Pulmonary Function Tests or PFTs are a set of tests that are used to determine, measure or observe the functioning of the lungs. The most common pulmonary function tests used are spirometry, gas diffusion, and lung plethysmography. 

Highlights of pulmonary function tests

A spirometry test is used to measure the amount of air inhaled and exhaled. It also measures the amount of time taken to complete a respiration cycle.
A lung plethysmography measures the amount of air in the lungs after the patient has taken a deep breath. It also measures the amount of air that remains in the lungs after the patient has exhaled as much air as possible.
What does a Pulmonary Function Test measure?
Pulmonary function tests would not only check how well the person is breathing but also how effectively the lungs are able to conduct oxygen to the rest of the body. In addition to air flow, these tests would measure the size and volume of the lung and lung diffusion.

These tests can also be used to measure

Total Lung Capacity   the amount of air present in the lungs after breathing in deeply
Forced Vital Capacity   the amount of air that can be exhaled after breathing in deeply
Minute Volume   the amount of air exhaled per minute
Vital Capacity   the total volume of air that can be breathed out after inhaling as much as possible
Tidal Volume   the amount of air inhaled or exhaled when breathing normally
Maximum voluntary ventilation   the amount of air that can be inhaled and exhaled in one minute
Functional Residual Capacity   the amount of air that remains in the lungs when breathing normally
Forced Expiratory Flow   the flow or volume of air during an exhalation
Peak Expiratory Flow Rate   the rate at which a person can exhale
When are Pulmonary Function Tests recommended?
A physician might recommend a patient undergo a PFT as part of a routine physical check-up. This test would be advised if the patient is experiencing any symptoms associated with lung problems or disorders such as asthma, respiratory infections, chronic obstructive pulmonary disease, COPD. A doctor would also use these tests to monitor and check whether a certain treatment prescribed for a lung disease or condition is working effectively.

Pulmonary function tests are safe as they are non-invasive but it is important to follow the instructions of the doctor or technician before, after and during the test. It is important to make your doctor aware of any surgeries, respiratory infections, chest pains or heart attacks that you might have experienced before the test. If you are taking any medications you might need to follow the advice of the doctor as to whether you can take them before the test.

Your doctor would also advice you on how to prepare for the test such as not eating a large meal, avoiding caffeine and wearing loose-fitting clothes. If you have any doubts, concerns or queries discuss them with your doctor.

Pulmonary Function Tests - Why Is It Required?

Upper respiratory infection (URI) is a condition, which involves illness, mainly caused by critical infection in the upper respiratory tract. This region includes the pharynx, larynx, nose and sinus. This infection causes diseases, such as tonsillitis (tonsils get inflamed), pharyngitis (causes sore throat) sinusitis (nasal passage becomes inflamed), laryngitis (voice box in your throat gets inflamed) and common cold.

Causes of upper respiratory infection (URI):
1. Both virus and bacteria cause upper respiratory infection (URI). The most common form of virus causing this infection is known as 'rhinovirus.'

2. The immune system of young adults and children are often very vulnerable. Hence, they are more likely to develop upper respiratory tract infection.

3. URI is also contagious and airborne in nature. So if a person comes in contact with an infected person suffering from URI, he/she is likely to develop this infection.

4. Not washing hands before meals can also cause upper respiratory infection because the virus can be transferred easily to the mouth and can travel into your system.

5. If you have any lung problem or heart disease, you are more likely to be susceptible to upper respiratory infection.

6. Those who already have inflamed tonsils can trigger tonsillitis by drinking any cold or spicy beverage like ice-creams or cold milkshakes.

7. Exposure to some flu or cold can cause pharyngitis. It can also be caused by second hand smoking.

8. Birth defects or structural defects in the nasal cavity or nasal polyps can cause sinusitis. Sometimes the inside part of the nose may get swollen due to common cold and block your ducts. This is a common cause for sinusitis.

Symptoms of acute upper respiratory infection:
1. Congestion in the lungs or nasal area.
2. Whooping cough
3. Running nose due to common cold.
4. Feelings of fatigue and lethargy throughout the day.
5. Your body will start aching without engaging in any physical exercise.
6. You can also lose consciousness in severe respiratory tract infections.
7. Difficulty in breathing.
8. Oxygen levels in blood drop down drastically.

Sometimes in worse cases, acute upper respiratory tract infection (URI) can also cause respiratory failure, respiratory arrest and congestive heart failure. Therefore, it is necessary to book an appointment with a doctor as soon as you start experiencing the above symptoms.

Acute Upper Respiratory Infection: Causes and Symptoms

Whooping cough, also known as pertussis, is a bacterial infection of the respiratory system that is known to affect children below five years of age. It affects the lungs and is caused by the bacteria Bordetella pertussis. In some cases, even adults can also be afflicted with this infection. The infection is characterized by coughing or bouts of coughing, which is followed by a whooping sound made by the patient as they gasp for breath. 

Also, symptoms of a whooping cough are similar to that of cold and include low-grade fever, sneezing, runny nose. mild coughing, sore throat, loss of appetite, weakness, tears, and inability to sleep. Allopathic medicines, mainly antibiotics and cough suppressants, are prescribed by doctors but they impact the body adversely and do not treat the disease completely either. On the other hand, Ayurveda remedies are gentle in nature. They do not carry any side effects and cure the infection completely. 

Here are some well-known and effective Ayurvedic remedies for whooping cough.

Basil (Tulsi): Basil or Tulsi is one of the oldest and most popular herbs that carry strong anti-bacterial properties. Being an anti-allergic as well, it boosts the immune system and helps the body fight various infections. It provides instant relief from cough, cold, and fever.
Calamus (Vacha): This proves to be very effective in curing coughing. It flushes out phlegm and clears congestion. It also provides relief from a sore throat and cures hoarseness of voice.
Honey (Shahad): It is a gentle antibiotic and mild cough suppressant. Since it is sweet in taste, it is perfect for children. It soothes the throat walls and calms the patient. It can be consumed with lukewarm water as well.
Ginger (Adrak): A natural cough suppressant, ginger gives relief in throat irritation. Analgesic in nature, it also reduces pain in the throat and body. Its anti-inflammatory action relaxes the irritated respiratory tract and eliminates mucus from the lungs. Since ginger is bitter, its juice can be mixed with honey before consumption.
Dashamuli Ghrita: Medicated clarified butter (ghee) is for external use and it gives quick relief from a sore throat when massaged on the chest. It is also effective in the case of coughing as ghee loosens the cough. It provides relief from congestion too.
Oil Massage: Massaging the chest and throat with ginger, cinnamon, or eucalyptus oil gives relief from nighttime congestion and cough. It soothes the throat and ensures sound sleep.
Black Pepper (Kaali Mirch): Black pepper is a natural decongestant and thus, clears the nasal passage, bringing relief in coughing. It also eases the respiratory tract and boosts the immune system, helping it to fight the bacterial infection. To dilute its bitter taste, a little honey can be added during consumption.
Ayurveda believes that a whooping cough is the result of vata and kapha imbalance in the body and hence, all these remedies focus on correcting this imbalance. Though all these remedies are safe and free from side effects, it is always advised to consult an Ayurveda doctor. If given on one s own, the dosage should be kept light.

Ayurveda And Whooping Cough!

The inflammation of the cavities around nasal passage is known as sinusitis. When the cavities are full of fluid, germs attach themselves to the fluids, which give rise to infections. Some of the causes of sinusitis are common colds, allergic rhinitis, nasal polyps and deviated septum.

There are 4 different types of sinusitis:

    Acute sinusitis: It remains for about 4 weeks or less. It is usually characterized by a runny nose and pain in the face which will stay for at least 10 to 14 days.
    Sub acute sinusitis: It is almost like the acute sinusitis but stays longer for about 4 to 8 weeks.
    Chronic sinusitis: The inflammation in this case lasts about 8 weeks, sometimes longer than that.
    Recurrent sinusitis: In this, the sinusitis attack keeps occurring all through the year.

At times, to clear up the blocked sinuses, a surgery is mandatory. This can be painful hence many are hesitant to go through with a surgery. If you want to control sinusitis so that it doesn't reach the limit where you have to go through a surgery, here are some tips of what you might be able to do regularly to clear your chances of controlling this:

    Take steam: This is the most common and easy way to control sinusitis. The steam helps to break down the excess mucus in the nasal passage and also reduces the inflammation of the sinuses. All you need is water. Heat it up to the required temperature and then inhale the steam. You will get a lot of relief if you do this regularly.
    Nasal Irrigation: This is basically the process of flushing the infected and stale mucus out of the nasal cavity. Take a liter of sterile water, mix one tablespoon of kosher salt and baking soda each. Then with the help of a syringe or a neti pot, wash your nostrils with the solution. The mucus will start coming out and your nasal cavity will clear out.
    Use warm washcloth: Lie down and place a warm washcloth (a washcloth dipped in warm water and wringed) on your forehead and nose region. The warmth from the washcloth will break down the mucus and clear the congestion.

Sinusitis: Controlling it without Surgery

Pulmonary hypertension mainly occurs due to narrowing of the arteries of the lungs as a result of which the flow of blood is restricted. In this kind of condition, blood fails to carry oxygen to your heart and thus your heart gets adversely affected. The blood pressure of your body will get increased to a great extent if this situation remains untreated, thus leading to bdreadful consequenses, specifically situation like heart failure, serious pulmonary diseases, blood clots in lungs and congenial heart defects, etc.

There are certain forms of pulmonary hypertension, which are serious in nature and worsen with time, so much so that they are even fatal at times. It also includes forms which are non curable in nature, however, in order to improve the quality of life, symptoms can be reduced with proper treatment. The treatment for pulmonary hypertension is often complex and it takes some time to find the most appropriate treatment and requires extensive follow-up care. Your doctor might also need to change your treatment if it's no longer effective. However, when pulmonary hypertension is caused by another condition, your doctor will treat the underlying cause whenever possible.

Common treatments for pulmonary hypertension:

Medications

1. Blood vessel dilators (vasodilators): vasodilators open narrowed blood vessels. They are one of the most commonly prescribed vasodilators for pulmonary hypertension is epoprostenol (flolan, veletri). The drawback to epoprostenol is that the effect lasts only for few minutes. This drug is continuously injected through an intravenous (iv) catheter via a small pump that you wear in a pack on your belt or shoulder.

2. Ventavis: another form of the drug, iloprost (ventavis), can be inhaled six to nine times a day through a nebulizer, a machine that vaporizes your medication. Because it's inhaled, it goes directly to the lungs.

3. Treprostinil (tyvaso, remodulin, orenitram): it is another form of the drug, which can be given four times a day and can be inhaled or can be taken as an oral medication and can also be administered through injection.

4. Endothelin receptor antagonists: these medications reverse the effect of endothelin, a substance in the walls of blood vessels that causes them to narrow. These drugs may improve your energy level and symptoms. However, these drugs shouldn't be taken if you're pregnant. Also, these drugs can damage your liver and you may need monthly liver monitoring.

6. Sildenafil and tadalafil: sildenafil (revatio, viagra) and tadalafil (cialis, adcirca) are sometimes used to treat pulmonary hypertension. These drugs work by opening the blood vessels in the lungs to allow blood to flow through more easily.

6. High-dose calcium channel blockers: these drugs help relax the muscles in the walls of your blood vessels. They include medications, such as amlodipine (norvasc), diltiazem (cardizem, tiazac, others) and nifedipine (procardia, others). Although calcium channel blockers can be effective, only a small number of people with pulmonary hypertension respond to them.

7. Soluble guanylate cyclase (sgc) stimulator: soluble guanylate cyclase (sgc) stimulators (adempas) interact with nitric oxide and help relax the pulmonary arteries and lower the pressure within the arteries. These medications should not be taken if you're pregnant. They can sometimes cause dizziness or nausea.

8. Anticoagulants: your doctor is likely to prescribe the anticoagulant warfarin (coumadin, jantoven) to help prevent the formation of blood clots within the small pulmonary arteries. Because anticoagulants prevent normal blood coagulation, they increase your risk of bleeding complications. Take warfarin exactly as prescribed, because warfarin can cause severe side effects if taken incorrectly. If you're taking warfarin, your doctor will ask you to have periodic blood tests to check how well the drug is working. Many other drugs, herbal supplements and foods can interact with warfarin, so be sure your doctor knows all of the medications you're taking.

9. Digoxin: digoxin (lanoxin) can help the heart beat stronger and pump more blood. It can help control the heart rate if you experience arrhythmias.

10. Diuretics: commonly known as water pills, these medications help eliminate excess fluid from your body. This reduces the amount of work your heart has to do. They may also be used to limit fluid buildup in your lungs.

11. Oxygen: your doctor might suggest that you sometimes breathe pure oxygen, a treatment known as oxygen therapy, to help treat pulmonary hypertension, especially if you live at a high altitude or have sleep apnea. Some people who have pulmonary hypertension eventually require continuous oxygen therapy.

Surgeries

1. Atrial septostomy: if medications don't control your pulmonary hypertension, this open heart surgery might be an option. In an atrial septostomy, a surgeon will create an opening between the upper left and right chambers of your heart (atria) to relieve the pressure on the right side of your heart.

2. Lung transplantation: in some cases, a lung or heart lung transplant might be an option, especially for younger people who have idiopathic pulmonary arterial hypertension.

Reducing complications

1. The complications need to be reduced by taking proper health care. Healthy diet needs to be taken regularly along with proper medications. Smoking should be stopped and exercising sessions should be attended daily without any fail

2. Overweight or obesity needs to be controlled properly for reducing the complications. Specialized caring strategies need to be maintained for avoiding severe kinds of health complications that are quite annoying.

Pulmonary Hypertension: How to Treat It?

Asthma is a disease that can be only controlled and not completely cured. This chronic disease can make one feel breathless and experience chest tightening. Modern medicine has an answer to the stressful symptoms of asthma. A wide range of tools and medicines help a great deal in controlling this disease. Find what tools and medicines can help in bringing down the symptoms of asthma and help one breathe with ease.

Pink flow meter: This small tool helps in measuring the movement of air in the lungs. You need to blow into it and read the number. The result helps in finding out the frequency of doctor visits and the dosage of the medicines. Forthcoming asthma attack too is indicated by this device, and you can see it declining with constant use. In fact, you would slowly stop experiencing any other symptoms. Using the pink flow meter forewarns you about a forthcoming asthma attack.

Checkups: You need to visit your doctor regularly. The frequency can vary. You will be seeing your doctor after every two to six weeks, based on the severity of the disease. If you strictly stick to the instructions of your doctor, you can improve the lung function. You can stay active and sleep well if you follow the medicines. This way, there will be no fear of emergency treatment as the peak flow is almost always above 80 percent in case of complete compliance to medicine. Even if you know your condition cannot be cured, you can keep it in check to lead a healthy life.

Medications: Asthma has to be controlled with two types of medicines. You will need to take fast-reacting medicines and the long-term medications. Providing immediate relief is what the quick-relief medicines do, and reducing inflammation of the airways is what the long-term medicines aim at. While there are pills available, the inhalers play a vital role in keeping asthma patients healthy. Through an inhaler, the medication is administered straight into the airways. This makes it easy to give larger and continuous dose of medicines. In fact, this is the most effective way to prevent and treat the asthma symptoms. Corticosteroids are inhaled with an inhaler and it results in long-term relief. Even if taken daily, patients do not get addicted to corticosteroids. Physicians may also prescribe pills that reduce inflammation of the airways. Short-acting b2 agonists are often prescribed as quick-relief medicines. Asthma-affected individuals must carry the inhaler and the quick-relief medicines with themselves, wherever they go.

Treatment for different age groups: In children, only the quick-relief medicines are prescribed. If required, the long-term medications are used after six years of age. If desired results are obtained, the treatment is stopped after six weeks. Children can also be administered corticosteroids. This may result in slowed growth in a few children but the effect does not last long. In elders, long-term inhaling of corticosteroids can increase the risk of osteoporosis. It is essential to take vitamin D supplements along with it. Also, do not take pain suppressants and anti-inflammatory drugs. Speak with your doctor about taking pills for other diseases. When a pregnant mother is asthmatic, the chances of the child getting asthma are higher. They also suffer the risk of premature birth and low birth weight. Check with your doctor about taking medicines for asthma when you are pregnant. You need to consider the risk and stick to safe medication practices.

Asthma - Know About Its Treatment In Modern Medicine! 

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