma this has been recognized and published at the proceedings of the World Congress of Asthma. Talking about this Dr. Vyakarnam added “ The Contribution of Wockhardt Hospitals, Hyderabad towards management of Asthma has come across not because we have done something new its because we have looked at asthma from a different perspective our patients perspective.”
ABOUT DOCTOR
Dr. Vyakarnam Nageshwar is a young, dynamic Pulmonologist, active in clinical practice since half a decade. Over these years he has been involved in performing interventional Pulmonology procedures. To his credit there are over 500 Tube Thorocostomies, 600 Pleural Aspirations, 300 Pleural Biopsies, 200 Fiber Optic Bronchoscopies ,35 FNAC Procedures, 20 Tru Cut Lung Biopsies and 30 Thoracoscopies.
Dr. Vyakarnam Nageshwar, has also been involved in many Health Awareness Campaigns organized at different levels. The District Collector, Khammam, has honoured him as “Best doctor of Khammam District” for his care and compassion towards his patients. Besides many other laurels, he distinctly holds the honour of treating thousands of patients suffering with Chest diseases especially in HIV positive cases. For this work he received appreciation and blessing from The Holy Father Benedict XVL from the Vatican City (The Holy Pope) in recognition of his attitude of sincere commitment and involvement in relief of patient’s suffering. He is known for his Clinical acumen and dedication towards his patients.
His success rate in treatment of Asthma (Acute / Chronic) is noteworthy with very good patient satisfaction.
Expertise
· Fiber Optic Bronchoscopies
· Thoracoscopies
· Asthma Allergy Counselling
· Needle Aspirations
· Transbronchoscopic Lung Biopsies
Papers, Publications & Awards
· Author of the Text “ The Fundamentals of Hospital Practice and Patient care.”
· Co-author of the “Textbook of Community Medicine”
· He has presented many papers at the state and the national level conferences.
DR. VYAKARNAM NAGESHWAR
M.B.B.S., MD, FCTP, ATC (New Delhi)
CONSULTANT INTERVENTIONAL PULMONOLOGIST.
WOCKHARDT HOSPITALS
HYDERABAD. INDIA
PH : +91 99495 29392
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