Dr. R.K.Chopra

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

1. Fever
2. Anorexia and weight loss
3. Dyspnoea
4. Paroxysmal nocturnal dyspnoea
5. Fatigue

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:

1. Oral hemostatics
2. Cough suppressants
3. Anticoagulants
4. Radiation of laser treatment
5. 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.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Allergies are the result of the immune system’s response to foreign objects such as pet dander, pollen, certain foods, bee venom etc. In response to the allergen, the immune system produces antibodies, anticipating that the allergen is harmful in nature, even though that might not be the case always. The immune system can inflame the digestive system, skin, airways or sinuses when it comes in contact with allergens. The severity of allergies can vary from anaphylaxis to a minor irritation. In most cases, allergies cannot be fully cured. It, however, can be controlled with medication.

What are the symptoms of allergy?

1. Various allergies cause different kinds of symptoms.
2. Hay fever can cause sneezing, fluffy nose, itching of the eyes, nose, and mouth, swollen eyes etc.
3. Food allergy can cause hives, mouth tingling, anaphylaxis, body itching etc.
4. Insect sting produces symptoms such as anaphylaxis, cough, swelling on the source etc.
5. Drug allergy can result in a rash, wheezing, swelling of the face, hives etc.
6. Atopic dermatitis often lead to flake, itching, and reddening of the skin.
7. There are other allergies that are triggered either by food or by insect bite. These can lead to a medical emergency known as the anaphylaxis. Some symptoms include skin rash, loss of consciousness, weak pulse, vomiting and nausea, shortness of breath etc.

What are the possible causes of allergy?

1. Air:  A number of allergies occur from the surrounding air. Examples of such airborne allergies include pollen, animal dander, mould etc.
2. Food items: Certain foods are known to be causing allergy such as tree nuts, eggs, peanuts, soy fish etc.
3. Medication: There are medications such as penicillin-based antibiotics that can lead to allergy.
4. Insect bite: Bite from insects such as wasp or bee can trigger an allergy in adults and kids.

What are the possible complications?
Allergy often leads to complication such as asthma, infection of the lungs, sinusitis, infection of the ear and anaphylaxis. The risk of getting these conditions increase, provided no treatment is done for a long duration.

How is the diagnosis done?
To investigate the type of allergy a person has, the doctor might ask for the exact symptoms that a person is encountering. He may ask questions related to intake of food and the possible triggers. A skin test is often performed, followed by a blood test to confirm the presence of allergy in an individual.

What are the methods of treatment?
Depending on the type of allergy one has, a doctor might prescribe nasal spray, eye drops, and pills to reduce the symptoms. Apart from this, if the allergy is severe in nature, a doctor might suggest going for immunotherapy and emergency epinephrine. Certain lifestyle changes and food habits go a long way in cutting down the symptoms.

Pulmonary edema is a disorder wherein fluid accumulates in the lungs leading to lack of oxygen in the body. The usual cause of pulmonary edema is congestive heart failure (the muscles of the heart are unable to pump blood). In this disorder, the heart has to work extra hard to pump blood, so this adds extra pressure on the blood vessels that are present in the lungs. In a bid to relieve this added pressure, fluid is released into the lungs by the blood vessels.

The function of your lungs is to take in oxygen from the air and circulate it in the bloodstream. However, fluid accumulation in the lungs impairs the ability to supply oxygen in the blood. As the oxygen does not reach the blood, the body gets deprived of oxygen.

Causes
The most frequent cause of pulmonary edema is congestive heart failure. Some other causes of pulmonary edema are pneumonia, failure of the kidney, damage to the lungs, high blood pressure and sepsis of the blood (infection). Apart from these internal medical causes, certain external factors such as exposure to high altitudes, drug overdose and inhalation of toxic substances can also cause pulmonary edema.

Symptoms
The symptoms of pulmonary edema are coughing, swelling of the legs, breathlessness and wheezing. In case of severe pulmonary edema, symptoms such as respiratory failure, shock and organ damage due to lack of oxygen may occur.

Treatment
The initial step to treat pulmonary edema is to administer oxygen. Oxygen is given through a nasal cannula; it is a flexible tube made of plastic with two openings that allow oxygen to be delivered to the nostrils. The oxygen levels in your body are closely monitored by the doctor.

Based on the cause of pulmonary edema, the following treatments are administered:

1. Morphine: Morphine is administered to reduce breathing difficulties and anxiety.
2. Preload reducers: These medications help relieve the pressure in the lungs and the heart. Diuretics are a type of preload reducers; it is also known to cause excessive urination.
3. Afterload reducers: Afterload reducers are medications that relieve pressure from the left ventricle by dilating the blood vessels.
4. Use of blood pressure medication: Pulmonary edema caused by blood pressure changes i.e. if the disorder is caused by changes in your blood pressure, then blood pressure medications are administered to get your pressure back to normal levels. In case you have a concern or query you can always consult an expert & get answers to your questions!