Dr. Vivek Kumar

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  • ABPA

    ABPA, i.e. Allergic Broncho Pulmonary Aspergillosis is a frequently missed and under diagnosed cause of shortness of breath.

    It usually mimics asthma , but is a separate entity. It occurs due to hypersensitivity reactions in lungs to Aspergillus fungus allergen.

    Diagnosis:

    1. Either Skin prick test to Aspergillus positive, or Specific IgE against Aspergillus fumigatus more than 0.35 IU

    2. Total IgE more than 1000.

    Types:

    Depending on how much lung has been damaged

    1. ABPA-S: no damage to lung parenchyma

    2. ABPA-CB: Bronchiectasis present

    3. ABPA-CB-ORF: apart from Bronchiectasis Other Radiological Features present in chest HRCT

    Treatment:

    Mainly Oral steroids apart from supportive therapy for concomitant diseases and regular monitoring

    Allergen avoidance

    Chest physiotherapy

    Breathing exercises

    LTOT where needed

    Immunisation

    Patient education on side effects of oral steroids, teaching how to identify early signs, prophylactic measures.

    Clue:

    Severe asthma not getting controlled on high dose ICS-LABA.

  • World COPD day 2019

    A mass awareness program was organised on the occasion of world COPD day 2019, 20th November, Wednesday.

    A group of volunteers travelled through the town and distributed pamphlets about means of keeping safe from harmful effects of smoke and how to stay safe during winter.

    The bike rally ended by converting into a meeting at Dhanwantari Allergy and Asthma Clinic located at dhaka road, Chhatauni chowk, motihari bihar.

    Dr Vivek kumar, gold medalist, allergy & asthma specialist addressed the gathering on this occasion. He focused on the need of certified high quality masks to safeguard from smoke & particulate matters. Other points to prevent the COPD exacerbation are use of vaccines like that of influenza , pneumonia etc. he focused on the use of maintenance therapy of inhalers.

    We should discourage use of biomass fuels in kitchen, incentivise use of battery operated bikes & cars, promote use of roof top solar panels.

    We all should focus of tree plantation to curb the rising menace of pollution as COPD is being caused mainly by smoke and harmful gases.

    It’s high time we change ourselves else 3/4 th of our generation will have COPD in later ages and most of our children will suffer from this dreadful disease.

  • Is’t allergy or corona?

    Symptoms of allergy & corona can mimic each other. It’s better not to self diagnose and take help of an allergist/immunologist. Allergists are specialised doctors who treat allergy & asthma.

    Corona patients have predominantly respiratory symptoms like cold, cough, fever, sore throat, chest pain, difficulty in breathing. Similar symptoms occur in many other diseases like allergies or asthma or other respiratory infections like influenza etc.

    Allergy has a tendency to relate with seasonal or diurnal variations. They are there for long time and without fever. Covid 19 patients have a typical history of short duration with either a history of travel from endemic area or contact history with other Covid patients. Characteristic x-ray chest & CT-Chest help in differentiating between two.

    CBC, total IgE, spirometry, family history of atopy, childhood pneumonia, atopic dermatitis, lack of points in favour of Covid 19 goes in favour of allergies.

    For more information you can contact us @ info@drjha.in

    • Write to us @
    • Dr Vivek kumar
    • Allergy & asthma specialist
    • Dhanwantari Allergy & Asthma Clinic
    • Dhaka road, Chhatauni chowk
    • Motihari
    • Bihar
    • India

    Keep visiting our site for best allergy related information by one of the best doctors in the field. We are one of the few dedicated allergy asthma centres in bihar/India.

    Our allergy asthma clinic is professionally managed by a team of doctors comprising young dynamic as well as elderly experienced doctors who have dedicated themselves in the field.

    You can contact on our allergy helpline number: +91-8448455545 for any query.

    To book an online video consultation, use the link: www.docon.co.in/info-card/vivekkumar

    PPE

  • Prevention is better than cure

    Allergic disorders follow the concept of “Allergic march”.

    Allergic march is often seen in ‘Atopic’ individuals. Atopy is the inherent tendency to form igE in large numbers.

    IgE or immunoglobulin-E is the antibody responsible for development of allergic symptoms. There are other antibodies in our body; like IgG, IgA, IgM, IgD- they have different functions.

    It’s seen that atopic individuals first develop food allergy in infancy resulting in atopic dermatitis with itching and rashes. With passing time the child develops allergic-rhinitis, later allergic-bronchitis, then allergic bronchial asthma. Later on airway remodelling takes place. In older age asthma mimics as COPD, they develop underlying ILD features and pulmonary hypertension. In the end stage respiratory failure takes place.

    The allergic component goes on progressing in a march like fashion. If you identify the causative allergen and start avoiding it from beginning, the march stops.

    Sometimes avoidance measures are not enough and you need immunotherapy which is a kind of desensitisation process.

    Time is very precious in allergy. The level of atopic march an individual has gained, that can’t be reversed. So earlier you identify the allergen and change your lifestyle, better prognosis you can expect. The dose of drugs needed for best symptom control goes on increasing with increasing age. That’s why called- prevention is better than cure.

    Allergy test

  • Corona lockdown

    Every country in world is facing the same question. When and how to lift the lockdown. If we continue more and more people will die of hunger as we don’t have any magical never ending food stock. Economy is already nose diving, unemployment rate is all time high.

    Governments all over world have to make a critical choice where the least number of people suffer from corona and hunger. Sudden opening of lockdown will result in flare up of cases and a new wave of deaths.

    Lockdown is supposed to give the time for strategic planning and its implementation.

    Out of 100 positive cases, 35 may be totally asymptomatic, 50 only with mild symptoms, and the remaining 15 may require hospitalisation. Currently we are testing the symptomatic ones and their close contacts. There are possibilities of undetected asymptomatic positive cases in community. If you lift the lockdown suddenly, these asymptomatic cases will result in spurt of symptomatic cases.

    Our healthcare facilities were not designed to handle this kind of exceptional situation. We have limited number of ICUs, intensivists, PPE, masks, sanitizer etc needed to fight this pandemic. Lockdown has given us time to arrange for the same. By gradually opening the restrictions, we shall be able to handle the flood of patients. Our government is working in same direction.

    The disease itself doesn’t look to be vanishing anytime soon. We have to accept the new normals. Face masks in public area, public transport, or in private transport with co-passengers, use of sanitiser after coming in contact with any fomites, social distancing, avoiding crowded places like malls, cinema etc are going to be included in our habits.

    With passing time we will have corona vaccine and better anti-viral drugs, better understanding of its patho-physiology. Doctors will learn how to best manage the Covid cases. Hopefully all these will happen in 2020 itself.

    All countries will gradually lift the restrictions depending on their preparedness and economic strength.

    Corona warriors
  • Lung Function Test in Covid times

    Lung Function Test in Covid times

    Lung function tests are the widely used tests performed in respiratory clinics all over world to differentiate types of lung diseases. It’s used for diagnostic as well as prognostic purposes. Being an aerosol generating procedure it was stopped in almost all respiratory clinics with the onset of Covid 19 disease. The other procedure routinely used previously which got hit is nebulization.

    Both these procedures are so indispensable that doctors want to start them as early as possible, still are scared to do so because of associated risk factors. A consensus is yet to be reached on how and when to start them.

    Nebulisation has other alternatives like MDI with spacer.

    To do spirometry is a tricky situation for doctors.

    1. A doctor needs to wear complete PPE.
    2. PPE for helping staffs.
    3. Isolated/designated place for spirometry with restricted access to others.
    4. Use mouth pieces with bio filters only.
    5. Sanitise the spirometer machine, key boards, computer after every use.
    6. Use separate moth piece for delivering Broncho-dilators with spacer.
    7. Sanitise your spacer after each use.
    8. Per-screen your patients for suspected corona infection by taking fever, travel history, contact history, place of residence. Don’t do the procedure if slightest of doubt.
    9. Take help of alternative investigations like chest x-ray, blood investigations, auscultation, detailed clinical history and your clinical acumen. Avoid doing the spirometry whenever possible for time being.
    10. Most of the respiratory physicians are able to reach a working clinical diagnosis without spirometry, but they will need it to perform in coming future. So start adapting the new way of life with new normals.
    Spirometry mouth pieces with filter
    Spirometry mouth piece with filter

  • Covid 19 in Allergy Clinic

    Covid 19 in Allergy Clinic

    Taking precautions is the only way to prevent spread of infection.

    Now government ordering all private doctors and clinics to reopen their OPD has resulted in gradually increasing number of Opd cases.

    Covid19 patients can be absolutely asymptotic still be able to spread infection to others. In symptomatic patients they can mimic other respiratory infections like influenza etc.

    Ideally you should avoid visiting a clinic/hospital for minor problems. Consult your doctor over phone or take advantage of video consultation facilities.

    Doctors need to wear PPE inside clinic, also make it available for all the staffs coming in direct contact with patients. Minimum 1 meter distance has to be maintained between 2 patients. Provide mask to all the patients and relatives. Ask your patients, relatives and staffs to use sanitizer after touching any object or person. Disinfect all the chairs, reception counter, billing counter, beds using 0.1% sodium hypochlorite solution. Depute a staff for this purpose who keeps spraying on regular interval.

    In case you are our patient, I.e. Dhanwantari Allergy & Asthma Clinic, Dhaka road, Chhatauni chowk, motihari, bihar, India; reach us @ 844-845-55-45 for tele enquiry. For video consultation use the app @ www.docon.co.in/info-card/vivekkumar

    Remember, hospitals are potential source of infection spread. No doctor can say whether you are having corona infection or not. Even tests are coming out to be negative which is called “false negative”. PCR based tests are much better compared to rapid blood antibody based tests. Few patients need repeated tests to get diagnosed. So, it’s better to treat all subjects as suspected. Keep maintaining the social distance even with asymptotic persons.

  • Corona & COPD

    Corona & COPD

    One of the risk factor associated with Corona deaths is elderly age group, I.e. above 60.

    COPD, a lung condition which means Chronic Obstructive Pulmonary Disorder affects elderly population.

    So, in case you are a known COPD patient you have to take extra precautions, like staying safe at home, maintain social distancing, avoid coming in contact with outside objects without gloves. Sanitise yourself and gloves frequently. Don’t venture outside without mask. Use your maintenance inhaler regularly. Try not to visit your doctor unless very necessary, instead you can use online video consultation services. Like one available with us @ Dhanwantari Allergy & Asthma Clinic. We have best allergy Asthma COPD facilities and we are a team of best professionals @ Motihari in Bihar India.

    You can reach us online www.docon.co.in/info-card/vivekkumar

  • अस्थमा- जानकारी हीं बचाव

    अस्थमा पर जीत के लिए ज़रूरी है सही जानकारी!

    इसीलिए हम लाए हैं- एक हिंदी पुस्तिका- दम्मा

    आप इसे मुफ़्त पा सकते हैं यहाँ-

    धन्वंतरि एलर्जी एवं अस्थमा क्लिनिक, ढाका रोड, छतौनी चौक, मोतिहारी, बिहार, भारत। (स्टॉक रहने तक)

  • Corona virus

    Corona virus

    If you are searching for Coronavirus , it means you are like millions of netizen who are scared of the news getting spread faster than the virus itself.

    Let’s cut the scrap and come to the main point- how to safeguard from it?

    1. You got to be insanely cautious for hygiene.

    2. It can spread through air or fomites.

    3. Don’t shake hands with anyone, instead do namaste or Salam or ram ram.

    4. Don’t touch your face or nose with your hand

    5. Wear mask/gloves at most of the time.

    6. Use sanitizer frequently.

    7. Keep door knobs, faucets, handles, flush buttons, sterile.

    8. Use protective gowns when outdoor. Learn to remove it without touching the outer surface. Go through YouTube videos to see how doctors get dressed before an OT.

    9. Report any suspected case to national helpline for corona virus, it’s important not only for you but for our society.

    10. Same holds true in case of outbreak of many other communicable diseases like influenza, bird flue etc.