Cancer drug

Too many cancer drug trials, too few patients (The Times of India:

20170814)

http://epaperbeta.timesofindia.com/Article.aspx?eid=31808&articlexml=Too-many-cancer-

drug-trials-too-few-patients-14082017019004

Experimenting On Limited Number Of People Can Be Perilous As Side Effects Can Easily

Be Missed

With the arrival of two revolutionary treatment strategies, immunotherapy and personalised

medicine, cancer researchers have found new hope -and a problem that is perhaps

unprecedented in medical research.

There are too many experimental cancer drugs in too many clinical trials, and not enough

patients to test them on. The logjam is caused partly by companies hoping to rush profitable

new cancer drugs to market, and partly by the nature of these therapies, which can be

spectacu larly effective but only in select patients.

In July, an expert panel of the US Food and Drug Administration (FDA) approved a

groundbreaking new leukaemia treatment, a type of immunotherapy . Firms are scrambling to

develop other drugs based on using the immune system itself to attack cancers. Many of these

experimental candidates in trials are quite similar. Yet each drug company wants to have its

own proprietary version, seeing a potential windfall if it receives FDA approval.

As a result, there are more than 1,000 immunotherapy trials underway , and the number keeps

growing. “It's hard to imagine we can support more than 1,000 studies,“ said Dr Daniel Chen,

a vicepresident at Genentech, a bio technology company .

In a commentary in the journal `Nature', he and Ira Mellman, also a vice-president at the

company , wrote that the proliferating trials “have outstripped our progress in understanding

the basic underlying science“.

DAILY NEWS BULLETINLEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE DayMonday 20170814

“I think there is a lot of exuberant rush to market,“ said Dr Peter Bach, director of the Center

for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center, “ And we are

squandering our most precious resource -patients.“

Take melanoma: There are more than 85,000 cases a year in the US, according to Dr Norman

Sharpless, director of the Lineberger Comprehensive Cancer Center at the University of

North Carolina. Most melanomas are cured by surgery, leaving about 10,000 patients who

have had relapses and could be candidates for an experimental treatment. But nearly all will

be treated by doctors outside of academic medical centres, who are not part of the clinical

trials network and so do not offer patients experimental treatments.

Companies therefore must compete for the few patients with relapsed melanoma who are at

centres offering clinical trials. Many end up struggling to find enough subjects to determine

wheth er a treatment actually works -and if so, for whom.

The problem is that many of the trials are uninteresting from a scientific view, said Dr Roy

Herbst, the center's chief of medical oncology . The companies sponsoring these trials are not

addressing new research questions, he said; they are trying to get proprietary drugs approved.

Trials involving limited numbers of patients can be perilous. In tiny studies, serious side

effects can be missed, said Dr Scott Ramsey , an oncologist at the Fred Hutchinson Cancer

Research Center, US.

Childcare

Childcare remains in infancy across state(The Tribune: 20170814)

A reality check at five government hospitals in major cities reveals that some basic facilities

are not available

http://www.tribuneindia.com/news/punjab/childcare-remains-in-infancy-across-

state/451833.html

The state government claims to have put an emphasis on better child and mother care, but a

survey of five major hospitals of the state presents a picture of contrast. The possibility of a

Gorakhpur-like tragedy can’t be ruled out.

If somewhere there is a lack of proper oxygen system, in others there is a shortage of nurses.

It is common to find shortage of pediatricians in all hospitals. In the name of “referring”,

parents of newborn and sick children keep shuttling from one place to another.

Patiala: No lessons learnt from past mistakes

In 2009, six infants were charred to death at Government Rajindra Hospital incubators, while

four others were critically injured in a fire that broke out due to electric short circuit at the

phototherapy unit of the hospital, but that doesn’t seem to have brought much change. Even

as a neonatal intensive care unit and a paediatrics intensive care unit has been set up in the

hospital, parents can’t rely on these in times of emergency.

Dr Jasvir Singh, head of paediatrics department, admitted that they had the equipment, but it

was not fully operational due to lack of proper oxygen system in the hospital. There is no

intensive care facility for children. Many basic things, including neonatal ventilators,

paediatrics ventilators and pulse oximeters are either missing or lying defunct in these units

following which more than 50 per cent critical cases are referred to the PGI, Chandigarh, or

private hospitals.

Amritsar: Diagnostic facility unavailable

A plethora of problems plagues Bebe Nanki Mother and Child Care Centre of Government

Medical College in the holy city. The parents of children coming to the centre have to take

them to private labs even for the basic tests.

The tests for sodium, potassium, calcium, CBC and others are not usually conducted at the

centre. Even the machine for conducting trans-bilirubin test is lying dysfunctional. Though

the hospital authorities claim otherwise, the presence of a large number of agents of private

labs at the entrance of the centre belie their claim. Besides, post-graduate students hold the

fort at the centre as no senior doctors are available after 2 pm.

Ludhiana: Inadequate staff to handle equipment

A visit to the Mother and Child Hospital on the premises of the Civil Hospital revealed that

although infrastructure and machinery are available, a shortage of staff has crippled its

functioning. Children requiring intensive care are either referred to the PGI or Rajindra

Hospital, Patiala. As per norms, a nurse should be available for every newborn baby, but in

reality, a single nurse is taking care of more than three babies at a given time. The other

major problem is the non-availability of doctors.

Jalandhar: Six specialists needed, two available

Every month around 400-700 children are born at the Jalandhar’s Civil Hospital. But it is ill-

equipped to deal with the patient load. There are just two child specialists against the

requirement of six. Most parents complain of a delayed response to their repeated calls during

emergencies. Besides, the hospital doesn’t have a single ventilator in the newborn baby care

unit. As per the staff, a subsidiary C-pipe ventilator alternative is used in time of

emergencies. Dr Vijender Singh, medical officer, said a demand regarding ventilators had

already been raised.

Bathinda: Services hit by lack of paramedics

While nurses are crucial to childcare, Bathinda’s Civil Hospital which caters to several

districts of the Malwa region struggles with inadequate staff. A query reveals that the hospital

doesn’t have enough trained nurses to take care of prematurely born and sick babies.

Untrained nursing students are thus making up for the staff shortage. The hospital has 17

nursing staff against 32 posts. At the childcare unit, out of 10 sanctioned posts, there are only

five nurses who work in three shifts. Since no ventilator is available for newborn babies,

emergency patients are referred to Government Medical College, Faridkot.

(Inputs by Gagan K Teja, Manmeet Singh Gill, Manav Mander, Aparna Banerji and

Sukhmeet Bhasin)

Japanese Encephalitis

Japanese Encephalitis in Gorakhpur: A deadly disease explained (The Hindu: 20170814)

http://www.thehindu.com/sci-tech/health/japanese-encephalitis-a-deadly-disease-

explained/article19486806.ece

Gorakhpur offers the only tertiary care centre for Japanese Encephalitis with 100 dedicated

beds.

What is Japanese Encephalitis?

Japanese Encephalitis (JE) is a mosquito-borne viral infection of the brain. There is, however,

a debate about the origin of the disease and whether it is enteroviruses — caused by virus

found in pigs and birds. There is no cure for JE.

Why only Gorakhpur?

While Gorakhpur has a considerable burden of disease, it is incorrect to assume that JE cases

are clustered in Gorakhpur district alone. JE epidemics are reported from many parts of India

however, it is highly endemic in Eastern Uttar Pradesh. Gorakhpur is a nodal point not

because there are more cases in the district but because the only tertiary care centre with 100

beds dedicated to JE is in Gorakhpur. So, cases from nearby districts like Kushinagar and

Deoria districts are referred to there for treatment.

Japanese Encephalitis

Why does vaccination not work?

It is a misconception that the JE vaccine will eradicate the disease in a short span of time.

While vaccination is critical, at the heart of U.P.’s crisis is lack of infrastructure, unclear data

on disease burden and lack of access to clean water and toilets. In March, the State

government launched a JE vaccination drive in 38 districts in U.P. but it was not

supplemented with access to clean water and sanitation.

The efficacy of the JE vaccine is between 85-90%. The lessons learnt from polio vaccination

drives is that people left out of each round of vaccination are the most disenfranchised, most

likely to take ill and least likely to seek medical care in time.

The Gorakhpur mystery...

Over the years, there have been cases in the area which are clinically different from one

another. JE is one kind of encephalitis which falls under a spectrum of diseases called Acute

Encephalitis Syndrome (AES). Doctors in endemic regions in U.P. have found cases with

similar symptoms but without the virus, leading to some debate over the cause of the disease.

While public health experts have found a difference in case definitions across Eastern

districts of U.P., this is something Indian scientific community is still trying to understand.

However, specific research on this has not been supported by the government so far, despite

decades of annual outbreaks. Due to lack of research, U.P. government gets their burden of

disease data from hospitals, essentially leaving out cases that do not come into public health

facilities. This results in wrong forecasts as the government budget for next year’s JE

intervention. Because of the lack of reliable data & research, UP’s policy intervention to curb

JE cases has failed for decades.

Were all those who died in BRD Hospital suffering from JE?

No. The State government is yet to release data of exactly how many of them were admitted

for JE treatment.

Telemedicine

Telemedicine: Odisha shows the way (The Hindu: 20170814)

http://www.thehindu.com/sci-tech/health/odisha-shows-the-way/article19482213.ece

The model of a telemedicine project begun in the State, that is creating jobs and widening

health access, is now going national

A telemedicine project started by an Odisha-based social entrepreneur is slowly going

national after the Central government adopted it as a model project two years ago. Started in

2009, the unique model that focusses on sustainability involves training of local youth in e-

medicine services and enables them to set up e-health centres in government-run primary

health-care centres (PHC), community health centres (CHC) and subdivisional hospitals.

These centres have created job opportunities for over 500 youth in Odisha and reached out to

over five lakh patients.

For jobs and health

“There are two main problems that ail us — unemployment and bad health. Through this

micro-entrepreneurship programme we have attempted to tackle both,” says Kedarnath

Bhagat, managing trustee of Odisha Trust of Technical Education and Training (OTTET)

under the aegis of which the telemedicine model was conceptualised. At OTTET, local youth

are trained for a month in an e-health assistance programme, after which they can apply for a

bank loan to start an e-health centre in PHCs and CHCs. “On average, the cost of starting a

telemedicine centre goes up to ₹6 lakh. A centre needs a staff of four people, including the

entrepreneur,” explains Mr. Bhagat, adding that typically a centre is equipped with a laptop

with video camera and basic diagnostic testing facilities like blood glucose meter, urine

analyser, heart rate monitor, etc. So far, 127 such centres have been opened in Odisha at the

village and district level (see picture).

“At no cost to the government, these centres help in offering basic testing facilities. Patients

suspected to have major illness get the benefit of the telecommunication facility for

consultations with senior doctors,” says Mr. Bhagat. The OTTET has tie-ups with

government hospitals as well as private hospitals such as Apollo, Global and Narayana

Hrudayalaya.

These telemedicine centres also create a database of personal health records of every patient

walking in for future reference. Mr. Bhagat says for a centre to be viable, the PHC or CHC

should have a footfall of about 50 patients a day. “The revenue comes from charges for tests

and tele-consultation fees. In case patients are covered under any health scheme for the poor,

these charges are borne by the scheme,” he says. The charges for tests and consultation are

fixed by the government; a basic consultation costs ₹100 while that with a super-specialist

costs ₹300.

Across other States

In 2015, a team of government consultants termed this project as one of the eight “best

practices globally”. The World Health Organisation too believes telemedicine to be

particularly beneficial for rural and underserved communities in developing countries.

While the OTTET plans to cover all 51,000 villages in Odisha, pilot programmes have begun

in Gujarat, Jharkhand, Bihar, Himachal Pradesh and Uttar Pradesh while four other States are

also in line. “Telemedicine offers phenomenal opportunities to doctors to reach out to

patients,” says Dr. Devi Shetty of Narayana Hrudayalaya. “It acts as a good bridge.”

jyoti.shelar@thehindu.co.in

Zika vaccine

More potent, safer Zika vaccine developed (The Hindu: 20170814)

http://www.thehindu.com/sci-tech/health/more-potent-safer-zika-vaccine-

developed/article19479682.ece

Scientists have developed the world’s first plant-based Zika vaccine that may be more

effective, safer and cheaper than other vaccines against the mosquito-borne virus.

Currently, there are no licensed vaccines or therapeutics available to combat Zika, researchers

said.

The vaccine developed by researchers from Arizona State University (ASU) in the U.S.

works against a part of a Zika viral protein, called DIII, that plays a key role for the virus to

infect people.

“All flaviviruses have the envelope protein on the outside part of the virus. It has three

domains,” said Qiang Chen, a scientist at ASU.

“The domain III has a unique stretch of DNA for the Zika virus, and we exploited this to

generate a robust and protective immune response that is unique for Zika,” said Chen, who

led the research published in the journal Scientific Reports.

The researchers first grew the envelope protein in bacteria, then prepared the DIII protein

domain in tobacco plants.

The team then performed immunisation experiments in mice, which induced antibody and

cellular immune responses that have been shown to confer 100% protection against multiple

Zika virus strains in mice.

The team’s protein-based vaccine uses the smallest and most unique part of the Zika virus

that can still elicit a potent and robust immune response.

“In our approach, we make what we call a pseudovirus. It is a fake virus. The pseudovirus

displays only the DIII part of the envelope protein on the surface,” said Chen.

“We did a test to make sure that the vaccine produces a potent protective immune response,

but also, that it does not produce antibodies that may be cross reactive for dengue, West Nile,

yellow fever or others,” he said.

The worldwide Zika threat first emerged in 2015, infecting millions as it swept across the

Americas.

It struck great fear in pregnant women, as babies born with severe brain birth defects quickly

overburdened hospitals and public health care systems.

Child Diseases (The Asian Age: 20170814)

http://onlineepaper.asianage.com/articledetailpage.aspx?id=8778544

Backache (The Asian Age: 20170814)

http://onlineepaper.asianage.com/articledetailpage.aspx?id=8777485

Negative emotions

Embracing negative emotions could boost psychological well-being

(Medical News Today: 20170814)

http://www.medicalnewstoday.com/articles/318933.php

When feelings of sadness or disappointment take hold, most of us do our utmost to escape

them. However, according to new research, embracing these darker emotions is more likely

to benefit psychological health in the long-term.

In a study of more than 1,300 adults, researchers found that people who regularly try to resist

negative emotions may be more likely to experience symptoms of mood disorders months

later, compared with subjects who accept such emotions.

Lead study author Brett Ford, an assistant professor of psychology at the University of

Toronto in Canada, and colleagues recently reported their findings in the Journal of

Personality and Social Psychology.

Previous research has suggested that acceptance - whether it is embracing our good and bad

attributes, or accepting the way we look - is associated with better psychological well-being.

For this latest study, Prof. Ford and team sought to determine how acceptance of negative

emotions - such as sadness, disappointment, and anger - might influence psychological

health.

Embrace or avoid negative feelings?

To reach their findings, the researchers conducted three experiments, the first of which

involved 1,003 participants. All subjects completed a survey, in which they were asked to

rate how strongly they agreed with certain statements, such as "I tell myself I shouldn't be

feeling the way that I'm feeling."

The researchers found that participants who had lower agreement with such statements as

these - indicating a greater acceptance of negative feelings - showed higher levels of

psychological well-being, compared with subjects who attempted to resist negative feelings.

In the second experiment - involving 156 participants - subjects were asked to record a 3-

minute speech as part of a mock job application, which they were told would be shown to a

panel of judges. The subjects were given 2 minutes to prepare their speech, and they were

instructed to promote their relevant skills.

A leisurely walk can boost mood, psychological well-being

A leisurely walk can boost mood, psychological well-being

A short, leisurely walk could do wonders for psychological health, say researchers.

READ NOW

Once the recording was complete, each subject was asked to report how they felt about the

task.

The team found that participants who tried to avoid feeling negativity about the task were

more likely to experience distress, compared with subjects who embraced any negative

feelings.

The third study involved 222 participants. For 2 weeks, each subject was asked to keep a

journal to record any bad experiences, as well as their emotions in response to such

experiences. Participants were followed-up with a psychological assessment 6 months later.

The researchers found that subjects who reported trying to avoid negative emotions in

response to bad experiences were more likely to have symptoms of mood disorders, such as

anxiety and depression, 6 months later, compared with those who embraced their negative

emotions.

"We found that people who habitually accept their negative emotions experience fewer

negative emotions, which adds up to better psychological health," says senior study author

Iris Mauss, an associate professor of psychology at the University of California, Berkeley.

Acceptance may be key to stress coping

Overall, the team believes that when bad things happen, it may be better to let negative

emotions run their course rather than trying to avoid them.

"It turns out that how we approach our own negative emotional reactions is really important

for our overall well-being. People who accept these emotions without judging or trying to

change them are able to cope with their stress more successfully."

Prof. Brett Ford

"Maybe if you have an accepting attitude toward negative emotions, you're not giving them

as much attention," speculates Prof. Mauss. "And perhaps, if you're constantly judging your

emotions, the negativity can pile up."

The researchers now plan to investigate how an individual's upbringing influences their later

experiences of negative emotions and their acceptance of such feelings.

Leukemia

Leukemia: Mushroom protein could be used in future treatments (Medical

News Today: 20170814)

http://www.medicalnewstoday.com/articles/318910.php

A protein found in the edible mushroom known as "shaggy ink cap" might be able to kill a

type of leukemia cell, new research suggests.

Coprinus comatus, also known as "shaggy ink cap" or "lawyer's wig," is a type of edible

mushroom normally found in North America and Europe. Its habitat is usually meadows and

grasslands, but it can also sometimes be found along gravel roads or on lawns in towns and

cities.

It takes its common names from its white, shaggy appearance when mature, but also from the

fact that it starts "dissolving" into a black, inky mass once it starts to decay, or soon after

being picked.

This type of mushroom is already known for its nutritional value, as well as for its

antioxidant and antimicrobial potential. Some studies have also variously linked Coprinus

comatus elements with potential for HIV, prostate cancer, and ovarian cancer treatments.

Researchers from the University of Florida in Gainesville have now uncovered a new

potential for a Coprinus comatus protein: killing a type of leukemia T cell.

Dr. Yousong Ding, an assistant professor at the University of Florida, and his team looked at

how Y3, a protein present in Coprinus comatus, binds with the LDNF glycan, which is a

sugar molecule usually found in parasites. This activates a cell-signaling cascade that can

program a type of leukemia T cell to commit suicide, the researchers explain.

Their findings have recently been published in Proceedings of the National Academy of

Sciences.

Glycan binding protein programs cell suicide

Dr. Ding and his colleagues noted that the protein Y3 from Coprinus comatus has significant

glycan binding properties. This is important because the interactions of glycan binding

proteins (GBPs) can provide a better understanding of how systems respond to pathogens and

can facilitate the creation of new therapeutic pathways.

In the course of this study, the scientists tested the interaction between Y3 and LDNF using

model leukemia cells. They found that the enzymes triggered by this interaction were able to

cause the death of over 90 percent of the leukemia T cells.

In the researchers' view, this result suggests that the action of the Y3 GBP on this type of

leukemia cell can be productive and very efficient.

They suggest that this may have meaningful implications for T cell acute lymphoblastic

leukemia treatment. This type of blood cancer is particularly aggressive, and it is responsible

for up to 25 percent of acute lymphoblastic leukemias.

According to the National Cancer Institute, the estimated number of adult deaths owed to

acute lymphoblastic leukemia in 2017, in the United States, will be 1,440.

Potential pathways for new treatments

Dr. Ding suggests that the study has offered the scientists a new way of determining the

functions of proteins present in Coprinus comatus mushrooms, and of studying their action on

unhealthy cells.

The next step for the researchers is to examine other potential GBPs in more edible

mushrooms, as well as gain a better understanding of Y3 functions in relation to leukemia

cells.

Dr. Ding suggests that he and his colleagues might start testing the action of Coprinus

comatus Y3 proteins on diseased cells in animal models within a year.

The researchers express their hope that this, and similar studies, could reveal pathways for

new, more efficient drugs in the treatment of leukemia and other diseases.

"In addition to their dietary value, these proteins can be important to health improvement and

disease prevention," concludes Dr. Ding.

Restrictive lung disease

Restrictive lung disease: Types, causes, and treatment (Medical News

Today: 20170814)

http://www.medicalnewstoday.com/articles/318905.php

Restrictive lung diseases are chronic lung conditions that limit the ability of a person's lungs

to expand during inhalation.

Most cases of restrictive lung diseases are not curable, but they are often manageable with

medication and exercise regimes.

Contents of this article:

What are restrictive lung diseases?

Types

Symptoms

Diagnosis

Treatment

What are restrictive lung diseases?

Man with asthma inhaler.

Obstructive lung diseases, such as asthma, prevent normal exhalation. In contrast, restrictive

lung diseases prevent normal inhalation.

Long-term lung conditions are traditionally separated into two main categories based on how

they affect a person's breathing. These categories are either obstructive or restrictive.

A third category, called mixed lung disease, is smaller and has characteristics of both

obstructive and restrictive lung diseases.

Mixed lung disease most commonly occurs in people with chronic obstructive pulmonary

disease (COPD), who also have congestive heart failure.

In cases of obstructive lung diseases, such as asthma, bronchiectasis, COPD, and

emphysema, the lungs are unable to expel air properly during exhalation.

Restrictive lung diseases, on the other hand, mean the lungs are unable to fully expand, so

they limit the amount of oxygen taken in during inhalation. This limitation also restricts what

can be exhaled when compared to an average person.

Restrictive lung diseases cause a decreased lung capacity or volume, so a person's breathing

rate often increases to meet their oxygen demands.

Most restrictive lung diseases are progressive, meaning they worsen over time.

One study estimated that, from 2007 to 2010, 6.5 percent of Americans aged 20 to 79 had

restrictive lung disease.

Types

Restrictive lung diseases are often divided into two groups, depending on whether their cause

is intrinsic or extrinsic.

Intrinsic restrictive lung disorders cause an internal abnormality, usually leading to the

stiffening, inflammation, and scarring of the lung tissues.

Types of diseases and conditions involved in intrinsic restrictive lung disease can include:

pneumonia

tuberculosis

sarcoidosis

idiopathic pulmonary fibrosis

interstitial lung disease

lung cancers

fibrosis caused by radiation

rheumatoid arthritis

infant and acute respiratory distress syndrome

inflammatory bowel disease (IBD)

systemic lupus

Extrinsic restrictive lung disease is caused by complications with tissues or structures outside

of the lungs, including neurological conditions.

External factors that cause an extrinsic restrictive lung disease are often associated with

weakened muscles, damaged nerves, or the stiffening of the chest wall tissues.

Types of diseases and conditions involved in extrinsic restrictive lung disease can include:

pleural effusions, or the buildup of excessive fluid between tissue layers surrounding the

lungs

scoliosis, or twisting of the spine

neuromuscular disease or conditions, such as Lou Gehrig's disease (ALS), multiple sclerosis,

and muscular dystrophy

obesity

myasthenia gravis, or intermittent muscle weakness

malignant tumors

rib damage, especially fractures

ascites, or abdominal swelling connected with liver scarring or cancer

diaphragm paralysis

kyphosis, or hunching of the upper back

diaphragmatic hernia

heart failure

Symptoms

Most people with restrictive lung diseases have similar symptoms, including:

shortness of breath, especially with exertion

inability to catch their breath or get enough breath

chronic or a long-term cough, usually dry, but sometimes accompanied by white sputum or

mucus

weight loss

chest pain

wheezing or gasping breath

fatigue or extreme exhaustion without a logical reason

depression

anxiety

Diagnosis

Doctors look at x-ray of lung.

Diagnosis will be based on a variety of tests, and in some cases scans such as x-rays.

A doctor will normally perform or order a pulmonary function test to assess total lung

capacity (TLC), or the total amount of air the lungs take in when a person inhales. The total

lung capacity is usually decreased in restrictive lung disease.

Other tests may be necessary for a full diagnosis and to ensure the correct treatment plan is

arranged. The specific tests used are usually determined by whether the suspected cause of

the restrictive lung disease is intrinsic or extrinsic.

Tests that show reduced lung functioning may indicate that scarring, stiffening, or

inflammation is affecting a large portion of the lungs.

Commonly used tests for restrictive lung disease include:

Forced vital capacity (FVC) test, which involves inhaling and filling the lungs with as much

air as possible, then exhaling with as much force as possible. The FVC of those with

restrictive lung diseases is typically decreased. A FVC value of less than or equal to 80

percent of what is expected can be a sign of a restrictive disease.

Forced expiratory volume in 1 second (FEV1) test, which measures the amount of air exhaled

during the first second of the FVC test. Most people expel about three-quarters of the air

inhaled during this initial period of exhalation. In restrictive disease, because the FVC is

usually reduced, the FEV1 will be lower, proportionally.

FEVI to FVC ratio test, which compares the amount of air expelled during the first second of

exhalation (FEV1) to the total amount of air exhaled during an FVC test. This ratio is often

normal or even increased in those with restrictive lung disease.

Chest X-ray, which creates images of the entire chest and lung area for evaluation.

Computed tomography (CT) scans, which create more detailed images of the chest and lung

area compared to chest X-rays.

Bronchoscopy, where a flexible tube with a camera is inserted through the nose or mouth into

the airways of the lung for examination.

Treatment

Treatment plans depend on the cause or the type of restrictive lung disease.

In some cases, delivering oxygen to a person using oxygen therapy may be necessary to help

them breathe properly.

In severe cases, lung transplant surgery, corrective surgery, or stem cell therapy may be

options.

Medications commonly used to treat restrictive lung diseases include:

azathioprine

cyclophosphamide

corticosteroids, usually in an inhaler form

methotrexate

other immunosuppressing and anti inflammatory medications

anti-scarring medications, such as pirfenidone or nintedanib

Unfortunately, a majority of the scarring, thickening, or loss of elasticity associated with

restrictive lung diseases is irreversible. There are ways, however, to reduce the symptoms or

impact of restrictive lung diseases.

Doing at-home exercises and making some lifestyle changes have been shown to reduce the

severity of restrictive disease symptoms.

Commonly recommended methods include:

breath conditioning, often pursed lip breathing, slow-deep breathing, or diaphragmatic

breathing

upper and lower limb strengthening and conditioning exercises

respiratory muscle strengthening exercises

level walking

relaxation or visualized meditation

eating a balanced, nutritious diet

quitting smoking

avoiding environments with toxins, irritants, or allergens that may worsen symptoms

Following a treatment plan and sticking to certain lifestyle changes can help alleviate the

symptoms of a restrictive lung disease and improve a person's quality of life.

Tea (Dainik Gagaran: 20170814)

http://epaper.jagran.com/ePaperArticle/14-aug-2017-edition-Delhi-City-page_19-1214-4804-

4.html