8 The pathogenesis of RADS is not fully understood. The acute pathological changes of RADS have been studied by subjecting mice to a high concentration of chlorine in the atmosphere.

The findings include flattening of bronchial epithelium, necrosis, and evidence of epithelial regeneration, while bronchoalveolar lavage reveals an increased number of neutrophils.9 Due to the persistence of the symptoms, the Inhibitors,research,lifescience,medical bronchial biopsy in our patient was done after 4 months and it revealed a chronic inflammatory response with lymphocytic and plasma cell infiltration and the absence of eosinophils. There is no single gold standard for the diagnosis of RADS. The diagnosis is likely when there is acute onset of respiratory tract symptoms such as cough, breathlessness, chest tightness, etc., within 24 hours of exposure to an agent with irritating properties in the atmosphere. However, the symptoms should persist for at least 3 months. Clinical examination may show hyperinflation Inhibitors,research,lifescience,medical of lungs, use of accessory

respiratory muscles, and wheeze. Lung function may reveal mild obstruction or a significant bronchodilator reversibility response or a GABA receptors review positive bronchoprovocation test such as positive methacholine test. However, our patient Inhibitors,research,lifescience,medical showed a mild obstruction with an FEV1 of 72% of predicted and a significant bronchodilator reversibility test (14% increase in FEV1 above the baseline) and his spirometry showed an improvement in FEV1 to 88% at 4 months from the incident. The management of RADS is the same as that for patients suffering from asthma from any other cause.10 Our patient was managed similar to bronchial asthma. For the first few days, he received intravenous hydrocortisone (100 mg) every 8 hours along with oxygen Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical and salbutamol nebulization. Once his symptoms improved, he

was switched to inhaled rotacaps, containing formoterol fumarate (6 mcg) and budesonide (400 mcg). The prognosis of RADS is highly variable. In some cases, the symptoms may persist for months or even years.11 In our case, however, the prognosis was better. Our patient’s symptoms persisted for 5 Urease months, after which he had only occasional cough, which did not affect his routine work. We have herein described a classic case of RADS due to exposure to porcelain tile dust, the like of which has not been previously reported to the best of our knowledge. Conclusion The present case was RADS as a result of first time heavy exposure to porcelain tile dust, which was diagnosed according to the criteria laid by Brooks et al.4 Our case report draws attention towards the recognition of this entity; otherwise, most of these patients are wrongly labeled as bronchial asthma by the majority of general physicians. Conflict of Interest: None declared.
Hyperbilirubinemia has been recognized as the most common cause of readmission of healthy newborns after early hospital discharge.