Around 500 million microscopic air sacs called alveoli are found in your lungs. These alveoli are reservoirs of the air you breathe and draw oxygen from the air you breathe and expel carbon dioxide. Smoking kills the cells that line these air sacs, which causes them to collapse. This hampers the process of breathing and air exchange and leads to insufficient oxygenat

Alveoli damage deteriorates over time as well. Additionally, as lung tissue deteriorates, it gets more fibrous, making it more difficult for people to fully expand their lungs upon inhalation. Less lung tissue and lung expansion result in less oxygen reaching all the necessary locations. Due to this, many individuals do not realize there is an issue until they begin to experience shortness of breath.

Your lungs and airways undergo major modifications due to smoking. Some changes happen quickly and suddenly. These include things like pneumonia and colds. Emphysema is one example of another, more chronic alteration that occurs gradually and can last a lifetime.

Here are a few detrimental modifications that smoking makes to your lungs and airways.

Your lungs and airways’ mucus-producing cells enlarge and multiply when you smoke. As a result, mucus production rises and thickens.

This extra mucus cannot be removed by your lungs in an efficient manner. As a result, the mucus continues to obstruct your airways and causes you to cough. This extra mucus is also prone to infection.

Smoking speeds up the aging process of your lungs and interferes with their ability to defend you against infection.

The lungs get inflamed and itchy after smoking. Even one or two smokes might irritate the throat and make you cough. Additionally, smoking can damage the lungs and lung tissue. Less oxygen reaches your body’s vital organs because of the reduction in air gaps and blood arteries in your lungs.

The cilia, or broom-like hairs, that border the lungs clean and help keep the airways clean are damaged by smoking. After lighting a cigarette, cilia start to move more slowly. Even one cigarette can cause your cilia to function more slowly for several hours. The number of cilia in your lungs decreases as a result of smoking, leaving fewer cilia to effectively clean the breathing apparatus leading to greater chance of infection and injury.

Inflammation occurs in the tissues and tiny airways of smokers’ lungs. This could make your chest feel constricted, make you wheeze, or make you feel out of breath. Chronic inflammation causes the formation of scar tissue, which alters the structure of your lungs and airways and can make breathing difficult. A chronic cough with mucus might be caused by lung inflammation over many years.

Smoking damages the alveoli, or tiny air sacs, in the lungs that facilitate oxygen exchange. Some of those air sacs are harmed when you smoke. Because alveoli do not regenerate, when you destroy them, you permanently damage a portion of your lungs. Emphysema manifests itself when enough alveoli are lost. Emphysema causes severe shortness of breath and can lead to death.

Your airways are lined with cilia, which are small brush like hairs. The cilia remove debris and mucus, keeping your lungs clear. Cilia are killed or temporarily rendered paralyzed by smoking. You become more vulnerable to infection as a result. Smokers experience more respiratory infections and colds than non-smokers.

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The likelihood that you may get asthma can also depend on whether you are a boy or a girl and also your age. Before puberty, boys have a twofold increased risk of developing asthma compared to girls. However, girls are more likely to develop asthma after puberty.

Due to the complexity of triggers that cause asthma, we still cannot anticipate likelihood of developing disease based on family history alone.

Asthma may not be inherited in one of these ways and a person may develop asthma without any family history. In other words, neither the mother nor the father nor both directly contribute to the development of asthma. Your children will be more likely to develop asthma, eczema, or allergies if either parent has a history of any of these disorders. One must keep in mind that a number of genes have been linked to a higher risk of developing asthma. It must also be kept in mind a child’s exposure to specific environmental factors will also be a factored into the likelihood of developing disease. Because of this, some individuals who do not have any genetic risk factors for developing asthma may still develop ot in the future.

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Your doctor might arrange for Pulmonary Function tests (PFT) to evaluate how well your lungs are functioning. These are not blood tests but rather tests that are done by a trained technician in the clinic.  You will be explained and demonstrated on how to perform the test.  If you already have a lung-related underlying medical problem, your doctor may recommend this test to see how the disease has progressed or to see how the condition is responding to the treatment he has prescribed for you. Pulmonary function tests are not painful in any way and there is no special preparation that is needed ahead of time, such as use of extra medication or fasting to do them.

Pulmonary function tests may be ordered for you by your chest specialist or pulmonologist in the following common conditions:

1. If you are experiencing symptoms of cough or shortness of breath

2. If you have symptoms or history of Asthma, COPD or Lung fibrosis

3. For monitoring the progression of chronic lung diseases such as chronic obstructive pulmonary disease also known as COPD, asthma or lung fibrosis

4. To monitor the condition and function of your lungs, especially if you are regularly exposed to certain toxic substances in the workplace or your environment

5. Pulmonary function tests are also used to determine your safety and suitability for before surgery to ensure that anesthesia as well as recovery from anesthesia is safe and uncomplicated.

The following conditions can be diagnosed with the aid of pulmonary function tests

• Asthma
• Chronic Bronchitis
• Lung fibrosis
• Asbestosis, a disease brought on by asbestos exposure.
• Pulmonary tumor
• Bronchiectasis, a disease that causes the lungs’ airways to enlarge and extend making them less functional
• Sarcoidosis, a disease that results in inflammation of the liver, skin, eyes, lymph nodes, lungs, and other tissues
• Scleroderma, which is a condition that affects the body’s connective tissues and can also affect the lungs
• Weakness in the chest wall’s muscle as in Neuromuscular diseases and muscular dystrophy

Please inform your doctor:

If you recently suffered a heart attack or underwent chest surgery

If eye surgery was recently performed

If you recently underwent major abdominal surgery

If you have a history of cardiac arrythmias

Most patients are generally thought to be safe for pulmonary function tests. However, you may feel slightly dizziness during or after the test. This is not unexpected and improves in a few minutes. You should alert the technician performing the test or the physician. Difficulty in doing the test is extremely unusual and very easily manageable.

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What are common monkeypox symptoms?

According to the CDC, monkeypox infections often last two to four weeks and start with flu like symptoms. Symptoms common in monkey pox are fever, headaches, muscle pains, and fatigue. Over time, fluid-filled pimples, sometimes known as “pox,” blisters or vesicles appear all over the skin. Health officials have observed that the most recent instances of monkeypox frequently accompany genital rashes that can be mistaken for herpes or syphilis.

Although monkeypox can be fatal, there are two main viral types that carry differing levels of danger. According to the WHO, a strain from the Congo Basin kills around 1 in 10 of those who contract it, whereas a strain from West Africa seems to be less severe, killing about 1 in 100 of those who contract it.

People appear to be contracting the less severe strain right now all around the world, including in Europe and the United States. On July 29 and July 30, two deaths from monkeypox in Spain and one in Brazil were reported as the first known cases of the current outbreak outside of Africa. Five individuals have died in Africa, according to the WHO.

How is monkeypox transmitted?

The major way that human-to-human transmission of monkeypox occurs is by direct contact with infected lesions, scabs, or bodily fluids. During prolonged face-to-face contact or during close physical contact, such as kissing, snuggling, or sex can spread the virus as can through respiratory secretions. According to the CDC, people can contract an infection by coming into contact with clothing or bedding that has been used by an infectious person. The virus can infect a pregnant woman’s foetus or unborn baby.

A 2003 U.S. outbreak was caused by diseased animals being trafficked from Ghana to Texas, but it is not how the virus is presently spreading in the United States and Europe. People can also contract monkeypox via infected rodents or primates, as happened during that outbreak.

Is there a monkeypox vaccine or treatment?

Since smallpox and monkeypox are caused by the same virus family, antiviral medications and vaccines created and stored for smallpox, which has been completely eradicated, can also be used to treat monkeypox.

The White House in the United States is working to increase access to testing, vaccine doses, and treatments, but many people still have trouble getting access to these medications. According to some experts, monkeypox runs the potential of becoming another public health failure due to the same testing delays and vaccine shortages that the coronavirus had in its early stages. This is a frightening situation and requires individuals to be aware of modes and means of transmission and knowledge on how to best protect themselves.

How can I protect myself and others from monkeypox?

Health officials are warning people to exercise caution in crowded settings like family gatherings where it may be impossible to avoid bumping against individuals who may be infected and have active skin rashes or blisters because the virus transmits from skin to skin.

The CDC advises against kissing or hugging somebody who has a rash that resembles monkeypox or other potential symptoms, as well as refraining from sharing utensils. Along with not touching the clothing, bedding, or towels of someone who has monkeypox, refraining from sexual contact with them and maintaining proper hand hygiene are all appropriate approaches to prevent or minimize the risk of infections.

Infected people are advised to keep themselves away from other people and animals, and to cover any sores with long clothing and a mask.

In summary Monkeypox symptoms

• Swollen lymph nodes.
• Muscle aches and backache.
• Respiratory symptoms (e.g. Sore throat, nasal congestion, or cough)

Complications of monkeypox can include secondary infections which includes lung infections such as bronchopneumonia, widespread infection in blood called sepsis, infection and inflammation in the brain or spinal cord called encephalitis, and infection of structures within the eye such as the cornea with resulting in loss of vision. The extent to which infection can occur without a patient experiencing any outward symptoms or signs known also as asymptomatic infection is as yet unknown.

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A general term for illnesses that damage the heart or blood vessels is cardiovascular disease (CVD).

Since CVD includes any condition affecting the heart or blood vessels, most of the heart-related smoking-related problems fall under this heading. However, it is important to recognize that smoking related disease not only fall under the category of CVD, it is often a cause and major factor that aggravates the disease itself and leads to worse and earlier complications.

Smoking can cause the following effects on heart health such as arrythmias.

Arrhythmia is an irregular heartbeat. It is also called an abnormal heart rhythm. Cardiovascular fibrosis, or the scarring of heart muscle, is brought on by smoking. This may result in tachycardia, also referred to as a fast or irregular heartbeat. Cigarette nicotine known to speed up the heart rate can be a cause for tachycardia

Smoking also causes coronary artery disease. When the coronary arteries in the heart are unable to supply enough blood to the heart, coronary heart disease (CHD) occurs. It is also known as coronary artery disease or ischemic heart disease. Through atherosclerosis and increased blood pressure, smoking can lead to CHD.

Plaques accumulate in the coronary arteries due to atherosclerosis over time, obstructing blood flow and leading to inadequate blood flow or ischemia. The coronary arteries are harmed by high blood pressure, which causes them to become even narrower. Furthermore, the chemicals in cigarette smoke can thicken blood, forming clots that may block coronary arteries.

Smoking can also lead to a heart attack if it restricts blood flow to the heart. Another name for this is myocardial infarction. The muscle of the heart that helps pump blood through the body called the cardiac muscle begins to deteriorate in the absence of sufficient oxygen-rich blood.

Smoking can also lead to heart failure. Once the heart cannot pump enough blood to the body, heart failure follows. Heart failure can be caused by numerous conditions. Smoking raises the risk of heart failure because it causes damage to the blood vessels, the muscle of the heart as well as the electrical signaling process or the rhythm through which the heart synchronizes its pumping activity.

It is important to realize that one out of every five smoking-related deaths is caused by heart disease

Smoking and using birth control pills increase the risk of heart disease or stroke in women over 35.

Smokers have a 2–4 times higher risk of developing heart disease than nonsmokers.

Smoking increases a person’s risk of stroke by twice the risk over non-smokers.

Please protect yourself from cardiovascular disease by quitting smoking. Your pulmonologist can guide you on means and medications that help you to quit smoking.

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There seems to be a great deal of confusion as when to receive the Flu, Pneumococcal vaccine as well as the Covid-19 vaccine or its booster.

Vaccines are designed different ways and each vaccine works by activating our body’s own immune response in a particular manner.

The Center for Disease Control in the United States known as the CDC has made guidelines with regards to the spacing of vaccine according to their type and mechanism of action. You must also seek advice from your physician before proceeding with any vaccine.

What is the appropriate interval between Flu and Pneumonia Vaccine (Prevnar 13):

As per the guidelines Flu and Pneumonia vaccine shot can be taken at one time, on different sites of injection. As desired, they can also be administered separately in which case no definite minimum interval of waiting is required.

Interval between Flu and Covid-19 Vaccine:

Covid -19 Vaccines are relatively new, the scientific date to this date, do not show any interaction between Flu shots and Covid-19 Vaccinations if they are taken simultaneously. The guidelines states that both these shots can be taken on same time, at different sites. One can take the two shots any time before or after each other with no defined interval.

Interval between Pneumonia Vaccine and Covid-19:

The guidelines are same, both Pneumonia Vaccine and Covid-19 vaccines can be taken on same time, at different sites. If on different days, they can be taken any time before or after each other with no defined interval.

Special note:

Patient suffering from acute or chronic illness, on medications, should always seek advice from their primary physician before proceeding for any kind of Vaccination.

Taking vaccinations, that can safely be administered together, do not cause any exaggerated side effects. However, vaccines can tend to cause local reaction on the different arms causing no serious side effects. The advantage of taking the vaccines simultaneously is a reduction in the number of visits to the hospital and risk of developing side effects, even mild, on separate intervals after the vaccines.

Should you or anyone you need to see a pulmonologist, please call The Chest Clinic- Dr. Javed Husain & Associates. We offer both online video consultation as well as outpatient clinic and in-hospital care for all our patients. To make an appointment please call +923018479066 or leave us a message by WhatsApp  requesting an appointment and a member of our team will call back and connect with you.

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Up until recently, there have not been any significant guidelines provided by the CDC, regarding mix regarding mix and matching of COVID-19 vaccines. Now the situation appears to be changing and greater clarity is available on booster doses for the COVID-19 virus. Fortifying an individual’s immunity by  booster whether by using the same or primary series of vaccine received earlier is called “homologous boosting” and if this increase in immunity is achieved by using a different type of vaccine, the process is called “heterologous boosting”.

Importance of booster doses has now been proven by studies. It is now accepted fact that booster vaccine doses tend to increase the antibodies response in an individual and is useful in protecting against newer variants as they emerge. Getting a booster vaccine aids in developing stronger immunity against different variants.

How many doses of booster vaccine do I need to take?

No definite guidelines have been published with regards to number of doses for booster vaccine. However, Covid vaccine booster doses are recommended to all high-risk population after 6 months of the last dose received as well as to those non high-risk populations who have completed 6 months from completion of their primary vaccination.

Who is eligible for booster vaccine?

To simplify, any one above 65 years of age who has completed their 6 months from their primary series of vaccination, as well as those ages 18 and above who are at high risk of Covid infections due to some underlying condition, those who are immunosuppressed or working in health care facilities may receive booster after completion of 6 months from their primary series.

Here to share some information of types of Covid Vaccine

Types of Covid vaccine:

There are 4 different types of Covid Vaccine approved. Each of these stimulates body’s immune response to generate antibodies against Covid-19.

Whole Virus: Here the whole virus after being inactivated, is administered to a patient to help protect them. Because the virus is not active, it will not cause disease after it is injected into the body. After being injected the body generates a robust immune response to this antigen or protein structure of the virus. The immunity generated helps protect an individual from severity of the disease if they are exposed to the live virus.

Viral Vector: This type of vaccination uses some genetic code from the targeted virus placed into a harmless virus called “vector virus”. Once injected into the body, our cells take up this genetic information to produce antigen or a protein code, towards which our immune system reacts and develops antibodies. This happens without a patient experiencing the symptoms of disease

mRNA vaccines: these vaccines also use genetic codes to insert into our body’s own cells to produce antigen which triggers our immune system to produce antibodies and hence create an ability to fight against the live virus should it be encountered at a future time.

Subunit vaccines:  In this situation some portion of the virus protein is used as the antigen and is injected into the body to help the body mount an antibody or protective response without creating the actual symptoms of the disease.

Types of Covid Vaccine and their doses

Whether a vaccine is an mRNA vaccine or an inactivated vaccine, studies have proven that Covid-19 vaccines have shown to bring not only a decline in the number of cases, but very importantly, a very significant reduction in the severity of the illness leading to a reduction in hospital admission.

For the booster shots, especially if an inactivated virus has been administered, the approach of “Mix and Match”, is recommended, using a mRNA or viral vector vaccine, because each vaccine have different methods of generating body’s own immune response and may be able to help with augmenting immunity. Receiving a vaccine via a more robust and different technology may help in generating a greater boost in the immunity.

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This new variant of Covid-19 has been considered as a variant of concern by WHO. The cases have shown that Omicron as compared to the previous variants, has the tendency to spread fast and causes more severe illness.

Studies are being conducted to learn more about the Virus.

Is it more transmissible than its other variants?

There is no clarity as yet whether Omicron is more easily spread from person to person compared to the other variants. With the number of cases rising in some countries, studies are being conducted to understand if it because of Omicron or other factors or variants are involved.

Is it causing more severe illness?

More information is required to make a confirmed statement if Omicron causes more severe illness compared to the other variants. Up until now, the preliminary data suggests that the number of cases requiring hospitalization has significantly risen in South Africa.  It will take many days to gather more information and understand the degree of the severity of infection caused by Omicron. However, experience with the Delta variant, leads to the recommendation that it is prudent to take precautions, complete your primary vaccination series and get a booster dose if you fit the eligibility criteria.

Are the current vaccines effective against Omicron?

So far, vaccines play a pivotal role in reducing the severity of the disease and number of positive cases. The World Health Organization (WHO) and other organizations are working to understand the effectiveness of the current available vaccines on the Omicron variant.

As we have experienced from the past, each new emerging variant has been more critical from previous variants. Studies are underway to understand Omicron, its transmissibility, infection severity, tests, treatment and the effectiveness of the vaccine.

The Sindh Government has made an initial announcement for all the citizens to ger their booster shots. Final announcement for the launch is awaited and will be made available within the near future.

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The most important thing that we must understand is that there is a great deal about these variants especially the new variants that we do not fully know as yet including whether the variant is more contagious and whether or not it causes more severe disease or what its effect might be on vaccine efficacy. This variant has been identified in many countries all over the world it has been identified in South Africa, Hong Kong, Belgium and Botswana. New travel restrictions have undergone into effect in which travel has been restricted from South Africa as well as many countries within the African continent. The European Centre for disease prevention and control very recently stated that the variant could have an immune escape potential and potentially have increased transmissibility advantage compared to the delta variant.

Th Omicron has an unusual high number of mutations with more than 30 within the key spike protein. The key spike protein is a structure that viruses use to get into the cells which they attack. This higher number of mutations could make the variant not only more transmissible but also could cause this particular variant to escape protection even if an individual has been fully vacccinated.

It is not unexpected that we will see new mutations of a virus. New variants of viruses continue to emerge as time goes on. We have seen a lot of variants come up over the last five or six months that have not really been of serious concern. This variant, Omicron, is of serious concern, because it seems to be more contagious than the delta variant due to its very high number of mutations. It can take several months for one particular variant to become the dominant variant, so we will really need to wait until we have a better understanding of this particular problem. What we do understand at the present time is that the new variant ,Omicron, seems to have a higher risk of reinfection compared to other variants of concern.

Vaccine manufacturing companies such as Moderna are working rapidly to test the ability of their vaccinations to neutralize or protect patients from this variant and several vaccination companies including Moderna and Astra Zeneca are working hard to understand how to protect patients against this new variant.

At makes complete sense to keep oneself vaccinated and to exercise common sense precautions as we navigate the pandemic.

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If you need to receive the flu vaccine please call us to set up a time.

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