The following points highlight the ten important disorders related to respiration. The disorders are: 1. Bronchial Asthma 2. Emphysema 3. Occupational Respiratory Disorders 4. Bronchitis 5. Pneumonia 6. Pulmonary Tuberculosis 7. Diphtheria 8. Coryza 9. Influenza 10. SARS — Severe Acute Respiratory Syndrome.
Respiration: Disorder # 1. Bronchial Asthma:
It is usually due to an allergic reaction to foreign substances that affect the respiratory tract.
Cause:
Allergens (which cause allergy) stimulate the release of histamine from the mast cells. Histamine has several effects, one of which is to cause bronchiolar smooth muscle to contract.
Symptoms:
The symptoms of bronchial asthma may be coughing, wheezing (breathing noisily), difficulty in breathing mainly during expiration. Excess amount of mucus is secreted on the wall of the respiratory tract which may clog the bronchi and bronchioles. These symptoms are often worst at night.
Prevention:
Since it is an allergic disease, therefore, one must avoid exposure to the allergens. Smoking should be discouraged.
Cure:
Treatment of bronchial asthma includes antibiotic therapy to remove infection and use of bronchodilator drugs and inhalers for symptomatic relief.
Respiration: Disorder # 2. Emphysema:
The word “emphysema” means “inflation” or “full of air”. Emphysema is an inflation or abnormal distension of the bronchioles or alveolar sacs of the lungs.
Cause:
Many of the septa between the alveoli are destroyed and much of the elastic tissue of the lungs is replaced by connective tissue. Major causes are cigarette smoking and the inhalation of other smoke or toxic substances over a period of time.
Symptoms:
As the alveolar septa collapse, the surface area for gas exchange is greatly reduced. There is loss of elasticity in the walls of bronchioles or alveolar sacs. As a result, the alveolar sacs remain filled with air even after expiration. The exhalation becomes more difficult. The lungs remain inflated.
Prevention:
Emphysema is closely related to cigarette smoking. Therefore, it must be avoided. One must avoid air pollutants.
Cure:
Emphysema causes irreversible distension and loss of elasticity of alveoli of the lungs. Hence, there is no permanent cure for the disease. Its treatment is also symptomatic. Bronchodilators, antibiotics and oxygen therapy are used.
Diseases such as bronchitis, bronchial asthma and emphysema have in common some degree of obstruction of the air passage ways. The term chronic obstructive pulmonary disease (COPD) is to refer to these disorders.
Respiration: Disorder # 3. Occupational Respiratory Disorders:
As the name indicates, these disorders are due to the occupation of the individual.
Cause:
These are caused by the harmful substances, such as gas fumes or dusts, present in the environment where a person works. Silicosis and asbestoses are common examples, which occur due to chronic exposure of silica and asbestos dust in the mining industry.
Symptoms:
It is characterised by proliferation of fibrous connective tissue (fibrosis) of upper part of lung, causing inflammation.
Prevention:
The occupational disease expresses symptoms after chronic exposure (i.e., 10-15 years or even more). Most of occupational diseases including silicosis and asbestosis are incurable. Therefore, the person who is exposed to such irritants should adopt preventive measures.
These protective measures are as follows:
(i) Minimize the exposure of harmful dust at the work place.
(ii) Workers should be informed about the harm of the exposure to such dusts.
(iii) Workers must use the protective gears and clothing at the work place.
(iv) Health of the workers should be regularly checked up.
(v) Workers should be given holiday from duty at short intervals in such areas.
Cure:
As stated above, there is no permanent cure for this disease. The patient is provided with symptomatic treatment such as bronchodilators and antibiotics for secondary infection.
Respiration: Disorder # 4. Bronchitis.
It is the inflammation of the bronchi.
Cause:
It is caused by an infection. It may also be caused by cigarette smoking and exposure to air pollutants like carbon monoxide.
Symptoms:
Bronchitis is characterised by hypertrophy (overgrowth) and hyperplasia (an increase in number of cells leading to hypertrophy) of sero-mucous gland and goblet (mucous) cells lining the bronchi. The linings of bronchi swell and produce excess mucus. The typical symptom is regular coughing, with thick greenish yellow sputum that indicates the underlying infection.
Prevention:
One should avoid smoke, chemicals and pollutants.
Cure:
The underlying infection of the disease is treated with suitable antibiotics. Bronchodilator drugs are used to widen the bronchial passage by relaxing the smooth muscles. It provides symptomic relief.
Respiration: Disorder # 5. Pneumonia:
It is an acute infection or inflammation of the alveoli of the lung.
Cause:
Pneumonia is caused mainly by bacteria Streptococcus pneumonia. Sometimes, other bacteria or fungi, protozoans, viruses and mycoplasma may cause pneumonia.
Symptoms:
Infants, elderly persons and immune-compromised individuals (who are treated with immunosuppressive drugs, e.g., patients of AIDS) are more susceptible to the pathogens of pneumonia.
The alveoli become acutely inflamed. Most of the air space of the alveoli is filled with fluid and dead white blood corpuscles limiting gas exchange in the alveoli. Oxygen has difficulty diffusing through the inflamed alveoli and the blood oxygen may be drastically reduced.
Prevention:
Infection is the main cause of pneumonia, therefore, people should protect themselves from the pathogens, causing this disease. In case of immune-compromised individuals this disease can be prevented by proper and timely vaccination.
Cure:
Antibiotics are used to treat bacterial infections. Oxygen may be given to increase the partial pressure of oxygen in the blood.
Respiration: Disorder # 6. Pulmonary Tuberculosis (ТВ):
It is caused by Mycobacterium tuberculosis. It most often affects the lungs and the pleura. The bacteria destroy parts of the lung tissue and the tissue is replaced by fibrous connective tissue. Gases do not diffuse easily through the fibrous tissue. Its symptoms include fatigue, weight loss, lethargy, anorexia, a low grace fever, night sweats, cough, dyspnea and chest pain. Tuberculosis bacteria are spread by inhalation.
Respiration: Disorder # 7. Diphtheria:
It is caused by Corynebacterium diphtheriae resulting enlarged mucous membranes of the oropharynx, nasopharynx and larynx. It may obstruct air ways and cause death from asphyxiation.
Respiration: Disorder # 8. Coryza (= Common Cold):
Hundreds of virus can cause coryza or the common cold. But a group of viruses called rhinovirus is responsible for about 40% of all colds in adults. Its symptoms include sneezing, excessive nasal secretion, dry cough and congestion.
The uncomplicated common cold is not usually accompanied by a fever. Complications include sinusitis, asthma, bronchitis, ear infections and laryngitis. Recent investigations suggest an association between emotional stress and the common cold. The higher the stress level the greater the frequency and duration of colds.
Respiration: Disorder # 9. Influenza (Flu):
It is caused by Influenza virus. Its symptoms include chills, fever headache and muscular pain. Cold like symptoms appear as the fever subsides.
Respiration: Disorder # 10. SARS — Severe Acute Respiratory Syndrome:
The first patient of SARS was reported on Feb. 26, 2003 in China. In India first patient of SARS was Prasheel Verde of Goa.
Causing Agent:
Human coronavirus (HCV). It is a new member of influenza virus family which is considered as a mutant form of influenza virus. Human coronavirus has 2- 10 days incubation period.
Mode of transmission:
Human coronavirus spreads through contact, respiratory secretions and cockroaches.
Symptoms:
Symptoms include cold dry cough, headache, loss of appetite, high temperature, fever and hypoxia at later stage followed by muscular stiffness, malaise (feeling of bodily discomfort, but without clear signs of a particular illness).
Diagnosis:
It is diagnosed by ELISA and rapid molecular genetic test.
Prevention:
Patients of SARS should be separated from other patients and placed in their own hospital room. Health care workers and visitors should wear efficient filter masks, goggles, aprons, head covers and gloves when in close contact with the patient. Screening for SARS at points of entry like airports and keeping neighbourhoods clean with no spitting or urination in public places are very important measures.
Cure:
While some medicines have been tried, no drug can, at this time, be recommended for prophylaxis or treatment. Ribavirin with some corticosteroids is found effective in Hong Kong. Ribavirin is chosen as the antiviral agent. Methylprednisolone in the form of pulse therapy is effective.