Brief Answer:
Need further information

Detailed Answer:
Dear
Thanks for contacting with your health concern and after reviewing your health query I'm of the following opinion

1. As child is also showing features of low immunity: any past history of lack of breast feeding?
2. any history of poor digestion or gluten allergy? [since weak digestion increases allergy]
3. any history of Worms/parasites?
4. any Emotional/mental anxiety or work pressure? [STRESS]
5. Are you consuming too much Artificial Food/Fast Food [Environmental Toxins].
6. what was the opinion of the ENT Specialist? [any suggestion regarding CHRONIC Rhino sinusitis]
7. Asthma is a risk factor.

PS: were you examined by a chest specialist for the same [regarding the clinical examination and baseline investigations]
8. A poor immune system makes you more prone to any infection, thus could be one of the reasons for recurrence, also because you are taking steroids which do depress the immune system could also be an aggravating factor.

9. As your mother is both diabetic and hypertensive (which means is double Immunocompromised, thus in spite of receiving the COVID Vaccine, care should be taken of checking her vitals (blood pressure, pulse rate with oximetry,) and any change in behavior like (restlessness/ undue lethargy, digestion trouble (diarrhea), breathlessness/ coughing out of proportion, pain/swelling in lower limbs should be informed immediately to your attending Physician. ( otherwise pain at the injection site and mild fever are healthy signs of the Vaccine ), blood clotting is one of the rare side effect observed in people with Astra Zeneca Pharmacy Vaccine (but still benefits of the vaccine outweighs the risks).

P.S. Even if she is vaccinated, precautions in public places like wearing a mask, staying 6 feet apart from others, and avoiding crowds and poorly ventilated spaces should be maintained.

Please revert back with the following concerns for further line of Clinical Aspect and Observation.

Dr. Munish
Naimittika.

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Brief Answer:
management Aspect.

Detailed Answer:
Dear
Thanks for reverting back, and following is my opinion based on your investigations done and history provided:

1.     As allergy panel is negative , thus as suggested in report too; raised IgE suggests that a person has one or more allergies due to:
-     Allergic disorder: present [allergic asthma present]
-     Parasitic infestation: check with stool test.
-     As absolute Eosinophil count and Eosinophil are normal: tropical eosinophilia is ruled out
-     Check with a Medicine specialist or Rheumatologist for any Autoimmune [AI] disease/condition.
-     For pulmonary Aspergillosis exclusion: chest x-ray, aspergillosis antibody test and opinion of Chest Specialist is required. [since serum IgE is raised but test for mold panel is negative]
2.     As digestive issues are there: are there any signs and symptoms of:
-     Unexplained weight loss, constipation or diarrhea, abdominal pain, fullness of abdomen, fatigue, skin problems, heart burn.
-     Check with a Gastroenterologist, for gluten allergy, who may ask for investigations like: Total serum IgA then tTG-IgA test. [although test for gluten and wheat are normal]
3.     As CRP level is elevated which could be because of an inflammation or infection: thus again rule out: Inflammatory bowel disease [IBD], any hidden infection or malignancy [as ESR is also raised]
4.     As your child was not breast fed: so developing recurrent infection and weak infection: Since breast milk contains antibodies which provide natural [passive] immunity to the new born, which he never got.
-     Regarding Iron deficiency in child, check with iron studies and CBC test to further establish the diagnosis and treatment/management aspect.

5.     I will be providing treatment/management o the basis of Tamak shwas [as referred in Ayurveda], so please adopt the following treatment principles of healthy living and Immunomodulation concept
A.     HEALTHY LIVING:
•     Anything you do, go low and go slow and make changes gradually, as your small changes become habit, you can continue to ADD more healthy choices.
•     Eat a variety of nutrient rich food but who have some added advantage like: Cabbage (cholesterol lowering benefits), carrot (helps in liver detoxification), cauliflower (ideal against abdominal problems), date)-(best for muscle development), onions ( contains flavinoids which protect against cardiovascular disease), garlic ( has broad spectrum antibiotic properties)
. Daily regime: Don’t skip breakfastTake your lunch between 12 -1 PM which is the peak period of Pitta (responsible for digestion)have your dinner 2 hours before sleeping.
. Make sure you do not travel, do strenuous exercise, or indulge in sexual activities within one hour after meal.
. It would be good if you cook some quick and healthy food and avoid taking junk/processed, easily available food from outside unless your job/occupation is of constant touring or mental/physical stress is more.
. Proper sleep with proper diet is the key to healthy living in Ayurveda.
. Avoid smoking, alcohol, caffeine, eating late at night, stress, and drink water instead of colas.
. Practice Yoga, Meditation and go for an exercise regime.
. Walk a while after meal to help digestion.
. Remember good food leads to noble thoughts with sound memory helping in mental health and social well being.

IMMUNOMODULATION (Immunity)
As suffering/experiencing recurrent viral infection, Rasayana drugs (Rejuvenation/Immunomodulators) should be instituted in you and your Child management as part of XXXXXXX (palliative) therapy i.e. which corrects the dysfunction of tissues without disturbing the functions of normal tissues, also Rasayana drugs potentiates humoral antibodies, by increasing serum Immunoglobulin’s such as IgA,IgG and IgM.
i.     Proteins are essential for antibodies production so milk, egg (white), beans, yogurt, soymilk, pumpkin, squash, watermelon, peanuts, almonds, if non-vegetarian (meat) are choices
ii.     Vitamin A: helps to maintain Thymus gland which is a powerful antiviral gland : thus XXXXXXX carrots, cantaloupe, egg yolk, apricots, pumpkin, papaya, are ideal.
iii.     Vitamin C: is needed for proper functioning of immune system: amla is best .
iv.     Vitamin E: is a powerful anti oxidant which helps to stimulate antibody production: peanuts, dried apricots, cooked spinach) taro root can be taken.
v.     Vitamin B is important for the activity of phagocytes: eggs, cheese, pistachio, raw garlic, sunflower and sesame oil.
vi.     I do prepare result oriented Immunomodulation Medicine suitable for your Asthma problem and for weak immunity of the child, If interested I can courier you the medicine.

PS. If after exhaustive physical examination and investigation, problem is of Asthma, I will furnish the dietary regimen and Medicine according to that, till then continue with swashari and coronil, till then take
-     somkasa XXXXXXX 1-2 tsf in lukewarm water [twice daily] after meals.
-      in morning [empty stomach] take 1 pinch of asafetida [hinga] in 1 cup hot water for 1 month.
-     Take pinch of vacha [acorus calamus] powder and add 2 tablespoon bitter gourd juice [of leaves] and 2 tablespoon of honey: motion will start for sometime, and swelling will eventually reduce [if bronchitis is there]

Dr. Munish
Naimittika

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Brief Answer:
management Aspect.

Detailed Answer:
Dear
Thanks for reverting back.
1.     As there are no reports attached, kindly ask the HCM team to do the same, or get attached by you again.

2.     DIETARY REGIME

i. WHOLESOME DIET [PATHYA]: old brown rice, horse gram, rice gruel, garlic, tomato, eggplant, green beans, cucumber, Terminalia chebula, goat’s milk, honey, black pepper, lukewarm water, day time sleeping, carrots, idli, corn flakes, biscuits, warm drinks like tea-coffee-soup, bread sandwich, green leafy vegetables, pumpkin, spinach, methi, salad, avocado, apple, XXXXXXX papaya, banana, turmeric, omega 3 fatty acids, vitamin D, breathing exercises, walking, use of a humidifier, eat frequent and small meals and take early dinner.

ii. UNWHOLESOME DIET [APATHYA]: deep-fried, sour food/fruits, chickpea flour, curd, potato, sweet potato, okra, mustard leaves, XXXXXXX milk, ghee, fish, cold water/season, suppression of natural urges, excess physical/mental exertion, avoid sleep for at least 2 hours after a meal, jaggery, red chili, eggs, chickpea, bottled lemon/lime juice, dry fruits, peanuts, acidic fruits, carbonated beverages, salt.

HOME REMEDIES AND MANAGEMENT.
•     Put 500 – 1 gm dose of potash alum on the tongue.
•     One should eat before sunset and eat less than demanded by the appetite. [if possible].
•     Indigestion and constipation should be properly treated or should not be present in the patient with Asthma.
•     Take 6 gm juice each of bamboo, ginger, and honey plus 50 mg Amlasar gandhak and black pepper: make a powder, after sieving, put them in an air-tight glass container and take 4-5 gm daily with ghee/honey.
•     Mix salt and camphor in lukewarm ghee and massage on the back. [between scapular region]
•     Take 2 tablespoon ginger and 2 tablespoon honey: drink for 21 days, do not drink water for half an hour.
•     Tak e ½ black pepper powder and 4 tablespoon honey: god for asthma due to cold cough.
•     1 cup hot water with 1 pinch of asafetida for 1 month.


3.     As I prepare/manufacture, medicine by myself, and because they are not for online sale [to check piracy] and are certified by the ministry of AYUSH, thus cannot comment on the medicine available near your locality/hometown.
4.     Regarding the duration of prescribed Ayurveda medicine(s), which you are taking, I cannot comment on the subject, since they are been advised by someone else and they are answerable to that. I can only let you know about the dose/duration of medicines being prescribed by me.
5.     As said earlier, your child needs Immunomodulation [to build immunity] and medicine to increase the Agni [Metabolism] of the body. [same holds true to your husband], so basically three of you need Rasayana/DhatuAgni Vardhak/ and XXXXXXX Drugs.
6.     Do not give cetirizine, since one will not know any allergic response to the vaccine and symptoms might get passed unnoticed resulting in complications. [tell the health care provider about the same, so that he/she can give him a test dose before getting the full dose of covishield.

7.     In nutshell [SUMMARY]
•     There might be prolonged remissions in patients with Asthma i.e. in between attacks there may be no signs, no symptoms, and no positive laboratory tests.
•     In the acute phase, one should primarily focus on how to relieve the difficulty in breathing, and when under control one should try to eradicate the disease with a proper therapeutic approach.
•     If despite taking inhaled steroids and bronchodilators, asthma attacks are recurring, one can ask for use of mast cell stabilizer drugs [on prescription].
•     As Asthma is a psychosomatic disease thus calmness of mind is essential, as such XXXXXXX Drugs [nootropic herbs] are a useful part of treatment.
•     Deep breathing exercises help increase the lung capacity and also create awareness of the lungs and breathing process.
•     Advice holiday in a dry climate [if there are repeated attacks] or one can think of shifting his/her residence.

Dr. Munish
Naimittika
YYYY@YYYY
What's App number: 0000 [for medicine-related queries]

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Brief Answer:
Assocaited Health Conditions

Detailed Answer:
Dear
Thanks for reverting back.

1. All the image's/screenshot are blurred, so request you to upload same with good resolution camera.

2. Patients with AS are at a higher risk of developing asthma/ allergic asthma-rhinitis, than the general population, regardless of gender and age. (since AS causes inflammation and scarring into the lungs). The pathophysiology needs further investigation, since both Th2 and TH17 are associated with developing AS and Asthma.

PS. You need to consult with an Immunologist and/or Rheumatologist.

3. Although both are inflammatory disorder, thus treatment is multifactorial and towards cause specific. Thus because you are under constant observation of your attending Physician thus continue with the medicine which he has prescribed, and neither coronal or shwasari will interfere with modern drugs or their is any known drug-drug interaction, so you can safely take the same for 2-3 months.

Dr. Munish
Naimittika

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