The World Health Organisation reports that lung cancer is the most prevalent cancer in the world, accounting for 2.09 million annual new diagnoses and 1.76 million cancer-related deaths. The main risk factor for lung cancer is smoking, however it’s not the only one: The probability of acquiring the disease is further increased by exposure to particular carcinogens and a family history of the condition.

Key points on Lung cancer

• Uncontrolled cell growth is the cause of cancer. Lung cancer develops in different parts of the lungs. Cancer from Lungs can spread to different parts of the body, this is called as metastasis. Lung cancer is tough to treat and sometimes identified too late.
• Non-small-cell lung cancer (NSCLC), small-cell lung cancer (SCLC), and lung carcinoid tumour are the three main kinds of lung cancer. NSCLC, which can be further divided into adenocarcinomas, squamous cell carcinomas, and big cell (undifferentiated) carcinomas, accounts for about 80 to 85 percent of lung cancer cases.
• Risk factors : Lung cancer risk is increased by a number of variables, including:
• Cigarette smoking is the leading cause of lung cancer. As much as smoking conventional cigarettes, the risk of lung cancer is increased by smoking cigars, pipes, low-tar cigarettes, and menthol cigarettes. Lung cancer can also be brought on by inhaling second-hand smoke.
• Positive family history or personal history of lung cancer: Lung cancer survivors are at risk of developing another lung cancer, especially if they smoke. A person’s risk of lung cancer is also higher if a relative had the disease.
• Exposure to carcinogenic (cancer causing toxins/chemicals) exposure to radon gas, which naturally develops from the decomposition of radioactive elements in rocks and soil and can become trapped in homes and buildings. Other substances like Asbestos, arsenic, diesel exhaust, and other cancer-causing compounds prevalent in workplaces raise the risk of lung cancer.
• Chest radiation therapy: People who have undergone radiation therapy for other types of cancer are more likely to get lung cancer.
• Symptoms: The symptoms may overlap with other respiratory illness, these are cough, maybe dry or with discoloured phlegm. Sometime patient cough up blood with sputum, which is an alarming sign, shortness of breath, chest pain, wheezing, weight loss, loss of appetite and hoarseness of voice.
• Diagnosis and Treatment: timely identification is the key factor in treatment of Lung cancer. If you or anyone around is suffering from any of symptoms above, immediately seek medical help.

The initial test carried out on a patient with lung cancer symptoms is frequently a chest X-ray. Lung tumours are more noticeable on detailed cross-sectional images created by CT scans, which employ X-rays. A biopsy may be performed to ascertain the malignancy of a tumour or nodule if one is discovered. Cytology(analysis of cancer or abnormal cells) on sputum or BAL (Broncho alveolar lavage) sample is processed to see abnormal cells. If a patient develops pleural effusion (collection of fluids around the lungs due to complication of lung cancer), it can be aspirated and the fluid is send for cytology.

The post LUNG CANCER DAY, 1st August 2023 appeared first on The Chest Clinic Karachi.

Aspiration pneumonia leads to inflammation and infection in the lower respiratory tract, posing a significant health risk, especially for those who are vulnerable.

Several factors may contribute to the development of this condition:

•  Dysphagia: Swallowing difficulties caused by neurological disorders, stroke, or structural abnormalities can increase the risk of aspiration.
•  Consciousness Impairment: Individuals under the influence of alcohol, narcotics, or anesthesia may be less able to protect their airways, resulting in aspiration.
• Chronic acid reflux can aggravate the esophagus and contribute to aspiration in patients with gastroesophageal reflux disease (GERD).
• Age and Underlying Health Conditions: The elderly, neonates, and those with compromised immune systems, respiratory illnesses, or neuromuscular disorders are at a greater risk for aspiration pneumonia.

Depending on the severity of the infection and the patient’s overall health, the symptoms of aspiration pneumonia can vary.

Examples of common symptoms include:

•  Cough: Typically productive and capable of producing foul-smelling or discolored sputum.
•  Chest Pain: Discomfort or pain in the chest that is exacerbated by breathing or coughing.
•  Shortness of Breath: Breathing difficulty, particularly during physical activity.
•  Fast/ rapid breathing
• Fever.
•  Rapid Heart Rate it is possible to observe tachycardia, or a rapid heart rate.
• Fatigue.
• In severe cases low oxygen levels.

Diagnosis

Typically, healthcare professionals will conduct a comprehensive evaluation to diagnose aspiration pneumonia.

A detail history of past medical conditions, recent illnesses, and potential risk factors.

Physical Examination of the entire body.

Certain relevant investigation, including blood test and radiological tests including chest x-ray, Ct of the chest and brain imagining. These are conducted to identify the cause and the possible presence of aspiration pneumonia.

Bronchoscopy: In certain instances, a thin, flexible tube with a camera (bronchoscope) may be inserted into the airways to visualize the lungs and capture samples for additional testing.

Treatment

Aspiration pneumonia is treated by addressing the underlying infection, improving respiratory function, and preventing complications. The strategy may involve:

• Antibiotics: Antibiotics that target the infectious agent causing pneumonia.
• Oxygen Therapy: The administration of supplemental oxygen to maintain adequate levels of oxygen in the circulation.
•  Chest Physiotherapy: Techniques such as percussion and postural drainage can assist in loosening and expelling mucus from the airways.
•  Swallowing Therapy: Speech and swallowing therapy can enhance swallowing function and reduce the risk of future aspiration in patients with dysphagia.
• Intravenous Fluids: Ensuring appropriate hydration, particularly for patients with swallowing or eating difficulties.

Aspiration pneumonia is a potentially fatal respiratory illness that requires immediate diagnosis and treatment. Early detection of risk factors, such as dysphagia and reduced consciousness, can help prevent aspiration events. In addition to supportive care, prompt medical intervention can improve outcomes and lower the risk of complications associated with this illness. If you or someone you know shows symptoms of aspiration pneumonia, get medical help immediately for a comprehensive evaluation and appropriate treatment.

The post Aspiration pneumonia: appeared first on The Chest Clinic Karachi.

Vaping doesn’t produce smoke, so it’s better?

The aerosol produced by vaping does contain fewer toxin chemicals. But the aerosol isn’t harmless. The studies have shown it can contains harmful and potentially harmful substances, including nicotine, heavy metals like lead, volatile organic compounds and cancer-causing agents.

 Vaping contains less nicotine product, so it’s less addictive?

Both e-cigarettes and regular cigarettes contain nicotine. The amount nicotine used varies depending on the nicotine concentration in the e-cigarette liquid/cartridges or puffing intensity, vaping technique and increase the e-cigarette’s voltage to get a greater hit of the substance.

Vaping doesn’t cause second hand smoking, so it not causing harm to others?

Though e-cigarette do not involve combustion of tobacco, it does generate aerosol which contains nicotine and other chemicals. This can be inhaled by others and can enter into their systems. More evidence is required as to how much health-related issues does second hand smoking caused by vaping. Needless to say, anything that’s causing harm to the user, presence around it should be avoided.

Vaping can be used as bridge to quit smoking?

It has not yet been approved by the FDA, till now the evidence is insufficient to recommend e-cigarette as an aid to quit smoking.

The post Is vaping safer than smoking? appeared first on The Chest Clinic Karachi.

It was initially recognised in year 2019. The exact mechanism of EVALI is still not clearly known. It a serious respiratory illness, that leads to hospital admission, requiring intensive care units and deaths.

One of the most prominent product identify to cause the lung damage is tetrahydrocannabinol and/or Vitamin E acetate. Other additives may be involved include nicotine, cannabinoid (CBD) oils, coconut oil ad limonene.  These products causes inflammatory response in the air way system, which over the time lead to permanent damage to the air sacs and the airways.

Symptoms:

• Cough
• Shortness of breath
• Pleuritic chest pain
• Blood in sputum (haemoptysis)
• Some patient might experience gastrointestinal symptoms as well nausea, vomiting, diarrhea and abdominal pain.
• Fast heart breath
• Low oxygen levels.

Diagnosis:

There is no single test for making diagnosis of EVALI, it’s rather a diagnosis of exclusion from the other respirator illness which share the similar sign and symptoms. History and clinical examination along with investigation are performed to make the diagnosis. Blood tests, to assess the presence of infectious and non-infectious causes of such respiratory symptoms. CT chest plain that is high resolution CT scan and/or  with contrast, CTPA to rule out other causes of low oxygen levels. Flexible bronchoscopy (a procedure to view the airways by passing a small camera through nose or mouth), to collect BAL (bronchoalveolar lavage), to exclude infectious or non-infectious cause. On some occasion lung biopsy.

Treatment

The most important step in treatment is to ensure all other possible causes have been excluded.

Depending on the severity of the symptoms patient may be treated as outpatient or hospitalised.

IV antibiotics, empirically started to cover pneumonia, systemic steroids and supportive treatment such has oxygen.

Its recommend to avoid the use of E-cigarette or vaping. For those who wish to use vaping as a bridge to quit smoking, should avoid THC or vitamin E acetate containing E-cigarette.

To quit smoking, best recommendation is take professional, physician, psychiatrist and certain groups, who can help to quit smoking

Yet more is to be learn about EVALI, but the data till now has shown hazardous impact with the use of e- cigarette. The best way to protect your lungs is to quit smoking. If you are unable to quit smoking, you should visit health care professional for guidance.

The post Evali (E-cigarette associated lung injury) appeared first on The Chest Clinic Karachi.

E-cigarette comes in various shapes and sizes. It works by heating liquid to aerosol, then the aerosol in inhaled by the individual. The liquid typically contains a mixture of water, food grade flavoring, a choice of nicotine levels, cannabis (THC, CBD), propylene glycol (PG) or vegetable glycerin (VG), certain heavy metals and carcinogens (chemicals known to cause cancer, including acetaldehyde and formaldehyde) are also preset. PG and VG are humectants used in e-liquid to produce aerosols that simulate combustible tobacco cigarette smoke.

DEVICES

Over the course of many years, e- cigarette have evolved into new shapes and slight modification in the aerosol producing method.

1^st generation Disposable e-cigarettes, sometime refer to as cigalikes.

2^nd generation E-cigarettes with prefilled or refillable cartridge

3^rd generation Tanks or Mods (refillable)

4^th generation Pod Mods (prefilled or refillable)

Despite of variations and modifications, the harmful effect with the use e- cigarette are still there. CDC is still working on gathering more data on the impact on health with the usage of these devices.

The post E-cigarette or vapping: appeared first on The Chest Clinic Karachi.

Bronchiectasis is a chronic condition of the lungs that has affected hundreds of thousands of people worldwide.  The second world bronchiectasis day will be celebrated on 1^st July, 2023. The purpose of this is it to spread awareness about the disease, and to provide a platform for the patient as well as the care givers of these patients to best manage the disease.

BRONCHIECTASIS

Bronchiectasis, is a lung disease, in which the airways become enlarged or scarred. The damaged airways are unable to clear up the mucous properly, which results in recurrent lung infections. It’s a chronic condition affecting single or both lungs.

In most of the cases the cause remain undiagnosed, this is called as Idiopathic Bronchiectasis.

Other causes includes, condition causing infections or inflammation which damages the airways leading to bronchiectasis. There are certain genetic condition, in which the cilia (small thread like structure in the airways, which clear the secretions with their movement) malfunctions, leading to recurrent infection and developing bronchiectasis. Another condition is cystic fibrosis, in which there is production of thick sticky mucus which is hard to clear and causes recurrent infections and further damage to the airways.

Currently, no cure has been found for this disease. Treatment of bronchiectasis is aimed towards, early diagnosis, to treat the cause, prevention of further damage, and preventing future exacerbations.

Preventive measures involve good pulmonary toilet, which includes clearing of mucous with physiotherapy, airway clearance manually or assist devices and medicines. These can improve quality of life and may impact the longevity of those affected.

The post World Bronchiectasis day 1st July appeared first on The Chest Clinic Karachi.

As the airways are damaged, drainage of the secretions gets impaired and secretions build up in those passages. The impaction of the secretions leads to growth of infections and inflammation, which further cause damage to those airways “a vicious cycle”.

What are the symptoms?

• Persistent Cough with discoloured phlegm
• Occasional haemoptysis
• Shortness of breath
• Fatigue
• Fever
• Weight loss
• Chest pain

What causes Bronchiectasis?

It is often brought on by damaged from other condition, infection (pneumonia tuberculosis), cancer, non-infectious pneumonia, autoimmune disease and diseases that causes structural abnormalities. And on certain occasion the cause remains unknown it’s called Idiopathic Bronchiectasis.

How is it diagnosed?

If you are suffering from cough from many months, associated with phlegm and it’s recurring, visit  a Pulmonologist/ Chest Physician to confirm the diagnosis.

A details medical history, a thorough physical examination, certain investigations including sputum cultures, blood tests and chest X ray are routinely used to make a diagnosis.

Radiological investigations play the most important role in identifying the presence and extent of bronchiectasis. A High resolution CT chest is the most important test to confirm the diagnosis.

Lung assessment test are also done to estimate the functional capacity of the lungs. In certain situations a bronchoscopy is performed to visualise the airways and to remove the secretions or foreign body.

To identify the cause, sputum cultures for infection and certain blood test are conducted.

Is bronchiectasis contagious?

This condition isn’t contagious, but if the cause is due to underlying infection then the risk of transmitting infecting to others are high.

Is there a cure?

There is no cure for bronchiectasis, but it can treated and certain measures can be used to prevent an exacerbation.

What is the treatment?

Managing bronchiectasis requires diagnosing and treating the cause to prevent the progression.  Clearing up the thick secretions and managing the infections is the cornerstone of therapy. The use of nebulized hypertonic saline, chest physiotherapy and acapella devices assists in regular removal of the thick secretions. Additionally, the judicious use of appropriate antibiotics (inhaled and systemic) is essential to treat the exacerbations

The post Do you know what Bronchiectasis is? appeared first on The Chest Clinic Karachi.

As the airways are damaged, drainage of the secretions gets impaired and secretions build up in these damaged breathing channels. The impaction of the thick secretions leads to recurrent infections and inflammation, which further causes damage to those airways “a vicious cycle”.

Symptoms:

• Persistent Cough with discoloured phlegm
• Occasional haemoptysis ( coughing up blood)
• Shortness of breath
• Fatigue
• Fever
• Weight loss
• Chest pain

Causes of Bronchiectasis

It is often brought on by damaged from other condition, infection (pneumonia, tuberculosis), cancer, non-infectious pneumonia, autoimmune disease and diseases that causes structural abnormalities. And on occasion the cause remains unknown it’s called Idiopathic Bronchiectasis

Diagnosis

If you are suffering from persistent cough lasting more than a month, associated with copious phlegm, visit a Pulmonologist/ Chest Physician to get an accurate diagnosis.

The diagnostic evaluation includes a detailed medical history, a thorough physical examination followed by certain investigations like blood and sputum tests and radiological assessment. An HRCT chest assists in confirming the diagnosis of Bronchiectasis. Lung assessment tests including spirometry and lung volume assessment are also done to estimate the functional capacity of the lungs. In certain situations, a bronchoscopy is performed to visualise airways and to remove the secretions and foreign body from the lung.

Treatment

Managing bronchiectasis requires diagnosing and treating the cause to prevent the progression.  Clearing up the thick secretions and managing the infections is the cornerstone of therapy. The use of nebulized hypertonic saline, chest physiotherapy and acapella devices assists in regular removal of the thick secretions. Additionally, the judicious use of appropriate antibiotics (inhaled and systemic) is essential to treat the exacerbations.

Regular follow ups with your Pulmonologist/Chest Physician plays a key role in prevention of the flare up.

The post Bronchiectasis: appeared first on The Chest Clinic Karachi.

The World Health Organisation’s World No Tobacco Day is every year on 31st May. It was created to bring awareness to more people about the dangers and health risks of smoking tobacco, and ultimately, to stop use of tobacco around the world

Over 1 billion people worldwide are tobacco smokers, majority of whom ( up to 80%) are in low-income countries where tobacco-related disease and death will have the hardest impact. Over 7 million people die because of smoking tobacco alone.

Tobacco use is one of the most lethal global health hazards. Smoking tobacco and passive or second-hand smoke, causes cancer of mouth, lungs liver, urinary and gastrointestinal tracts amongst others. It is the 2^nd most important risk factors for heart disease, directly damages lung causing diseases like COPD, interstitial lung diseases (ILD) and Emphysema, contributes to chronic illnesses like Diabetes, vascular diseases, eye problems, weakening of bones and muscle.

The theme for this year “ world no tobacco day”  is “we need food, not tobacco!” this was the 34th annual No Tobacco Day the WHO.

This year the global campaign aims to raise awareness about alternative crop production and marketing opportunities for tobacco farmers and encourage them to grow other sustainable and nutritious crops.

World No Tobacco Day (WNTD) was initiated by the member states of the World Health Organization in 1988. The WHO had started a campaign to enlighten the public about the health-related problems caused with tobacco consumption and its impact on the community.

The post World no Smoking/ Tobacco day (31st of May 2023) appeared first on The Chest Clinic Karachi.

Over view

• Mpox is a viral illness caused by a virus named Monkey pox.
• Mpox can spread from person to person or occasionally from animals to people.
  • transmission of mpox can occur through direct contact with infectious skin or other lesions such as in the mouth or on genitals; this includes contact which is
  • face-to-face (talking or breathing), respiratory droplets or short-range aerosols from prolonged close contact.
  • skin-to-skin, mouth-to-mouth and mouth-to-skin contact.
  • Animal to human transmission of mpox occurs from infected animals to humans from bites or scratches, or during activities such as hunting, skinning, trapping, cooking, playing with carcasses, or eating animals.

• A global outbreak occurred in 2022–2023
• It can cause a painful rash, sore throat, headache, enlarged lymph nodes and fever. Rash maybe he first symptom, it is fluid filled an itchy. Later it dries up, crusts over and the fall off. It develops itn different areas of the including face, mouth, throat, genital areas, arms and soles.
• Treatment is supportive.
• Recovery takes about 2- 4 weeks.

Things to do if you have Mpox

• stay home and keep yourself away from people at home as well, till your rash heals.
• Maintain good hand hygiene, wash hands often with soap and water or hand sanitizer, especially before or after touching sores
• Practise wearing the mask even at home, when you are interacting with your family member.
• Skin should be kept dry and not to be covered.
• Practise frequent use of disinfected after touching surfaces or object if they are being shared with any other member who isn’t infected.

Things not to do if you have Mpox

• Do not scratch the sores or pop blisters, as they can become infected and can lead to further spread of the rash.
• Do not try to remove the dry scale/ crusts. This can also to spread of the rash in different areas of the body. This also delays the healing process.
• Do not unnecessarily touch objects, hand shaking, or meet with another person.
• Do not break your isolation without a physician’s advice.
• Do not do any remedy, orally or topically without your physician consultation.

The post Monkey-Pox (MPOX) appeared first on The Chest Clinic Karachi.