The lungs are responsible for taking in and filtering out oxygen which is then supplied to the body via circulation. They are also responsible for removing the carbon dioxide from the body. This happens through breathing, and though no effort is required, when the function is impaired, the entire body system takes a toll.

Lung function can be impaired by a multitude of issues including infections like pneumonia, chronic diseases like COPD and pulmonary hypertension, heart conditions like a congestive failure, etc. While the acute cases would go off once the infection is treated, the long-term conditions are helped by physiotherapy in addition to medications.

The lungs are made up of elastic tubules and have the ability to hold secretions. Therefore training the lungs to improve their function via exercise can help improve overall lung function. Some of the routine exercises are simple ones as below.

Active breathing: The patient is taught to breathe in a more aware manner so that the lungs take in air to their maximum ability.
Postural drainage: The lungs are like containers for mucus, and over a period of time, they need to be drained. Depending on where the fluid accumulation is, the patient is taught to lie in various positions so that it can be drained, allowing for instant relief.
Nasal saline rinse: This helps in clearing the secretions and also the saline provides an antibacterial effect to clear off residual infection. Clearing sputum is highly critical for reducing chances of repeat infections and hospitalizations.
Peripheral and respiratory muscle training: Though it goes unnoticed, breathing also involves neck and shoulder muscles and strengthening these is also essential for effective breathing.
Multiple studies have shown that physiotherapy plays a vital role in lung rehabilitation. As noted above, while the benefit may be not very evident in short-term lung impairment, it makes a significant difference in long-term and chronic conditions like COPD, pulmonary hypertension, and even congestive heart failure. Lung rehab has shown to produce the following changes:

Reduce episodes of breathlessness and fatigue. A person can gradually resume his normal chores without too much assistance.
Help in clearing secretions, which can worsen congestion and breathlessness.
Increase overall quality of life. There could be even people who cannot do routine activities like walking to the bathroom. They could be benefitted with pulmonary rehabilitation.
Reduce the number of hospitalizations due to mucus accumulation and breathlessness.
Improve exercise tolerance. It is well known and proven that those who exercise on a regular basis can improve lung function over a period of time.

Lung Rehabilitation - How Physiotherapy Can Help?

People suffering from pneumonia, postoperative partial or complete collapse of the lungs, chronic respiratory conditions like Chronic Obstructive Pulmonary Disease, Cystic Fibrosis etc as well as people suffering from neuromuscular diseases can get partial relief by respiratory physiotherapy. If a person is suffering from retained secretions, increased effort to breathe or volume loss, he or she may be referred to Respiratory Physiotherapy.

Respiratory Assessment Of The Patient

A Respiratory Physiotherapist will assess the condition of the patient with the help of Respiratory Assessment or Respiratory Examination. It includes:

Auscultation and review chest X-Ray

Interpreting arterial blood gasses test and blood tests

History of present illness

History of past illnesses

Details of cough, breathlessness, sputum, chest pain  

Other symptoms like headache, fever, CO2 retention, heart failure, peripheral oedema, shivering, palpitations, weight loss, Gastrointestinal Reflux Disease, vomiting and nausea etc.

Respiratory Physiotherapy Techniques -

After the Respiratory Assessment the doctor may prescribe the following:

Breathing Exercises

Exercises like Active Cycle Of Breathing Techniques can help in clearing phlegm. Since people in respiratory distress often produce more phlegm than normal, it is essential that this excess phlegm be removed. This can help the person breathe more freely. Removing the phlegm can also help prevent infections in the chest and reduce coughing. It is a set of exercises that together help in establishing breathing control, huffing and deep breathing.

Mobilisation

Early mobilization is one of the most important aspects of chest physiotherapy. It includes positioning, active and passive turning, cycling pedals, standing, stepping etc. 

Manual Techniques

The Physiotherapist may apply pressure on the chest to facilitate airway clearance while keeping the patient in gravity assisted phlegm drainage position. 

IPPB

It employs a device that helps patients take a deep breath, cough and clear lungs. The device offers short-term and intermittent mechanical ventilation of a positive pressure set by a physiotherapist. The device pushes a mixture of oxygen through a facemask.

Suction

Here too the physiotherapist uses a device to suck out excess mucus from the chest and facilitate breathing. Here the cough is stimulated by a catheter and phlegm is sucked out using another catheter.

MHI

It is the acronym for Manual Hyperinflation. This procedure is carried out by a Respiratory Physiotherapist to give volume to partially or completely collapsed lungs.

BiPAP or CPAP

The device delivers pressurized air into the patient's airways through a facemask. The pressure of air prevents collapse of the throat muscles and reduces airway obstructions. In essence, they allow patients to breathe more freely and regularly. 

Conclusion

Right Respiratory Assessment or Respiratory Examination is crucial to applying the right physiotherapy techniques. Right techniques may help patients breathe more freely and avoid respiratory infections. 

Know More About Respiratory Examination!

Pericardial effusion is the excess fluid between the heart and sac surrounding the heart. The fluid keeps the heart moving in the sac. The excess fluid can cause a problem in the workings of the heart and may lead to death. The space between two layers of sac usually contain 2-3 tablespoons of clear liquid. But pericardial effusion can affect the heart beats and make it weaker.

Causes 

The leading cause of the pericardial effusion is pericarditis. In this condition, the layered sac of the heart is inflamed due to some viral infection. This inflamed sac produces more fluid.

Some of the most common infections that cause pericarditis are: 

  Viral infection 

  Cytomegalovirus 

  Coxsackieviruses 

  Echoviruses 

  HIV 

The other causes of pericarditis and pericardial effusion are: 

  Injury in the heart or the sac 

  Cancer 

  Kidney failure 

  Tuberculosis 

  Lupus 

Symptoms 

Generally, when there is minimal or no inflammation in the sac, there are no symptoms. However, chest pain and short-breathing are the most common symptoms for pericardial effusion. 

The large pericardial effusion in the heart sac can show symptoms like: 

  Shortness of breath 

  Passing out occasionally 

  Fast heart pounding 

  Fatigue 

  Clammy skin 

In some cases, where the condition is not worse, patients may experience: 

  Fever 

  Fatigue 

  Vomiting 

  Muscle aches 

  Viral illness

Diagnosis 

The person experiencing the above-mentioned symptoms should visit a cardiologist for a checkup. The doctor may ask for following tests and checkups for determining the condition: 

  Physical Checkup: In the physical checkup, the doctor listens to the heartbeat of the patient and assess the heart beat rate. He will also ask about the family history and medication records. 

  EKG: With EKG, doctors determine the heart rate with the help of electronic devices. Electrodes are placed on the chest, and heart activity is tested. However, the presence of pericardial effusion is difficult with EKG. 

  Chest X-Ray: X-Ray is an excellent way to detect the presence of pericardial effusion in the patient. The enlarged portion is detected in the image. Once an enlarged sac is detected, doctors order the echocardiogram test. It is an Ultrasound for the heart and gives a clear picture of the patient&#39;s heart condition. Once it is determined that the patient has pericardial effusion, the doctor determines the size of the enlarged sac and quantity of liquid in it. Most of the time, pericardial effusion is small and not severe. But if the size and quantity of the liquid are high, the doctor determines the condition of the heart and the ability to pump the blood. The doctor may also take a sample of the fluid from the sac to determine the exact cause for inflammation. 

Take Away 

Pericardial Effusion is a condition in which fluid is accumulated between the heart and sac surrounding the heart. Though the problem is not severe, it is advisable to consult a doctor.

Pericarditis / Pericardial Effusion - Know More About It!

The Interstitium is a network of tissues in the lungs. It supports the functioning of microscopic air sacs in the lungs, known as Alveoli. Tiny blood vessels travelling through the interstitium help in exchange of gases between blood and air. In ILD or Interstitial lung disease, this important function of the lungs is disturbed. This can lead to ILD, including Sarcoidosis.

In general, the symptoms of ILD include shortness of breath, dry and non-productive cough and unexplained weight loss.

Causes Of Interstitial Lung Disease

It is estimated that regular exposure to irritants through inhalation, at work or otherwise, can precipitate ILD. Bacteria, Viruses, and Fungi are known to cause Interstitial Pneumonias. The following irritants can cause ILD:

  Silica dust
  Asbestos
  Coal dust and other dusts, such as those inhaled during working in mines
  Talc
  Bird proteins (such as Chicken or Pigeon food)
  Grain dust inhaled from farming

Drugs such as Amiodarone, Nitrofurantoin, Bleomycin etc. may also cause Interstitial Lung Disease. However, a fair chunk of the causes of Interstitial Lung Disease are unknown.



About Sarcoidosis

In Sarcoidosis, there is growth of tiny inflammatory cells in different organs of the body, such as the Lymph nodes, Skin, Eyes and the Lungs. Lungs are the most common organs which Sarcoidosis affects.

Symptoms of ILD and Sarcoidosis

  Symptoms may include Fever, Fatigue, Shortness of breath, Weight loss, Persistent cough, Swollen lymph nodes, Chest pain, Wheezing etc.
  There may be reddish-purple bumps on shins or ankles, sores on nose, ears and cheeks, growth of nodules under the skin, etc.
  The patient may have Blurred vision, Eye pain, Severe redness and Sensitivity to light.
  A patient may also suffer from Chest pain, Shortness of breath, Fainting, fatigue, Irregular heartbeats, Palpitations, Swelling due to Accumulation of Fluid, etc.

Treatment of ILD and Sarcoidosis

  Antibiotics for Interstitial Pneumonia condition
  Corticosteroids or Immunosuppressants for skewed immune response
  Oxygen inhalation for low oxygen level in body due to ILD
  Antioxidants to reduce the rate of decline in lung function.

Sarcoidosis

  Though there is no cure for this disease, a patient may be treated through medicine if the disease starts affecting the functioning of other organs.
  The patient may be given Corticosteroids to Suppress Inflammation.
  If the condition is worse, the patient may also be given Immunosuppressants and other medicines to overcome specific organic problems.

ILD and Sarcoidosis are common diseases nowadays due to increasing pollution all around. In case of any of the symptoms of ILD and Sarcoidosis show up in a patient, it is highly recommended to get advice from an experienced Pulmonologist. The treatment is mostly antibiotic-based, and curbs the infection out of the body. The sooner the treatment can start, the better it is.

ILD And Sarcoidosis - Causes, Symptom And Treatment Of Them!

An allergy occurs when your body s immune system reacts abnormally to certain substances or chemicals (known as allergens) that may actually be harmless.

Respiratory allergies are one of the most common forms of allergy seen in people of all ages. This type of an allergy occurs when the immune system reacts negatively to airborne substances, for example, dust. Although normally these substances do not pose a threat to your body, the antibodies consider allergens dangerous and release chemicals (histamines) to fight it. This response of the body to an allergen is expressed in the form of symptoms like a rash and is known as an allergic reaction.

Causes of Respiratory Allergy-
Some of the common causes of respiratory allergy are-

Dust/pollen- when you are exposed to dust mites that are usually found indoors
Mold- when you inhale mold spores
Pet dander- when you inhale or come in contact with pet dander/saliva
Apart from these, exposure to certain irritants such as fumes and smoke may also trigger a respiratory allergy in individuals.

Symptoms to watch out for-
The symptoms of respiratory allergy in each person may vary from those in another. Usually, the symptoms affect the airway, skin, or eyes.

Coughing/sneezing
Nasal congestion/discharge
Difficulty breathing
Runny/blocked nose
Watery, itchy eyes
Swollen eyelids
Sinus pressure
Severe allergic reactions may also lead to chest tightness, asthma, and conjunctivitis.

How Homeopathy treats Respiratory Allergy-

Homeopathy treatment is based on a paradoxical theory- a substance that triggers a set of symptoms is also capable of curing them. Homeopathy thus aims to evaluate what is causing the illness and eliminate its underlying causes.
As stated above, allergies are the result of an unknown immune response to an otherwise harmless substance. This usually occurs if you have a weak immune system. Homeopathy works to improve and boost your immune system, so you do not encounter allergic reaction to such conditions in future.
Medications and drugs used in conventional treatment methods often lead to side effects, but Homeopathy uses natural ingredients and substances, and hence these are 100% safe for consumption.
Allergies are usually curable, only if one takes prompt action. Allergic reactions, if left untreated for long, can quickly aggravate to cause a life-threatening condition like anaphylaxis. So if you see any of the above symptoms, consult a doctor as early as possible.


Can Homeopathy Treat Respiratory Allergies?

When man first started using tobacco, he probably did not know that it would grow to be an epidemic that could cause multiple health issues. Be it smoking or chewing, tobacco has severe negative effects on health. Take any of the current lifestyle diseases from diabetes to obesity, the common risk factor is tobacco abuse. In addition, depending on the form of tobacco used, specific organs are affected. For instance, chewing tobacco leads to oral cancer while smoking causes lung cancer.

The statistics around tobacco abuse are extremely startling and can be read below:

A total of about 90 trillion rupees are spent on various tobacco products.
About 1.4 trillion is spent on healthcare-related to conditions caused by tobacco abuse.
India has about 120 million tobacco users.
More than 7 million people die every year due to tobacco usage.
The Government has levied a GST of 28% on cigarettes, making them unaffordable, which is one of the ways to promote quitting.
For those who want to quit but are not able to, there is a quit-line setup, which is toll-free, 1800-11-2356 and is accessible from 8 a.m. to 8 p.m.
Tobacco is a menace in all the strata of society. The lower economic classes are adversely affected both due to lack of knowledge and healthcare facilities. Therefore, the government uses the World No Tobacco Day (WNTD) that is observed by all members of the World Health Organization as an opportunity to drive this awareness.

This is celebrated on May 31st every year. Some measures that are taken to promote 'say no to tobacco' campaign are listed below.

In 1975, the Cigarettes (Regulation of Production, Supply, and Distribution) Act was introduced, which made it mandatory for cigarette packs to have a warning stating  Smoking Kills  or  Smoking is injurious to health. 
Marketing campaigns are shown in the movie theatres at the beginning of movies which depict the hazards of tobacco
Smoking is banned in most public areas, and warnings are on display.
Children below 18 are not sold tobacco products. If in doubt, the seller can ask for age identification.
Schools and colleges do not have tobacco selling within 100 meters of the campus.
The price increase ensures that not everybody has easy access to cigarettes.
Celebrities promote quitting tobacco and smoking by talking about their personal stories.
How can a healthcare professional help you?

A healthcare professional plays a vital role in a smokers life, as it the healthcare professional that can increase the odds of quitting with guidance, medication, and support. 

What should a healthcare professional do?

Identify people who smoke 
Motivate them to quit or think about quitting
Refer a person who smokes for treatment and support
Support ongoing abstinence
What is the right smoking cessation strategy?

Ask: Every smoker to visit a healthcare professional
Advice: Urge the smoker to leave smoking
Assess: Assess whether the person is willing to quit in 30 days
Assist: Plan and help Rx Quit
Arrange: Arrange a follow-up through phone or SMS or in-person
What is that people who smoke need help with?

First and  the foremost challenge are the withdrawal symptoms 
Urge to smoke and borderline depression with a possibility of relapse
People who have high pre-abstinence nicotine intake
How to get over the initial withdrawal discomfort?

Behavioural support is of proven efficacy
Can be delivered in different formats
Face-to-face
Telephone
Internet
Nicotine replacement therapy and nortriptyline are of proven efficacy
Facts On Nicotine Replacement Therapy (NRT)

There are no real contradictions related to NRT
No drug interactions 
Side effects, if there are any are localized e.g.
Taste of oral products
Hiccups with the mouth spray 
Skin irritation with patch 
Treatment for quitting Nicotine  - Medications: Medicines which are useful adjuncts in the determined but unsuccessful quitters are Varenicline and Bupropion. 

Though smoking out in the open has reduced, there are miles to cover when it comes to eradication of tobacco. 

World No Tobacco Day - Making An Effort To Control Tobacco Usage!

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