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Best Pulmonologist in Jaipur-Dr. Nishtha Singh

Dr. Nishtha Singh is an experienced Chest Specialist and Pulmonologist in jaipur at Asthma Bhawan with special interests in respiratory medicine, critical care, and sleep medicine. Dr. Nishtha Singh offers complete diagnostic and treatment of all Respiratory conditions, including Tuberculosis, Allergy, Asthma, Lung Cancer, and SLEEP APNEA.<br>Make an appointment with the best doctor or call us: 91 946 1685 766 and get more information.<br>Visit: https://drnishthasingh.com/

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Best Pulmonologist in Jaipur-Dr. Nishtha Singh

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  1. New approach to intermittent & mild asthma therapy: evolution or revolution in the GINA guidelines? Dr Nishtha Singh Executive Director & Senior Pulmonary Consultant Asthma Bhawan, Jaipur

  2. The TREXA study • If asthma is well controlled on low dose ICS or LTRA, one could step down to SOS low dose ICS/formoterol; another option is SOS ICS/SABA • Do not completely stop ICS in a patient of asthma 2 Lancet. 2011;377:650-57

  3. Landmark changes in GINA 2019-2022 Step 1 & Step 2 Use low dose ICS/formoterol as needed Replacing regular ICS & as needed SABA 3

  4. Why patient do not adhere to treatment? Adherence- <50%* Why? 1. They forget 2. Fear of Side-effects 3. Fear of Dependence *RESPONSE Study: • Patients prefer to use fewer asthma drugs and to have just 1 inhaler • ½ of patients tend to rely on reliever medication. • A fixed combination of ICS with RABA as a reliever therapy eliminates the risk of using RABA relievers alone *Ståhl E. Respiratory patients opinions survey (RESPONSE): market research for asthma patients in Europe. Am J Resp Crit Care Med. 2002;165:A109.

  5. What Indian studies suggest?

  6. Asthma treatment in India What is current practice? Noncompliance A. Stop Rx as per advice of doctor 9% B. Stop Rx when asymptomatic 35% C. Stop Rx when able to tolerate symptoms 56% Singh V. etal Respiratory Medicine 2002; 96: 835-40

  7. How many wheezers have confirmed diagnosis & ICS treatment? (GAN study: 9 cities & 20084 children): Underdiagnosis & Undertreatment Groups Diagnos ed asthma Undiagnos ed asthma Wheeze + Rx ICS Rx ICS Wheeze + 115 (18%) 6-7-year-age (n=634) 30 % 519 (82%) 1.7% 13-14-year- age (n=940) 239 (25%) 35 % 701 (75%) 2.7% Adults (n=2680) 603 (23%) 2077 (77% 26 % 0.6% Diagnosed Asthma<25%  Undiagnosed Asthma > 75% S Singh et al ERJ Open research 2022;8  Rx ICS<35% Rx ICS<2.7%

  8. 10 most frequently asked questions by asthmatic patients: 1420 physicians replied Panel of patients graded replies Convincing Just convincing Not convincing 2% 16% 82% Singh V etal JAPI 2002; 50:1266-69

  9. 11% of global asthmatic patients are Indian. 43% of global death due to asthma are from India. GBD data What is solution?

  10. H M L New approach to intermittent & mild asthma therapy: evolution or revolution in the GINA guidelines? Dr Nishtha Singh

  11. Thank you! Thank you!

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