Respiratory system include about various respiratory diseases and its diagnosis and treatment.pptx

about various respiratory diseases and its diagnosis and treatment

1. Respiratory System Diseases Prepared by: Yasmeen Farag Mohamed

2. Content: Definition Types Signs and Symptoms Causes Risk Factors Diagnosis Preventive Care Treatment Approach Case References

3. Asthma

4. Definition: Asthma is a chronic inflammatory disorder of the airways( the lower respiratory tract) in which many cells and cellular elements play a role: in particular, mast cells, eosinophils , T lymphocytes, macrophages, neutrophils, and epithelial cells.  (1) There are two main problems in asthma: swelling and increased mucus (inflammation) in the airways, and squeezing of the muscles around the airways (bronchospasm ).These problems can make it hard to breathe .(4)

5. Types of asthma: 4 Sever Persistent Asthma You have symptoms throughout the day and wake up seven nights a week

6. Signs and Symptoms: Asthma often presents clinically in attacks or episodes(1) Asthma symptoms tend to be worsen at night, which is concordant with the cycle of endogenous cortisol levels.(1) Four cardinal symptoms of asthma: (1) Wheezing Shortness of breath Coughing Chest tightness

7. Causes : The cause of asthma is not known , but risk factors have been identified and gene-environment interactions are important . Genetics are known to play a role, with asthma with heritability ranging between 35% and 95 %. Large genetic studies have identified hundreds of genetic variants associated with an increased risk of asthma(1) Humidity Animals

8. Risk Factors: Genetic factors: Have an important effect on the inception, severity, and treatment of asthma . Environmental risk factors: Tobacco Pollution Obesity Microbes Stress Occupational risk factors : Work environment is an important potential risk factor for asthmatic patients  . Traditionally , sensitizers to occupational asthma have been divided into: High–molecular weight compounds (HMW): The most relevant causes of HMW agents include flour dust, enzymes (plant and animal derived), gums, foods, rubber-derived proteins, animal-derived and insect-derived allergens, and fish/seafood–derived allergens Low–molecular weight compounds (LMW ): The most relevant LMW agents include polyisocyanates and their polymers, acid anhydrides, metals, and a spectrum of chemical substances(2)

9. Risk Factors cont.: Medications : including aspirin and beta-blockers Sulfites (a type of preservative): in foods/drinks, such as dried fruits, wine, and beer (4)

10. Diagnosis: Diagnostic Testing Spirometry Bronchodilator Response Testing Inhalation Challenge Test Radioallergosorbent Test Allergen Skin Test Exhaled Nitric Oxide Radiographic Imaging (3)

11. Preventive Care : Here are some things you can do to avoid the most common triggers of asthma: Quit smoking and avoid secondhand smoke. Wear a mask when painting, doing construction work or yard work. Get your flu shot. Use HEPA filters in your vacuum, furnace and air conditioner. Use protective bedding and pillow cases to reduce allergies. Keep pets out of your home. Manage stress levels to avoid panic attacks. See a specialist to identify allergies and learn how to avoid them. Stay on your prescribed maintenance medicine.

12. Treatment Approach: Lifestyle interventions focus on : Manipulating diet and/or exercise, with specific attention to obesity. Other interventions include meditation , yoga , massage therapy and acupuncture . ( 5)

13. Treatment Approach cont. : Dietary interventions: 1-Dietary patterns Anti-inflammatory eating patterns, such as the Mediterranean diet , which is traditionally high in fruits, vegetables, dietary fiber and omega-3 fatty acids, has been linked to anti-inflammatory pathways. (have been explored in the management of asthma .) (5)

14. Treatment Approach cont. : 2-Nutrients: Sodium : reducing sodium intake may be beneficial in improving lung function . Dietary fiber: there is some evidence demonstrating poorer lung function and increased airway inflammation in asthmatics with lower dietary fiber intake. Saturated fat : High circulating levels of saturated fatty acids have been found to increase oxidative stress and inflammation and reduces efficacy of bronchodilator medications . (5) Omega-3 fatty acids : Omega-3 polyunsaturated fatty acids (n-3 PUFAs) well known for their anti-inflammatory properties, which include inhibiting inflammatory cytokine production by modifying cell membrane fatty acid composition. Vitamin D: is suggested to be beneficial in asthma due to its effects on the immune system and genetic regulation of asthma susceptibility genes.(5)

15. Treatment Approach cont. : Pharmacotherapy of bronchial asthma Bronchodilators Anti-inflammatory agents Mediator release inhibitors Phosphodiesterase inhibitors Cytokine inhibitors β- adrenergic agonists Anti- cholinergics Methyl- xanthines Corticosteroids Anti- leukotrienes Mast Cell Stabilizers Cromolyn sodium Sildenafil Interleukin-1 receptor antagonist 

16. Herbal drugs used for asthma: Plant Chemical constituents Mechanism of action Ammi visnaga (Fruits) (8) Khellin Visnagin (8) Support body to combat spasms in smooth muscles (antispasmodic) Dilate blood vessels (Bronchodilator) (7)

17. Herbal Drugs used for Asthma cont.: Plant Chemical constituents Mechanism of action Ephedra (Stem) (8) Ephedrine (8) Bronchodilator(8) Inhibitory action against prostaglandins, histamine and serotonin mediators that are released during bronchial asthma and inflammation. Thus it showed an anti-inflammatory effect by inhibiting these mediator receptors.(9)

18. Herbal Drugs used for Asthma cont.: Plant Chemical constituents Mechanism of action Glycyrrhiza glabra Root (8) Licochalcone A Glycyrrhizinic acid (8) licorice flavonoids decrease eosinophilic lung inflammation and IgE levels (10) Antihistaminic (8) Antiallergic (8)

19. Herbal Drugs used for Asthma cont.: Plant Chemical constituents Mechanism of action Nigella sativa (Seed) (8) The fixed oil contains: unsaturated fatty acids which includes: arachidonic , eicosadienoic , linoleic, linolenic , oleic, palmitic , stearic and myristic acid .(12) Reduce the eosinophil count to normal values.(11)

20. Cough

21. Definition : Expiration associated with a characteristic sound,  cough serves to protect the lung from inhalation of noxious agents and clear the airway of unwanted secretions .(13)

22. Types : Based on the perception of presence of sounds related to secretions in the airways, cough is classified into the two categories: Wet cough ( Productive cough) Dry cough ( Non productive cough) Depending on its acoustic quality cough is characterized as wet when the sounds carry features indicative of mucus; in the absence of perceivable wetness they are called dry (14)

23. Types cont.: Types of coughs may be related to how they last Acute cough: begins suddenly and lasts for two to three weeks. Subacute cough: is one that stays around after you’ve had an infection and lasts three to eight weeks. Chronic cough   :lasts longer than eight weeks. Long-lasting coughs may also be called persistent coughs . Refractory cough: is a chronic cough that hasn’t responded to treatment.

24. Causes: Wet coughs Dry cough usually caused by : Common cold or flu Pneumonia COPD (chronic obstructive pulmonary disease) Asthma Acute bronchitis usually a gag reflex often caused if there is : An inflammation or irritation in the respiratory tract Air-born pollutants Irritants such as smoke and dust Sore throat Tonsillitis Sinusitis Allergies GERD( Gastroesophageal reflux disease) Common symptom of covid-19.

25. Risk factors: There are certain risk factors that can increase your risk of cough hypersensitivity and with it, the duration or severity of a cough they include: Smoking (including second-hand smoke) Vaping Allergies (especially seasonal allergies) Air pollution Industrial fumes and dust Uncontrolled asthma

26. Diagnosis: Your doctor will ask about your medical history and perform a physical exam. A thorough medical history and physical exam can provide important clues about a chronic cough. Your doctor may also order tests to look for the cause of your chronic cough include: Imaging tests X-rays .   Computerized tomography (CT) scans. Lung function tests Laboratory tests Scope tests Bronchoscopy Rhinoscopy .

27. Preventive Care: You can prevent some kinds of cough by avoiding irritants that you know cause you to cough. You can help prevent coughs caused by infections by: Getting vaccinated for influenza, COVID-19 and pneumonia. Avoiding people who are ill. Avoid touching your eyes, nose and mouth. Wash your hands often with soap and water and/or using hand sanitizers.

28. Treatment Approach: Lifestyle and home remedies Drink fluids : Liquid helps thin the mucus in your throat. Warm liquids, such as broth, tea or juice, can soothe your throat. Suck on cough drops or hard candies : They may ease a dry cough and soothe an irritated throat. Consider taking honey : A teaspoon of honey may help loosen a cough. Don't give honey to children younger than 1 year old because honey can contain bacteria harmful to infants. Moisturize the air.  Use a cool-mist humidifier or take a steamy shower. Avoid tobacco smoke : Smoking or breathing secondhand smoke irritates your lungs and can worsen coughs caused by other factors. If you smoke, talk with your doctor about programs and products that can help you quit.

29. Treatment Approach cont.: Diet Foods That May Help (15) Ginger Vitamin C Oregano Foods to avoid when suffering from cough : Dairy products Caffeine and alcohol  Fried foods Histamine Dense foods Sugar

30. Treatment Approach cont.: Medications Medications used to treat chronic cough may include: Antihistamines, corticosteroids and decongestants . Inhaled asthma drugs.  Antibiotics . Cough suppressants

31. Herbal Drugs used for cough: Plant Chemical constituents Mechanism of action Fennel (Fruit) Trans- anethole Fenchone   It is enriched with the goodness of antioxidants and vitamin C, which naturally combats infections and seasonal cold. Fennel seeds are also loaded with anti-inflammatory volatile oils and phytonutrients, which helps in preventing as well as cutting sinus congestion and cold.

32. Herbal Drugs used for cough cont.: Plant Chemical constituents Mechanism of action Opium poppy (fruit) Codeine Noscapine   Depressant effect on the cough center General sedative and analgesic properties

33. Herbal Drugs used for cough cont.: Plant Chemical constituents Mechanism of action Thyme (herb) 1- Volatile oil: Thymol Carvacrol Linalool 2- Flavonoids: Apigenin Luteolin Antiseptic Anti-inflammatory

34. Herbal Drugs used for cough cont.: Plant Chemical constituents Mechanism of action Ginkgo biloba (leaves) Terpene lactones : Ginkgolides Diterpenes Ginkgo flavone glycosides: Ginkgetin Bilobetin Sciadopitysin This is attributed to the anti-inflammatory compounds in ginkgo, which may allow for reduced inflammation of the airways and increased lung capacity.

35. Case A 71-year-old man had battled a persistent cough for 25 years. It had become more frequent and intense in the last three years. Standard treatments didn’t seem to help. Prednisolone wasn’t effective long-term. Neither were numerous other allergy and inflammation medications. Nate Bergman, DO, MBA, of Cleveland Clinic’s Center for Functional Medicine, recommended a range of lifestyle interventions, including dietary changes and relatively low-risk detoxification methods . An anti-inflammatory, low-glycemic food plan was the foundational treatment. “Patients tell us all the time how certain foods — corn, dairy and gluten , for example —  cause reactions in their body, such as swelling or sluggishness ,” says Dr. Bergman. “When we remove those food triggers and lower the overall inflammatory burden, it improves the body’s ability to detoxify itself .”

36. Dr. Bergman also recommended that the patient sit in a dry sauna for 30 to 60 minutes per day (for thermal depuration), perform aerobic exercise as able, drink 3 to 4 liters of water per day , and take nutraceutical supplements . Nutraceuticals were intended to fill measurable gaps in nutrient levels associated with reduced inflammation and to support phases of liver detoxification . Within six weeks, the patient’s cough had reduced dramatically — by 75 percent according to the patient. A year later, his cough had reduced by 85 percent. The patient also reported sustained weight loss, lower blood pressure and normalized HbA1c levels. He was able to reduce his blood pressure medication and stop using multiple other medications for diabetes and gout. The patient’s cough symptoms and HbA1c levels remain significantly reduced despite discharge from functional medicine care and discontinuation of rigorous aspects of the intervention.

37. References: 1-Mims , James W. "Asthma: definitions and pathophysiology."  International forum of allergy & rhinology . Vol. 5.IssueS1. 2015 , Pages  S2-S6. 2- Elina Toskala MD, PhD, David W. Kennedy MD , Asthma risk factors , International forum of allergy & rhinology . Volume5,  IssueS1 , 2015 Pages   S11-S16 3- Meredith C McCormack MD MHS and Paul L Enright MD , Making the Diagnosis of Asthma, RESPIRATORY CARE • MAY 2008 VOL 53 NO 5 4- Sockrider, Marianna, and Lynn Fussner . "What is asthma?."  American journal of respiratory and critical care medicine  202.9 (2020): P25-P26. ‏ 5-Stoodley I, Williams L, Thompson C, et al. Evidence for lifestyle interventions in asthma. Breathe 2019; 15: e50–e61 . 6- Ravindra G. Mali & Avinash S. Dhake, A review on herbal antiasthmatics , Orient Pharm Exp Med (2011) 11:77–90 7-Hashim, Saima , et al. " Phytochemistry and medicinal properties of Ammi visnaga ( Apiacae )."  Pak J Bot  46.3 (2014): 861-7.‏ 8-Kale et al , ASTHMA AND HERBAL DRUGS, IJPSR, 2010; Vol. 1 (12): 37-42 9- Choudhary , Shailja , Hemlata Kaurav , and Gitika Chaudhary. "Medicinal importance of in ayurveda and modern sciences: A Ephedra gerardiana ."  Asian Journal of Pharmacy and Pharmacology  7.3 (2021): 110-117.‏ 10-Icer, M. Arif , Nevin Sanlier , and N. Sanlier . "A review: Pharmacological effects of Licorice ( Glycyrrhiza glabra ) on human health."  International Journal of Basic and Clinical Studies  6.1 (2017): 12-26.‏ 11-ARCHANA N. PARANJAPE, ANITA A. MEHTA, A Study on Clinical Efficacy of Lepidium sativum Seeds in Treatment of Bronchial Asthma, IJPT | January 200 6 | vol. 5 | no. 1 | 55 - 59 12-Forouzanfar F, Bazzaz BS, Hosseinzadeh H. Black cumin (Nigella sativa) and its constituent ( thymoquinone ): a review on antimicrobial effects. Iran J Basic Med Sci. 2014 Dec;17(12):929-38. 13-McGarvey, Lorcan , and Peter G. Gibson. "What is chronic cough? Terminology."  The Journal of Allergy and Clinical Immunology: In Practice  7.6 (2019): 1711-1714.‏ 14-Swarnkar, Vinayak , et al. "Automatic identification of wet and dry cough in pediatric patients with respiratory diseases."  Annals of biomedical engineering  41 (2013): 1016-1028.‏ 15- Kanj , Ghassan . "Whooping Cough: Causes, Symptoms, Treatment, and More." ‏ 16- https ://consultqd.clevelandclinic.org/patients-25-year-cough-relieved-by-diet-and-thermal-depuration/