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History and Diagnosis of Asthma
There is no universal definition of asthma. The Concise Oxford Dictionary describes it as “respiratory disease, difficulty in breathing, cough, etc.” has done so. Any good medical book will describe it in more technical terms but ‘difficulty breathing’ is something any asthmatic is familiar with, even if it varies from mildly uncomfortable to life-threatening. Asthma is the news now. The condition grew so dramatically in the late twentieth century that it now affects an estimated 100 to 150 million people worldwide, but this is not a recent phenomenon.
The word “asthma” in Greek translates to wheezing or wheezing, and this problem was treated by the Chinese physician Ma Huang in 2000 BC with the herb Ma Huang. The first known recording of symptoms dates back to about 3,500 years ago in an ancient Egyptian manuscript called the Ebers Papyrus. Throughout the ages, asthma has received varying degrees of attention; Symptoms and their accompanying anxiety have been described by many prominent historical figures, including the famous Greek physician Hippocrates.
Over the centuries, different theories have been floated about the causes of asthma, and various remedies have been advocated, including horse riding, strong coffee, tobacco, faith cures, chloroform, and even drinking owls’ blood. Wine, as practiced by the ancient Romans. Van Helmont, who lived in the early part of the seventeenth century, claimed that asthma was an epileptic seizure of the lungs due to a sudden and unpredictable attack. Based on his own experience of asthma, the English physician Thomas Willis said that “the blood boils”, and “rare is anything sharper or fiercer than its fits”.
It was not until the eighteenth century that Lavoisier provided the first realistic account of the workings of the lungs, which laid the foundation for the modern understanding of the respiratory system. Previously, it was generally believed that air was drawn into the lungs to cool the body. Lavoisier’s contribution was that air is extracted to be converted into energy by metabolism, and carbon dioxide and heat are produced as end products of the process. Lavoisier’s work recognized that oxygen is necessary to sustain life.
Asthma affects more people worldwide now than at any other time in evolution, especially in more developed countries. According to an April 2002 World Health Organization (WHO) report on the link between ill-health among children and a deteriorating environment, it causes more economic and social damage than TB or HIV in Western Europe.
According to the 1998 International Study of Asthma and Allergy in Childhood (ISAAC), the countries with the highest twelve-month incidence of asthma were the UK, Australia, New Zealand and the Republic of Ireland, followed by North, Central and South America. The same report found that several Eastern European countries had the lowest rates in centres, followed by Indonesia, Greece, China, Taiwan, Uzbekistan, India and Ethiopia. Other studies have shown that the prevalence of asthma among rural Africans who migrate to cities and adopt a more ‘Western’ urban lifestyle. According to the UCB Institute of Allergy in Belgium, the prevalence of asthma has doubled in Western Europe in the last ten years.
In the Western world, asthma crosses all class, race, geography and gender boundaries. Although up to seventy percent of all people diagnosed have persistent symptoms, asthma causes only minor discomfort for the majority of people. In fact, some of the most influential people of our time in all walks of life had asthma, including Russian Tsar Peter the Great, actors Liza Minnelli, Jason Alexander and Elizabeth Taylor, revolutionary Che Guevara, and former US President John F. Kennedy, Calvin. Coolidge and Theodore Roosevelt. All of them have lived or are still living full lives.
What are the symptoms?
This condition involves inflammation, narrowing, and swelling of the airways in the respiratory system, resulting in obstruction of airflow to and from the lungs. Asthma symptoms include shortness of breath, wheezing, coughing, and chest tightness. Sufferers may also have nasal congestion and hay fever or rhinitis. Symptoms and their severity are unique to the individual and vary with each season and with the individual’s sensitivity to a wide range of triggers.
An ‘asthma attack’ is a term used to describe an episode of difficulty breathing. In some cases, this can be caused by exposure to specific triggers such as dust, pollen, or certain foods. In other cases no specific trigger appears. Some people may have no cough and wheezing, while others may have wheezing and very little coughing, but in each case there is some degree of difficulty breathing. Symptoms may occur intermittently, on a day-to-day or season-to-season basis, or they may be more or less severe.
A ‘trigger’ is something that makes asthma worse. The most common triggers include (in alphabetical order): allergies; cigarette smoking (and cigarette smoke for non-smokers); colds and flu; cool air; dust particles; exercise under certain conditions; mold; noxious fumes; Pollen; Stress and weather conditions such as fog and dampness. In some cases, the combination of stimulants can trigger an asthma attack. Variations on the asthma theme can cause anxiety, especially where a young child is involved. Sometimes, there can be confusion between the doctor and the patient while the diagnosis is being made.
Asthma symptoms also vary. The following is a list of the most commonly affected people.
It is a high-pitched whistling sound when air is forced through a narrowed airway. If you blow on a biro pen after removing the ink refill, the sound is the same.
• Shortness of breath
This is the feeling of not being able to get enough air. It is necessary to exhale, at the same time, there is a force to inhale. If this symptom develops to a severe level, it can be frightening for the sufferer and very distressing for those close to him or her.
It can be either a recurrent dry cough or a cough with phlegm, often occurring at night or early in the morning. Repeated coughing puts strain on the heart and sputum goes deep into the lungs. Patients with this symptom may feel like they are on a conveyor belt: the more they cough, the more they need to cough again.
• Chest tightness
Air trapped in the lungs causes the chest to feel over-inflated. It is often described as someone squeezing or sitting on someone’s chest.
• Frequent yawning
When asthma symptoms are at their worst, periods of difficult breathing can disrupt sleep, leading to fatigue.
Non-asthmatics can, of course, see these symptoms, but they may not appreciate the feelings of stress, panic, uncertainty and helplessness that accompany them, especially when the asthmatic has trouble breathing. If you don’t have asthma, try breathing while a pillow is pressed against your face. What you imagine someone with asthma feels like during an attack. In our case, the imaginary pillow can be easily removed so that we can breathe easily; For asthma, the solution is not so simple.
Given the variety of symptoms and their severity, diagnosing a condition without a commonly accepted definition is not an exact science. Many asthma symptoms are also symptoms of other conditions, such as chronic bronchitis or bronchiectasis, for example. Diagnosis should take into account the chronic nature of asthma and the narrowing of the airways due to inflammation of various cells and chemicals. Generally, the diagnosis of asthma is based on the following factors.
• Patient history
This includes determining whether the patient has had asthma symptoms at rest, during exercise, or after exposure to a known trigger.
• Pulmonary function tests
A peak flow meter measures the maximum velocity a patient can exhale in one second. A person with asthma has lower readings and, generally speaking, a more inconsistent range of results than someone without the condition. Spirometry measures both the speed and volume of air expelled with each breath, providing information on additional airway obstruction.
• Effects of reliever or steroid medications
To some extent, the diagnosis of asthma is based on the results of medication and whether it temporarily reverses symptoms. Other conditions that show common asthma-type symptoms, such as emphysema, involve irreversible airway obstruction.
• Stimulus test
The patient inhales a broncho-constricting agent, such as histamine or methacholine. The airways of people with asthma are more responsive to inhalation of these substances; Agents like these cause narrowing of the airways in people with asthma.
• Skin tests to determine allergies
A number of common allergens are chosen, such as dust mites, pollen or animal dander. One at a time, the allergens are placed on the forearm and then the skin is gently punctured to allow the substances to penetrate. After fifteen minutes, a small rash may appear on the skin around this spot. Although this test is not always conclusive, the presence of a rash and the size of the wheal indicate an allergy to a specific substance.
• Chest X-ray
X-rays are used to rule out other respiratory diseases in people with severe asthma symptoms. X-ray charts show irreversible damage to the airways and help diagnose other respiratory disorders.
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