I am Dr. Hemant Kalra. I am a pulmonologist. Today our talk will be about inhalation therapy in respiratory disorders. So what is inhalation? Inhalation is when we give drugs or solution of drugs by nasal or oral respiratory route. Inhalation is also called inspiration. What is the inspiration? Inspiration is movement of air from external environment by our breathing pipes into our lungs. This is inhalation and inspiration also. In which conditions we use inhalation therapy? Inhalation therapy is used in Obstructive Airway Disorders. What are these disorders? These are Asthma, COPD, Bronchitis and some cases of Sarcoidosis. You may ask me why tablets and syrups are not used in such disorders?
Why inhalation therapy is preferred over tablets and syrup in such disorders because- tablets and syrup are in high doses, they are very toxic, very costly, they reach systemic blood circulation, they have got adverse side effects. When you give a drug, tablet or syrup it first enters your stomach, then via your blood stream it enters your airways where inflammation is there and where these types of drugs are required. So why to give a drug in oral or syrup form when inhalation therapies are available. Inhalation therapies takes drugs directly where it is required. Inhalation therapy can be given in various forms. First is metered dose inhaler. You might have seen inhaler people using in movies.
Dry powder inhalers are also available in market and other forms like nebulation is also available. What drugs can be given in inhalation therapies? We can give bronchodilators, which can open up the airways. We can give Cortico-steroids. Mucolytics and some antibiotics can also be given via inhalation route. Nowadays insulin is also given in inhalation route. Inhalation therapy is very very effective in certain disorders. I started this topic because I felt that we in India do not use inhalation therapy because of various myths in our society. So what are the myths? Firstly, inhalers are very costly- absolutely wrong. Secondly, inhalers are addictive- absolutely wrong. Thirdly, inhalers have got side effects- also absolutely wrong. Inhalers do not have any side effects. I can assure you this that inhalers can be given in pregnancy from day 1 to 9th month when very few drugs are recommended in pregnancy.
It can be given in any age group from 1 year to 90 years. Fifthly, inhalers are always given when disease is very severe- it is also wrong. On the contrary inhalers are recommended or should be given as early as possible in the disease. So inhalation therapy is the best option for any kind of obstructive airway disorders. I can proudly say that we have got the best inhalation technique or inhalers available in India. You must use them as advised by the doctor. Do not say no when the doctor writes an inhaler for you. It is the best option for obstructive airway disorders because it is most effective with no side effects, very cheap and can be given for many years. Thank you very much! In the nutshell please use inhalers as adviced by a doctors. Do not hesitate to take inhalers. Inhalers are best option for obstructive airway disorders, very safe, very effective, no side effect and very cheap.
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Good afternoon friends,
I am Dr Hemant Kalra, I am a pulmonologist.
Today I will talk about a very-very important topic that is Obstructive Sleep Apnea which is widely prevalent in our country but very-very underdiagnose and awareness is very-very less. So what is obstructive sleep apnea, those patients who snore very-very heavily, who feel tired or feel sleepy during the daytime they may have Obstructive Sleep Apnea. So what is normal breathing, normal breathing is when our upper airways they allow free air to go inside the lungs and out of the lungs, this is normal breathing. So what are the obstructive airways, obstructive airways is then these upper airways collapse and this collapse of upper airways causes snoring and sensation in breathing, this is abnormal breathing or obstructive breathing at night time when we sleep? So what are the symptoms, symptoms can be nighttime symptoms can be there or daytime symptoms can be there. Night time symptoms are frequent visits to bathroom, weakness, sensation in breathing, choking or gasping for air or loud a persistent snoring or restless sleep, these 5 can be there in the night time symptoms and daytime symptoms are early morning headache, lethargy, and poor concentration, poor memory, feeling asleep during and routine activities and daytime somnolence or daytime sleepiness, these are daytime symptoms. So what kinds of patients are prone to have obstructive sleep apnea. Those patients who are obese with a short and thick neck with large tongue or hypothyroidism such patients if they snore heavily or feel tired or sleepy during the daytime or if they have night time or daytime and symptoms they must be investigated for obstructive sleep apnea. So how to diagnose obstructive sleep apnea, there is a very small test called polysomnography that can be done at a house or in hospitals. That is conducted in two parts, one is diagnostic, one is titration in diagnostic. We diagnose, whether a patient is having obstructive episodes in the night or not, or in another part, if an obstruction is there what is the pressure required to eliminate those obstructions in the night time. So obstructive diagnostic and titration component one night sleep steady is more than enough. Once we diagnose obstructive sleep apnea then we have to treat it also. There are so many treatments available but gold standard till now is CPAP therapy Continuous Positive Airway Pressure therapy is the most appropriate therapy to treat obstructive sleep apnea and once you treated you will feel that next day if you get up you will feel very-very energetic and if you do not treat obstructive sleep apnea then you may have heart problems, rythm problems, your BP may not be controlled, your sugar may not be control, you may have strokes in future also. So, if you treat obstructive sleep apnea with CPAP therapy, it is a gold standard therapy in India it is widely available in our country but lack of awareness is there. It is a very important disorder you must be treated as early as possible.
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Hello friends, I am Dr Hemant Kadra. I am a pulmonologist. A pulmonologist is a doctor who deals with respiratory problems. Today I will be explaining Asthma in a very simple manner because it is a simple disease.
So, when to suspect asthma?
All patients who are present with a cough with or without breathlessness on exposure to dust, fumes, cold atmosphere, on eating chilled vegetables and fruits can have asthma. They also give family histories of allergic disorders like allergic dermatitis, allergic rhinitis so we can suspect asthma in our patients who are present with a cough with or without breathlessness and on exposure to such triggers like cold, dust, fumes, change of weather- this is the clinical history.
There are 2 components-
One is prevention. You must avoid all your triggers. And treatment part is slightly different. Treatment is we have to control swelling in the area, narrowing of the airways.
There are 2 kinds of medication- one is a reliever and the other is preventer medication. Reliever medication gives you immediate relief and preventer medication is given for a longer amount of time just to maintain the anti-inflammatory component in the airways. So, we combine both the type of medications in an inhaler or one rhotahaler to give maximum benefits to the patients. So, these are the basic things about asthma.
I will tell you about basic myths about asthma. What people think about asthma but is not true. People think that asthma is a contagious disease. It is communicable. No, it is not true.
- It is an allergic disorder first of all. Asthma or allergy runs in families because it is a genetic disorder.
- Secondly, an inhaler is a drug delivery system. It is not a drug. It delivers lowest possible drugs to the airways to a very minimum side-effect. So, this myth is not true that inhalers are very hard, they are addicting, habit forming, it is not true. It is a drug delivery system.
- Third myth is that inhalers are to given to severely ill patients or very chronic asthmatic patients this is also not true. We believe that inhalers should be given early whenever they are detected with asthma early in the disease. So, to prevent later chronic changes in the airbase, we should start inhalers in the beginning only.
So, if you want to consult me, you can cotact me through Lybrate. You can contact me through sms, sudio clips, video clips, whatsapp, email only through lybrate. Com. I am available 24 hours a day and ready to help you.
Thank you.read more
Doctor in MGS Hospital ( Mgs Institute Of Respiratory Sciences)
Treatment of Chest Pain
Treatment of Asthma
Treatment of Tuberculosis
Treatment of Lung Cancer
Treatment of Fluid in the chest
Treatment of Sleep Disturbance
Treatment of Left Chest Pain
Treatment of Lung DIseases
Treatment of Interstitial Lung Disease
Asthma Management Program
Treatment of Pulmonary Hypertension
Management of Smoking Cessation
Oxygen Therapy Treatment
Treatment of Sarcoidosis
Bronchial Asthma Treatment
Obstructive Sleep Apnea Treatment
Asthma Treatment & Management
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Patient Review Highlights
I was already suffering from severe lung infections and was misguided by several Pvt. and government doctors due to which my health condition was deteriorating day by day. My husband googled for the best pulmonologist in Delhi and he convinced me to visit Dr. Hemant Kalra, when we first met Dr. Kalra we were confident that we have met the correct doctor and since then my health started to improve due to correct diagnosis and psychological support given by Dr. Kalra. I will always be indebted to him for putting me on the correct path of recovery; I am still undergoing treatment but have returned to my normal life. I, my husband and my 5 year old son owe a big Thank You to Dr. Hemant Kalra.
Dr. Hemant kalra is a eminent doctor.wonder to meet such a good doctor in profession or good human .He is very helpful and careful about patient problem,and also discussed the problem of patient in Q&A manner.I Feel very happy to concern Dr. Kalra , about my asthma allergic and throat infection , he explain the disease in good way. He has no attitude of profession , talk as friend. He has well specialized cest doctor .I strongly recommend to Dr. kalra because before Dr. kalra i had consult so many doctors and took lots of medicines . then after I consult Dr. Kalra .And once again thanks to Dr. kalra and Lybrate.
I just cant explain in words, he did magic. My husband is suffering from bronchitis with very bad cough and sleeping problem. He is taking homeopathic medicines but there was no signs of improvement. when we visited doctor Hemant Kalra after reading over internet my husband got quick relief within 2 days. He is taking medicines since 10 days and now he is perfect. He had bad coughing since 6 months and breathing problem since 2 months and after takin his medicines he felt realy good now he is perfectly ok.. lots of thanks to dr. hemant kalra.
Never thought I will suffer from something polysomnography like this. He is so nice that they even at odd hours one can call him in case of emergency. I read about the Hemant Kalra on one of the social media platform. The entire Maharaja Agrasen Hospital (Maharaja Agrasen Super Specialty Chest Centre) was spotlessly, clean. It's been more than a year now, and I have noticed considerable change in myself. Finally with his treatment, I am completely cured from the disease. Hemant Kalra has expert knowledge in the field.
The symptoms of smoking were severe and unmanageable, as I was addicted to smoking, but Dr Hemant was able to handle it. He is a afamous Pulmonologist in Delhi. He is not just friendly, but also is very motivating. My problem was such that it required a number of sessions, and I must say after all the sessions, I am feeling much better now. His guidance has helped me immensely and has helped gain confidence.
It's been so long, I have lost all hope, but then I met Hemant Kalra and I am hopeful again that I will be fine. I was shocked to experience the symptoms of upper respiratory tract infections With great ease Hemant Kalra explained us the problem and how the treatment will be carried out. Thanks to him that the treatment he gave me has given brilliant results.
Our experience was very good . He is very friendly person who always motivates his patients. He is not in a hurry to treat his patients and listen to their problems and then give best advice to them. I would suggest others to consult Dr. kalra for any chest related issues, as now I am felling better after taking diagnosis of Dr. Kalra .
I was having bad thoughts about my snoring. I consulted Dr Hemant, who is one of the best pulmonologist. He is very talented and seasoned doctor. He definitely is aware about the latest and advanced ways to treat serious cases. Thanks to him for the perfect advice. The overall outlook of the Maharaja Agrasen Hospital was very nice.
I found out Dr. Kalra online. I am very much satisfied by treatment. He is the kindest nicest doctor I have ever met.would recommend Dr. Kalra to people who r suffering from any kind of respiratory disease... very friendly,first meeting with the doctor but I was feeling that he knows me a long time. Gives always his best to all
My Father was TB Patient in month of Oct 2016 and he was so much pain due to my coughing issue. Due to this Dr Hemant Kalra was suggested to me to admit my father in MGS Hospital in ICU and Dr Hemant kalra helped me alot for my father recovery within 7 days & The medication he prescribed was extremely beneficial for my father.
I was in too much pain because of sleep disturbance, but even after consulting a number of doctors, I was not getting any relief. I consulted Dr Hemant, his advice and counselling has helped me immensely. The guidance he gave me has helped me immensely with my situation. The entire Maharaja Hospital was spotlessly, clean.
dr Hemant Kalra helped me in doing Asthma managment as I was very sick because of my asthma problem. he did my treatment at his clinic Maharaja Agrasen Hospital (Maharaja Agrasen Super Specialty Chest Centre) in Delhi. he is a very nice doctor who takes good care of his patients.
I was shocked to experience the symptoms of asthma. then i consulted dr Hemant Kalra at Maharaja Agrasen Hospital (Maharaja Agrasen Super Specialty Chest Centre) in Delhi.he is not just friendly, but also is very motivating. he did a very good treatment for my problem.
Neeraj R Sharma
Dr Kalra is one of the best doctors in his field. He not only treats his patients but also motivates them. He is available round the clock in case of emergencies. I have peraonally experienced this.Thanks Sir for the coopration you did for us.
I was suffering from breathing issue since long for which I was looking for a pulmonologist. Dr Hemant Kalra 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.
Being a tuberculosis patient my father was vry much worried about his health....bt jst communicating with Dr.hemant made him realise tht his disease is curable n he'll get healthy as soon as possible...It was really a great experience
Amazing docter. All the good reviews written here about him are very much true. I have happy that I hv met a good docter in case I need to consult in future for any chest related concern. Thanku so much docter for being so positive.
Dr Hemant is the best chest specialist at present in Delhi . Not only is he well learned and up to date in his field but very encouraging too. Dr hemant diagnosed the problem instantly and resolved it with accurate medicines .
I was in so much pain due to my coughing issue. But Dr Hemant kalra helped me alot in the recovery. The medication he prescribed was extremely beneficial for me. I am glad that I visited to him for my coughing treatment
Kamalpreet Singh Chauhan
Dr. Kalra's experience in medical field is evident in his way of conduct. Extremely polite and explains every aspect properly. He is very thorough and precise in his diagnosis.
Hypersensitivity pneumonitis is a rare disorder caused by an immune system response in the lungs after breathing in certain triggers.
How Hypersensitivity Pneumonitis Is Treated?
The single most important thing that you can do is avoid the dust that causes the disease. If you do so, your lungs can return to normal function, as the disease is completely reversible in the early stages. Completely avoiding the dust is sometimes not possible, unless you remove yourself from the dust-causing environment. Your doctor may recommend completely avoiding the dust by relocating to a new home or job. If you have bird fancier's lung, then it is possible you may have to give up your pet bird.
In patients who have severe cases, treatment may include prescription steroids, such as prednisone. You may be required to take this medication for up 3 months and sometimes longer. Steroids may help with your symptoms; however, it will not cure the disease. Steroids can also cause certain side effects such as weight gain, thinning of the bones, cataracts, abnormal blood sugar levels and increased pressure in your eyes.
Idiopathic pulmonary fibrosis (IPF) is a type of chronic lung disease characterized by a progressive and irreversible decline in lung function. Symptoms typically include gradual onset of shortness of breath and a dry cough. Other changes may include feeling tired and nail clubbing. Complications may include pulmonary hypertension, heart failure, pneumonia, or pulmonary embolism.
Inhalers have been proved to be the safest and most effective way to treat and control asthma and COPD, as the inhaled medication reaches the lungs directly and do not need to go through your blood stream first.
Pneumonitis is often confused with pneumonia, but these are similar ailments but not the same. While pneumonia is a type of infection which causes lung inflammation, pneumonitis is a general term to describe inflammation in pulmonary, or lung, tissue. So technically pneumonia would fall into the category of being a type of pneumonitis.
Allergic rhinitis can be one of the reasons for your constant sneezing. It can either be there throughout the year or during specific seasons.
Allergic rhinitis, also known as hay fever, is a type of inflammation in the nose which occurs when the immune system overreacts to allergens in the air.
Possible triggers include grass, pollen, dust mites, cockroaches, cigarette smoke, and perfume. Tree and flower pollens are more common in the spring.
Purpose of the Thoracoscopy:
- To visually inspect the lungs
- To obtain tissue biopsies or fluid samples from the lungs
- To remove excess fluid in the pleural cavity or pleural cysts
- To evaluate patients with pulmonary disease or abnormalities
- To obtain a tissue sample (biopsy) for further evaluation and to diagnose inflammation, infection, fibrosis and cancer
Sarcoidosis is an inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands. In people with sarcoidosis, abnormal masses or nodules (called granulomas) consisting of inflamed tissues form in certain organs of the body.
A bronchoscopy is an ideal tool for diagnosing any obstruction or disease pertaining to your airways, using an instrument called Bronchoscope. It can be used to detect lung diseases such as
A chronic cough
If you are feeling any obstruction or abnormality of the airways then seeking the right treatment at the right time is important.
- If you have obstructive sleep apnea (OSA) and you are using CPAP therapy, you may be wondering whether sleeping position matters when it comes to having or treating sleep apnea.
Believe it or not, sleeping positions have a big influence on how well we sleep, not only with regard to OSA, but in relation to other health conditions.
COPD or chronic obstructive pulmonary disease is one of those lung diseases that does not exist in a vacuum. It is associated with at least one or two comorbid conditions like pulmonary hypertension, osteoporosis, dementia, anaemia , hypertension, coronary artery disease (CAD) and depression. It is necessary to seek treatment on time to prevent the aggravation of the condition and development of these comorbid conditions.