Management Of Respiratory Illness Research Articles

The Utilization of Plant-Material-Loaded Vesicular Drug Delivery Systems in the Management of Pulmonary Diseases.

Medicinal plants have been utilized to treat a variety of conditions on account of the bioactive properties that they contain. Most bioactive constituents from plants are of limited effectiveness, due to poor solubility, limited permeability, first-pass metabolism, efflux transporters, chemical instability, and food-drug interactions However, when combined with vesicular drug delivery systems (VDDS), herbal medicines can be delivered at a predetermined rate and can exhibit site-specific action. Vesicular drug delivery systems are novel pharmaceutical formulations that make use of vesicles as a means of encapsulating and transporting drugs to various locations within the body; they are a cutting-edge method of medication delivery that combats the drawbacks of conventional drug delivery methods. Drug delivery systems offer promising strategies to overcome the bioavailability limitations of bioactive phytochemicals. By improving their solubility, protecting them from degradation, enabling targeted delivery, and facilitating controlled release, drug delivery systems can enhance the therapeutic efficacy of phytochemicals and unlock their full potential in various health conditions. This review explores and collates the application of plant-based VDDS with the potential to exhibit protective effects against lung function loss in the interest of innovative and effective treatment and management of respiratory illnesses.

Vascular dementia has the highest hospitalisation rate in China: a nationwide hospital information system study

BackgroundAlthough vascular dementia (VaD) is not uncommon in the hospital, most studies on VaD are community based. This study on VaD is the first to use a national hospital information...

Performance Evaluation of TaqMan SARS-CoV-2, Flu A/B, RSV RT-PCR Multiplex Assay for the Detection of Respiratory Viruses.

PurposeTo detect and differentiate co-infection with influenza and respiratory syncytial virus during the COVID pandemic, a rapid method that can detect multiple pathogens in a single test is a significant diagnostic advance to analyze the outcomes and clinical implications of co-infection. Therefore, we validated and evaluated the performance characteristics of TaqMan SARS-CoV-2, Flu A/B, RSV RT-PCR multiplex assay for the detection of SARS-CoV-2, Flu A/B, and RSV using nasopharyngeal and saliva samples.Materials and MethodsThe method validation was performed by using culture fluids of Influenza A virus (H3N2) (A/Wisconsin/67/2005), Influenza B virus (B/Virginia/ATCC4/2009), RSV A2 cpts-248, SARS-CoV-2 (USA-WA1/2020) and quantitative RNA controls of Influenza A virus (H1N1) strain A/PR/8/34 (VR-95DQ), RSV A2 (VR-1540DQ) and SARS-CoV-2 (MN908947.3 Wuhan-Hu-1) from ATCC and Zeptometrix, NY, USA. A total of 110 nasopharyngeal specimens and 70 saliva samples were used for the SARS-CoV-2 detection, and a total of 70 nasopharyngeal specimens were used for Influenza and RSV detection. Total RNA was extracted from all the samples and multiplex PCR was performed using TaqMan SARS-CoV-2, Flu A/B, RSV RT-PCR multiplex assay. The assay was used for SARS-CoV-2 variant (B.1.1.7_601443, B.1.617.1_1662307, P.1_792683, B.1.351_678597, B.1.1.529/BA.1).ResultsValidation controls showed accurate and precise results. The correlation study found the accuracy of 96.38 to 100% (95% CI) in nasopharyngeal and 94.87 to 100% (95% CI) in saliva for SARS-CoV-2 and 91.1 to 100% (95% CI) for both Influenza A/B and RSV. The diagnostic efficiency of this assay was not affected by SARS-CoV-2 variant, including Omicron.ConclusionThe TaqMan SARS-CoV-2, Flu A/B, RSV RT-PCR multiplex assay is a rapid method to detect and differentiate SAR-CoV-2, Flu A and B, and RSV in nasopharyngeal and saliva samples. It has a significant role in the diagnosis and management of respiratory illnesses and the clinical implications of co-infection.

Role of Diet, Lifestyle and Yoga in the Prevention and Management of Respiratory Illnesses in Children

Acute respiratory infection is the biggest cause for mortality among children aged less than 5 years, especially in developing countries. A community-based survey study showed that prevalence of respiratory infections was found to be 63.7% and 53.7% in urban and rural areas respectively. Respiratory infections account for 40% of child mortality globally. Burden of acute respiratory infection is increasing day by day due to the growing trend of modernization and urbanization. Overcrowding, repeated exposure to several allergens, poor nutrition are the other major etiological factors in the development of respiratory illness. After Corona virus 2019 (Covid-19) pandemic, the number of cases rose to millions and several countries across the globe were impacted severely.
 Ayurveda is a holistic science which aims at health protection, promotion and strengthening immunity to overcome diseased condition. Diet and lifestyle modification, Yogic methods like Asana, Pranayama and Neti improve respiratory health by cleansing airways, strengthening respiratory muscles, enhancing lung capacity and tissue oxygenation. Assessment of Prakriti, cause behind the illness, treating the existing morbidity, Rasayana prayoga, following necessary precautions and using certain home remedies at an early stage are important to maintain respiratory as well as overall health.
 This paper highlights preventive modalities in every level of health condition, both physical and mental, stressing especially on diet and lifestyle practices of a child.

Compounds of Citrus medica and Zingiber officinale for COVID-19 inhibition: in silico evidence for cues from Ayurveda

BackgroundThe nasal carriage of SARS-CoV-2 has been reported as the key factor transmitting COVID-19. Interventions that can reduce viral shedding from the nasopharynx could potentially mitigate the severity of the disease and its contagiousness. Herbal formulation of Citrus medica and Zingiber officinale is recommended in an Ayurvedic text as a nasal rinse in the management of contagious fevers. These herbs are also indicated in the management of respiratory illnesses and have been attributed with activity against pathogenic organisms in other texts. Molecular docking studies of the phytocompounds of C. medica and Z. officinale were done to find out whether these compounds could inhibit the receptor binding of SARS-CoV-2 spike protein (S protein) as well as the angiotensin-converting enzyme 2 (ACE-2), as evidenced from their docking into binding/active sites.ResultsThe proteins of SARS-CoV-2, essential for its entry into human cells and highly expressed in the goblet and ciliated cells of nasal epithelium, play a significant role in contagiousness of the virus. Docking studies indicated that the specific compounds present in C. medica and Z. officinale have significant affinity in silico to spike protein of virus and ACE-2 receptor in the host.ConclusionIn silico studies suggest that the phytochemical compounds in C. medica and Z. officinale may have good potential in reducing viral load and shedding of SARS-CoV-2 in the nasal passages. Further studies are recommended to test its efficacy in humans for mitigating the transmission of COVID-19.

Prevention and management of respiratory disease in young people with cerebral palsy: consensus statement.

Respiratory illness is the leading cause of mortality in children with cerebral palsy (CP). Although risk factors for developing chronic respiratory illness have been identified, comprehensive clinical care recommendations for the prevention and management of respiratory illness do not currently exist. We invited over 200 clinicians and researchers from multiple disciplines with expertise in the management of respiratory illness in children with CP to develop care recommendations using a modified Delphi method on the basis of the RAND Corporation–University of California Los Angeles Appropriateness Method. These recommendations are intended for use by the wide range of practitioners who care for individuals living with CP. They provide a framework for recognizing multifactorial primary and secondary potentially modifiable risk factors and for providing coordinated multidisciplinary care. We describe the methods used to generate the consensus recommendations, and the overall perspective on assessment, prevention, and treatment of respiratory illness in children with CP.What this paper adds The first consensus statement for preventing and managing respiratory disease in cerebral palsy (CP).Risk factors for respiratory disease in CP should be identified early.Individuals with CP at risk of respiratory disease require regular assessment of risk factors.Effective partnerships between multidisciplinary teams, individuals with CP, and families are essential.Treatment of respiratory disease in individuals with CP must be proactive.

Evaluation and Management of Respiratory Illness in Children With Cerebral Palsy.

Cerebral palsy (CP) is the most common cause of disability in childhood. Respiratory illness is the most common cause of mortality, morbidity, and poor quality of life in the most severely affected children. Respiratory illness is caused by multiple and combined factors. This review describes these factors and discusses assessments and treatments. Oropharyngeal dysphagia causes pulmonary aspiration of food, drink, and saliva. Speech pathology assessments evaluate safety and adequacy of nutritional intake. Management is holistic and may include dental care, and interventions to improve nutritional intake, and ease, and efficiency of feeding. Behavioral, medical, and surgical approaches to drooling aim to reduce salivary aspiration. Gastrointestinal dysfunction, leading to aspiration from reflux, should be assessed objectively, and may be managed by lifestyle changes, medications, or surgical interventions. The motor disorder that defines cerebral palsy may impair fitness, breathing mechanics, effective coughing, and cause scoliosis in individuals with severe impairments; therefore, interventions should maximize physical, musculoskeletal functions. Airway clearance techniques help to clear secretions. Upper airway obstruction may be treated with medications and/or surgery. Malnutrition leads to poor general health and susceptibility to infection, and improved nutritional intake may improve not only respiratory health but also constipation, gastroesophageal reflux, and participation in activities. There is some evidence that children with CP carry pathogenic bacteria. Prophylactic antibiotics may be considered for children with recurrent exacerbations. Uncontrolled seizures place children with CP at risk of respiratory illness by increasing their risk of salivary aspiration; therefore optimal control of epilepsy may reduce respiratory illness. Respiratory illnesses in children with CP are sometimes diagnosed as asthma; a short trial of asthma medications may be considered, but should be discontinued if ineffective. Overall, management of respiratory illness in children with CP is complex and needs well-coordinated multidisciplinary teams who communicate clearly with families. Regular immunizations, including annual influenza vaccination, should be encouraged, as well as good oral hygiene. Treatments should aim to improve quality of life for children and families and reduce burden of care for carers.

Antimicrobial and cytotoxicity properties of the crude extracts and fractions of Premna resinosa (Hochst.) Schauer (Compositae): Kenyan traditional medicinal plant.

BackgroundPremna resinosa (Hochst.) Schauer also called “mukarakara” in Mbeere community of Kenya is used in the management of respiratory illness. In this study we investigated antituberculous, antifungal, antibacterial activities including cytotoxicity and phytochemical constituents of this plant.MethodsAntibacterial and antifungal activities were investigated by disc diffusion and micro dilution techniques. Antituberculous activity was investigated using BACTEC MGIT 960 system while cytotoxicity was analyzed by MTT assay on Vero cells (Methanolic crude extract) and HEp-2 cells (fractions). Finally, phytochemicals were profiled using standard procedures.ResultsP. resinosa had high antituberculous activity with a MIC of <6.25 μg/ml in ethyl acetate fraction. The antibacterial activity was high and broad spectrum, inhibiting both Gram positive and Gram negative bacteria. Dichloromethane fraction had the best antibacterial MIC of 31.25 μg/ml against Methicillin-resistant S. aureus while Ethyl acetate fraction had the highest zone of inhibition of 22.3 ± 0.3 against S. aureus. Its effects on tested fungi were moderate with petro ether fraction giving an inhibition of 10.3 ± 0.3 on C. albicans. The crude extract and two fractions (petro ether and methanol) were not within the acceptable toxicity limits, however dichloromethane and ethyl acetate fractions that exhibited higher activity were within the acceptable toxicity limit (CC50 < 90). The activity can to some extent be associated to alkaloids, flavonoids, terpenoids, anthraquinones and phenols detected in this plant extracts.ConclusionOur findings demonstrate that P. resinosa has high selective potential as a source of novel lead for antituberculous, antibacterial and antifungal drugs. Of particular relevance is high activity against MRSA, S. aureus, C. albicans and MTB which are great public health challenge due to drug resistance development and as major sources of community and hospital based infections.

Respiratory emergencies and airway management in children

Respiratory emergencies in children are frequent and are caused by the specific airway anatomy and the susceptibility for infections.This article reviews the specific approach to pediatric airway management. According to the ABC guidelines of the European Resuscitation Council, the described algorithm should help to identify, classify, and treat such emergencies, giving those with less pediatric experience a tool for the management of respiratory illness in children. Focus is on the emergency care of the most common diseases in this age group.

English

BACKGROUND: Menstrual cycle is an integral part of life in women. The characteristic rhythmic changes in the rate of secretion of ovarian hormones produce physiological changes in different organ systems, in addition to changes in the reproductive system. AIM: The present study is done to elucidate a possible correlative changes in respiration during the different (menstrual, luteal and follicular) phases of menstrual cycle in healthy young girls. MATERIAL AND METHODS: Volume and rate of resting ventilation were measured serially in 40 healthy female student’s volunteers, during menstrual, follicular and luteal phases of menstrual cycle. STATISTICAL ANALYSES: ANOVA, ‘T’ test and ‘P’ value are applied to find out statistical significance and conclusions are drawn based on this statistical treatment. RESULTS: Respiratory Rate was significantly higher (P<O.OO6) in luteal phase than in menstrual and follicular phases. The Minute ventilation though showed slight increase in LP, was not statistically significant. The Tidal Volume showed fall during LP. CONCLUSION: The luteal increase in ventilation suggests a possible role for progesterone in stimulating the respiratory drive, either centrally or through the peripheral chemoreceptors or by both, thus suggesting a possible beneficial role of progesterone in the management of respiratory illnesses.

Acute Care of At-Risk Newborns (ACoRN): quantitative and qualitative educational evaluation of the program in a region of China.

BackgroundThe Acute Care of at-Risk Newborns (ACoRN) program was developed in Canada for trained health care providers for the identification and management of newborns who are at-risk and/or become unwell in the first few hours or days after birth. The ACoRN process follows an 8-step framework that enables the evaluation and management of babies irrespective of the experience or expertise of the caregiving individual or team. This study assesses the applicability of the program to Chinese pediatric practitioners.MethodsCourse content and educational materials were translated from English into Chinese by bilingual neonatal practitioners. Confidence and knowledge questionnaires were developed and reviewed for face and content validity by a team of ACoRN instructors. Bilingual Chinese instructors were trained at the tertiary perinatal centre in Hangzhou Zhejiang to deliver the course at 15 level II county hospitals. Participants completed pre- and post-course confidence and knowledge questionnaires and provided feedback through post-course focus groups.Results216 physicians and nurses were trained. Confidence and knowledge relating to neonatal stabilization improved significantly following the courses. Participants rated course utility and function between 4.2 and 4.6/5 on all items. Pre/post measures of confidence were significantly correlated with post course knowledge. Focus group data supported the perceived value of the program and recommended course adjustments to include pre-course reading, and increased content related to simulation, communication skills, and management of respiratory illness and jaundice.ConclusionsACoRN, a Canadian educational program, appears to be well received by Chinese health care providers and results in improved knowledge and confidence. International program adaptation for use by health care professionals requires structured and systematic evaluation to ensure that the program meets the needs of learners, reflects their learning styles, and can be applied in their setting.

Risk and Spectrum of Diseases in Travelers to Popular Tourist Destinations

Traveling to tropical regions is related to increased health risks. Travelers' diarrhea is the most frequent health problem, but the range of travel-related diseases also includes potential life-threatening diseases such as malaria. The actual risk of European travelers acquiring specific infectious diseases and other hazards in the tropics is to a large extent unknown and is therefore often adopted from that of the indigenous population. The objective of this study was to elucidate the risk for travel-related diseases, symptoms, and accidents in a population of Europeans who travel to popular tourist destinations. From July 2003 to June 2004, 794 travelers consulting the travel clinic of the Berlin Institute of Tropical Medicine were recruited for a questionnaire-based observational study before traveling to Kenya, Tanzania, Senegal, the Gambia, India, Nepal, Thailand, or Brazil. Overall, illness was reported by 42.9% of travelers, with 10.2% reporting more than one adverse health event. Most frequently gastrointestinal symptoms were noted (34.6%), followed by respiratory symptoms (13.7%). More than 5% experienced an accident. Travel to the Indian subcontinent nearly doubled the risk of becoming ill; travel to Thailand significantly decreased the risk. Additional risk factors were a long duration of staying abroad, young age, and traveling under basic conditions. Of all travelers, 80% did not follow the traditionally recommended dietary restrictions. Among travelers visiting malaria-endemic areas, 20% did not carry any antimalarial drugs with them, not continuous chemoprophylaxis or standby medication. Because of the rising travel activity, especially to tropical countries, the importance of qualified pretravel advice consultation is increasing. To improve the travelers' health, attention needs to be paid to individual risk factors, the prevention and therapy of travelers' diarrhea, malaria prophylaxis, management of respiratory illness, and personal safety.

Health problems in a large cohort of Americans traveling to developing countries.

Millions of Americans visit developing countries each year, however, little is known about their health during travel. This study describes health problems in a large cohort of American travelers during and after their trip. A 2-year survey of 784 travelers (95% follow-up) was conducted for persons traveling for < or = 90 days. At the pretravel visit, travelers were given a postcard to record adverse health events. Following travel, standardized telephone interviews were performed for any positive responses, or if the card was not returned. All travelers were contacted 2 months after return to determine late occurring illness and compliance with antimalarials. Travelers had a mean age of 44 years, a median duration of 19 days, and visited 123 countries. An illness was reported by 64% (1.6 illnesses per traveler). Ill travelers were more often female, and traveled longer than those who were not ill; depending upon destination, each day of travel increased by 3 to 4% the chance of becoming ill. Diarrhea was most common, occurring in 46%; 34% met a strict definition for traveler's diarrhea. Respiratory illness occurred in 26%, skin disorders in 8%, acute mountain sickness in 6%, motion sickness in 5%, accidents and injuries in 5%, and isolated febrile episodes in 3%. Medical care was sought by 8% of all travelers and 12% of those reporting illness. On return, 26% of travelers were ill, 56% of whom became ill after return. Diarrhea, respiratory illness, skin disorders, and febrile syndromes were most common, and 46% of those who were ill sought medical care. Complete compliance with antimalarials was 80%. Noncompliant individuals usually discontinued medications on return. Side effects were reported by 4% of those taking chloroquine, 11% of those taking chloroquine plus proguanil, and 14% of those taking mefloquine, with half of these neuropsychiatric. The incidence of documented malaria was 3.8 cases per 1,000 travelers. Many travelers experience adverse health events during and after travel to the developing world. Attention to the prevention and therapy of traveler's diarrhea, prophylaxis of malaria, management of respiratory illness, personal safety, and access to medical care during travel, and, recognition of clinical syndromes after return, will help to improve the traveler's health.

An update on the diagnosis and management of respiratory illness.

An update on the diagnosis and management of respiratory illness.