Treatment of Chronic Cough in IPF

IPF remains to be one of the most unrecognized and undiagnosed respiratory illness. IPF leads to stiffening of lung making it hard due to progressive replacement of lung tissue with scarred tissue (fibrosis). The symptoms are dry cough and progressive symptom of breathlessness. 

Dry cough constitutes to be the most common symptom in IPF. Many patients of IPF complains of chronic refractory cough. Chronic cough in IPF is important symptom leading to significant deterioration of quality of life. Chronic cough in IPF is not just a disabling symptom but also and an important predictor of disease progression.

Important triggers for cough in IPF patients are   

 - smoke perfumes

 - throat irritation

 - noxious fumes 

 - speech

 -  exercise 

 -  cold dry air

 -  eating and 

 -  humidity

The co- morbidities influencing cough in IPF are 

-gastroesophageal Reflux disease (GERD)

- emphysema 

- Ace inhibitor use 

- chronic Sinusitis 

- lung cancer and 

- infection

Usual cough syrups aur antitussives Do not benefit much. Steroids and antifibrotic may benefit In cough but further studies are required. Treatment of comorbidities, neuromodulator like gabapentin or pregabalin have been shown to improve cough. There are various trials undergoing evaluating novel medications, Azithromycin, laparoscopic anti Reflux surgery, supplemental oxygen, Omeprazole and cognitive behavioral therapy for management of cough

Asthma: Inhalers hai sahi (inhalers are right treatment )

Asthma, also known allergic bronchitis, is a condition where the airways (air tubes) get swollen and narrowed up due to allergic trigger and causes cough, breathlessness, wheezing in individuals living with this lung condition. It may be associated with allergy of nose, eyes or skin etc. Asthma affects 339 million people across the globe. Globally asthma ranks 16th in causing Life lived with disability and 28th in global burden of diseases. In India though the prevalence is less than western world, about 5 to 10 percent, Over 80 percent of deaths occur in low or middle group countries like India. There is a rise in number of cases every year and the reasons attributed are better detection, air pollution, smoking and environmental tobacco smoke exposure etc.

We as health care professionals have a responsibility to curb down the sufferings from asthma along with health authorities and Government to India. Encouraging patient advocacy, following guidelines, empowering patients with right knowledge about disease and treatment (inhalers) are few steps which will bring down sufferings, disability and deaths in people living with this lung condition. 

Why should we really talking about asthma? Asthma kills people in young age,  is a cause of school or work absenteeism, compromises quality of life and puts economic enormous burden on individuals and country. And the worse is, with present treatment options, they are preventable. There is enough medical evidence to support that the best treatment option in asthma is inhalers. There are a lot of myths regarding the disease and inhalers. We need to disseminate knowledge about disease and inhalers to bring down sufferings of individuals living with asthma. The disease still continues to be a stigma and treatment with inhaler is a taboo. We need to join  the social campaign "INHALERS HAI SAHI" and reach to maximum number of people with right information about disease and treatment options. 

There are two groups of medications.

1. Reliever medications 

    • Gives immediate relief 

    • most commonly used in asthma

    • available in tablets, syrups and inhaler form

    • makes asthma worse of used alone without preventor group of medications 

    • may increase death rate in asthma patients if used alone

    • latest guidelines prohibit using it alone in any category or severity of asthma patients due to higher death rates observed in such patients 

2. Preventor medication

    • available in tablets, syrups and inhaler forms

    • tablet and syrups have significant side effects

    • inhalers have medication in very less amount, so targeted drug delivery to lung gives benefit without significant side effect profile

    • enormous amount of medical evidence about efficacy and safety of inhalers present to prove that it is the best form of treatment 

3. Preventor + Reliver

    • it has become the backbone of asthma management 

    • it is the most commonly prescribed form worldwide

    • gives both benefits of reliever and preventor with lovely safety profile data

    • prevents both sufferings and death from asthma 

Don't shy away from inhalers and inhaled steroids. Inhalers are the best form of treatment due to very low dose of medication (in micrograms or a 1/1000 of milligram). It is safe both children and adults. 

#asthma #inhalers #asthmadeaths #inhalershaisahi #asthmaeducation #asthmatreatment #chandanhospital #newlifechestandfamilyclinic #draksinghchest 

What is Allergy and is it curable?

Some people become ill after coming in contact with substances which have no effect on most other people. This is called an allergic reaction. Or you can say that the person has 'an allergy' to the substance.

One can have an allergic reaction on  breathing or eat or have physical contact with the substance you are allergic to. An allergic reaction can show itself in different ways, such as:

• sneezing
• an itchy or runny nose
• red eyes
• breathing problems and coughing
• common skin problems such as hives or eczema

The substances which cause these reactions are known as allergens. Common examples of allergens that affect the lungs include:

• pollen from grass and trees
• house dust mites
• animal fur

Some people - between a quarter and a third of us - have a tendency to develop allergies. This runs in families. However, not all the people with this tendency will actually get allergy problems. Allergic problems should not be ignored. Though, it cant be cured but there are good medicines to control and measures to attenuate allergic responses.

Understanding and treatment of allergy in medical science have grown beyond anti-allergic these days. Patients with severe, intractable or life threatening allergies have other options like anti-IgE antibodies, immunotherapy and organ targeted treatment modalities.

Images: Courtesy Internet

Diagnosing OSA (obstructive sleep apnea)

Sleep apnea is a sleep disorder characterized by abnormal pauses in breathing or instances of 

abnormally shallow breathing, during sleep. Each pause or cessation in breathing is called an apnea,

 can last from a few seconds to minutes, and may occur 5 to 30 times or more an hour. Similarly, 

each abnormally low breathing event is called a hypopnea. Sleep apnea is diagnosed with an 

overnight sleep test called a polysomnography, or "sleep study".

Diagnosis of OSA usually happens at a sleep clinic. Sleep study is simple test requiring no needle prick or pain. It is done with few probes overnight when the person sleeps.

Bronchoscopy: an important aid to make appropriate pulmonary diagnose

Bronchoscopy is a procedure that allows the doctor to look inside patient’s lungs (airways). During the procedure, a thin, flexible tube called a bronchoscope is inserted into patient nose or mouth and passed down the throat into the airways. The patient will be given medicine to make feel relaxed and sleepy during the procedure. The sedation makes patient undergo the procedure with no discomfort.

Bronchoscopy can help find the cause of a lung problem. For example, during the procedure, the doctor may see

·         A tumor or narrowing

·         Signs of infection

·         Excess mucus in the airways

·         Site of bleeding & Foreign body such as a piece of food in patient airway 

Bronchoscopy is a same day out-patient procedure. It is a safe procedure. Side effects and complications usually are minor.

Flu shot is the right choice for asthamatics

Adults with asthma are at high risk of developing complications after contracting the influenza virus, yet most adults with asthma do not receive an annual flu vaccination.

Respiratory infections like influenza are more serious in patients with asthma, and such infections can often lead to.pneumonia and acute respiratory disease

Routine annual influenza vaccination is recommended for all persons aged ≥6 month). To permit time for production of protective antibody levels vaccination should optimally occur before onset of influenza activity in the community, and providers should offer vaccination as soon as vaccine is available. Vaccination also should continue to be offered throughout the influenza season.

A just simple vaccine can change the severity of disease during seasonal changes.

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OBSTRUCTIVE SLEEP APNEA- A SILENT KILLER

Obstrutive sleep apnea (OSA) is a sleep disorder in which a person stops breathing intermittently during sleep. This leads to fall in oxygen levels during sleep. OSA is associated with high blood pressure, diabetes, decreased concentration levels, falling asleep during day, depression, sexual dysfunction, learning and memory impairment. It can be diagnosed with a simple non invasive test.