The lungs are two of the most important organs that are affected by the coronavirus, which leads to Covid infection in the respiratory system. It has been noticed that while most patients recover completely after the infection, at least 5 per cent to 10 per cent experience prolonged symptoms that last for several months or even years. This is known as ‘long Covid‘.

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Dr Vishal Sehgal, the president of Portea Medical says “pulmonary rehabilitation” can improve a person’s lung function, their exercise performance, quality of life, and even counter any anxiety associated with the condition.

“Pulmonary rehabilitation is symptom-based; it requires a multi-pronged approach to deal with the various related complications. It is a holistic plan that comprises preliminary patient assessment followed by medicinal treatment, lifestyle modifications, physical exercise, nutritional support, self-awareness and psychological counselling,” he says.

According to the expert, some major aspects of a rehabilitation programme are as follows:

1. Physical activity

Physical activity can significantly improve the quality of daily living. From low-impact training for the chest and back muscles, to more intense forms of exercise, there is a range of activities that can help. Under the guidance of a trained specialist, these are done depending on individual progress and capacity, says Dr Sehgal.

2. Breathing techniques

Breathing techniques can help alleviate the pressure on the lungs. There are different types of breathing techniques including those that are part of yoga that can help in case the patient experiences symptoms of breathlessness, he adds. “For instance, pranayama — the ancient practice of breath control — helps in improving multiple aspects of physical health, including lung function.”

3. Diet and lifestyle

A balanced diet helps in boosting immunity and overall wellness. It can also help in alleviating certain symptoms of long Covid, the doctor states. “Those who are put under a pulmonary rehab programme are given a diet rich in complex carbohydrates and fibres, as well as other micronutrients. In case a patient lacks access to a proper rehabilitation facility at hospitals, it is possible to do this process at home.”

“People who survive Covid-19 can experience long-term consequences: respiratory, neuropsychiatric, cardiovascular, hematologic, gastrointestinal, renal, and endocrine. There is a rapid increase in the burden of long Covid which calls for strategies that can help improve outcomes over time,” says Dr Sehgal, adding that on World Lung Day, it is important to understand and discuss these strategies as well as take precautions and prevent the spread of the virus further.

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In her mid-20s, Joanna Lumley experienced "a complete nervous breakdown". Quitting the play she was performing at the time, the young, single mum fled to her parents' home in Kent. "I was off [work] for six months," Lumley recalled. "I was pretty badly shaken up," she said of her anxiety. "My nerves were gone. I didn’t dare go to the shops. I had a really ropey old time. I was spending all day thinking, 'How will I get through the day?'"

Lumley told The Times: "I had those panic attacks when you think, 'Breathe in, breathe out, just keep breathing in. Study the flowers. What colour are the flowers?'

"Anything to stop your mind going mad. And I thought, 'I’ve got to get out of this, how do I?’"

Panic attacks

A panic attack "is a feeling of sudden and intense anxiety," the NHS explains.

Physical sensations can include: shaking, feeling disorientated, nausea, rapid heartbeat, breathlessness, sweating, and dizziness.

READ MORE: ‘Normal’ bowel habits – doctor’s guide to stool appearance and if something is abnormal

"The symptoms of a panic attack are not dangerous, but can be very frightening," the NHS adds.

"They can make you feel as though you are having a heart attack, or that you are going to collapse or even die."

Most panic attacks last between five minutes to half hour, but they will "always pass".

Professor Paul Salkovskis, Professor of Clinical Psychology and Applied Science at the University of Bath, discussed how you can effectively manage a panic attack.

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"They can teach you ways of changing your behaviour to help you keep calm during an attack.

"You may need to see your GP regularly while you're having CBT so they can assess your progress."

Following her period of ill health, Lumley went on to star in the BAFTA award-winning sitcom Absolutely Fabulous alongside co-star Jennifer Saunders.

Joanna Lumley also stars in Absolutely Fabulous: The Movie, which airs on Saturday, September 24 at 11.40pm on BBC Two.



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World Heart Day 2022: Panic attack may seem like a heart attack at times as it shares some of its symptoms with heart attack be it chest pain, increase in heart rate or shortness of breath. However, one can differentiate between the two keeping in mind the location of pain and the duration of symptoms. Experts say patient must be given immediate medical attention as one can never be sure if it isn't a heart attack. (Also read: World Heart Day 2022: Foods to eat and avoid for better heart health)

The cases of both heart attack and panic attack are increasing in the wake of Covid pandemic as weakening of heart muscles and anxiety issues are becoming common post Covid. In such situations symptoms like shortness of breath, pain in chest, nausea, palpitations could make one confused if they are suffering from a heart attack or panic attack.

"We as doctors, all agree fervently that one should not take a chance of it not being a heart attack. And the reason is simple; sometimes it can be difficult to tell the difference," says Dr Atul Mathur, Executive Director – Interventional Cardiology & Chief of Cath Lab, Fortis Escorts Heart Institute, Okhla road, New Delhi.

"Panic attacks occur when stress hormones trigger the body's "fight or flight" response, often resulting in fast heartbeats, tightness in chest, chest pain and breathlessness. In the case of a heart attack, a blockage in a coronary artery may show the same symptoms. Chest pain, rapid heartbeat and shortness of breath may be a result of insufficient amount of blood reaching the heart muscle, says Dr Dhaval Naik, Heart Transplant Surgeon, Marengo CIMS Hospital.

"A panic attack patient might have some factors like anxiety or stress related to family/job where is the heart attack patients usually tend not to have this kind of stress, they are more often seen in panic attacks," says Dr Sunil Kumar Wadhwa, Principal Consultant Cardiology, Max Hospital Gurugram.

WHAT IS A HEART ATTACK

Dr. Atul Mathur says heart attacks can be sudden and intense, but mostly start slowly, with mild chest pain or discomfort which progressively worsens over few minutes. Dr Mathur says these episodes might come and go several times before actual intensive heart attack occurs.

"When blood flow to the heart muscles is reduced severely or completely obstructed, it results in heart attack. The typical symptoms are chest discomfort beneath the breastbone, discomfort radiating to the neck, jaw, or upper arm, shortness of breath, light headedness, fatigue, feeling of doom or dying, nausea, palpitations and sweating. Risk factors of the heart attack are diabetes mellitus, high blood pressure, high cholesterol levels and sedentary lifestyle," says Dr Mathur.

WHAT IS A PANIC ATTACK

Dr Mathur says that if the medical workup shows that you have a healthy heart, then you might be experiencing a panic attack – this is especially if the person is having intense fear, which is the hallmark symptom.

"Panic attack is the flight or fright response, an alarm system that has gone haywire. These attacks come fast and generally peak in intensity in about 10 minutes. Also the attacks are triggered by a traumatic events or major stress in life; in some conditions it may happen without any apparent reason," says Dr Mathur.

"The symptoms can be intense fear and racing thoughts, feeling of losing control, fear of dying, feeling of detachment from surroundings, racing heart or palpitations, chest discomfort, choking sensation, nausea, shortness of breath or rapid breathing, numbness or tingling, feeling hot or cold, dizziness or light headedness," adds the cardiologist.

DIFFERENCE BETWEEN HEART ATTACK AND PANIC ATTACK

In heart attack, the pain is classically felt below breastbone as a dull pressure. It may radiate up to neck and jaw or down the left arm.

"It is a vague pain and one cannot specifically locate with the tip of finger. If you are able to localise the pain with finger it is unlikely to be from the heart.

Panic attacks, on the other hand, may cause chest pain with a sharp or stabbing sensation, or a choking sensation in the throat. One should however 'never ignore chest pain'," says Dr Mathur.

Dr Wadhwa says both the patients of panic attacks as well as heart attacks can have difficulty in breathing but it is seen that patients with panic attacks over-breathe where is the patient of heart attack do not over-breathe.

"Patients with panic attacks can have cold sweats like sweating on the palm or sweating in sole of their feet Which is less common in case of heart attack patients. A patient with heart attacks may have some associated symptoms like vomiting, whereas the patients of panic attacks may have shaky hands because they are constantly under stress," adds Dr Wadhwa.

"One of the key differences between these two conditions is that a heart attack often develops during physical exertion, whereas a panic attack can occur at rest. A heart attack is more likely to develop when the workload of the heart increases, for example while a person is exercising or gymming or running up the stairs, more in people who do not engage in physical exertion on a daily basis. Panic attacks can start randomly or be triggered by psychological distress. For example, some people experience panic attacks suddenly, and others may have panic attack symptoms when faced with a phobia, like claustrophobia or a fear of heights or when a person is deeply shocked by something," says Dr Naik.

Here are other differences between heart attack and panic attack according to Dr Mathur:

ASSOCIATED SYMPTOMS

Heart attacks may also be accompanied by fatigue, fainting, or loss of consciousness. Panic attacks, on the other hand, are characterized by racing heart, racing thoughts, trembling, tingling or numbness, and a choking sensation.

DURATION OF SYMPTOMS

Heart pain lasts longer than few minutes and may come and go. It may be brought on or worsened by physical exertion. During a panic attack, on the other hand, symptoms typically peak in intensity after about 10 minutes, and subside after half an hour.

TRIGGERS

Any chest discomfort that is triggered by exertion should not be taken lightly and immediate physician consultation should be sorted out. Panic attacks can start randomly or be triggered by psychological distress. For example, some people experience panic attacks out of the blue and others may have panic attack symptoms when faced with a phobia, like claustrophobia or a fear of heights.

PREVENTION

Dr. Ashish Jai Kishan, Consultant, Interventional Cardiology, Fortis Escorts Heart Institute shares prevention tips for heart attack and panic attack.

Prevention of heart attack includes controlling risk factors like high blood pressure and high cholesterol, avoiding cigarette smoking and alcohol, eating a healthy diet, and living an active lifestyle.

Prevention of panic attack includes controlling of stress and anxiety, introducing exercise, and medications. Attention needs to be given to the mental health.

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In predominantly collectivist societies in Southeast Asia, mental health unfortunately takes a backseat. While more and more people are beginning to conduct open dialogs about the pressing issues of mental health (and the social taboo that comes with treating it), this culturally-diverse region still has a long way to go.

This means that access to adequate mental health treatment is still not as easy as it should be for people who are silently suffering. And like any professional treatments, they can be rather expensive too.

With that said, it's probably safe to assume that you (the reader) have gone through your fair share of panic attacks, whether in the distant past, or more recently.

But first, what are panic attacks?

A panic attack is a feeling of intense anxiety that usually strikes suddenly, with no warning. Common symptoms of a panic attack include breathlessness, profuse sweating, dizziness, and nausea. They usually occur during periods in which you're experiencing increased stress in your life.

They can last anywhere between five minutes and up to an hour. I know, they're definitely unpleasant, and some major panic attacks can even have long-lasting effects on a person's mental health.

But you don't have to go through your next panic attack (there's no cure for it, after all) without any way to help shorten or alleviate it. Here are some methods that you might find very helpful.


Breathing exercises.

IMAGE: Anthony Tran / Unsplash

No, it's not the generic "take deep breaths in and out" that most people will probably tell you to do. Of course, as breathing normally works, you will have to inhale and exhale (duh), but these exercises take a little more concentrated effort.

There are multiple variations, so pick one that you feel is more well-suited to your preferences.

Breathing Exercise 1 (Basic – Low concentration).

Step 1: Close your eyes. Don't strain when doing this, it's okay if they're slightly open.

Step 2: While seated in a comfortable position (or laying in bed), breathe in gently and deeply through your nose. You can count steadily up to four while doing this.

Step 3: Breathe out gently and deeply through your mouth. You can also count steadily up to four during this exhale.

After a while (usually a few minutes) you'll start to feel much better, and perhaps even a little tired – because yes, this exercise does require effort, despite how simple it seems!

Breathing Exercise 2 (Hands on chest and diaphragm – Requires more concentration).

Similar to the first breathing exercise above, this one requires a bit more concentration and attention.

Step 1: Sit (or lie down) in a comfortable position.

Step 2: Place one hand over your chest and the other over your diaphragm. If you don't know where the latter is, it's the area below the bottom of your ribcage and above your belly button.

Step 3: Like the first breathing exercise, inhale gently and deeply through your nose while mentally counting to four. Concentrate on the hand placed over your diaphragm, which should be expanding as you breathe in. The hand on your chest should be relatively still.

Step 4: Breathe out, gently and deeply. Your diaphragm should be going back to its original (deflated) state. Watch as your hand moves in and out with it. The hand over your chest should be relatively still.

Step 5: Repeat until you feel calm enough. Concentrate on your hands moving (or staying still) with your diaphragm and chest.


Meaningful distractions.

This writer really got into keyboards as a form of therapy. IMAGE: Pedro Costa / Unsplash

Aside from breathing exercises, a good way to deal with panic attacks is to find distractions tailored specifically to your likings.

1. Therapeutic hobbies.

If, for example, you've got a hobby that involves building and/or modifying keyboards, take out that toolkit and start tinkering away when you feel a panic attack coming. It's these little mundane things that a lot of us may find therapeutic, making you forget you had a panic attack coming.

2. A good support system.

However, not all of us can be that easily distracted. In this case, it's good to have a support system that you can rely on – like a close friend who's willing to be there for you. They can even talk you through the breathing exercises mentioned previously, on the phone or in person.

3. A walk or run.

If you'd rather be alone during a panic attack, one of the easiest ways to deal with one is to go for a walk or run, provided you can do it safely. Keep consistent with your pace, and put on your favorite jams while you're at it.

In fact, many people claim they feel a "runner's high" after completing a good run. It's actually a brief, relaxing state of euphoria brought on by a release of endorphins into your bloodstream.

4. Cuddles with pets.

Got some pets running around the house? Give them some cuddles, because animals feel (and give) nothing but pure love, even if they expect a snack afterwards.


Seek help, if you haven't already.

IMAGE: Rendy Novantino / Unsplash

Panic attacks are inevitable – they're an unfortunate effect of anxiety and depression, and can leave us feeling trapped. But acknowledging them is the first step to getting better. For more long-term assistance, it's definitely a good idea to seek help from a qualified professional, like a psychologist, therapist, or counselor. Choices will vary, depending on your budget, of course.

But if you're in need of someone to talk to, here are some 24-hour mental health resources that might help:

Befrienders KL (Malaysia) – Emotional support hotline: 03-7627-2929.

Didi Hirsch Torture Crisis Line (Vietnam) – Crisis hotline: 877-727-4747.

National Mental Health Crisis Hotline (the Philippines) – 1553 (Luzon-wide, landline toll-free), 0966-351-4518/0917-899-8727 (GLOBE/TM subscribers), and 0908-639-2672 (SMART/SUN/TNT subscribers).

Love Inside Suicide Awareness (Indonesia) – Mental health and suicide prevention hotline: +62-811-3855-472 (Bahasa) and +62-811-3815-472 (English).

Institute of Mental Health (Singapore) – Mental health hotline: +65-6389-2222.

For more mental health resources in Southeast Asia, click here.


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What does "Pulmonary Fibrosis" mean?  
The word “pulmonary” means lung and the word “fibrosis” means scar tissue— similar to scars that form on the skin from an old injury or surgery. So, in its simplest sense, pulmonary fibrosis (PF) means scarring in the lungs.

Pulmonary fibrosis is a lung disease that occurs when lung tissue becomes damaged and scarred. This thickened, stiff tissue makes it more difficult for your lungs to work properly. As pulmonary fibrosis worsens, people can become progressively more short of breath.

The scarring associated with pulmonary fibrosis can be caused by a multitude of factors. But in most cases, doctors can't pinpoint what's causing the problem. When a cause can't be found, the condition is termed idiopathic pulmonary fibrosis.

The lung damage caused by pulmonary fibrosis can't be repaired, but medications and therapies can help ease symptoms and improve quality of life. For some patients, a lung transplant might be appropriate.

Symptoms of Pulmonary Fibrosis:  
The most common symptoms of pulmonary fibrosis are dry, persistent cough and shortness of breath. Symptoms may be mild or even absent early in the disease process. As the lungs develop more scar tissue, symptoms worsen. Shortness of breath initially occurs with exercise, but as the disease progresses patients may become breathless while taking part in everyday activities, such as showering, getting dressed, speaking on the phone, or even eating.

Due to a lack of oxygen in the blood, some people with pulmonary fibrosis may also have “clubbing” of the fingertips. Clubbing is a thickening of the flesh under the fingernails, causing the nails to curve downward. It is not specific to pulmonary fibrosis or idiopathic pulmonary fibrosis and occurs in other diseases of the lungs, heart, and liver, and can also be present at birth.

How Do Doctors Recognize and Diagnose Pulmonary Fibrosis? 
There are three consequences of pulmonary fibrosis. Doctors use these consequences to recognize that someone has PF:

1. Stiff Lungs. Scar tissue and inflammation make your lungs stiff. Stiff lungs are hard to stretch, so your breathing muscles have to work extra hard just to pull air in with each breath. Your brain senses this extra work, and it lets you know there’s a problem by triggering a feeling of breathlessness (or “shortness” of breath) while exerting yourself.

Also, stiff lungs hold less air (they shrink a bit). Doctors take advantage of this “shrinking” to diagnose and track the disease using breathing tests (called Pulmonary Function Tests) that measure how much air your lungs can hold. The more scar tissue your lungs have, the less air they will hold.

2. Low blood oxygen. Scar tissue blocks the movement of oxygen from the inside of your air sacs into your bloodstream. For many people living with pulmonary fibrosis, oxygen levels are only reduced a little bit while resting, but their oxygen levels drop quite a bit during activity. The brain can sense these low oxygen levels, triggering breathlessness.

Doctors will check your oxygen levels to see if they drop after walking, which could be a clue that PF might be present. Doctors also often prescribe oxygen to be used through a nasal cannula or a facemask during activity and sleep for those with PF. As pulmonary fibrosis progresses, oxygen may be needed 24 hours a day and flow rates may increase.

3. “Crackles" lung sounds. Your doctor may have told you that “crackles” were heard in your lungs. Crackles (also called “rales”) sound like Velcro being pulled apart.

They are heard in many lung diseases because any type of problem affecting the air sacs (such as PF, pneumonia, or a buildup of fluid in the lungs from heart failure) can cause crackles. Some people with pulmonary fibrosis don’t have crackles, but most do.

Can pulmonary fibrosis be reversed? 
Unfortunately, lung damage due to pulmonary fibrosis is permanent (not reversible). Getting diagnosed and starting treatment as early as possible may help your lungs work better, longer.

How is pulmonary fibrosis treated? 
Most pulmonary fibrosis treatments focus on easing symptoms and improving your quality of life.

Your provider may recommend one or more treatments: 
• Medication: Two medications — pirfenidone (Esbriet®) and nintedanib (OFEV®) —may slow down lung scarring. These medications can help preserve lung function.

• Oxygen therapy: Giving your body extra oxygen helps you breathe more easily. It may also increase your energy and strength.

• Pulmonary rehabilitation: Staying active in this special exercise program may improve how much (or how easily) you can do everyday tasks or activities.

• Lung transplant: A lung transplant replaces one or both diseased lungs with a healthy lung (or lungs) from a donor. It offers the potential to improve your health and quality of life. A lung transplant is major surgery, and not everyone is a candidate. Ask your provider if you may be eligible for a lung transplant.

Can pulmonary fibrosis be cured? 
No cure for pulmonary fibrosis exists today. But researchers around the world are working to change that.



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UPDATED guidelines for the management of chronic obstructive pulmonary disease (COPD) include both non-pharmacological and pharmacological strategies to reflect the importance of a holistic approach to clinical care for people living with the disease.

Developed by the Lung Foundation Australia and the Thoracic Society of Australia and New Zealand, and published as a summary in the MJA, the guidelines include 26 recommendations addressing:

  • case finding and confirming diagnosis – confirmation by spirometry, blood eosinophil levels, behaviour and risk factors (smoking, treatment adherence, self-management skills, physical activity, comorbid conditions);
  • optimising function – non-pharmacological therapies, pharmacological therapies, managing comorbid conditions, palliative care, lung volume reduction surgery, pulmonary rehabilitation, non-invasive ventilation;
  • preventing deterioration – smoking cessation, immunisation, oxygen therapy, prophylactic antibiotics, biologic therapies, palliative care, home bilevel ventilation;
  • developing a plan of care; and
  • managing exacerbations – pharmacological management, non-invasive ventilation, and multidisciplinary care.

“About one in 13 Australians over the age of 40 years is estimated to have chronic obstructive pulmonary disease (COPD),” wrote the authors, led by Associate Professor Eli Dabscheck, a respiratory and sleep physician from Melbourne’s Alfred Hospital.

“In 2018, COPD was the leading cause of potentially preventable hospitalisations, the third leading specific cause of total disease burden, and the fifth leading cause of death in Australia. The impact of COPD is even greater among Indigenous Australians compared with non-Indigenous Australians.”

Non-pharmacological therapies for COPD include walking and structured exercise, as well as pulmonary rehabilitation to improve breathlessness, exercise performance, physical activity level and health status. Pharmacological therapies, including short- and long-acting inhaled bronchodilators, inhaled corticosteroids (ICS), and long-acting β-agonists, are evaluated in the guidelines.

The full guidelines are available at copdx.org.au/.

Supervised injecting centres: 21 years of evidence

TWENTY-one years after the establishment of the Uniting Sydney Medically Supervised Injecting Centre (MSIC), research shows that, rather than becoming a “honeypot”, the MSIC has led to improved and sustained public amenity, leading to a call for the establishment of more supervised injecting facilities. Associate Professor Carolyn Day, from the University of Sydney, and colleagues wrote in the MJA that they had “addressed key questions regarding [supervised injecting facility (SIF)] operations and contend that there is sufficient evidence to support SIF rollout and expansion”. “Good policy, with clear legislation and careful management of clients within a harm reduction framework, can and does alleviate problems that may be perceived as inherent to the operation of such services. Given the solid evidence, current governments, in Australia and elsewhere, should expand SIF services without unnecessary protracted trial periods. The key challenge in SIF expansion is supporting legislation. Questions regarding the scientific and operational merit of SIFs have been answered. After 21 years of success, it is time for robust support for further services to be implemented both within Australia and internationally.”

Neurological manifestations of COVID-19 in adults and children

An international group of researchers, including from Australia, have detailed the differences in neurological manifestations of COVID-19 in adults and children in an article published in Brain. Researchers analysed data from the International Severe Acute Respiratory and emerging Infection Consortium cohort across 1507 sites worldwide from 30 January 2020 to 25 May 2021 – 161 239 patients (158 267 adults, 2972 children) admitted to hospital with COVID-19 and assessed for neurological manifestations and complications were included. “In adults and children, the most frequent neurological manifestations at admission were fatigue (adults: 37.4%; children: 20.4%), altered consciousness (20.9%; 6.8%), myalgia (16.9%; 7.6%), dysgeusia (7.4%; 1.9%), anosmia (6.0%; 2.2%), and seizure (1.1%; 5.2%). In adults, the most frequent in-hospital neurological complications were stroke (1.5%), seizure (1%), and central nervous system (CNS) infection (0.2%). Each occurred more frequently in [intensive care unit (ICU)] than in non-ICU patients. In children, seizure was the only neurological complication to occur more frequently in ICU vs. non-ICU (7.1% vs. 2.3%, P < .001). Stroke prevalence increased with increasing age, while CNS infection and seizure steadily decreased with age. There was a dramatic decrease in stroke over time during the pandemic. Hypertension, chronic neurological disease, and the use of extracorporeal membrane oxygenation were associated with increased risk of stroke. Altered consciousness was associated with CNS infection, seizure, and stroke. All in-hospital neurological complications were associated with increased odds of death. The likelihood of death rose with increasing age, especially after 25 years of age.”

Counting steps important but faster cadence matters too

Research published in JAMA Internal Medicine, including authors from the University of Sydney, has found that accumulating more steps per day (up to about 10 000) may be associated with a lower risk of all-cause, cancer, and cardiovascular disease (CVD) mortality and with lower incidence of cancer and CVD, and that higher step intensity may provide additional benefits. The authors analysed data from 78 500 participants in the UK Biobank for 2013–2015, including adults aged 40–79 years. Participants were invited by email to partake in an accelerometer study. Registry-based morbidity and mortality were ascertained through October 2021. “The study population … was followed for a median of 7 years during which 1325 participants died of cancer and 664 of CVD (total deaths 2179). There were 10 245 incident CVD events and 2813 cancer incident events during the observation period. More daily steps were associated with a lower risk of all-cause ([mean rate of change (MRC)], −0.08; 95% CI, −0.11 to −0.06), CVD (MRC, −0.10; 95% CI, −0.15 to −0.06), and cancer mortality (MRC, 95% CI, −0.11; −0.15 to −0.06) for up to approximately 10 000 steps. Similarly, accruing more daily steps was associated with lower incident disease. Peak-30 cadence was consistently associated with lower risks across all outcomes, beyond the benefit of total daily steps,” the authors reported. “Steps performed at a higher cadence may be associated with additional risk reduction, particularly for incident disease.”

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The exhibition will premiere on 21 October as the Manchester Science Festival’s headline exhibition before going on tour

Manchester’s Science and Industry Museum will next month open Turn It Up: The power of music, an immersive exhibition exploring our emotional responses to music.

Made up of interactive installations, music-making opportunities and inventions, and testimony from musicians, the exhibition will premiere on 21 October as the Manchester Science Festival’s headline exhibition. It will run until 21 May 2023 before going on a national and international tour.

Curator of exhibitions at the Science and Industry Museum, Steven Leech, said: ‘We are incredibly excited to be able to bring to life for the first time the astounding and universal story of the mystery of music and the incredible ways that it impacts all aspects of our lives.’

The exhibition presents research into how music influences our emotions, our shopping habits, and our health and wellbeing. It includes contributions from classical music organisations including the Royal Northern College of Music, English National Opera (ENO), Manchester Camerata and Sheku Kanneh-Mason.

It will also include a collaboration with the Royal Philharmonic Orchestra, who will play a new commission,created in partnership with children’s mental health charity, Place2Be, which is designed to carry the listener through a range of emotions and improve children’s emotional literacy.

Guest curator Dr Emily Scott-Dearing, from Oxford University Museum of Natural History, commented: ‘We are restless in our musical creativity – always looking for new ways of innovating and expressing ourselves. And we are profoundly affected by music – from feeling the musical ‘chills’ to its ability to lift our mood, calm our nerves or boost our performance. ‘

Visitors will see unusual instruments such as the 19th century Pyrophone organ powered by flames and can learn about studies including ENO Breathe, an online breathing and wellbeing programme designed in partnership with the ENO using singing to help people experiencing breathlessness as a result of long Covid.

As part of the exhibition programme, the museum will also host an evening of live music, art and performance on 22 October.

You can find out more about the exhibition (including tickets) here.

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Gold Coast (Australia), Sep 16 (360info) Compiled by the Royal Australian College of General Practitioners, HANDI is the world’s first compendium of drug-free medical treatment.

In 2017, while travelling around rural India, Rae Thomas’s adolescent daughter began experiencing dizziness and nausea lasting for several hours.

Rae recalled hearing that a head rotation procedure could help with the most common cause of persistent dizziness.

Using her mobile phone she found a description of the Epley manoeuvre (or canalith repositioning) on the HANDI (Handbook of NonDrug Interventions) website, watched the linked video a few times, and performed the procedure.

Her daughter’s relief was immediate - though it needed repeating over the next few days. Rae was aware of this option only because she worked at the same university as the developers of HANDI.

The Epley manoeuvre is just one of dozens of effective ‘non-drug’ treatments which are under-used by doctors and patients.

Some have substantial, research-supported effects: exercise (as part of “pulmonary rehabilitation”) for patients with chronic airways disease can prevent 70 per cent of hospital re-admissions and deaths; daily sunscreen can cut invasive melanoma rates by 50 per cent; and ‘external cephalic version’, turning an in-utero baby by pushing on the mother’s abdomen, can avoid 50 per cent of dangerous breech births.

If there were drugs that were similarly effective, doctors and patients would clamour for access; companies would set high prices. But unlike their pharmaceutical brethren, these non-drug treatments are less intensively researched, poorly described in that research, weakly regulated, and unmarketed – especially when free or cheap.

One explanation for their relative neglect has been the lack of a respected compendium, equivalent to the pharmacopoeias (drug handbooks) which doctors look up when prescribing.

Instead, the trials of effective non-drug treatments are widely scattered in the vast oceans of research literature. There is no regulatory body (such as the TGA in Australia or FDA in the USA) to pass judgment on which are effective. And usually no company has an interest in marketing them.

Non-drug treatments fall into several generic classes: exercise (general and specific), diet, cognitive behavioural therapy, physical manoeuvres, but also a wide range of others.

Perhaps the most neglected non-drug ‘treatment’ is exercise for chronic illness – lung disease, heart failure, cancer fatigue, diabetes, depression, and so on.

While exercise is often promoted for prevention in healthy people, ill people have the most to gain, but are often fearful of exercise.

Exercise can bring on symptoms such as breathlessness and fatigue, but, with persistence, will improve function and quality of life, and often reduce relapses and improve survival.

In the past decade, we recognised that specific exercises can often overcome functional deficits. Some of these are described in Norman Doidge’s popular book The Brain that Changes Itself which sets out the discovery and impact of brain plasticity for rehabilitation. One clinical example is “mirror therapy” – where patients perform activities via feedback from a mirror – successfully used to treat phantom limb pain and regional pain syndromes after stroke.

To address the lack of a compendium, in 2013 Australia’s Royal College of General Practitioners (RACGP) began to compile effective non-drug interventions relevant to primary care.

Based on the format of modern drug handbooks, each HANDI entry includes indications, contraindications and "dosing".

The aim is to make ‘prescribing’ a non-drug therapy almost as easy as writing a prescription for a drug. It enables clinicians to offer a greater choice of interventions to a patient, who may wish to avoid drugs and the risks and lifestyle changes often associated with drug treatment regimes.

Since its launch in 2015 HANDI has become steadily more popular with Australian GPs, and has been incorporated into many local "clinical pathways", but it is under-used compared with drug-based options.

HANDI is one step towards improved non-drug interventions, but other problems are yet to be tackled. One issue is how poorly non-drug treatments are described in current medical trials – one study showed less than half are sufficiently clearly described to allow replication in follow-up studies; this also creates problems in reviewing the evidence and making recommendations.

Another barrier is the lack of inclusion in medical training – pharmacology is taught but not as much "non-pharmacology".

But perhaps the most important problem is that many of these non-drug treatments are free or cheap and have no copyright, so there is no one to profit other than the patient.

The pandemic has taught us the important role of non-drug interventions - such as social distancing, avoiding crowds, better ventilation, and masks. Let’s hope that lesson is not forgotten.

The HANDI development process The RACGP’s HANDI working group meets six times per year, collecting possible topics from a variety of sources. Each potential HANDI entry then goes through a three-step process before being published.

Step 1: Assessing the evidence and relevance The group assesses the proposed non-drug intervention, by considering two questions: 1. Is the evidence strong enough? 2. Is the intervention relevant to and practical for general practitioners? Treatment must be supported by at least two positive, good-quality randomised controlled trials (RCTs) with patient-relevant outcomes, or one RCT with strong supportive evidence for the causal connection under investigation.

Step 2: Drafting the HANDI entry Next a group member works with a medical writer to develop a detailed “how to” guide for the use of the non-drug intervention which includes indications, contraindications, precautions, adverse effects, availability and description of intervention, plus consumer resources.

Step 3: Final review and posting The draft entry is reviewed at a subsequent committee meeting prior to finalisation and publication onto the HANDI website. (360info.org) PY PY

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I wore a mask to protect myself from germs and viruses before it was required by the COVID-19 pandemic. After my diagnosis of idiopathic pulmonary fibrosis (IPF), a debilitating and life-threatening respiratory disease, in April 2016, I now do everything I can to protect my lungs.

Unfortunately, I learned the hard way how serious respiratory viruses can be for those of us with IPF. A year after I was diagnosed, I caught a common respiratory virus and both of my lungs collapsed, landing me on a ventilator. I still suffer from post-traumatic stress from that incident and am deeply fearful of it happening again.

The months leading into winter can be brutal due to respiratory viruses, partly because kids head back to school. Last week, I was excited to see a friend who just had her second baby, but the visit was postponed after her toddler caught a cold just one week into day care.

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pulmonary fibrosis experimental treatments | Pulmonary Fibrosis News | illustration of mice

Here in Canada, the cold and flu season extends through most of the winter, but September, October, and November are particularly difficult months for my breathing. I usually catch a virus that knocks me down for a few weeks, making work and other responsibilities challenging. However, it’s not just the common cold that poses a threat to my breathing every fall.

The following are some of the things that will be stacked against me in coming months, creating a perfect storm for my breathing:

Allergies

As the summer fades into fall, I notice my environmental allergies flare up, causing congestion, itchy eyes, and a dry cough. Many places in Canada are still screening people for COVID-19 symptoms before appointments or visits to certain locations, so I’m sure I’ll be doing a lot of explaining this fall that my symptoms are not related to COVID-19, but rather due to my lung disease or allergies.

Fluctuating temperatures

September and October typically have warm days and cool nights. While this is ideal for sleeping, the temperature fluctuation isn’t good for my breathing because it causes increased breathlessness and discomfort in my chest. Temperature changes also cause a runny nose, which makes me cough or clear my throat more than I otherwise would.

Cold and flu season  

I always get my flu shot, and if you’re immunocompromised and living with IPF, you should talk to your doctor about doing the same. While I do whatever I can to protect myself, I often end up with a cold or the flu. However, I believe the flu vaccine helps me avoid more serious symptoms.

Change in medications

It may seem odd that my medications change with the seasons, but it’s true. My pulmonologist typically increases the dose of my prescribed antihistamine in the fall to help reduce allergy-related symptoms. The increased dosage and the more frequent use of inhalers in the fall can make me feel fairly lousy.

What season is particularly difficult for your IPF symptoms? I’d love to hear your thoughts in the comments below. 


Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.

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For people already dealing with respiratory problems a clean sleep environment free from dust and mites could aggravate the state Ideally one must replace the mattress every five to seven years This however can vary on the mattress type and how it is used

For people already dealing with respiratory problems, a clean sleep environment free from dust and mites could aggravate the state. Ideally, one must replace the mattress every five to seven years. This, however, can vary on the mattress type and how it is used.

Photo : iStock

New Delhi: Some people opt for the spring version; others prefer cotton or foam-based – in either case, mattresses are often associated with back-related issues. However, they are rarely or never associated with breathing problems or asthma. But now, experts have established a shocking link between mattresses and the risk of respiratory disorders. Turns out, using a mattress for longer than 10 years could be a mistake – harbouring several dust mites and bacteria which can lead to respiratory problems like asthma, bronchitis, allergies or headaches, and eczema

For people already dealing with respiratory problems, a clean sleep environment free from dust and mites could aggravate the state. Ideally, one must replace the mattress every five to seven years. This, however, can vary on the mattress type and how it is used.

How to mitigate the risk of dust and mites in the mattress?

Doctors recommend regular vacuum cleaning of a mattress to prevent dust accumulation. Asthma patients are most prone to developing health problems due to the mattress. This is because mites and dust are the key triggers of respiratory problems.

Asthma is a condition characterised by swollen breathing tubes that carry air in and out of the lungs. It forces the tubes to narrow down temporarily if exposed to triggers.

Some of the key triggers of asthma are:

  1. Exercise
  2. Infections
  3. Allergies to animal fur, pollen, or dust mites
  4. Cold or flu

When looking for the symptoms of asthma, watch out for the following:

  1. Breathlessness
  2. Cough
  3. Tightness in the chest
  4. Whistling sound while breezing known as wheezing

Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.

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Dyspnea, commonly known as shortness of breath, is one of the common problems faced during pregnancy. Shortness of breath can also be considered as an early symptoms of pregnancy. Generally, dyspnea doesn’t cause any harm to the mother and the growing baby. But still, in some severe complicated conditions, it can lead to difficulty in breathing.

Reasons of breathlessness during pregnancy

An increase in levels of progesterone is the main cause of increase in shortness of breath during the first trimester of pregnancy, explains Dr. Anjali Chaudhary (PT), senior executive physiotherapist, Cloudnine Group of Hospitals, Noida.

it is basically due to increased capacity of lungs. The body adjusts itself to the new hormonal changes. However, other medical conditions such as asthma, anemia and pulmonary embolism, too can contribute to the same. Suitable precautions should be taken for the treatment of asthma and other underlying conditions.

shortness of breath
Keep a check on breathing patterns. Image courtesy: Shutterstock

As the size of the baby grows, other organs get compressed and start changing their position. At around 31st week to 34th week, the growing size of the belly exerts pressure on the diaphragm (the main muscle for breathing). This increase in the size restricts the lungs to expand fully and take in air.

Towards the end of pregnancy, the foetus head settles into the pelvis and eventually exerts less pressure on the diaphragm muscle. Therefore, the shortness of breath eases during the last few days of pregnancy.

How to handle the shortness of breath during pregnancy

You can try various breathing techniques and tips to manage and cope up with the situation of dyspnea or shortness of breath. By following these simple tips you can ease down the breathlessness.

1. Maintain a good posture:

Posture during pregnancy is important. Slouching while sitting will affect your lungs as lungs will not get enough space for expansion while breathing in. This may result in less oxygen intake. Sitting on a chair with your chest slightly bent forward can help relaxing the body and in creating extra space for breathing.

Standing with your back well-supported by a wall and body slightly leaned forward can also help relieve shortness of breath.

2. Sleep in a relaxed position

Dyspnea often leads to inability to sleep at night, leading to waking up several times and creating disturbance in sleep. To avoid this, sleep on the back with head elevated using extra pillows and knees bent with pillows below the feet. The right sleeping posture during pregnancy helps in keeping the airway relaxed and making breathing better.

sleeping posture during pregnancy
The right sleeping posture during pregnancy is important. Image courtesy: Shutterstock

3. Pursed lip breathing:

A very easy and a simple breathing technique that makes each breath deeper by helping release trapped air in the lungs, can help to manage shortness of breath during pregnancy.

Follow the simple steps to perform pursed lip breathing:
* Sit with shoulders relaxed.
* Slowly take in air through nose and keep the mouth closed while inhaling.
* Gently exhale or blow out air with pursed lips as if about to blow a candle.
* Practice for 5-10 minutes for about three to four times a day.

4. Diaphragmatic breathing:

Diaphragmatic breathing is basically deep breathing exercise which is also known as abdominal breathing or belly breathing.

To do diaphragmatic breathing or belly/abdominal breathing, follow these steps:

* Sit on a chair or simply lie down comfortably with knees bent and upper body relaxed.
* Place one hand on the chest and other below the rib cage (over the abdomen/belly) so that you can feel your diaphragm movement while breathing in and breathing out.
* Breathe in slowly and steadily so that the abdomen rises fully while doing so, making the hand to rise. Make sure the hand on the chest stays still.
* Then slowly exhale through pursed lips but make sure the abdomen lowers down while doing so and the hand on the chest remains still.
* Start practicing this exercise for 5-10 minutes for about three to four times a day. Gradually increase the number of times and even place a book over the abdomen to increase the efforts.

deep breathing
Deep breathing is good for lungs. Image courtesy: Shutterstock

5. Deep breathing with arm raise:

Deep breathing exercise with raised arms raises the diaphragm to open up the lungs. This helps to increase the capacity of the lungs and results in more oxygen uptake. It is similar to deep breathing, but along with breathing, hand movement is added.

* Stand and take a deep breath while raising arms slowly over your head. Exhale as you lower your arms. Repeat several times a days or whenever you feel breathlessness.
* Seeking Medical Help for Shortness of Breath during Pregnancy

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Pulmonary edema occurs when fluid accumulates in the air sacs of the lungs, making it difficult to breathe. This interferes with gas exchange and can cause respiratory failure.

Pulmonary edema can be acute (occurring suddenly) or chronic (occurring more slowly over time). Acute pulmonary edema is a medical emergency and requires immediate medical attention.

One of the most common causes of pulmonary edema is congestive heart failure, in which the heart cannot keep up with the demands of the body.

Treatment of pulmonary edema usually focuses on improving respiratory function and addressing the source of the problem. It generally includes providing additional oxygen and medications to treat the underlying conditions.

illustration of a person's lungs with pulmonary edemaShare on Pinterest
Pulmonary edema can be acute or chronic. Image credit: Adisorn Chiamchitr/Alamy Stock Photo

During normal breathing, the small air sacs in the lungs, known as alveoli, fill up with air. The lungs take in oxygen and expel carbon dioxide. Pulmonary edema occurs when fluid floods the alveoli.

This flooding causes two problems:

  1. The bloodstream cannot get enough oxygen.
  2. The body cannot expel carbon dioxide properly.

Common causes of pulmonary edema include:

  • pneumonia
  • sepsis (blood infection)
  • exposure to certain chemicals
  • organ failure that causes fluid accumulation, such as congestive heart failure, kidney failure, or liver cirrhosis
  • near-drowning
  • inflammation
  • trauma
  • reaction to certain medications
  • overdose of certain drugs, including opioids

Pulmonary edema also occurs as part of a condition called acute respiratory distress syndrome (ARDS), a severe inflammation of the lungs that leads to significant breathing difficulties. Direct injury to the lungs or inflammation in other parts of the body can cause this condition.

Other possible causes include:

  • brain injuries such as brain bleeding, stroke, head injury, brain surgery, tumor, or seizure
  • high altitude
  • blood transfusion

Cardiogenic pulmonary edema

Pulmonary edema that results from a direct problem with the heart is called cardiogenic pulmonary edema.

Congestive heart failure is a common cause of cardiogenic pulmonary edema. In this condition, the left ventricle is unable to pump out enough blood to meet the body’s needs.

This causes a buildup of pressure in other parts of the circulatory system, forcing fluid into the air sacs of the lungs and other parts of the body.

The following heart-related problems can also lead to pulmonary edema:

  • Fluid overload: This can result from kidney failure or intravenous fluid therapy.
  • Hypertensive emergency: This is a severe increase in blood pressure that places excessive strain on the heart.
  • Pericardial effusion with tamponade: This is a buildup of fluid around the sac that covers the heart, which can decrease the heart’s ability to pump.
  • Severe arrhythmia: This can be tachycardia (fast heartbeat) or bradycardia (slow heartbeat), both of which can result in poor heart function.
  • Severe heart attack: This can damage the muscle of the heart, making pumping difficult.
  • Abnormal heart valve: This can affect the flow of blood out of the heart.

Causes of pulmonary edema that are not due to poor heart function are called noncardiogenic and are often the result of ARDS.

Acute pulmonary edema causes significant breathing difficulties and can appear without warning. It is an emergency and requires immediate medical attention. Without proper treatment and support, it can be fatal.

In addition to breathing difficulties, the following symptoms can indicate acute pulmonary edema:

  • cough, often with a pink, frothy sputum
  • excessive sweating
  • anxiety and restlessness
  • feelings of suffocation
  • pale skin
  • wheezing
  • rapid or irregular heart rhythm (palpitations)
  • chest pain

If the pulmonary edema is chronic, symptoms are usually less severe until the body’s system can no longer compensate. Symptoms may include:

  • difficulty breathing when lying flat (orthopnea)
  • swelling (edema) of feet or legs
  • rapid weight gain due to the accumulation of excess fluid
  • paroxysmal nocturnal dyspnea, or episodes of severe sudden breathlessness at night
  • fatigue
  • increased breathlessness with physical activity

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Sometimes a chest X-ray can assist in the diagnosis of pulmonary edema. Image credit: Photographee.eu/Adobe Stock

A person will undergo a physical exam first. A doctor will use a stethoscope to listen to the lungs for crackles and rapid breathing and to the heart for abnormal rhythms.

The doctor will order blood tests to determine blood oxygen levels. They will often order additional blood tests to check the following:

  • electrolyte levels
  • kidney function
  • liver function
  • blood counts and blood markers of heart failure

An echocardiogram or an electrocardiogram (EKG) can help determine the condition of the heart.

The doctor may order a chest X-ray or a lung ultrasound to see whether there is any fluid in or around the lungs and to check the size of the heart. They may also order a CT scan.

Pulmonary edema happens when fluid collects inside the lungs, in the alveoli, making it hard to breathe. Pleural effusion also involves fluid in the lung area and is sometimes called “water on the lungs.”

However, in pleural effusion, fluid collects in the layers of the pleura that are outside the lungs.

Often, pleural effusion results from inflammation or a blockage due to a condition such as pneumonia, tuberculosis, or cancer. This is known as an exudative pleural effusion.

A transudative pleural effusion is another type that can also be due to excess fluid buildup in the body. This can result from heart failure, cirrhosis, or kidney failure.

Pulmonary edema can overlap with pneumonia, but it is a different condition. Pneumonia is an infection that often occurs as a complication of a respiratory infection such as the flu.

Though it can be difficult to distinguish between the two, a doctor will try to make a correct diagnosis and determine the best course of treatment based on a person’s detailed medical history, physical exam, and test results.

To raise a person’s blood oxygen levels, a healthcare professional will administer oxygen through either a face mask or nasal cannulas, which are tiny plastic tubes that a healthcare professional places in a person’s nose to provide oxygen.

Healthcare professionals may place a breathing tube in the trachea if a ventilator — a machine that helps a person breathe — is necessary.

If tests show that the pulmonary edema is the result of a problem in the circulatory system, healthcare professionals will administer intravenous medications to help reduce fluid volume and regulate blood pressure.

Diuretics are the most commonly used medication and can help reduce fluid buildup by increasing the production of urine.

Depending on the specific cause and a person’s symptoms, a healthcare professional may use any of the following other medications to treat pulmonary edema:

  • Vasodilators: These medications dilate the blood vessels to decrease pulmonary congestion.
  • Calcium channel blockers: These help reduce high blood pressure.
  • Inotropes: This type of medication can increase the force of heart muscle contractions so that the heart can pump blood throughout the body.
  • Morphine: This medication can help reduce anxiety and shortness of breath. However, because of its potential risks, healthcare professionals do not often recommend it.

People with an increased risk of developing pulmonary edema should follow a doctor’s advice to manage the condition.

If a person has congestive heart failure, following a healthy, balanced diet and maintaining a moderate body weight can help ease symptoms and reduce the risk of future episodes of pulmonary edema.

Regular exercise also improves heart health, as do other lifestyle habits, including:

  • Reducing salt intake: Excess salt can lead to water retention, which requires the heart to work harder.
  • Lowering cholesterol levels: High cholesterol can lead to fatty deposits in the arteries, which can increase the risk of heart attack and stroke in addition to pulmonary edema.
  • Smoking cessation: Tobacco increases the risk of a number of health conditions, including heart disease, lung disease, and circulatory problems.

It is possible to minimize altitude-induced pulmonary edema by making a gradual ascent, taking medications before traveling, and avoiding excess exertion while progressing to higher altitudes.

Pulmonary edema can be a result of several conditions, including congestive heart failure, pneumonia, and sepsis.

In addition to causing symptoms such as cough, wheezing, chest pain, and excessive sweating, pulmonary edema can result in severe breathing difficulties and may be fatal without proper treatment.

For this reason, if a person experiences any symptoms of pulmonary edema, it’s important to consult a doctor to determine the cause and the best course of treatment.

Read this article in Spanish.

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It’s said that singing heals the soul, but what if it actively helps people with respiratory disease? In a world first, Monash University researchers are currently recruiting people with two common, and incurable, chronic lung diseases into a two-year trial to see whether online group singing improves their condition.

Chronic obstructive pulmonary disease (COPD) is an incurable condition characterised by airflow limitation, persisting respiratory symptoms, and progressive respiratory failure. In Australia, COPD represents 43% of all chronic respiratory disease burden, affecting 30% of people aged over 75 years, with disproportionate impacts on those living in regional areas or with lower socioeconomic status. With over 72,000 admissions each year attributable to COPD, it is the third leading cause of avoidable hospitalisation and generates significant healthcare costs. Internationally, COPD is the second most common respiratory disease after asthma in the United Kingdom and the third leading cause of death worldwide.

Interstitial lung disease (ILD) is an umbrella term which captures a large group of diseases resulting in fibrosis of the lungs which often generate distressing, progressive symptoms, and account for a further 8% of chronic respiratory disease burden in Australia.

According to Associate Professor Natasha Smallwood, the Head of the Chronic Respiratory Disease laboratory at Monash University’s Central Clinical School who is leading the trial, pulmonary rehabilitation which includes exercise, breath training, psychosocial counselling, and patient education, has been shown to improve symptoms and function, and reduce hospitalisations. “Despite these benefits, of the nearly 1.5 million older Australians living with symptomatic COPD, fewer than 10% have ever accessed a program,” she said.

“Singing can be delivered as a guided, weekly, group-based activity, emphasising focus and control of breathing for patients with COPD and ILD.”

Online singing gained traction during COVID lockdowns when the risk of aerosol spread of the virus led to banning of choirs. “Online delivery of singing represents an attractive opportunity to improve healthcare access for participants with limited mobility, poor health, or who live in a rural location with limited access to health services,” the authors added.

The SingINg For breathing in COPD aNd ILD pAtients (SINFONIA) trial is a phase II/III trial of guided, online group singing that will be conducted over 24 months. Data will be collected on quality of life, anxiety and depression, breathlessness, mastery of breathing, exercise tolerance, loneliness, healthcare utilisation, and carer quality of life (optional).

/Public Release. This material from the originating organization/author(s) may be of a point-in-time nature, edited for clarity, style and length. The views and opinions expressed are those of the author(s).

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Conditions such as heart disease, stroke, and respiratory infections account for the majority of deaths each year around the world. With that said, there are many steps you can take to prevent these deadly diseases.

When people think of the deadliest diseases in the world, their minds probably jump to the fast-acting, incurable ones that grab headlines from time to time. However, many of these types of diseases don’t rank in the top 10 causes of worldwide deaths.

An estimated 55.4 million people passed away worldwide in 2019, and 74% of these deaths were because of noncommunicable diseases, or chronic conditions that progress slowly.

Perhaps even more surprising is that several of the deadliest diseases are partially preventable. Non-preventable factors include where a person lives, access to preventive care, and quality of healthcare, all of which factor into risk.

But there are several steps that everyone can take to lower their risk.

Read on to see 10 of the deadliest diseases worldwide.

The deadliest disease in the world is coronary artery disease (CAD).

Also called ischemic heart disease, CAD occurs when the blood vessels that supply blood to the heart become narrowed. Untreated CAD can lead to chest pain, heart failure, and arrhythmias.

Impact of CAD across the world

Although it’s still the leading cause of death, mortality rates have declined in many European countries and in the United States.

This may be because of better public health education, access to healthcare, and other forms of prevention. However, in many developing nations, mortality rates for CAD are on the rise.

An increasing life span, socioeconomic changes, and lifestyle risk factors play a role in this rise.

Risk factors and prevention

Risk factors for CAD include:

Talk with a doctor or healthcare professional if you have one or more of these risk factors.

You can prevent CAD with medications and by taking steps to improve heart health. Some of the ways you can decrease your risk include:

  • exercising regularly
  • reaching or maintaining a moderate weight
  • eating a balanced diet that’s low in sodium and high in fruits and vegetables
  • avoiding smoking, if applicable
  • drinking only in moderation

A stroke occurs when an artery in your brain is blocked or leaks. This causes the oxygen-deprived brain cells to begin dying within minutes.

During a stroke, you feel sudden numbness and confusion or have trouble walking and seeing. If left untreated, a stroke can cause long-term disability.

In fact, strokes are the leading cause of long-term disabilities. People who receive treatment within 3 hours of having a stroke are less likely to have disabilities.

The Centers for Disease Control and Prevention (CDC) reports that one survey found that 93% of people knew sudden numbness on one side was a symptom of stroke. However, only 38% knew all the symptoms that would prompt them to look for emergency care.

Risk factors and prevention

Risk factors for stroke include:

  • high blood pressure
  • family history of stroke
  • smoking, especially when combined with oral contraceptives
  • being African American
  • being female

Some risk factors of strokes can be lowered with preventive care, medications, and lifestyle changes. In general, good health habits can lower your risk.

Stroke prevention methods may include controlling high blood pressure with medications. You should also maintain a healthy lifestyle, complete with regular exercise and a balanced diet that’s low in sodium.

If you smoke, consider quitting and drink only in moderation, as these activities increase your risk of stroke.

A lower respiratory infection is an infection in your airways and lungs. It can be due to:

Though viruses usually cause lower respiratory infections, they can also be caused by bacteria.

Coughing is the main symptom of a lower respiratory infection. It may produce blood sputum. You may also have a fever, sweating, or chills or experience breathlessness, wheezing, and a tight feeling in your chest.

Risk factors and prevention

Risk factors for lower respiratory infection include:

  • the flu
  • poor air quality or frequent exposure to lung irritants
  • smoking
  • a weak immune system
  • crowded child care settings, which mainly affect infants
  • asthma
  • HIV

One of the best preventive measures you can take against lower respiratory infections is to get the flu shot every year. People at high risk of pneumonia can also get a vaccine.

Be sure to wash your hands regularly with soap and water to avoid transmitted bacteria, especially before touching your face or eating.

If you have a respiratory infection, stay at home and rest until you feel better, as rest improves healing.

Chronic obstructive pulmonary disease (COPD) is a long-term, progressive lung disease that makes breathing difficult. Chronic bronchitis and emphysema are types of COPD.

In 2018, about 16.4 million people in the United States reported a diagnosis of any type of COPD.

Risk factors and prevention

Risk factors for COPD include:

  • smoking or secondhand smoke
  • lung irritants such as chemical fumes
  • family history, with the alpha-1 antitrypsin deficiency gene being linked to COPD
  • history of respiratory infections as a child

There’s no cure for COPD, but its progression can be slowed with medication.

The best ways to prevent COPD are to stop smoking, if applicable, and avoid secondhand smoke and other lung irritants. If you experience any COPD symptoms, getting treatment as soon as possible improves your outlook.

Respiratory cancers include cancers of the trachea, larynx, bronchus, and lungs.

The main causes are smoking, secondhand smoke, and environmental toxins. However, household pollutions, such as fuels and mold, also contribute.

Impact of respiratory cancers around the world

A 2015 study reports that there are around 18 million new cases of lung cancer annually. In developing countries, researchers project an 81% to 100% increase in respiratory cancers because of pollution and smoking.

Many Asian countries, especially India, still use coal for cooking. Solid fuel emissions account for 17% of lung cancer deaths in males and 22% in females.

Risk factors and prevention

Trachea, bronchus, and lung cancers can affect anyone, but they’re most likely to affect those who have a history of smoking or tobacco use.

Other risk factors for these cancers include family history and exposure to environmental factors such as diesel fumes.

Aside from avoiding fumes and tobacco products, it isn’t known if there’s anything else that can be done to prevent lung cancers. However, routine lung scans and early detection can result in more effective treatment and an improved outlook.

Diabetes is a group of diseases that affect the production or use of insulin.

In type 1 diabetes, the pancreas is unable to produce insulin. This type of diabetes is believed to be caused by an autoimmune reaction.

In type 2 diabetes, the pancreas doesn’t produce enough insulin, or insulin can’t be used effectively. Type 2 diabetes can be caused by a number of factors, including poor diet and physical inactivity.

Impact of diabetes around the world

Over time, uncontrolled diabetes can cause damage to the nerves and blood vessels. This can lead to complications such as impaired wound healing, kidney failure, and blindness.

People in low- and middle-income countries are more likely to die of complications from diabetes because of limited access to medications and technologies needed to manage blood sugar levels.

Risk factors and prevention

Risk factors for diabetes include:

  • having overweight or obesity
  • high blood pressure
  • older age
  • not exercising regularly
  • an unhealthy diet

While diabetes isn’t always preventable, you can control the severity of symptoms by exercising regularly and following a well-rounded, nutritious diet. Adding more fiber to your diet can also help with controlling blood sugar levels.

Alzheimer’s disease is a progressive disease that destroys memory, interferes with decision making, and interrupts normal cognitive functions. These include thinking, reasoning, and other everyday behaviors.

Alzheimer’s disease is the most common type of dementia and accounts for about 60 to 70% of cases.

The disease starts off by causing mild memory problems, difficulty recalling information, and slips in recollection. Over time, however, the disease progresses, and you may not have memory of large periods of time.

Risk factors and prevention

Risk factors for Alzheimer’s disease include:

There’s not currently a way to prevent Alzheimer’s disease, and researchers aren’t sure why some people develop it and others don’t. As they work to understand this, they’re also working to find preventive techniques.

One thing that may be helpful in lowering your risk of the disease is following a healthy diet. In fact, some research suggests that eating plenty of fruits, vegetables, whole grains, heart-healthy fats, and legumes could support brain function and prevent cognitive decline.

Diarrhea is when you pass three or more loose stools in a day. If your diarrhea lasts more than a few days, your body loses too much water and salt. This causes dehydration, which can be fatal in severe cases.

Diarrhea is usually caused by an intestinal virus or bacteria transmitted through contaminated water or food. It’s particularly widespread in areas with poor sanitary conditions.

Impact of diarrheal diseases around the world

Diarrheal disease is the second leading cause of death in children younger than 5 years old. About 525,000 children die from diarrheal diseases each year.

Risk factors and prevention

Risk factors for diarrheal diseases include:

  • living in an area with poor sanitary conditions
  • not having access to clean water
  • age, with children being the most likely to experience severe symptoms of diarrheal diseases
  • malnourishment
  • a weakened immune system

The best method of prevention is practicing good hygiene. Handwashing, improved sanitization and water quality, and access to early medical treatment can also help prevent diarrheal diseases.

TB is a lung condition caused by bacteria called Mycobacterium tuberculosis. It’s a treatable airborne bacterium, although some strains are resistant to conventional treatments.

TB is one of the top causes of death in people who have HIV. Furthermore, people who have HIV are 18 times more likely to develop active TB.

Impact of TB around the world

The cases of TB have fallen 2% each year between 2015 and 2020.

One of the targets of the United Nations Sustainable Development Goals is to end the TB epidemic by 2030.

Risk factors and prevention

Risk factors for TB include:

  • diabetes
  • HIV infection
  • a lower body weight
  • proximity to others with TB
  • regular use of certain medications such as corticosteroids or drugs that suppress the immune system

The best prevention against TB is to get the bacillus Calmette-Guerin vaccine, which is commonly given to infants and children in areas where TB is common.

If you think you’ve been exposed to TB bacteria, a doctor can prescribe preventive medications (chemoprophylaxis) to lower the likelihood of developing an active infection.

Cirrhosis is the result of chronic or long-term scarring and damage to the liver. The damage may be the result of a kidney disease, or it can be caused by conditions such as hepatitis, alcoholic liver disease, or nonalcoholic fatty liver disease.

A healthy liver filters harmful substances from your blood and sends healthy blood into your body. As substances damage the liver, scar tissue forms. As more scar tissue forms, the liver has to work harder to function properly and may eventually stop working.

Risk factors and prevention

Risk factors for cirrhosis include:

  • chronic alcohol use
  • fat accumulation around the liver (nonalcoholic fatty liver disease)
  • chronic viral hepatitis

Moderating alcohol intake can help prevent liver damage and cirrhosis.

Likewise, you can prevent nonalcoholic fatty liver disease by enjoying a nutritious diet rich in fruits and vegetables and low in sugar and fat.

Lastly, you can lower the likelihood of contracting viral hepatitis by using barrier methods each time you engage in sexual activity and by avoiding sharing anything that could have traces of blood such as needles, razors, or toothbrushes.

How many rare diseases are there?

A rare disease is usually defined as a disease or condition that affects fewer than 200,000 people in the United States.

According to most scientists and clinicians, there are around 7,000 different rare diseases. However, this estimate can vary from 5,000 to 8,000 rare diseases, depending on the source.

It’s believed that around 1 in 10 people in the United States, or around 30 million people in total, has a rare disease.

Some rare diseases are hereditary and can be passed from parent to child. Some may be visible from birth, while others might show up later in life.

Which disease has no cure?

There’s no known cure for many conditions, including several on the list of the deadliest diseases.

This also includes conditions such as cancer, Alzheimer’s disease, multiple sclerosis, and muscular dystrophy.

In many cases, certain lifestyle factors, such as smoking cessation and modifying your diet or exercise routine, may lower the risk of developing some of these conditions.

In other cases, a combination of lifestyle changes, medications, and other treatment methods might help manage or reduce symptoms of a condition, though it may not necessarily cure it.

What’s the deadliest disease?

Ischemic heart disease is the leading cause of death around the globe. Other conditions, such as stroke, COPD, lower respiratory infections, and respiratory cancers, also account for a significant portion of deaths each year.

While deaths from certain diseases have increased, those from more serious conditions have also decreased.

Several factors, such as an increasing life span, naturally increase the prevalence of age-related diseases such as CAD, stroke, and heart disease.

However, many of the diseases on this list are preventable and treatable, and as medicine continues to advance and prevention education grows, we may see improved outcomes for many of these diseases.

A good approach to lowering your risk of any of these conditions is to follow a balanced diet, live a healthy lifestyle, and stay active.

Moderating your alcohol intake and quitting smoking, if applicable, can also help.

For bacterial or viral infections, proper handwashing can help prevent or lower your risk.

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Seventeen students from Kendriya Vidyalaya, Kakinada, were admitted to a hospital following breathing-related complaints. The students were admitted to the Government General Hospital of Kakinada.

"We have given oxygen support to students and their health condition is stable now and we have taken blood samples for testing to detect the reason, " said Kakinada collector, Kritika Shukla. Regarding the possible cause of breathlessness, Shukla, said, " No chemical or gas leakage was detected in the school. Water samples from the school were also taken for testing. We are monitoring the situation closely.(ANI)

(This story has not been edited by Devdiscourse staff and is auto-generated from a syndicated feed.)

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The name "Pickwickian syndrome" was coined after a fictional obese character named Joe in Charles Dickens's novel the “Pickwick Papers” [1]. There has been an inexorable rise in the number of cases of obesity worldwide in the past four to five years. India is undergoing a rapid epidemiological transition, from an underweight to an overweight/obese population. It can be attributed to the rapid lifestyle changes associated with high caloric intake and reduced physical activity, putting Indian people at a high risk of obesity. Obesity is associated with innumerable comorbidities including hypertension, diabetes mellitus, and cardiac complications [2]. Obesity hypoventilation syndrome (OHS), the prevalence of which has been shown to rise in direct proportion to the prevalence of obesity, is considered an important sequela of severe obesity. Patients with OHS experience a wide variety of difficulties ranging from congestive cardiac failure, metabolic syndrome, and obstructive sleep apnea (OSA). We report the case of a 62-year-old female who presented with severe dyspnea and, after polysomnography (PSG), was diagnosed with OHS and managed with non-invasive positive pressure ventilation (NIPPV) support.

A 62-year-old female presented to the ED with complaints of breathlessness for six months, which had been initially mild but progressed to severe dyspnea in the last 15 days prior to the admission. The patient also had complaints of a productive cough and intermittent low-grade fever with chills for 10 days. She had consulted at a local hospital for the same complaints and received symptomatic management with inhaled bronchodilators and oxygen support, but did not show any clinical improvement and was referred to our tertiary care center in Wardha, India for further management.

Clinical examination and routine investigations

On general examination, the patient was found to have severe obesity with a BMI of 42 Kg/m2. The vital parameters of the patient were as follows - pulse rate: 98 beats/minute, blood pressure: 150/90 mmHg, respiratory rate: 28 breaths/minute, and oxygen saturation: 84% on room air on pulse oximetry. She also had bilateral pitting edema present on the lower limbs and a raised jugular venous pressure (JVP). No other obvious abnormalities were found on the rest of the clinical examination. The clinical image of the patient on admission to the ICU is shown in Figure 1.

The patient underwent arterial blood gas (ABG) analysis, which revealed respiratory acidosis along with hypoxia and hypercapnia; other routine blood investigations showed no abnormalities apart from elevated blood d-dimer levels. The results of significant blood investigations are summarized in Table 1.

Arterial blood gas analysis (ABG) Patient values Normal range
Potential of hydrogen (pH) 7.26 7.35–7.45
Partial pressure of carbon dioxide (pCO2) 70 mmHg 35–45 mmHg
Partial pressure of oxygen (pO2) 58 mmHg 80–100 mmHg
D-dimer levels 980 ng/ml Less than 500 ng/ml

The patient was put on NIPPV support, but a repeat ABG analysis showed no improvements in her oxygenation status. She was intubated and put on mechanical ventilatory support in volume control (VC) mode. She was gradually weaned off mechanical ventilation and, following extubation after five days, was again put on NIPPV support. A detailed history of the patient did not reveal any major risk factors for chronic obstructive pulmonary disease (COPD). Further diagnostic imaging tests such as a chest X-ray and two-dimensional echocardiography (2D-echo) were done to rule out any comorbid cardiorespiratory conditions. The chest X-ray of the patient revealed bilateral mid-zone and lower-zone haziness, which may be seen in bilateral lower-lobe pneumonia or pleural effusion, as shown in Figure 2.

Ultrasonography (USG) of the thorax was done, which revealed no evidence of underlying pleural effusion. 2D-echo of the patient revealed a mildly dilated right atrium and right ventricle with a left ventricular ejection fraction (LVEF) of 55%. After the clinical stabilization of the patient, we conducted a PSG of the patient to investigate further causes of her respiratory failure, especially given her history of daytime sleepiness and excessive snoring. PSG revealed that the patient had an apnea-hypopnea index (AHI) of 58.2, which was classified as severe OSA as per a recent classification of OSA severity [3]. A summary of the PSG findings of the patient is given in Table 2.

Respiratory disturbance index including respiratory effort-related arousals (RERA) and total sleep time (TST)
  REM (episodes/hour) NREM (episodes/hour) TST (episodes/hour)
RDI 30 58.6 58.2
Apnea-hypopnea index (AHI) excluding central apneas
  REM (episodes/hour) NREM (episodes/hour) TST (episodes/hour)
AHI 30 58.6 58.2
Hypopnea summary
  Total events With drops in heart rate With drops in oxygen saturation
Total number 108 92 94
Max length (sec) 57.5 57 57.5
Central apnea summary
  Total events With drops in heart rate With drops in oxygen saturation
Total number 187 149 145
Max length (sec) 50 50 50
Apneas preceded by sighing 8 7 6

The hypnogram of the patient, showing multiple episodes of apnea and hypopnea and oxygen desaturation in various sleep stages, is shown in Figure 3.

After extensive investigations, we diagnosed the patient with OHS based on persistent daytime hypercapnia, OSA diagnosed on a PSG, and clinical findings of severe obesity. Overnight NIPPV support along with intermittent oxygen support during the daytime was continued. She was discharged after 15 days with stable vitals, with a prescription for overnight NIPPV support and a specialist consultation with a bariatric surgeon to consider possible weight-reduction interventions/surgeries.

After ruling out other pathologies that could lead to alveolar hypoventilation, OHS is characterized as the presence of obesity (BMI of 30 kg/m2), and daytime hypercapnia [arterial carbon dioxide tension (PaCo2) of more than 45 mmHg], with sleep-disordered breathing [2]. An upper airway obstruction, a deficiency in ventilatory drive, and obesity are the leading causes of OHS. Patients with OHS who are obese are forced to breathe at low functional residual capacity (FRC) with reduced diaphragm activity [3]. Indian patients have an OHS prevalence that is comparable to that of Caucasians, despite having a reduced BMI and spirometric findings [4]. All individuals with centrally distributed morbid obesity should get a thorough OHS evaluation. To confirm daytime hypercarbia and hypoxia, it is important to check for pulse oximetry data indicating awake hypoxemia and to conduct ABG analysis. To look into respiratory disorders related to sleep, a PSG should be carried out.

The patient in this report presented with severe hypoxia and hypercarbia needing mechanical intubation initially. This shows that obesity hypoventilation can present as acute illness or exacerbation where patients are more hypoxemic and more hypercapnic than usual. Proper management at such times becomes crucial. Therapeutic errors, especially at the time of hospitalization for respiratory or cardiovascular decompensation, should be avoided. Subjects with OHS may develop acute hypercapnia in response to the administration of excessive supplemental oxygen and excessive diuresis for peripheral edema using a loop diuretic such as furosemide exacerbates metabolic alkalosis, thereby leading to the worsening of daytime hypoventilation and hypoxemia [5]. Post-discharge management is essential for OHS patients. The most important component of managing OHS is weight loss [6]; yet, it is sometimes challenging to achieve and maintain weight loss with medical care. Bariatric surgery helps OHS patients lose weight more effectively and sustain it for longer periods of time. Recent research has revealed that using NIV to treat chronic respiratory failure is linked to weight loss and a reduction in sedentary time. In addition to NIV, a multimodal rehabilitation program can benefit OHS patients by enhancing weight loss and improving their ability to exercise [7].

OHS is not very frequently diagnosed in general practice and hence its prevalence is underestimated. A patient presenting with hypoxia and hypercarbia with central obesity should be carefully evaluated for OHS and a proper plan of management should be implemented to avoid any detrimental consequences. NIPPV should be instituted at the earliest along with effective weight reduction strategies to improve the prognosis of the patient. A PSG should also be done in such patients to rule out sleep-disordered breathing. Obesity is a health condition affecting almost all body systems, and this case report highlights its detrimental effects on respiratory and sleep physiology, which, in this case, led to hypercapnic respiratory failure.



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Breathing difficulty is a common occurrence in older adults and is usually a symptom of an underlying health condition, most often cardiorespiratory disease.3,4

Patients presenting with acute breathing problems often experience the most distressing form of breathlessness known as “air hunger”.5 This is the sensation of needing to take in more air. Air hunger is an especially unpleasant symptom that can induce anxiety, panic, and fear.

In fact, breathing problems are one of the most common reasons for an ambulance call out.6 Older adults with breathing problems constitute a considerable proportion of emergency department case load and have a high admission rate and significant mortality.7 Exacerbations or worsening of pre-existing chronic disease account for a sizeable proportion of cases.

Many seniors presenting to emergency departments with breathing difficulties have time-sensitive diagnoses,8 emphasising the need for prompt medical attention and early diagnosis.

Delaying emergency intervention for older adults experiencing an incapacitating medical event while living at home, such as breathing difficulty or chest pain, can lead to a fatal outcome and also risks the ability of survivors to continue to live independently.9

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Chronic Obstructive Pulmonary Disease is a broad term used for defining progressive lung diseases like emphysema, refractory asthma, chronic bronchitis and some other forms of bronchiectasis. The symptoms of Chronic Obstructive Pulmonary Disease are so common that sometimes people fail to understand that they are suffering from Chronic Obstructive Pulmonary Disease and consider it as normal cold, cough and symptoms of aging. Symptoms are sometimes not even visible in the early stages of disease and the disease remains undiagnosed for a long time.

The symptoms of Chronic Obstructive Pulmonary Disease include wheezing, tightness in the chest, frequent coughing and increased breathlessness. Chronic Obstructive Pulmonary Disease can be treated using different types of drugs and therapies including oxygen therapy and pulmonary rehabilitation programs. In case of extreme severity of Chronic Obstructive Pulmonary Disease surgery is recommended which includes lung volume reduction surgery, lung transplant and bullectomy.

According to the data of British Lung Foundation approximately 1.2 billion people were suffering from Chronic Obstructive Pulmonary Disease in the U.K. alone in 2011. Also according to the COPD Foundation approximately 30million Americans were suffering from Chronic Obstructive Pulmonary Disease in 2013. Chronic Obstructive Pulmonary Disease is one of the leading causes of death worldwide. This data demonstrates the ever increasing demand of Chronic Obstructive Pulmonary Disease treatment worldwide and hence also shows the potential that the Chronic Obstructive Pulmonary Disease therapeutics market holds.

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Chronic Obstructive Pulmonary Disease Therapeutics Market: Drivers and Restraints

The most important factors that are expected to drive the growth of the Chronic Obstructive Pulmonary Disease market includes the ever increasing number of cases of Chronic Obstructive Pulmonary Disease globally. Also the change in the lifestyle is responsible for increasing the habits like smoking and increase in the number of genetic disorders which in turn are responsible for raising the number of Chronic Obstructive Pulmonary Disease patients.

Other factors that can boost the revenue from the Chronic Obstructive Pulmonary Disease therapeutics market are rising expenditures on healthcare that is leading to the adoption of Chronic Obstructive Pulmonary Disease treatments in the emerging economies. Increase in the level of awareness has also lead to the early diagnosis of the Chronic Obstructive Pulmonary Disease so that people can go for the treatment of the disease.

Factors that can limit the growth of the therapeutic enzymes in the forecast period include the fact that not all the patients who are suffering from Chronic Obstructive Pulmonary Disease are aware of the fact that they are suffering from the disease and therefore do not go for the treatment of the disease. Also sometimes people get to know about their disease when the disease can’t be cured by only medication and therapies and surgery becomes mandatory. This factor can also lead to a slow growth in the revenue from the Chronic Obstructive Pulmonary Disease therapeutics market.

Chronic Obstructive Pulmonary Disease Therapeutics Market: Overview

Chronic Obstructive Pulmonary Disease therapeutics market is a growing market and is expected to see an even higher growth in the forecast period. Factors such as increase in the population suffering from Chronic Obstructive Pulmonary Disease worldwide and increasing awareness about Chronic Obstructive Pulmonary Disease are responsible for fueling the growth of the Chronic Obstructive Pulmonary Disease therapeutics market.

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Betterment of the healthcare infrastructure in Asia Pacific and Middle East and Africa is also responsible for the revenue growth of the Chronic Obstructive Pulmonary Disease therapeutics market in the forecast period.

Chronic Obstructive Pulmonary Disease Therapeutics Market: Region-wise Outlook

Chronic Obstructive Pulmonary Disease therapeutics market is in its growth phase and hence this market is expected to see very high growth in the emerging economies like Latin America and Asia Pacific due to high population growth in these regions. North America Chronic Obstructive Pulmonary Disease therapeutics market is the most developed market in terms of revenue, followed by Europe. Middle East and Africa are also expected to see higher growth due to growing advancement in the healthcare infrastructure.

Chronic Obstructive Pulmonary Disease Therapeutics Market: Key Market Participants

Some of the key participants of Chronic Obstructive Pulmonary Disease therapeutics market include Pfizer Inc, Adamis Laboratories Inc., GlaxoSmithKline plc.

The report covers exhaustive analysis on

  • Market Segments
  • Market Dynamics
  • Historical Actual Market Size, 2012 – 2014
  • Market Size & Forecast 2017 to 2027
  • Supply & Demand Value Chain
  • Market Current Trends/Issues/Challenges
  • Competition & Companies involved
  • Technology
  • Value Chain
  • Aircraft Refurbishing Market Drivers and Restraints

Regional analysis includes

  • North America
  • Latin America
  • Europe
  • Asia Pacific
  • Middle East & Africa

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The report is a compilation of first-hand information, qualitative and quantitative assessment by industry analysts, inputs from industry experts and industry participants across the value chain. The report provides in-depth analysis of parent market trends, macro-economic indicators and governing factors along with market attractiveness as per segments. The report also maps the qualitative impact of various market factors on market segments and geographies.

Chronic Obstructive Pulmonary Disease Therapeutics Market: Segmentation

Chronic Obstructive Pulmonary Disease Therapeutics Market: Segmentation

Chronic Obstructive Pulmonary Disease therapeutics market can be segmented on the basis of components and end user.

On the basis of component

  • Drug Class
  • Bronchodilators
  • Steroids
  • Phosphodiesterase-4 inhibitors
  • Theophylline
  • Antibiotics
  • Delivery Systems
  • Oral
  • Inhalation

On the basis of end user

  • Hospitals
  • Private clinics
  • Out-patients

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Breathing is something we do automatically and take little notice of throughout our day.

n moments when you’re under pressure, you’ve probably told yourself to ‘just breathe’. We know in theory that breathing can control how we feel, but how much do we really understand about the power of breathwork?

Real Health Podcast: How breathing can transform your health


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This weel I’m joined by breathing expert, peak performance coach and host of BBC Radio 1’s Decompression Session, Stuart Sandeman.

Stuart’s new book Breathe In, Breathe Out, gives readers simple yet effective exercises that are guaranteed to charge you up, help you relax and improve your performance.

Stuart says people often say they are too busy to improve their breathing, but he believes it is something we should make time for.

“If you are doing something 20,000 times a day, would you not want to know if you’re doing it right? If you’re doing any other task that many times, surely, you’d like to know a bit more about that task Especially when it is linked to our energy levels, our stress levels, how we sleep, how we digest our food. All these things that are so important day to day.”

Knowing how to breathe properly can also improve our fitness levels. Learning some good techniques isn’t just for Olympic athletes. Stuart says it can also help those trying to get into a new fitness regime but always find themselves breathless.

“Our breathing has a direct correlation to our fitness levels. The two reasons you may not be able to go that extra round or extra mile would be either because you have muscle pain, lactic acid has built up, which is to do with breathing. Or, you have a feeling of breathlessness so much so you can’t carry on... Both of those are things we can fine tune and improve quite dramatically.”

We also discuss if hormonal contraception can impact women when training and how female body composition differs from men.

For more episodes, tips and advice from the show just click here.

And you can get in touch - I’m @KarlHenryPT on Instagram and [email protected].

Don’t forget to rate, review and follow on Apple and Google Podcasts, Spotify, or wherever you get your podcasts from.

The Real Health podcast is in association with Laya Healthcare.

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Pune’s KEM Hospital Research Centre Wednesday launched the short film ‘Breathing freely’ (Olakh Moklya Shwasachi) to create awareness about respiratory diseases. The 15-minute film is financially supported by the NIHR Global Health Research Unit in Respiratory Health (RESPIRE) at the University of Edinburgh, UK.

The film aims to target rural audiences in order to raise awareness about respiratory health with a focus on Chronic Obstructive Pulmonary Disorder (COPD) and asthma. It further aims to educate about the preventive measures, available treatments and rehabilitation possibilities. The film also sheds light on the important work being done at the Pulmonary Rehabilitation Centre at KEM Vadu.

Dr Parag Khatavkar, Chest Physician, KEM Hospital Research Centre told the media that respiratory diseases, especially COPD and asthma, are among the most misunderstood and underdiagnosed diseases. He said, “The film will help reduce the confusion and increase awareness about the disease and its diagnosis. The film attempts to debunk myths, misconceptions and superstitions surrounding the diseases and tries to de-stigmatise the use of inhalers and similar treatments. Such films are necessary to clarify misunderstandings regarding respiratory diseases.”

Diksha Singh, psychologist at KEM Hospital Research Centre, who conceptualised and coordinated the film production process, said the intention is to have screenings in urban as well as rural areas and also across social media platforms. The film will be screened in the waiting areas of the general as well as chest department OPDs, private chest clinics and study clinics under the Vadu Rural Health Programme.

The film revolves around a man who recently retired and stays in an urban area, an athlete who aspires to run a marathon and a middle-aged housewife of a rural area. All the three characters face symptoms like breathlessness, cough, wheezing and reduced exercise capacity. After a doctor’s consultation and further diagnosis, they learn about the preventive measures, available treatments and rehabilitation possibilities. The film shows healthcare professionals helping the patients debunk myths, misconceptions and superstitions surrounding the disease and the use of inhalers.

Pulmonary Rehabilitation Centre at Vadu

The KEM Hospital Research Centre works with a mission to provide evidence-based, sustainable and rational healthcare solutions for the rural population using globally-relevant community-based ethical research.

“A locally suitable Pulmonary Rehabilitation Centre was set up under the Vadu Rural Health Programme,” Dr Sanjay Juvekar, professor and head, Vadu Rural Health Program, KEM Hospital Research Centre, said. The Pulmonary Rehabilitation study is the first instance of pulmonary rehabilitation being systematically introduced in rural India and demonstrates the effects of Pulmonary Rehabilitation on improving health and quality of life of Chronic Respiratory Disease patients.



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