Respiratory Disease

Interstitial Lung Diseases (Pulmonary Fibrosis)
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Interstitial lung disease, or ILD, includes more than 180 chronic lung disorders, which may be:

•chronic
•nonmalignant (non-cancerous)
•noninfectious

Interstitial lung diseases are named for the tissue between the air sacs of the lungs called the interstitium -- the tissue affected by fibrosis (scarring). Its also called interstitial pulmonary fibrosis or pulmonary fibrosis.

The symptoms and course of these diseases may vary from person to person but all begin with Inflamation.

•bronchiolitis - inflammation that involves the bronchioles (small airways)



•alveolitis - inflammation that involves the alveoli (air sacs)


•vasculitis - inflammation that involves the small blood vessels (capillaries)

More than 80 percent of interstitial lung diseases are diagnosed as pneumoconiosis, a drug-induced disease, or hypersensitivity pneumonitis. The other types are:


•sarcoidosis
•idiopathic pulmonary fibrosis
•bronchiolitis obliterans
•histiocytosis X
•chronic eosinophilic pneumonia
•collagen vascular disease
•granulomatous vasculitis
•Goodpasture's syndrome
•pulmonary alveolar proteinosis

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In interstitial lung disease, the lung is affected in three ways:

1.Lung tissue is damaged in some known or unknown way.

2.The walls of the air sacs in the lungs become inflamed.
3.Scarring (fibrosis) begins in the interstitium.

Fibrosis results in permanent loss of that tissue's ability to breathe and carry oxygen. Air sacs, as well as the lung tissue between and surrounding the air sacs, and the lung capillaries, are destroyed by the formation of scar tissue.

Symptoms of interstitial lung diseases:


The following are the most common symptoms for interstitial lung diseases; however, each person may experience symptoms differently. Symptoms may include:

•shortness of breath, especially with exertion
•fatigue and weakness
•loss of appetite
•loss of weight
•dry cough that does not produce phlegm
•discomfort in chest
•labored breathing
•hemorrhage in lungs

The symptoms of interstitial lung diseases may resemble other lung conditions or medical problems. Consult your doctor for a diagnosis.

CAUSES OF INTERSTITIAL LUNGS DISEASE:

The cause of interstitial lung disease is not known; however, a major contributing factor is thought to be inhaling environmental pollutants. Other contributing factors include:


•sarcoidosis
•certain drugs or medications
•radiation
•connective tissue or collagen diseases
•family history

DIAGNOSIS

In addition to a complete medical history and physical examination, the doctor may also request the following tests:


•pulmonary function tests - to determine characteristics and capabilities of the lungs
◦spirometry - to measure the amount of air that can be forced out
◦peak flow meter - to evaluate changes in breathing and response to medications
•blood tests - to analyze the amount of carbon dioxide and oxygen in the blood
•x-ray
•computerized axial tomography (CAT) scan
•bronchoscopy - to examine the lung using a long, narrow tube called a bronchoscope
•bronchoalveolar lavage - to remove cells from lower respiratory tract to help identify inflammation and exclude certain causes
•lung biopsy - to remove tissue from the lung for examination in the pathology laboratory

Treatment:

Specific treatment will be determined by your doctor based on:


•your age, overall health and medical history
•extent of the disease
•your tolerance for specific medications, procedures or therapies
•expectations for the course of the disease
•your opinion or preference

Treatments may include:

•oral medications, including corticosteroids
•influenza vaccine
•pneumococcal pneumonia vaccine
•oxygen therapy from portable tanks
•lung transplantation

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What is Hepatitis C ?

INTRODUCTION
Almost one in every 70 persons in the US, that is 1.45% of the American population is estimated to be suffering with Hep C. The same is true with India and many other countries.


Hepatitis means an inflammation of the liver. When the inflammation of the liver is due to a specific RNA virus which leads to chronic inflammation, it is called Hepatitis C. There are several virus names as A,B,C,D,E, etc. which are known to affect the liver, producing Hepatitis A, Hepatitis B, Hepatitis C, etc. In fact, this particular virus has a capacity to induce not only inflammation but scarring of the liver, which is called as cirrhosis of liver. The virus tends to multiply rapidly hence not allowing to develop natural antibodies in adequate quantity. This virus is a slow and silent destroyer of liver cell. It may so happen that one may not realize the infection for years together.
After a prolonged state of inflammation cirrhosis may take place, which may take ten to fifty years. It is a very slow process, if not aggravated by certain food habits and alcohol.



How does one get this disease?


The virus spreads through blood or infected syringes. (Similar to Hepatitis A and HIV infection.) Those who are drug addicts using syringes, frequent blood donors (not using sterile syringes) are prone to catch this virus. Tattooing and body piercing could be a source of infection. Organ transplant, dialysis for kidney failure are other important sources of infection. It is uncommon that one may get this virus through sexual contact. It is believed by most, today that steady partner may not need physical protection if one partner is Hepatitis C positive. However, unsafe sex with changing partners may prove to be a source of infection. It does not spread by touch, saliva, air, food or water. Mother to baby transmission during the birth is possible. However, the rate of such transmission is not significantly high.

Symptoms


The HCV infection takes years to produce symptoms in those infected with this virus. About 35% of the infected people may produce symptoms while the rest may not produce symptoms at all. Hepatitis C does not have prominent symptoms in the early stage. The infected individual may experience vague symptoms such as abdominal pain, impaired digestion, loss of appetite, lassitude, weakness, itching, etc. However, these symptoms are so common that it is hard to point towards the diagnosis of Hepatitis C. The severity of the symptoms is not directly proportional to the intensity of liver dysfunction, however.

Patients in the advanced stage may experience more severe symptoms such as yellow sclera, sometimes paleness (whiteness) of eyes, loss of appetite, depression, bleeding from rectum, bloody vomiting, exhaustion and weight loss. Advanced stage symptoms of Hepatitis C are those due to chronic inflammation of liver (hepatitis), cirrhosis (scarring of tissues) of liver and/or liver failure.

The patients with acute Hepatitis C present with lethargic feeling, loss of appetite, nausea, vomiting, body pain, and exhaustion. Objectively, one may observe yellowness of sclera (icterus or jaundice as it is called).


CLLICK here to view books on hepatitis C treatment