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without a proper patient history.
Once asthma or COPD is diagnosed,
the patient will be prescribed the correct
medication which may include tablets
as well as inhalers. In most cases, the
symptoms should improve in a few days
or weeks. Not only has the cough problem
been resolved, the difficulty in breathing
would also have been minimised.
Dr Che’ Wan has been involved in
many multicentre trials on asthma and
COPD medications as well as constantly
keeping himself up to date on current
research and publications.
being a therapeutic function to clear
purulent secretions in the airway, it is also
used to gather endobronchial samples for
further investigations. Brushings and a
biopsy provide clinicians with samples
for cultures, as well as cells, for cytologic
studies.
A detailed history may reveal that a
patient is having a cough due to reflux
oesophagitis, a condition where the stom-
ach acid and juices flow backward in the
oesophagus, whichmay irritate the larynx
and vocal cords. This can be confirmed by
doing an oesophago-gastroscopy, which
can be done in this hospital by a resident
gastroenterologist. Another condition that
may lead to cough is known as post-nasal
drip. This is due to excessive mucus that
drips down the back of the throat. Once
the diagnosis is made, the best available
medication is then prescribed.
Cough is also one of the symptoms of
asthma and Chronic Obstructive Pulmo-
nary Disease (COPD), which is a disease
that mimics asthma but has a strong link
with a smoking habit. Both diagnoses can
be easily missed by clinicians working
Pasir Gudang Specialist
Hospital
Lot PTD 204871,
Jalan Persiaran Dahlia 2,
Taman Bukit Dahlia,
81700 Pasir Gudang,
Johor, Malaysia
Tel: +607 257 3999
Email: pgsh@kpjpgsh.com
Website: www.kpjpgsh.com
first, only then can the correct medication
be prescribed,” says Dr. Che’ Wan.
There are a few causes of a cough
that need to be considered. A detailed
history from the patient is very impor-
tant. Details checked are the onset of
the cough, continuous or nocturnal, the
presence of wheezing, chest discomfort
and breathlessness. Smoking, gastritis and
rhinosinusitis histories are also important.
The doctor would also probe into factors
like the environment at home and the
workplace, especially if you are living in
an area like Pasir Gudang, where the air
quality is poor.
A plain chest radiograph is done after a
thorough physical examination. If neces-
sary, this will be followed by a computed
tomography scan of the thorax as well as
a lung function test.
A procedure known as
bronchoscopy
is
also useful in managing a cough. Besides
Dr. Che’ Wan analysing CT Scan