Asian Clinic (2nd & 4th Wed)

Hello,

I am Dr. Manav Manchanda, Pulmonologist. Today I will talk about sleep disorders like obstructive sleep apnea. Sleep disorders are very common in our population. Or 10% of the population has this problem at some point in life. Obstructive sleep apnea is a very common form of sleep disorder. The risk factors for having the problem of obstructive sleep apnea is basically when the person is overweight, thick neck circumference, or hen he has increased the alcohol intake or when he is a heavy smoker. These are the common risk factors that the patient develops. Now the common symptoms that these patients are present to us is patient with day time sleepiness. Sometimes, the problem is so severe that he is driving the care and he sleeps off. This can lead to fatal accidents.

Spouse also complaints that the patient has the problem of snoring loud and because of the spouse is not able to sleep. This is the problem when the patient or the spouse usually complaints or when the patient comes to us. Now the common problem that these patients lands up into like diabetes, hypertension, heart attack, brain stroke, loss of daily activities and the sedentary lifestyle. How do we test this out? We do a procedure called a sleep study. Mosty these patients are subjected to sleep study in the hospital where we have machines which test out the disorders. It is like an ECG machine where we can test out the patient's problem. It can be done at home also, but we always prefer to do in the hospital. We test the snoring activity, the limb, the leg movements, the activity of the brain and the eyes and the activity of the muscles. If we see any problem then we prescribe various therapies to the patient. Why this problem is causing so much strain on the body?

The sleep is the function of the body which is very important to give rest to all the organs. So, when the patient is not sleeping properly, the patient is suffering from obstructive sleep apnea. Oxygen goes into the body is very less. That gives a lot of stress on all the organs of the body. So, the function of the body is to give rest to the body. So, what is the treatment for this problem? The treatment is consist of lifestyle modification. And most of the important component in weight loss. Every patient should be asked to do any regular activity. If you are drinking or smoking so these should be stopped completely. Next is the role of the C-Pap Machine. It is the common device which is offered to these patients of obstructive sleep apnea. It is a device with a mask. After the application of this mask, the oxygen goes properly. This machine comes in small size and very compatible to carry around. Mask can also be chosen by patient comfort. In a nutshell, I will say that this is a very common disorder. I hope my talk will increase the awareness among the general population.

Thank You.

Hi,

I am Dr. Manav Manchanda, Pulmonologist. Today I will talk about COPD. This problem is very common in India nowadays especially in ruler as well as in the urban population. 15-20% Indian population is affected by this disease. And it is the fourth most common cause of death in India as well as western hemisphere. The major risk factors for COPD is cigarette smoking, environmental pollution, industrial areas pollution, crop burning pollution, and indoor pollution. We can also find this disease in patients who are having second-hand exposure to smoke. Now the symptoms will be cough, breathlessness, wheezing, chest tightness and sputum production.

The diagnosis of this disease mainly rests with a certain investigation like pulmonary function test which is the most important test. In this, the patient blows into a machine which majors the lung capacity of the patient. Certain other tests like a blood test, x-ray, oxygen & carbon dioxide measurement, sputum test, CT scan maybe require in some group of patients. But pulmonary function test remains the mainstay of the diagnosis. It also tells us the severity of the disease. Now, this disease is basically characterized by irreversible destruction of the airways so until and unless you stop the offending agents the disease goes on progressively. Sometimes, the disease so worsens that patient is bedridden and requires oxygen.

So, the initial treatment starts with avoiding the risk factors. So, any patient who comes to us and having a history of smoking, we ask them to avoid smoking so that the disease progression can be stopped. If he is working in an industry where there is a lot of dust, we ask them to change their job. Next comes the role of medications for these patients. We grade the patients into severity. The commonly used medicines are in the form of inhalers which is the most effective treatment for the patient. A certain group of patients who are having more severe disease, they require some oral tables also. Also, these patients will be vaccinated for common virus and bacteria.

Then comes the role of exercises of the patients. These patients should be taught about respiratory exercises. So that their lung capacity can be improved and the disease progression can be stopped. Next, we give them a self-care management plan. So, when should a patient contact a Dr. Most of the patients have the problem of worsening the symptoms. And this occurs in the pollen season or in the winter season. The treatment has to be increased in consultation with Dr. Somtime ventilator is also required for the patient. The patient should go to the clinic regularly so that the patient should take the precaution prior to the disease is going to happen and to stop the disease from happening. We can also modify the treatment only on that basis.

Thank You!

Hello Everyone,

I am Dr. Manav Manchanda, senior consultant and head of pulmonology department. I treat respiratory and sleep disorders. My specialized for bronchial asthma and the patients who have COPD. COPD is the fourth most common cause of death in India. So, for the management we have OPD set up to diagnose and then the treatment. We have also well-equipped allergy testing lab or diagnosis of the various allergic disorder. We see the allergy and give the therapy to the patient. I also have done a lot of sleep studies where I get to see a lot of sleep disorder patients like obstructive sleep apnea, obesity hypoventilation syndrome.

Also, we have a nice setup for interventional procedures. It helps in diagnosing various lung disorder like lung cancer, tuberculosis. We also do the management of cancer patient also who requires airways procedure. This is my special interest procedures because I have done a lot of work in malignancy patient in the last 7-8 years. Viral infection in the air is causing trouble for the normal person. Typically those patients who have bronchial asthma or COPD.

So, these patient require special care because any virus or infection can cause many harms. So, they have to take extra precautions and medically they should be controlled. Recently so many viral infections are there like flu, swine. So, my advice to all those patients who are suffering from bronchial asthma and COPD, they should take special precautions. They should take medicines regularly. Avoid outside food. If they have any problem, they should report to their doctor immediately. So that timely evaluation and future complications can be avoided.

Thanks!