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Knowledge Base

What is Asthma?

Asthma is a respiratory condition characterized by episodes, difficulty in breathing and wheezing. Asthma also results in excessive mucus production in the bronchial tubes that leads to coughing up thick mucus, technically called sputum. Fortunately, episodes of asthma are often limited so that the patient notices no cough or impairment of breathing once the attack has resolved.

How common is Asthma?

Asthma is very common the latest estimates are that more than 10 million people have asthma.

What age groups develop asthma?

Asthma can occur in infants less than one year of age, and common in children, adoloscents and adults. Asthma also occurs in senior citizens and may even begin in patients aged 70 years or more.

What happens during an attack of asthma?

The patient notices difficulty breathing(asthma means "panting" in Greek) and coughing with excercise or excertion like walking quickly. These symptoms occur because of contraction of muscles that surround bronchial tubes in the lung. The medical term for this is Bronchospasm. The bronchial tubes narrow in asthma so that it becomes difficult for air to reach the smaller bronchial tubes.

This can cause a fall in oxygen if the attack is severe or if asthma symptoms last for days or weeks at a time. The bronchial tubes are "hyperreactive" - asthma symptoms occur after inhalation of cold air, fumes, insecticides and smoke that are no more than bothersome to people who do not have asthma.

The bronchial tubes produce excessive amounts of sputum in asthma. Patients with asthma often cough up sputum during an attack of asthma, but when the bronchospasm is more severe the patient may not be able to cough up any sputum at all until the bronchial tubes open up.

What is Allergic Rhinitis?

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What is Bronchoscopy?

Bronchoscopy is a diagnostic examination of the major air passages to the lung. The examination permits the physician to visualise the inside of the trachea or the windpipe and other major air passages of the lungs. Bronchoscopy is a safe diagnostic procedure in trained hands and carries little risk.

Why a Bronchoscopy

The reasons for having a bronchoscopy are many and varied. Common ones are the coughing up of blood, a persistent cough that has not responded to the usual medi- cations and abnormal chest x-ray film findings. Many ofthe diseases which affect the lung also affect the air passages. Often times disease far out in the lung will produce secretions, blood or other tell-tale materials which can, by appropriate laboratory examination, lead to correct diagnosis. At other times, tumor growths will either originate in the lining ofthe bronchial tubes or invade their walls. Through the aid of a bronchoscope, many of these can be seen. Basically, any disease that affects the lungs and air passages can be evaluated and sometimes treated with the aid of the bronchoscope.

Visual observation through the broncho-scope may lead directly to diagnosis. When tumors or other types of growth are seen, a biopsy tool can be passed down the channel of the bronchoscope to obtain biopsy samples for identification of the abnormality. The material then can be studied in the laboratory. Children, in particular, and adults under certain conditions may inhale foreign bodies, such as peanuts, denture parts, pins, etc., into the lung. Sometimes a special grasping device can be inserted into the lung through the bronchoscope to accomplish removal.

How is the procedure done?

With the aid of a bronchoscope, the physician can directly visualize the lung air passages. There are basically two kinds of bronchoscopes. Your physician will make a decision on which one to use. One is a flexible instrument which consists of many small glass fibers that transmit light and also permit the physician to see clearly through it. A small channel has been constructed in the instrument for the purpose of obtaining specimens that can be examined in the various laboratories of the hospital. The flexible fiberoptic instrument is passed through the nose or mouth into the air passages depending upon the preference of the physician performing the examination.

A second bronchoscopic instrument is the open tube bronchoscope which can be inserted only through the mouth. It is often utilized when larger biopsy specimens must be obtained or for the removal of foreign bodies which may have been inhaled into the air passages. Both bronchoscopes have specific advantages, and the choice is made by the physician based upon particular needs.

What is pneumococcal disease?

Pneumococcal disease is caused by the bacterium Streptococcus pneumoniae also known as the pneumococcus. Pneumococcal disease can lead to serious infections of the lungs (pneumonia), the blood (bacteremia/sepsis), and the covering of the brain (meningitis).' The latter 2 diseases are known as invasive pneumococcal infections. When infections are invasive, disease is usually very severe, causing hospitalization or even death.

How dangerous is pneumococcal disease?

Pneumococcal disease is a leading cause of serious illness and death worldwide. Pneumococcal pneumonia kills about 1 out of 20 pe le who get it. Bacteremia kills about 1 person in 5 and meningitis about 3 people in 10. ‘ In persons with chronic illness, pneumococcal infections are often more severe and can even further aggravate the underlying chronic condition.

How do you get pneumococcal disease?

The bacteria are spread through droplets of saliva or mucus, such as when an infected person sneezes or coughs. Infected persons may carry the bacteria without showing signs or symptoms of illness, but can still infect others. Young children are the most frequent carriers of the bacteria.

Who is at risk of developing pneumococcal disease?

Anyone can get pneumococcal disease yet the risk is highest in young children, the elderly, persons who have chronic medical conditions and among those who smoke.

ls there a way to treat these infections?

Pneumococcal infections can be treated with antibiotics. However some strains of the disease are becoming more and more resistant to these drugs. For this reason, it is especially important to prevent pneumococcal infections through vaccination.

What is Sleep Apnea?

Loud snoring which is interrupted by moments of respiratory arrest (apnea) of more than 10 seconds in duration is a sign of a disease with serious consequences:

Obstructive Sleep Apnea ln obstructive sleep apnea, the patient remains without breathing for atleast 10 times an hour - respiratory blocks can occur up to 600 times a night. ln sleep medicine a distinction is made between

  • so-called sleep related breathing disor-ders (SRBD) with obstruction ofthe upper airways, and ,
  • SRBD without airway obstruction.
SRBD with airway obstruction include both obstructive sleep apnea and mixed apnea. Central sleep apnea belongs to the SRBD without obstruction ofthe upper airways. Obstructive Sleep ApneaObstruction means "cIosure". In obstructive apnea, the throat closes during inhalation due to excessive relaxation of the pharynx muscles and the floor of the mouth, accompanied by increased tissue pressure from outside .This prevents air from entering the lungs, and the patient is threatened with suffocation.

Obstructive Sleep Apnea Prevalence

  • 1-3 % ofthe total population
  • Men are more often affected than women (9:4)
  • Mostly occurs from 40 to 60 years of age
  • 30 % ofthe high blood pressure patients
  • High mortality rate