Cause Of Cough In Children Research Articles

Formulation and Evaluation of Herbal Remedy for Cough

The most frequent reason patients seek medical assistance is because of a persistent cough, despite the fact that coughing is both a crucial defensive reflex and a universal indication of health. According to an epidemiologic study, up to 40% of people report coughing. Upper respiratory tract infections (URTIs) and the common cold are the most frequent causes of cough, but other causes include post-infectious cough, undiagnosed chronic cough, and cough brought on by pulmonary diseases like asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis, and lung cancer. The most common causes of cough in children are viral URTI, chronic bacterial bronchitis, and asthma. Whether acute or chronic, cough is linked to considerably reducing health-related quality of life. Patients with chronic cough commonly report sleep disturbance, nausea, chest pains, lethargy, social humiliation, urine incontinence, and low mood. Coughing may not be effective in certain circumstances (such as respiratory tract inflammation, neoplasia, eosinophilic bronchitis, airway irritation from various pollutants, airway hyperresponsiveness from infection, gastroesophageal reflux disease, and coughing without any known cause, also known as idiopathic cough). Opioidergic central cough suppressants, such as opioids, codeine, pholcodine, noscapine, and dextromethorphan, are useful when coughing is ineffective. Constipation, sedation, respiratory depression, dependence, drowsiness, addiction, and even mortality can result from prolonged use of these cough suppressants, which restricts their use in people. The proposed research project’s objective is to develop and assess herbal dosage forms that contain the widely used spice Piper longum L. (Piperaceae).

Evaluation of Chronic Cough in Children: A Prospective Study in a Tertiary Care Hospital

Background : Chronic cough is a common complaint in children which causes distress, and affects the quality of life of parents and children. While cough may be seen as a common condition of childhood without serious consequences, ignoring a cough that may be the sole presenting symptom of an underlying illness can lead to delayed diagnosis and progression to a chronic respiratory morbidity.Objective : To evaluate the specific diagnosis and prognosis of chronic cough in children.Methods : A prospective study was done on children with chronic cough (history of cough>8 weeks) referred to Dhaka Shishu (Children) Hospital, a tertiary hospital.Children aged 2 to 8 years with chronic cough referred by the general physicians, pediatricians and other peripheral hospitals were the study subjects. Exclusion criteria were children with immune-deficiency,congenital anomalies of lung,congenital heart disease, gastro-intestinal disorders (e.g. gastro-esophageal reflux, peptic ulcer disease), in born error of metabolism (e.g. cystic fibrosis) and other chronic conditions (e.g. gross neurodevelopmental delay). The evaluation of chronic cough was based on simple principles: careful history-taking concerning the characteristics of the cough, full clinical examination to look for any associated symptoms and relevant investigations done. Underlying diagnoses and outcomes were ascertained after follow-up for a period of six months and treatment was given as per the management protocol of the hospital.Results : The most common final diagnosis was allergic rhinitis (31%), followed by asthma (28.6%), rhinitis coexisting with asthma (23.8%), post viral cough (16.6). Cough resolved in 54.8%, partially improved in 40.5% and persisted in 4.7% of patients.Conclusion : Allergic rhinitis with or without co-existing asthma was the commonest cause of chronic cough in children referred to this hospital.Northern International Medical College Journal Vol.9(1) July 2017: 264-266

Update on Pediatric Cough

Despite the high prevalence of cough in children, the topic has been poorly researched. Although pediatricians recognize that chronic cough in children is different from that in adults, this difference seems less recognizable to other health professionals. During childhood, the respiratory tract and nervous system undergo a series of anatomical and physiological maturation processes that influence the cough reflex. Additionally, immunological responses undergo developmental and memorial processes that make infection and congenital abnormalities the overwhelming cause of cough in children. The lack of comprehensive clinical data regarding chronic cough in children has initially required pediatricians to adopt an adult approach to the problem. In the last 10 years, however, research has led to the reconsideration of the etiology of chronic cough in children. Currently, attention has focused on protracted bacterial bronchitis as a major cause of chronic cough in preschool-aged children and as a possible precursor of bronchiectasis. New research horizons are emerging for both the treatment and prevention of particular causes of chronic cough in children.

Cough in Children

Cough during childhood is very common, and is one of the most frequent reasons for consultation in daily pediatric practice. The causes differ from those in adults, and specific pediatric guidelines should be followed for correct diagnosis and treatment. The most common cause of cough in children is viral infection producing “normal cough”, but all children with persistent cough, i.e. a cough lasting more than 4–8weeks or “chronic cough”, must be carefully evaluated in other to rule out specific causes that may include the entire pediatric pulmonology spectrum. The treatment of cough should be based on the etiology. Around 80% of cases can be diagnosed using an optimal approach, and treatment will be effective in 90% of them. In some cases of “nonspecific chronic cough”, in which no underlying condition can be found, empirical treatment based on the cough characteristics may be useful. There is no scientific evidence to justify the use of over-the-counter cough remedies (anti-tussives, mucolytics and/or antihistamines), as they could have potentially serious side effects, and thus should not be prescribed in children.

Tos en el niño

Cough during childhood is very common, and is one of the most frequent reasons for consultation in daily pediatric practice. The causes differ from those in adults, and specific pediatric guidelines should be followed for correct diagnosis and treatment. The most common cause of cough in children is viral infection producing “normal cough”, but all children with persistent cough, i.e. a cough lasting more than 4-8weeks or “chronic cough”, must be carefully evaluated in other to rule out specific causes that may include the entire pediatric pulmonology spectrum. The treatment of cough should be based on the etiology. Around 80% of cases can be diagnosed using an optimal approach, and treatment will be effective in 90% of them. In some cases of “nonspecific chronic cough”, in which no underlying condition can be found, empirical treatment based on the cough characteristics may be useful. There is no scientific evidence to justify the use of over-the-counter cough remedies (anti-tussives, mucolytics and/or antihistamines), as they could have potentially serious side effects, and thus should not be prescribed in children.

Chronic Cough in Children: A Primary Care and Subspecialty Collaborative Approach

1. Robert Kaslovsky, MD* 2. Matthew Sadof, MD† 1. *Department of Pediatrics, Albany Medical College, Albany, NY. 2. †Department of Pediatrics, Baystate Children’s Hospital, Springfield, MA. * Abbreviations: AAP: : American Academy of Pediatrics ATAQ: : Asthma Therapy Assessment Questionnaire ACT: : Asthma Control Test ACQ: : Asthma Control Questionnaire CDC: : Centers for Disease Control and Prevention CF: : cystic fibrosis CT: : computed tomography DTP: : diphtheria and tetanus toxoids and pertussis FEV1: : forced expiratory volume in 1 second GERD: : gastroesophageal reflux disease ICS: : inhaled corticosteroid NHLBI: : National Heart, Lung, and Blood Institute RSV: : respiratory syncytial virus TEF: : tracheoesophageal fistula VCD: : vocal cord dysfunction Cough is an extremely common symptom in children and a cause of great concern. Because cough can be caused by a wide variety of infectious and noninfectious conditions, which will vary among different age groups, clinicians must take a logical approach to establishing a diagnosis, which will determine appropriate therapy. General pediatricians must know how to work in coordination with specialists when the cause of the cough is unknown or complex. After reading this article, readers should be able to: 1. Effectively evaluate the multiple causes of cough in children of various ages. 2. Prescribe appropriate therapies for the disorders that cause cough. 3. Understand how to coordinate the care of the generalist with that of the specialist. Cough – cough – cough – cough! A great many parents, grandparents, teachers, and child care providers express concern to health care clinicians regarding a child’s cough. Many hours of sleep and days of school and work are missed because of a child’s coughing. Simply suppressing the cough is not the answer because cough is an essential protective mechanism to keep the airways patent and clear. Well-meaning parents and grandparents often are quick to use over-the-counter products to suppress the cough, usually with no relief and occasionally with significant toxic effects. Treatment of cough is not a “one size fits all” proposition. Rather, the clinician must evaluate each case of cough individually and determine treatment according to the cause of the cough. It is important to consider the age of the child, the nature and timing of the cough (wet or dry, day or …

The development of chronic cough in children following presentation to a tertiary paediatric emergency department with acute respiratory illness: study protocol for a prospective cohort study

BackgroundAcute respiratory illness, a leading cause of cough in children, accounts for a substantial proportion of childhood morbidity and mortality worldwide. In some children acute cough progresses to chronic cough (>4 weeks duration), impacting on morbidity and decreasing quality of life. Despite the importance of chronic cough as a cause of substantial childhood morbidity and associated economic, family and social costs, data on the prevalence, predictors, aetiology and natural history of the symptom are scarce. This study aims to comprehensively describe the epidemiology, aetiology and outcomes of cough during and after acute respiratory illness in children presenting to a tertiary paediatric emergency department.Methods/designA prospective cohort study of children aged <15 years attending the Royal Children’s Hospital Emergency Department, Brisbane, for a respiratory illness that includes parent reported cough (wet or dry) as a symptom. The primary objective is to determine the prevalence and predictors of chronic cough (≥4 weeks duration) post presentation with acute respiratory illness. Demographic, epidemiological, risk factor, microbiological and clinical data are completed at enrolment. Subjects complete daily cough dairies and weekly follow-up contacts for 28(±3) days to ascertain cough persistence. Children who continue to cough for 28 days post enrolment are referred to a paediatric respiratory physician for review. Primary analysis will be the proportion of children with persistent cough at day 28(±3). Multivariate analyses will be performed to evaluate variables independently associated with chronic cough at day 28(±3).DiscussionOur protocol will be the first to comprehensively describe the natural history, epidemiology, aetiology and outcomes of cough during and after acute respiratory illness in children. The results will contribute to studies leading to the development of evidence-based clinical guidelines to improve the early detection and management of chronic cough in children during and after acute respiratory illness.

Evaluation of Chronic Cough in Children

Asilsoy S, Bayram E, Agin H, et al. Chest. 2008;134(6):1122–1128PURPOSE OF THE STUDY. To evaluate chronic cough in children in accordance with the 2006 American College of Chest Physicians (ACCP) guidelines.STUDY POPULATION. The study included 108 children between 6 and 14 years of age who presented with a cough lasting >4 weeks.METHODS. Using the algorithm suggested by the ACCP guidelines for chronic cough in children, a detailed history was obtained and a physical examination was completed. Patients were reevaluated at 2- to 4-week intervals. All patients underwent pulmonary function testing and chest radiography. Additional testing was performed as clinically indicated. Patients were classified into the following diagnostic categories: (1) asthma and asthma-like symptoms, (2) protracted bronchitis, (3) gastroesophageal reflux disease (GERD), (4) upper airway cough syndrome (UACS), (5) natural recovery, (6) bronchiectasis, (7) tuberculosis, and (8) Mycloplasma pneumoniae infection.RESULTS. The most common causes of chronic cough in this age group were asthma plus asthma-like symptoms (25%), protracted bronchitis (23.4%), and UACS (formerly postnasal drip) (20.3%). GERD accounted for <5% of cases.CONCLUSIONS. The authors concluded that ACCP guidelines for the management of chronic cough in children were effective. This study demonstrated the importance of the “watch, wait, and review” step. When therapy is initiated, the response to treatment should be evaluated at 2- to 4-week intervals, to prevent unnecessary evaluation of chronic cough. The causes of cough in children differ from the causes in adults. The evaluation of cough in children should include asthma, bronchitis, and UACS in the differential diagnosis. When treatment is initiated, a detailed investigation should be made for patients who do not respond to the treatment.REVIEWERS COMMENTS. Chronic cough in children is a common problem, and the most common causes are slightly different from those in adults, for whom GERD is listed in the top 3 causes. In this study, the authors concluded that GERD could be the result of cough and not just the cause. In this study, asthma and asthma-like symptoms were the most common cause. This may be attributable to the age of the participants. Previous studies in children included participants <2 years of age, for whom the diagnosis of asthma is more difficult. Observing and reevaluating children every 2 to 4 weeks when they present with chronic cough may decrease the need for extensive testing.

Treatment Options in the Child with a Chronic Cough

Chronic cough is a common symptom in many different disease processes. Because the most effective way to eliminate a chronic cough is to identify and treat the underlying disease, the physician must approach the paediatric patient based on his or her knowledge of the differential diagnosis. The most common causes of cough in children are upper respiratory tract infections, asthma, rhinitis, sinusitis, and gastroesophageal reflux. By using a systematic approach, the cause of a chronic cough can almost always be found, and the cough successfully treated. Asthma is the cause of most undiagnosed chronic coughs but sinusitis, rhinitis, and gastroesophageal reflux must also be considered in difficult patients.