As AQI worsens in national capital, spike in patients with respiratory issues; docs have some advice

As the air quality index (AQI) continues to dip in Delhi, the number of patients visiting hospitals for respiratory issues has increased significantly, particularly over the last week and a majority of patients have come up with breathing issues, headaches and migraines, nasal irritation and burning eyes, say doctors.

According to Dr G C Khilnani, chairman of PSRI institute of pulmonary, critical care and sleep medicine, patients coming in with respiratory problems have doubled at the institute’s out-patient department (OPD).

“There are two types of cases in the OPD now – those with pre-existing lung diseases, such as asthma, bronchitis and other previous infections, and others who do not have any existing condition but are coming with breathing issues, sore throat and wheezing,” he said.

Dr Khilnani added that these patients were developing severe breathlessness and a majority of them did not have any evidence of infection. “When we test, it is found that they do not have pneumonia, etc, but are requiring supportive therapies. There are patients who do not require admission and are developing asthma and chronic obstructive pulmonary disease. When we examine, there is a narrowing of their air tubes and we provide them with inhalers,” he said.

The most upsetting fact, Dr Khilnani pointed out, was that a large number of people in the 20-40 age group who did not have lung disease are coming with symptoms of sore throat, dryness of mouth, feeling unwell, loss of appetite, coughing and wheezing. “When we test them with lung function tests, they are also with narrow airway tubes. They are developing asthma-like features,” he said.

Besides, cases of headache, nasal irritation and burning of eyes have also gone up by 50 per cent, said a senior ENT specialist at Ram Manohar Lohia Hospital. “There has been an increase in the last week; patients are coming with watery eyes, watery nose and headaches,” he said, adding that the change of weather was one reason but winter has also not set in so far this year. “Pollution is a leading cause behind the increase in such cases,” he underlined.

According to Dr Sushila Kataria, senior director, internal medicine at Medanta in Gurgaon, people with chest infections and chronic cough have doubled. “On a daily basis, I see at least 10 cases of patients with respiratory disease,” she added.

There has been a spike in the number of headache and migraine cases as well. Dr Rahul Gupta, Director, neurosurgery at Fortis Escorts said the patient load for migraine and headache-related cases has increased by 30 per cent as compared to cases from a month ago.

He added that bad odour in the air can trigger migraine or cluster headaches in persons prone to migraine. “Pollution is a stress inducer, and any stress can be associated with early fatigue and tension headache which is noted mainly in the evening hours. It leads to an increase in blood pressure and more cardiac load leading to headaches. This may increase the chances of brain haemorrhage leading to sudden severe headaches. Headache increases with rising AQI as smog is a major irritant for our eyes and nasal cavity. Nasal congestion due to smoke and dust particles leads to inflammation of nasal and sinus mucosa which results in the activation of nerve endings culminating in headache. The incidence of respiratory tract infection increases with reduced oxygen and more carbon dioxide in the brain which leads to vasodilation and an increase in headache. Eye irritation and blurred vision lead to overactivation of facial and scalp muscles and later headache,” he said.

Dr Khilnani said that people should avoid going to crowded places. Youngsters and the elderly should remain extra cautious, especially in the early hours. “Those who have lung disease or heart disease should be confined to their houses. Air purifiers should be used and no one should go for walks in the morning when the AQI is severe,” he said.

He added that when the sunshine returns, there is a phenomenon called inversion during which pollutants go into the air. “Those who want to walk can go then,” he said.

According to Neetu Jain, senior consultant, pulmonary and critical care, sleep medicine at PSRI Hospital, many patients have also started understanding the importance of wearing a mask. “Many of my patients have started wearing N-95 masks and it is important to ensure the least amount of particulate matter inside remains in your house. For which, dry dusting should be avoided, a strong exhaust should be used, and air purifiers if one can afford,” she added.

The ENT specialist at RML said he has been giving patients anti-allergic medicines, advising them to take Vitamin C, plenty of water and food containing omega-3 fatty acids.

Meanwhile, there has been a rise in the number of patients with irritated and burning eyes as well. According to Dr Mahipal Singh Sachdev, chairman and managing director of Centre for Sight, several patients have approached them post-Diwali with complaints of red eyes, irritation and watery eyes.

“There are more people complaining of red and watery eyes and different eye allergies because poor air quality contains dangerous gases including carbon monoxide, nitrogen dioxide, and coarse dust particles. Eyes are also affected by hydrocarbon compounds that are typically created by automobiles, such as C4 and C5 olefins,” said Dr Sachdev.

Dr Rishi Bhardwaj head of the department and consultant of ophthalmology at Paras Hospitals, Gurgaon, said that the smog is the primary reason behind the patient load.

“We have also reported an increase in patients with conditions including headaches, nose discomfort, and burning eyes. People who complain of itching and burning in their eyes are primarily because of air pollution. The smog is likely to be blamed for eye issues, allergies, and burning sensations in the eyes. Additionally, one can be dealing with hazy vision, dry eyes, watery eyes, red eyes, and aching eyes due to pollution,” he added.

Dr Sachdev said that whenever the pollution level is dangerous, one should wear sunglasses while heading out.

“Wash hands frequently throughout the day and avoid touching the eyes. Drink a lot of water to assist your body produce enough tears. Your eyes become dry due to smog, which may result in burning or itching. Therefore, it is advised to consume 8-10 glasses of water each day. If you have intense burning, itching, or pain in your eyes, consult an ophthalmologist,” he added.

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