Treatment of Sleep Disturbance
Asthma Management Program
Management of Smoking Cessation
Oxygen Therapy Treatment
Obstructive Sleep Apnea Treatment
Lower/Upper Respiratory Tract Infection Treatment
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I was suffering from breathing issue and cough cold issue since long for which I was looking for an experienced pulmonologist. Dr Nikhil Modi helped me alot. I am glad that I visited herclinic for the treatment. He provided me the critical care after which I feel much better.
I was having very bad thoughts regarding my asthma.With great ease dr Nikhil Modi explained me the problem and how the treatment will be carried out.Thanks to him I am totally satisfied with the results. he can be consulted at Indraprastha Apollo Hospitals in Delhi NCR.
A cough is probably one of the most common respiratory diseases that people suffer from. In most cases, it is nothing to worry about and can be cured with cough suppressants and salt water gargles. However, coughing of blood is a serious problem. The coughing up of blood that originates from below the level of the larynx is known as hemoptysis. This can vary in terms of severity depending on the amount of blood being expelled. This disease is a common condition, but on an average, less than 5% of hemoptysis cases are life threatening.
Hemoptysis rarely affects children. The symptoms of this condition include:
Sudden onset of a cough with bloody phlegm
Chest pain: Medical attention should be sought in cases where this condition recurs often, if it lasts for longer than a fortnight or if the volume of blood expectorated is more than 30ml per day. The various tools that help in the diagnosis of this condition are:
Chest radiography: This imaging modality helps lateralize bleeding and understand the amount of lung involvement. It is quick, inexpensive and can also help detect other underlying abnormalities.
Bronchoscopy: This involves the insertions of a rigid or flexible endoscope into the bronchial passages to check the airways and determine active bleeding sites.
MDCT: A multidetector CT is a non-invasive imaging tool that provides a comprehensive evaluation of airways, lung parenchyma, and thoracic vessels. It can also be used to uncover potential causes of bleeding such as bronchiectasis, pulmonary infections and lung cancer. In some cases, a multidetector CT angiography may also be used.
Oral antibiotics are usually the first stage of treatment for this condition. Smokers will also be urged to quit cigarettes as this can worsen their condition. Treatment for minor hemoptysis may also include:
- Oral hemostatics
- Cough suppressants
- Radiation of laser treatment
- Therapeutic bronchoscopy
In its later stages, hemoptysis can be treated with a minimally invasive procedure known as endovascular embolization or with surgery. In some cases, endovascular embolization may also be sued to stabilise the patient before surgery. This procedure reduces the pressure in the hypertrophic arterial blood vessels and decreases the risk of perioperative bleeding.
Hemoptysis is also one of the most common complaints of lung cancer patients. Depending on the stage of cancer and the amount of blood expectorated, treatment in some cases may not be possible. In such cases, a parenteral opioid and fast-acting benzodiazepine may be administered. If you wish to discuss about any specific problem, you can consult a Pulmonologist.
Smoking can cause irreparable damage to your mind and body. Chemicals in the tobacco travel to all parts of the body, leaving no area unaffected. According to available data, smoking causes 30% of all cancer deaths and about 80% deaths from emphysema and bronchitis. In addition to adversely affecting yourself, smoking also has a severe impact on your near and dear ones. According to WHO, about 600,000 people die every year from passive smoking. Out of the deaths that occur due to this, 1/3rd is that of children.
The Indian situation
While 85% of tobacco users worldwide consume it in the form of cigarettes, in India only 13% use it in that form. Additionally, 54% use it in the form of beedis. A study conducted on Indian smokers has revealed that an average of 8.2 cigarettes is smoked by an individual daily.
The study also revealed that the number of cigarettes smoked every year had grown to over 6 trillion. While 1 out of 10 adults dies from tobacco use worldwide, 5% of deaths in women and 20% of deaths in men in India are caused by cigarette and beedi smoking.
What happens when you smoke?
Cigarette smoke is made up of 4000 chemicals that are present either as tiny particles or gases and about 50 are known to lead to cancer, the toxin nicotine being one of them. In addition to nicotine, the chemicals that make up cigarette smoke also include tar and carbon monoxide. Prolonged exposure to these toxins can hamper your body's ability to filter air and clean the lungs. The smoke not only irritates the lungs but also causes excess production of mucus.
It also causes a paralysis of the tiny hair-like structures like cilia that line the airways and are responsible for removing dust and dirt from the organ. Paralysis of these hair-like structures also causes a buildup of mucus and toxic substances, leading to lung congestion. The extra mucus that is produced causes smokers to suffer from the very ubiquitous smoker's cough and chronic bronchitis.
It's also one of the many triggers of asthma, which brings about the narrowing and inflammation of the airways. Long-term exposure to tobacco smoke causes the destruction of the structure of the lung, walls of the airways as well as lung tissue. The result is a condition known as emphysema. Additionally, smoking also leads to cancer of the lung and over 80% lung cancer cases occur due to this habit. If you wish to discuss about any specific problem, you can consult a Pulmonologist.
If you are facing difficulties in breathing, especially in the process of exhaling, you are suffering from emphysema. Emphysema is a condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness. It occurs as a result of several triggers, smoking being the most common one. Emphysema is a type of chronic obstructive pulmonary disease. People with this condition struggle to exhale, which implies that there is some obstruction in the air flow. This disease has no permanent cure but by quitting smoking, you can stop it from getting worse.
The progression and severity of emphysema occurs with the staging systems. The staging of the condition can help in developing a prognosis.
The Gold emphysema staging system
Gold is a major emphysema staging system created by a group known as the Global Initiative for Chronic Obstructive Lung Disease. The amount of air a patient can exhale forcefully in one second is determined during this stage. It is also referred to as the forced expiratory volume or FEV1.
The staging is as follows:
- Stage 1: Mild emphysema (FEV1 greater than 80% of normal)
- Stage 2: Moderate emphysema (FEV less than 80%, but more than 50% normal)
- Stage 3: Severe emphysema (FEV lesser than 50%, but more than 30% normal)
- Stage 4: Extremely severe emphysema. (FEV lesser than 30% of normal or lesser than 50% normal, with low levels of oxygen in the blood.
The BODE emphysema staging system
The condition affects several abilities. The BODE index, an acronym for BMI (body mass index), obstruction, dyspnea (breathlessness), exercise capacity (health index) is another staging system for emphysema in which the emphysema’s impact on several areas of life are measured. They include the following:
- Body mass index (B)
- Airflow limitation or obstruction (O), which is measured by pulmonary function tests
- Breathless or dyspnea (D), which is assessed thoroughly via a questionnaire
- Exercise capacity (E), which is measured to check how long a person with emphysema can walk in a span of six minutes
The prognosis of emphysema is impossible to be determined in any person individually. The staging system helps to identify the severity of the condition, but the future cannot be predicted. Not many studies have been undertaken for the determination of the effects of emphysema on life expectancy. The best research that has been carried out included around 100 people, which is very less. The condition varies largely among people, even if they are in the same stage.
The statistics available on emphysema are not reliable enough for individuals who wish to know their life expectancy. It is considered that if a patient falls in a higher stage, his/her long-term life expectancy is less. If you wish to discuss about any specific problem, you can consult a Pulmonologist.
Although your body is already in possession of the bacteria leading to tuberculosis, your immune system is able to prevent you from becoming sick. Doctors have made a distinction between latent and active tuberculosis (TB). In case of latent TB, the bacteria in the body in a passive state and it causes no symptoms, and therefore it is not contagious. But, in the case of active TB, you would become sick and may even spread the disease to others. It can take place in the first few weeks or even after several months of being infected with TB bacteria.
What are the symptoms of active TB?
If you are coughing for over three weeks and sometimes even coughing up blood, it can be a sign of TB. Chest pain and pain while coughing and breathing along with fatigue, fever, chills and night sweat are the common symptoms of TB along with loss of appetite and unintentional weight loss. TB may even affect other organs of your body, including your brain, spine and kidneys. When TB takes place outside the lungs, then the signs of TB can vary as per the organs that are involved. For instance, TB in the spine can cause back pain and that in kidneys may cause blood in the urine.
What are the causes of TB?
TB is stemmed from a bacteria which spreads from individual to individual via the microscopic droplets that are released into the air. This may happen when an affected person is left untreated and he speaks or sneezes or coughs or laughs. Though the disease is contagious, it is not easy to be affected by it. As a result, you are much more likely to get affected with active tuberculosis from a person you live with or come in regular contact with, rather than a stranger. It is important to note here that people who are affected with TB and going through proper medications for over two weeks are no more contagious.
Right from the 1980s, the number of individuals affected with TB has increased dramatically, owing to the spread of HIV, which is the virus known for causing AIDS. A person infected with HIV has a weak immunity system as a result of which it becomes difficult for the body to deal with TB bacteria. So those who have AIDS are more likely to be affected with active TB and sometimes the latent form also progresses to an active one very quickly. Therefore, it is important to seek medical assistance and detect if you have any such health complications concerning TB.
If you are experiencing a whizzing sound while you breathe or having difficulty in breathing, you are suffering from asthma. It is a medical condition characterized by paroxysmal wheezing respiration dyspnoea. There is no definite way to prevent asthma, but by following a step-by-step daily plan, you can prevent asthma attacks or keep them in check. Here are some important measures to follow to prevent asthma:
- You need to strictly follow your asthma action plan. The plan should be laid down after a detailed discussion with a doctor or healthcare team. All the medicines you require to prevent the asthma attacks will be written down for you.
- You should get vaccinated for pneumonia and influenza. This will prevent these conditions from triggering asthma attacks or flare-ups.
- You need to identify the asthma triggers and stay away from them. Several outdoors irritants and allergens from pollen to cold air can trigger asthma attacks.
- You have to monitor your breathing. By recognising the warning signs of an attack like wheezing, slight coughing or shortness of breath, you can prevent an asthma attack. You need to measure and record your peak airflow regularly using a home peak flow meter.
- By acting quickly, you can identify a fatal attack and prevent it from occurring. When the peak flow measurement decreases, you need to take your medicines immediately and abstain from any activity which may have triggered the attack.
- You need to keep taking your prescribed medicines, even if your asthma symptoms have improved. You should not change your medication schedule without consulting a doctor. It is recommended that you to bring along the medicines you take at your doctor’s appointment as he will be able to tell whether you are taking them right.
- If you use your quick relief inhaler a lot, the asthma is not under control. You need to visit your doctor as soon as possible and he/she will make some modifications to your treatment.
- For prevention of asthma, you should use allergy proof pillow covers and mattresses. You must wash your bedding every week in hot water to eliminate dust mites. You may use a dehumidifier for reducing excess moisture to prevent mold.
- Do not allow your pets in the bedroom and on the furniture. Pet dander is a common trigger of asthma and it cannot be avoided by people who own pets.
- You can also fit an air filtration system in your home. It will help in the elimination of asthma triggers such as pollen, dust mites and other allergens.
Many doctors suggest immunotherapy for asthma prevention in the form of allergy shots. Immunotherapy aims at altering a person’s immune response by making it less sensitive to asthma triggers.
COPD or Chronic Obstructive Pulmonary Disease is a lung disease wherein, it gets difficult for a person to breathe due to thickening and inflammation of airways. World COPD day is being celebrated on 16th November, in order to, raise wareness about COPD. It is a group of progressive lung diseases, the most common ones of which are emphysema and chronic bronchitis. Emphysema destroys your lungs’ air sacs while bronchitis leads to the inflammation and narrowing of your bronchial tubes.
Symptoms of COPD
The early symptoms of COPD include occasional shortness of breath, especially after physical exercise, mild and recurrent cough and having the urge to clear your throat many times. You may start avoiding physical activities eventually. Other symptoms, which follow include wheezing, chest tightness, chronic cough with mucus, an urge to clear mucus from the lungs, frequent flu, colds and fatigue.
Factors behind it
Smoking accounts for being the major cause of COPD in developed countries. Commonly, people over the age of 40 with a history of smoking are affected with COPD. The more you smoke, more are your chances of getting the condition increase. Exposure to chemicals and harmful fumes may also cause COPD. Long-term exposure to polluted air and inhaling dust are other causes. The deficiency of a protein called alpha-1-antitrypsin is also said to cause COPD.
COPD is diagnosed on the basis of several tests and examinations. They include spirometry, which is a noninvasive test for assessing lung function, imaging tests such as a chest X-ray or CT scan which provides an image of the lung for observation. An arterial blood gas test is also carried out for measuring blood oxygen levels.
The treatment options for COPD include the following:
- Medication: Bronchodilators are used for relaxing the muscles of your lungs’ airways which simplify breathing. They are taken via inhalers. Glucocorticosteroids may be added to reduce inflammation.
- Oxygen therapy: When your blood oxygen levels are low, oxygen is given via masks and nasal prongs which help you to breathe better.
- Surgery: Surgery is carried out in the case of severe COPD or when other treatment methods fail. Bullectomy is a common surgical procedure used, in which the large air sacs or “bullae” are removed from the lungs. The lung volume reduction surgery is also carried out in which damaged lung tissues are removed. Lung transplant is required in extreme cases.
- Lifestyle changes: You need to make some lifestyle changes to alleviate the symptoms of COPD which include the following:
- Quit smoking in case you are a regular smoker.
- Avoid any form of second-hand smoke and chemical fumes.
- Consume all the essential nutrients required by your body.
- Consult a doctor about your exercise patterns.
In case you experience any symptom of COPD, you should consult a doctor immediately for quick diagnosis and proper treatment.
Are you experiencing symptoms of flu, such as a cough, sore throat, fever, body aches and headaches? Are you feeling sick around your stomach and throwing up more than usual? This indicates you have H1N1 flu or swine flu. Swine flu is a form of influenza that affects pigs, or a form of human influenza that is caused by a related virus.
It is difficult to tell whether you have got swine flu or seasonal flu, as the associated symptoms are similar. There are a few different symptoms. A laboratory test is hence required for the detection of swine flu. Sometimes, a rapid flu test taken in a doctor’s chamber is not enough for the proper diagnosis of swine flu.
For swine flu testing, a swab is taken by a doctor from the insides of your nose and the back of your throat. This test is usually taken by people who are living in hospitals or are at a high risk of death because of life threatening conditions, because of swine flu. Children below the age of 6, people above the age of 65, and children taking aspirin therapy are more likely to develop swine flu. Adults or children suffering from lung, blood, liver and nervous system disorders are also prone to swine flu. Pregnant women and people with a weak immune system are also susceptible to swine flu.
Several antiviral drugs, which are used to treat seasonal flu, are used to treat swine flu as well. However, some drugs prescribed for seasonal flu do not respond to swine flu. Using these medicines enables faster treatment and also makes the patient feel better. You must take the medicines within 48 hours of observing the first swine flu symptom. They are also effective when given at a later stage. Antibiotics do not treat swine flu as the flu itself is caused by a virus and not by a bacterium.
Certain over-the-counter (OTC) painkillers and medicines for cold and flu may also help in relieving aches, fever and pain. Abstain from giving aspirin to patients below the age of eighteen as it could lead to Reye’s syndrome. You can prevent yourself from getting swine flu by taking a vaccine. The same flu vaccine, which prevents seasonal flu, also protects the H1N1 swine flu strain. This can be taken in the form of a shot or a nasal spray. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
If you have been diagnosed with asthma, it is important for you to know about the most common triggers of asthma. Asthma is a medical condition, which is characterised by paroxysmal wheezing respiration dyspnoea. It causes breathing difficulties, tightened chest and coughing. By identifying and reducing your exposure to several asthma triggers, you will be able to manage or control your asthma symptoms and the frequency of your asthma attacks. Here are the most common triggers of asthma you should know about:
Allergies that trigger asthma
Allergies, are common problems and over 80% of people are suffering from asthma and are allergic towards substances like weed pollens, animal dander, dust mites, mould and cockroach particles. Children having large amounts of cockroach droppings in their homes are more likely to develop childhood asthma. Dust exposure may lead to dust mite allergy in asthmatic patients.
Food which triggers asthma
Certain food allergies may lead to isolated asthma, where other symptoms are absent. Patients with food allergies can exhibit asthma as a part of anaphylaxis, which are food induced. The common food items which are associated with allergies include eggs, peanuts, cow milk, soy, fish, wheat, shrimps, salads and fresh fruits. Several food preservatives also trigger asthma. They may include sulfite additives such as potassium bisulfite, potassium metabisulfite, sodium sulfite, sodium bisulfate and many others. These are commonly used in food processing and trigger asthma in sensitive people.
Asthma induced by exercise
Strenuous exercise may lead to the narrowing of the airways in maximum people having asthma. Exercise acts as a primary trigger for asthma symptoms in many people. Patients having exercise induced asthma are likely to feel chest tightness accompanied by coughing and breathing difficulties after completing an aerobic workout session. Although the symptoms subside, they may reoccur within some hours. You should warm up properly and slowly before a rigorous workout session to prevent an asthma attack.
People who smoke are more likely to have asthma. If you have asthma and still smoke, the symptoms of wheezing and coughing worsen. Pregnant women who smoke increase the chance of wheezing in their to-be-born babies. You should absolutely quit smoking if you have asthma.
Infections which trigger asthma
Several infections such as cold, bronchitis, flu and sinus may cause asthma attacks. The respiratory infections, which are viral or bacterial, are a common cause and trigger asthma, especially in children. Asthma is also associated with severe heartburn. According to studies, more than 85% people with asthma also suffer from heartburn. This is a condition known as gastroesophageal reflux disease or GERD. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.