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OP Kapoor

Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.

There are 3 conditions occasions where the appearance of cough interferes with the normal day to day life activities. Examples are:

1. Patients of bronchial allergy start coughing as soon as they start laughing.

2. Patients of bronchial allergy start coughing while talking on the telephone (possibly also related to the dust on the telephone piece).

3. Patients who have allergic cough due to GERD (gastro-oesophageal reflux disease) develop cough whenever they are bending down or as soon as they lie down.

There are 3 other conditions where consequences of cough become a nuisance to the patient:
1. Precipitate micturition in women who pass a few drops of urine involuntarily during a bout of cough.

2. Patient getting an attack of cough syncope or severe giddiness - such patients even without syncope develop severe darkness in front of the eyes and giddiness during a bout of cough, but can faint .

3. Patients who develop severe chest pain due to cough fracture of the rib - such patients if they are on long term steroid therapy and are not treated for iatrogenic osteoporosis can develop repeated cough fractures of the ribs.

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