This is a condition in which there is the unexplained sudden death of an infant. SIDS mostly occurs under the age of 1 year. It is also known as crib death because the baby dies while sleeping in a crib. Infants of age 2-4 months are more susceptible to have it. Studies have suggested that it may be caused due to abnormalities in the area of the brain, which is responsible for breathing and arousal from sleep.
SIDS is responsible for nearly 1600 infants die each year in the US.

Possible causes of SIDS

What are the associated risk factors for SIDS?

According to a study done in the best lung hospitals in India, following the most common risk factors are discovered.

1. Boys are more prone to have SIDS than girls.

2. Infants of age between 2-4 months are more prone than others.

3. Non-whites are more susceptible than white infants.

4. Infants whose siblings or cousins have already died of SIDS are also more susceptible.

5. Babies living around smokers are more prone.

6. Premature babies or babies with low birth weight are more prone.

7. Infants having young mothers of less than 20 years of age are at higher risk.

Ways to reduce the risk of Sudden Infant Death Syndrome

• Back to sleep – At least during the first year of life, the baby must be put to sleep on his/her back and not on the stomach or side. Avoid using the stomach position to calm down the child.

• Keeping the crib empty – Thick and fluffy padded should be avoided for placing the infant. Do not leave any pillows, toys or stuffed animals in the crib. Such things can be pressed against the face and obstruct breathing.

• Avoid overheating – Do not cover the baby’s head and use a sleep sack to keep the baby warm. Use those sleep clothing that does not require additional covers.

• Make the baby sleep with your room – The child should be put alone in the crib but in the parents’ room for at least 6 months to 1 year.

• Breastfeeding – The child should be breastfed for at least 6 months to reduce the risk of SIDS.

• Avoid using any monitors or other devices to reduce the risk of SIDS.

• Use of pacifier – Sucking a pacifier without any strap while sleeping may also reduce the risk. However, if you are breastfeeding the child, do not offer a pacifier till the age of 3-4 weeks.

• Immunizations – Get all the immunizations of the child on time.

• Avoid addictive habits – It is important to get rid of addictive habits like drinking, smoking or use of other drugs, especially during pregnancy. Passive smoking can also lead to SIDS.

COPD means Chronic Obstructive Pulmonary Disease.

As per the studies conducted by WHO (World Health Organization), nearly 65 million people suffer from moderate to severe form of COPD. More than 3 million people have died due to COPD in 2005, which was 5% global deaths. It is estimated that COPD is going to be the 3rd leading cause of worldwide deaths.

What is Chronic Obstructive Pulmonary Disorder?

COPD is a relatively wider term used to describe progressive lung diseases including emphysema, chronic bronchitis, asthma. The most significant character of this condition is breathlessness.

Emphysema –
This is a condition in which the tiny air sacs of the lungs are damaged. The walls are stretched, increasing the size of the lungs and making it harder for air to move in and out. The inhaled air gets trapped inside the alveoli for a long time such that the next time you inhale more air cannot get into the alveolar sacs.

Chronic bronchitis –
This is caused by inflammation of the breathing tubes in the lungs. The cilia (the tiny hair-like structure that keep the airways clean) are damaged making the airways swollen and clogged. This limits the airflow in and out of the lungs.

Refractory or non-reversible asthma –
This kind of asthma do not respond well to the medications. The airways get permanently tighten and swollen up.

What causes COPD and what are the risk factors?

Inhaling pollutants –
Most of the COPD cases happen due to tobacco smoking such as cigarettes, pipes, cigars etc. and second-hand smoking. Though everybody who smokes does not get COPD, most of the COPD cases have a smoking history.

COPD most commonly occurs in people with 40 years of age or above.

Environmental fumes –
People with long term exposure to harmful pollutants in the workplace including lung irritants, chemicals, dust or fumes can cause COPD. Also, long term exposure and contact with secondhand smoke or other lung irritants at home like cooking fuel can also COPD.

Genetic causes –
The most common genetic risk factor for emphysema is Alpha-1 Antitrypsin Deficiency. The deficiency causes harm to the lungs with White Blood Cells.

Signs and symptoms

Most common signs and symptoms of COPD include,

• Tightness in the chest

• Wheezing

• Short breath

• Chronic cough with mucus

• Cyanosis of lips or fingernail beds

• Frequent respiratory infections

• Post nasal drainage

• Unintended weight loss

• Fatigue

• Swelling in ankles, feet or legs

Diagnosis of COPD

When you approach a pulmonologist, he/she will take a detailed case history. It is important to tell your doctor about all your past illnesses, family history, and any other medical information. Following tests are also advised to diagnose COPD that include:

• Lung Function Test – This test measures the amount of air the lungs can inhale and exhale and if the lungs are delivering enough oxygen to the blood.

• Spirometry – This is a widely used test. The patient is asked to blow into a large tube connected to a small machine known as a spirometer. This measures the amount of air the lungs can hold and the speed with which the air can be blown out of the lungs. Spirometry is used to track the progression of the disease and it can also diagnose COPD even before it manifests the symptoms.

• Chest X-ray – This helps in diagnosing emphysema, one of the main causes of COPD. A chest x-ray also helps to rule out lung problems and heart failure.

• CT scan – This is used to detect emphysema and also check if surgery is required. Other than this, the CT scan is also used to diagnose lung cancer.

• Arterial blood gas analysis – This tests the ability of the lungs to bring oxygen in the blood and remove carbon dioxide.

• Laboratory tests – Certain lab tests are used to check if there is any deficiency of alpha-1-antitrypsin deficiency which may be a cause of COPD. This is usually done if a person has a family history of COPD.

How is COPD treated?

Quit smoking – This is the most imperative step in treating COPD. The patient must take the help of a doctor regarding nicotine replacement products and medications.

Medications
Following type of medications are usually recommended to the patients by the doctors. These are listed below:

Inhalation steroids –
Sometimes, the doctors prescribe corticosteroids medications to reduce the inflammation in the airways. These medications help in frequent aggravation of the symptoms. A few examples are fluticasone and budesonide.

Bronchodilators –
The bronchodilators help in the relaxation of muscles of the respiratory airways. As a result, symptoms like shortness of breath and cough are relieved. Bronchodilators are either short-acting such as albuterol, levalbuterol, ipratropium etc or long-acting like salmeterol, formoterol, indacaterol etc.

Antibiotics –
Infectious diseases like bronchitis, pneumonia, and influenza are treated with the help of antibiotics. This is done to prevent the exacerbations of COPD.

Breathing therapies

• These include oxygen therapy which includes providing supplemental oxygen to assist the patient in breathing. Depending upon the severity of the illness, the oxygen supplementation can be used all the time or while doing physical activity and while sleeping.

• The other therapy is known as the Pulmonary rehabilitation program which includes a combination of counseling, exercise, nutrition, and education done by a team of specialists as per your needs.

Surgical options

Bullectomy –
There are large spaces formed in the lungs when the air sacs get destroyed. The spaces are very large and make breathing difficult. Bullectomy involves removal of these spaces to improve the airflow.

Lung Volume Reduction Surgery –
The damaged portion in the upper part of the lungs is removed to create extra space in the chest cavity for the rest of the lung to expand. The diaphragm also works more efficiently.

Lung Transplant –
This is the ultimate surgical option for cases where the entire lung has been damaged. However, according to some of the best lung doctors in India the surgery has high risks and complications such as immune organ rejection by the body.

Is pulmonary fibrosis fatal? Here are some true facts.
Pulmonary fibrosis involves scarring of the lungs causing thickening of the lung tissues. This causes difficulty in breathing for the patient by inhibiting the ability of the lungs to provide ample amount of oxygen to the blood. Pulmonary fibrosis is an irreversible process. However, the medications and other therapies can help relieve the symptoms to provide a better quality of life. In the most severe cases, a lung transplant may also be an option.

What are the signs and symptoms of pulmonary fibrosis?

The most common symptoms consist are as follows. A person experiencing these kinds of symptoms must consult the doctor.

• Shortness of breath

• The patient has a fast and shallow breath

• Dry frequent cough

• Wheezing

• Weight loss

• Muscle and joint aches

• Clubbing of fingers and toes (rounding of the tips)

• Loss of appetite

• Chest discomfort

Causes:

There are several kinds of possible reason that can eventually lead to pulmonary fibrosis. These are,

1. Environmental Factors– Several environmental factors such as the silica dust, coal dust, grain dust, dust from hard metals, asbestos fibers etc. might be responsible for pulmonary fibrosis, when a person is exposed for a long time. Moreover, people working in the industries which are poorly ventilated and are filled with excessive smoke are more prone to the pulmonary fibrosis and other lung conditions.

2. Medical conditions – There are several medical conditions that make a person at more risk than others. These conditions may involve such as,

• Sarcoidosis

• Wegener’s granulomatosis

• Rheumatoid arthritis

• Long-standing GERD

• Scleroderma

• Sjogren’s syndrome

• Viral infections

• Dermatomyositis

• Polymyositis

• Mixed connective tissue disease

• Pneumonia

• Lupus erythematosus

• Sarcoidosis

• Chronic interstitial pneumonitis

• Pneumoconioses

3. Radiation therapy – increased exposure to the ionizing radiation that is given for lung cancer, breast cancer or lymphomas. Usually, in such cases, pulmonary fibrosis starts with radiation pneumonitis, which is left untreated for a long time.

4. Genetics – Sometimes, the pulmonary fibrosis runs in the families for years and keeps passing on to the next generations.

5. Medications – Certain drugs can also have a damaging impact on the lungs. These medications may include,

• Chemotherapy drugs, which are made to destroy cancer cells can also kill the respiratory cells.

• The drugs that are used to treat arrhythmias like amiodarone can damage the lung.

• Certain antibiotics like nitrofurantoin or ethambutol.

• Some of the anti-inflammatory drugs like rituximab or sulfasalazine.

How is it treated?

The condition cannot be reversed to the normal condition. Hence the treatment options focus to relieve the symptoms. The treatment options include:

1. Medications

2. Oxygen therapy

3. Pulmonary rehabilitation

4. Lung transplantation

Medications

The doctors usually recommend following medications for the treatment for pulmonary fibrosis. These include,

1. nintedanib – This is an anti-fibrotic drug, which works by stopping the excessive production of growth factors. The side-effects may include abdominal pain, vomiting, nausea, weight loss, raised blood pressure and many more.

2. pirfenidone – This is anti-fibrotic as well as anti-inflammatory drug, which is known to slow down the progression of pulmonary fibrosis from mild to moderate.

3. Corticosteroids -These suppress the immune system and reduce the inflammation. Their mechanism of action involves mimicry of the cortisol action, which is a hormone produces by adrenal glands.

4. Cyclophosphamide -This is a chemotherapeutic agent that reduces the inflammation. It is used to treat certain forms of pulmonary fibrosis. The side effects include loss of appetite, inability to menstruate, change in the skin color etc.

Oxygen therapy

The oxygen therapy is recommended by the doctors when the oxygen level decrease below 88%. The oxygen levels are measured while sitting, during walking, on a treadmill, and during sleep. Wearing an oxygen mask is not very convenient. It can get difficult to adjust it while you are outside the home. However, it is a highly effective method to reduce the short breath and fatigue. Many patients have reported having experienced a more active lifestyle than before.

Pulmonary rehabilitation:

Pulmonary rehabilitation involves training related to breathing exercises, management of stress, anxiety, stress, and depression. The primary goal is to refurbish the lung function and enable the patient to exercise without much breathlessness. A pulmonary rehabilitation team is a vast group of nurses, respiration therapists, physiotherapist, and others. It also offers several advantages including improving the functioning of the respiratory system, relieving the symptoms and improvement in overall health. It is well-known in preventing the breathlessness and the continuous cough.

Lung Transplant

Lung transplantation is also a choice of treatment in certain cases of pulmonary fibrosis. However, this can only be done in cases where the patient is healthy, young and suitable for the lung transplant. A lung transplant can involve major complications such as sepsis or immune-rejection by the body.

Life-expectancy in case of pulmonary fibrosis

The overall prognosis of pulmonary fibrosis depends upon several factors related to the patient. The best pulmonologists in India say that since there is no absolute cure for the condition, the quality of life will depend upon the treatment and lifestyle changes made by the patient. For example, if the patient has been a smoker all his life and also continues to smoke after the diagnosis of pulmonary fibrosis. It also depends on if the patient is eating healthy, doing regular breathing exercises and if he is on pulmonary rehabilitation.
Proper care with complete treatment can help to extend the life expectancy of a person.