Dec 062012
 

Cystic fibrosis is an inherited disorder that causes thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body. It is one of the most common chronic lung diseases in children and young adults. It is one of the life-threatening disorder.

As cystic fibrosis leads to complex and multisystemic involvement patients need care by specialists, treatment and follow-up care at specialty centers with multidisciplinary care teams.

Although there is  no cure for cystic fibrosis there are several treatment methods available to control the symptoms and to prevent complications.

The primary goals of CF treatment include the following:

  • Maintaining lung function as near to normal as possible by controlling respiratory infection and clearing airways of mucus.
  • Administering nutritional therapy (ie, enzyme supplements, multivitamin and mineral supplements) to maintain adequate growth.
  • Managing complications.
Pharmacological treatment
  • Antibiotics: to treat and prevent lung infections
  • Mucus-thinning drugs: to help you cough up the mucus, which improves lung function
  • Bronchodilators: to help keep your airways open by relaxing the muscles around bronchial tubes
  • Oral pancreatic enzymes: to help digestive tract absorb nutrients.

Chest physical therapy

Loosening the thick mucus in the lungs makes it easier to cough up. Chest physical therapy helps loosen mucus and is usually done from one to four times a day. A common technique is clapping with cupped hands on the front and back of the chest.

Changing  position can also make it easier to remove mucus from lungs. This is known as postural drainage. Continue reading »

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Oct 302012
 

Children with asthma need a stepwise approach to classify the disease severity and guide treatment appropriately. The number and frequency of medications increase (stepup) as the need for asthma therapy increases and decrease (step down) when asthma is under control.

Persistent asthma is more effectively controlled by long term treatment to suppress  and reverse the inflammation than by only treating acute broncoconstriction and related symptoms.

Treatment is reviewed every 3 to 6 months once asthma is under control.

Classification Of Asthma Severity

1. Severe Persistent Asthma

Patients have continuous symptoms with limited physical activity and have frequent night time symptoms. PEF is 60% of predicted with variability more than 30%. Long term preventive treatment include high doses of inhaled corticosteroids 800- 2000 mcg along with anti leukotrines. Also add long acting bronchodilator either inhaled or oral form. Give long term corticosteroid tablets on lowest possible dose on alternate days.

2. Moderate Persistent Asthma

Patients have daily symptoms and attacks affect activity. night time symptoms are more than one time in a week. PEF is 60% less than of predicted and variability is more Continue reading »

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Sep 042012
 

The common cold is a viral infection with prominent symptoms of rhinorrhea and nasal obstruction, absent or mild fever and lacking systemic manifestations.

Etiology

The viruses primarily involved with colds are rhinoviruses and less commonly coronaviruses. Other viruses that cause common cold symptoms as part of broader clinical syndromes include respiratory syncytial virus and less commonly influenza viruses, parainfluenza viruses and adenoviruses.

Pathophysiology

Viral infection of the nasal epithelium causes an acute inflammatory response with mucosal infiltration by inflammatory cells and release of inflammatory cytokines. The inflammatory response is  partly responsible for many of the symptoms.

Clinical Features

Common cold symptoms typically develop 1 to 3 days after viral infection and include nasal obstruction, rhinorrhea, sore or scratchy throat and occasional non productive cough. Colds usually persist about 1 week although 10% lasts 2 weeks. there is often a change in color or consistency of nasal secretions, which is not indicative of sinusitis or bacterial superinfection.

Examination of the nasal mucosa may reveal swollen, erythematous nasal turbinates.

Diagnosis

Diagnosis is made clinically and laboratory studies are often not helpful.

Treatment

There is no specific therapy for the common cold. Antibacterial therapy is not beneficial and the management only consists of symptomatic therapies. Continue reading »

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