• Published on: Jul 14, 2021
  • 1 minute read
  • By: Raj Dwivedi

Telemedicine, COVID-19 And Liver Diseases

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  • For liver diseases, there have been successful experiences with the use of different modalities of telemedicine [i.e. asynchronous telemedicine (analysis of patient's data by a single physician or multidisciplinary team), synchronous real-time patient management and tele-education]
  • Our Telemedicine program showed successful results as the sustained virologic responses achieved by those patients treated in primary care settings under the expert guidance.
  • Currently, this type of care is considered a vital tool for the goal of global elimination of HCV infection.In addition to HCV management, telemedicine offers opportunities for a better management of patients with chronic liver diseases by increasing their access to tertiary care, thus improving efficiency of healthcare delivery at reasonable cost .
  •  We forsee expansion of telemedicine into other areas of hepatology is desirable and hold potential for improving management of pre- and post-liver transplant patients, patients with hepatocellular carcinoma (HCC) and patients with both compensated and decompensated cirrhosis.
  • It is important to note that in liver transplant setting existing data suggest that use of telemedicine may expedite evaluation and listing of patients referred to liver transplant centers and could improve outcomes (hospital readmissions, and quality of life) after liver transplantation.
  • In the case of HCC, telemedicine aslo offers the possibility of multidisciplinary evaluation in virtual tumor boards leading to tailored and more effective treatments . Finally, in cirrhosis, telemedicine may enhance self-care and facilitate HCC surveillance eventually preventing readmissions in recently hospitalized patients.
  • With the onset of COVID-19 pandemic everyone has forced the implementation of telemedicine actions for many liver patients.
  • Major international societies have released recommendations encouraging the use of remote care to manage patients with all liver diseases, particularly liver transplant patients.
  • However, the crisis will seriously impact cirrhosis care with social distancing and isolation causing major delays in elective procedures and routine care with potential overwhelm of medical centers managing postponed and potentially decompensated patients in the upcoming months.
  • Developing robust telemedicine programs and revamping remote care initiatives in hepatology will be critical during COVID times. The next challenge will be how to integrate telemedicine into routine clinical care beyond the COVID-19 pandemic.
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Asthma

Asthma Symptoms in Adults: Early Signs, Triggers, and When to Seek Care

Asthma is often perceived as a childhood condition, but a significant number of cases develop or persist into adulthood. In India, adult asthma is increasingly recognised due to rising air pollution, occupational exposure and lifestyle-related risk factors. Unfortunately, asthma symptoms in adults are frequently misdiagnosed as recurrent infections, allergies or age-related breathlessness, leading to delayed treatment.

Understanding adult asthma symptoms is critical for early diagnosis, effective control and prevention of severe attacks.

 

What Is Asthma?

Asthma is a chronic inflammatory disease of the airways. In asthma, the airways become:

  • inflamed
     

  • narrow
     

  • overly sensitive to triggers
     

This leads to difficulty in breathing, especially during exposure to specific stimuli.

 

Why Adult Asthma Is Often Missed

Adult asthma symptoms may:

  • appear gradually
     

  • vary in severity
     

  • mimic common respiratory conditions
     

According to Indian Council of Medical Research and WHO data, many adults remain undiagnosed for years, increasing the risk of complications.

 

Common Asthma Symptoms in Adults

Wheezing

A high-pitched whistling sound while breathing, especially during exhalation, is a classic asthma sign.

 

Shortness of Breath

Adults with asthma often feel:

  • breathless during routine activities
     

  • difficulty taking deep breaths
     

This may worsen at night or early morning.

 

Chest Tightness

Many describe a sensation of pressure or tightness in the chest, which can be mistaken for heart-related issues.

 

Chronic Cough

A persistent cough, especially:

  • at night
     

  • early morning
     

  • after exercise
     

is a common but overlooked asthma symptom.

 

Symptoms That Worsen With Triggers

Asthma symptoms often intensify after exposure to specific triggers.

Air Pollution and Smoke

Urban pollution, vehicle emissions and indoor smoke significantly worsen asthma symptoms in adults.

 

Allergens

Dust mites, pollen, mould and pet dander are common triggers.

 

Respiratory Infections

Viral infections can trigger asthma flare-ups or reveal undiagnosed asthma.

 

Physical Activity

Exercise-induced asthma causes breathlessness and wheezing during or after physical exertion.

 

Weather Changes

Cold air, humidity and sudden temperature changes can aggravate symptoms.

 

Adult-Onset Asthma

Adult-onset asthma differs from childhood asthma.

Characteristics include:

  • onset after age 20–30
     

  • less association with childhood allergies
     

  • more persistent symptoms
     

  • higher likelihood of severe disease
     

Occupational exposure and hormonal changes contribute to adult-onset asthma.

 

Risk Factors for Asthma in Adults

Several factors increase asthma risk:

  • long-term exposure to pollution
     

  • smoking or passive smoking
     

  • occupational chemicals or dust
     

  • obesity
     

  • family history of asthma
     

  • chronic sinusitis or allergies
     

Women may experience asthma onset or worsening during hormonal changes.

 

When Asthma Symptoms Become Serious

Seek immediate medical attention if experiencing:

  • severe breathlessness
     

  • difficulty speaking in full sentences
     

  • bluish lips or fingertips
     

  • rapid worsening of symptoms
     

  • poor response to usual inhalers
     

These signs indicate a potentially life-threatening asthma attack.

 

How Adult Asthma Is Diagnosed

Diagnosis includes:

  • detailed symptom history
     

  • physical examination
     

  • lung function tests (spirometry)
     

  • response to bronchodilators
     

Early diagnosis improves long-term outcomes.

 

Impact of Untreated Asthma

Untreated asthma can lead to:

  • frequent attacks
     

  • reduced lung function
     

  • sleep disturbances
     

  • missed workdays
     

  • reduced quality of life
     

According to Lancet respiratory studies, uncontrolled asthma increases hospitalisation risk.

 

Managing Asthma Symptoms in Adults

Effective asthma management focuses on:

  • identifying and avoiding triggers
     

  • using prescribed inhalers correctly
     

  • monitoring symptoms regularly
     

  • maintaining follow-up care
     

Asthma action plans help patients recognise worsening symptoms early.

 

Role of Preventive Healthcare

Preventive healthcare helps:

  • detect asthma early
     

  • assess lung function
     

  • guide lifestyle modifications
     

Regular health checkups are especially important for individuals with respiratory symptoms or occupational exposure.

 

Lifestyle Measures That Support Asthma Control

Helpful practices include:

  • avoiding smoking
     

  • improving indoor air quality
     

  • wearing masks in polluted environments
     

  • maintaining healthy weight
     

  • regular, moderate exercise
     

Lifestyle support complements medical treatment.

 

Mental Health and Asthma

Stress and anxiety can worsen asthma symptoms.

Stress management:

  • reduces symptom frequency
     

  • improves medication response
     

Holistic care improves asthma outcomes.

 

Importance of Medication Adherence

Asthma medications work best when:

  • taken regularly as prescribed
     

  • inhaler technique is correct
     

Skipping treatment increases flare-up risk.

 

Long-Term Outlook for Adults With Asthma

With proper management:

  • symptoms are well controlled
     

  • severe attacks are preventable
     

  • normal activity levels are achievable
     

Most adults with asthma lead active, productive lives.

 

Conclusion

Asthma symptoms in adults are often subtle, variable and easily mistaken for common respiratory problems. Wheezing, breathlessness, chest tightness and chronic cough should not be ignored, especially when triggered by pollution, exercise or weather changes. Early diagnosis, trigger control and consistent treatment are essential to prevent severe attacks and preserve lung health. Recognising adult asthma early empowers individuals to manage symptoms effectively and maintain a good quality of life.

 

References

  • Indian Council of Medical Research (ICMR) – Respiratory Disease and Asthma Studies
  • World Health Organization (WHO) – Asthma Management and Prevention Guidelines
  • National Family Health Survey (NFHS-5) – Respiratory Health Indicators
  • Lancet Respiratory Medicine – Adult Asthma Outcomes and Management
  • NITI Aayog – Air Pollution and Respiratory Health Reports
  • Statista – Global Asthma Prevalence and Trends

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