Dr. Rakesh Chawla

Nebulisation guidelines will help to serve the patients better.

COPD, which is short for Chronic Obstructive Pulmonary Disease, is a severe form of lung disease that is characterized by increased breathlessness and obstruction of airflow from the lungs. People who are suffering from COPD are at an increased risk of developing lung cancer, heart diseases and many other conditions. It includes progressive lung diseases such as chronic bronchitis, emphysema, few forms of bronchiectasis and refractory (non-reversible) asthma. The former two are the most common conditions contributing to COPD. 

Chronic bronchitis induces inflammation in the airway that carries air to the lungs and fills it with mucus. This either completely blocks the airway or narrows it, causing difficulty in breathing. However in emphysema, the air sacs inside the lungs which inflate and deflate as you breathe in and out, lose their elasticity due to which less air comes in and goes out leaving you breathless.

The best way to treat COPD is to quit smoking. Your doctor may also prescribe you medications or ask you to enroll in a lung rehab program. 

Causes:

1. Smoking: Smoking is one of the most common causes of COPD. This is because smoking is known to destroy the stretchy fibers in people's lungs and irritate the airways. Even passive smoking is unhealthy. About 90% of the people having COPD are current or former smokers. 
2. Genetics: Some individuals suffer from COPD even after refraining from smoking. Genes might be at the helm of COPD in such a case. AATD i.e. Alpha -1 Antitrypsin Deficiency, is a protein in the lungs, the lack of which is one of the most common genetic factor causing emphysema. 
3. Environmental Factors: Breathing in harmful pollutants present in your environment is also one of the causes of COPD. Fumes, dust or certain chemicals are a few examples of harmful lung irritants. Organic cooking fuel may also cause COPD. Exposing yourself to the aforementioned environmental factors for a prolonged period of time increases your risk of developing COPD substantially. 

Symptoms:

1. Shortness of breath especially after exercising
2. Wheezing
3. Tightness in your chest
4. Unintended weight loss
5. Lack of energy
6. Frequent respiratory infections
7. Wheezing
8. Cough accompanied by mucus

Diagnosis:

1. Physical Exam where your doctor monitors the functioning of your lungs. 
2. Questioning about your past health (Smoking or other harmful lung irritants).
3. Spirometry and other breathing tests.
4. Chest x-rays and other tests to eliminate other problems which could be causing your symptoms.

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.

Smoking
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.

Breathlessness is common in scleroderma, which can be worrying, but it is not always serious and does not necessarily mean you have lung fibrosis or PAH. However, make sure you tell your doctor so they can check your lungs.

Tuberculosis is a highly infectious and potentially fatal disease which primarily affects the lungs. It is highly contagious and can infect other people via the tiny water droplets released by an infected person while coughing or sneezing.

There are two types of tuberculosis, that are pulmonary tuberculosis and extrapulmonary tuberculosis:

1. Pulmonary tuberculosis is a type of disease in which bacteria invade your lungs. It is possible that the bacteria in your lungs could kill you. However, fortunately if you have been taking the right medicines for your bacterial infection you can get cured immediately. The name of the bacteria which causes tuberculosis is known as the Mycobacterium tuberculosis.

It is worth noting that latent tuberculosis has no symptoms and there is no way you can pass it to another person either. However, it is still crucial that you take treatment for it. If you do not complete your treatment, then your tuberculosis will progress to a very dangerous form of tuberculosis. This is known as multidrug-resistant tuberculosis. Multidrug-resistant tuberculosis is sometimes abbreviated as MDR TB.

2. Extrapulmonary tuberculosis is when tuberculosis affects in parts of the body other than the lungs. There are many parts of the body which tuberculosis can affect, including the lymph nodes, nervous system as well as the bone and joints. Luckily, it is easily curable.

Extrapulmonary tuberculosis has pretty much the same symptoms as pulmonary tuberculosis. This is because extrapulmonary tuberculosis is the exact same disease which occurs to the patient, it is just that it affects a different body part. Therefore, the exact treatment recommended for pulmonary tuberculosis can be used to cure extrapulmonary tuberculosis. In case you have a concern or query you can always consult an expert & get answers to your questions!