TRACHEOSTOMY — ARTIFICIAL AIRWAY FOR BREATHING
WHAT IS A TRACHEOSTOMY?A tracheostomy is an opening cut into the windpipe or trachea. It is used as ...
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- Asthma: One of the major noncommunicable diseases affecting both children and adults, asthma causes swelling of the airways, thus reducing their diameter, causing pulmonology symptoms such as cough, breathlessness, chest tightness, etc. This is a hypersensitivity reaction to allergens.
- Smokers Lungs—COPD: Chronic obstructive pulmonary disease (COPD) refers to diseases (emphysema and chronic bronchitis) that block airflow, creating breathing-related pulmonology problems. In COPD the walls of the airways become thick and inflamed (irritated and swollen).
- Interstitial Lung Diseases: This umbrella term denotes various diseases that scar the lungs (fibrosis), increasing stiffness in the lungs and breathlessness. Lung damage from these diseases is often irreversible and gets worse over time. The most common symptom of all diseases is shortness of breath.
- Tuberculosis: This infectious disease usually attacks the lungs but can spread to other parts of the body if not treated in time. Tuberculosis can be fatal if it's not treated, but medication adherence can cure it.
- Pneumonia: Pneumonia is an infection of the lungs caused by germs causing inflammation and producing fluid or pus in the lungs. Bacterial pneumonia is usually more severe than viral pneumonia but often resolves on its own.
- Lung Infections: A lung infection occurs when a virus, bacteria, or fungus enters the lungs and causes inflammation. Common types include pneumonia, which affects the smaller air sacs, and bronchitis, which occurs when large bronchial tubes become infected.
- Lung Cancer: This malignant disease demonstrates uncontrolled cell division in the lungs due to mutations in the DNA. These cells create masses, or tumours, that eventually disrupt organs. This disease can be caused in the lungs, or it can originate from other organs and could have migrated to the lungs (metastasis).[BM19.1]
- Atelectasis: Partial or complete collapse of the lungs. This condition is usually seen among patients who underwent surgery or maintained prolonged bed rest. Atelectasis impairs the gas exchange and respiratory function, leading to severe complications.
- Drug-Induced Pulmonary Toxicity: There is a list of drugs that are responsible for severe pulmonary diseases such as interstitial inflammation, fibrosis, bronchospasm, pulmonary oedema, pleural effusions, etc. The common drugs that can harm lungs are chemotherapeutic agents, antibiotics, antiarrhythmic drugs, immunosuppressive agents, etc. The pulmonologist usually confirms the diagnosis with the medication history.
- Pulmonary Eosinophilia: Eosinophils are a kind of white blood cell that are produced heavily during infections and stress. They help fight infections and allergic reactions. When such an eosinophilic response is seen within the lung compartments, it is called pulmonary eosinophilia. It causes lung inflammation, breathlessness, etc. Pulmonary eosinophilia could be due to parasite infection.
- Pleural Effusion: Abnormal accumulation of fluid in pleural space. It could be due to heart failure, pneumonia, lung cancer, systemic lupus erythematosus, etc. Pleural effusion compresses the lungs, impairing their ability to expand fully during inspiration and causing respiratory symptoms such as shortness of breath, chest pain, and cough.[BM23.1]
- Pleurodynia: Also called Bornholm’s disease, pleurodynia is a viral infection that produces sudden sharp knife-like pains in the chest or abdomen, lasting 15-30 minutes. [BM24.1]
- Pneumothorax: Accumulation of air outside within the pleural cavity, causing an increased pressure on the lung and, in severe cases, collapsing it. Smoking, pregnancy, and Marfan syndrome can cause pneumothorax.
- Pulmonary Hypertension: The condition of abnormally high pressure in the blood vessels between the lungs and the heart. It can restrict blood flow through the lungs, resulting in low levels of oxygen in the blood. Over time, pulmonary pressure can lead to other medical problems, specifically heart failure.
- Obstructive Sleep Apnoea: This is the most common form of sleep apnoea, which occurs due to a functional obstruction in the mouth and throat, such as the tongue falling against the soft palate during sleep, making breathing difficult or even impossible in some cases.
- Central Sleep Apnoea: This type of sleep apnoea occurs mainly due to the inability of the brain to send proper signals to the muscles that control breathing. The primary symptom is repeated pauses in breathing, especially during the transition from being awake to being in a stage of light sleep.
- Sleep-related hypoventilation and hypoxaemia: Sleep-related hypoventilation is a set of sleep-related breathing disorders that could harm the patient by increasing the overall levels of carbon dioxide in the blood. This can potentially cause symptoms that include poor sleep quality, excessive daytime sleepiness, and morning headaches. Nevertheless, some patients could be asymptomatic too.
- Snoring and Upper Airway Resistance Syndrome (UARS): Upper airway resistance syndrome (UARS) is a condition that is very similar to obstructive sleep apnoea, including excessive daytime sleepiness. It causes an increase in breathing effort and brief awakenings from sleep that are often undetected by the affected individual. Snoring is also common in this condition.
- Insomnia and Parasomnias: While insomnia is the inability to fall asleep, parasomnias are a set of sleep-disruptive behaviours that affect sleep and its quality. The patient might walk, talk, or make physical movements to act out a dream—all while sleeping. There are chances of a patient waking up in fear or finding themselves unable to move. There are a variety of parasomnias, e.g., sleepwalking, night terrors, etc., and treatment options available to help the patients fall and stay asleep.
- Movement disorders like restless leg syndrome and periodic limb movement disorder (PLMD): Both these conditions disturb the quality of sleep. While restless leg syndrome is a sensorimotor disorder marked by an irresistible urge to move the legs, periodic limb movement disorder, on the other hand, involves involuntary, repetitive twitching or kicking of the limbs during sleep, usually every 20–40 seconds. Both the conditions could be linked to iron deficiency, neurological disorders, or chronic illnesses, and often coexist. [BM31.1]
- Central Hypersomnia Disorders including Narcolepsy and Idiopathic Hypersomnia: Persistent daytime sleepiness can be more than just fatigue—it could be a neurological sleep disorder. While narcolepsy is marked by sudden sleep attacks, especially daytime sleeps with vivid dreams, sleep paralysis, etc., idiopathic hypersomnia (IH), on the other hand, could disrupt daily life despite adequate nighttime sleep. Many patients report persistent “brain fog” and cognitive sluggishness throughout the day.
- Pediatric sleep disorders, including snoring, bedwetting, and behavioural insomnia: Snoring in children could be signalling obstructive sleep apnoea, often due to enlarged tonsils, etc. Nocturnal enuresis (bedwetting) may persist due to genetic, developmental, or sleep-related factors. Behavioural insomnia can typically arise from inconsistent bedtime routines or sleep associations, such as needing a parent present to fall asleep. This affects 10–30% of children and is best managed through structured behavioural interventions rather than medication.
