Yash Chest Clinic

Advance Lung Functions Diagnostic are the tests that help to measure the lungs' ability to exchange oxygen and carbon dioxide appropriately. They are also known as Pulmonary Function Tests and are performed with the help of machines to assess lung functions.

Spirometry – is one of the simplest, most common pulmonary function test done by the use of device named spirometer. This helps in determining,how well the lungs receive air, holds it, and utilizes it, also in monitoring any  kind of lung disease, effectiveness of its treatment, severity of a lung disease and whether the lung disease is restrictive (decreased airflow) or obstructive (disruption of airflow)

Lung Diffusion Capacity - measures the efficiency of airsacs to allow oxygen to diffuse into the blood stream.

Lung Test Measures are:

• Total lung capacity (TLC): Total volume of the lungs at maximal inflation i.e when lungs are filled with as much air as possible.

• Tidal volume (TV): Refers to air movement in and out of lungs during quiet breathing.

• Residual volume (RV): is the volume of air remaining in the lungs after a maximal exhalation

• Functional Residual Capacity (FRC) – the volume of air left in the lungs after exhaling normally

• Vital Capacity (VC): the volume of air breathed out after the inhaling as much air as one can.

• Functional Residual Capacity (FRC): the volume of air left in the lungs after exhaling normally

• Forced Vital Capacity (FVC): the determination of amount of air exhaled forcefully and quickly after inhaling as much as one can

• Forced Expiratory Volume (FEV) – indicates the amount of air exhaled under forced conditions during the first, second and third seconds of the FVC test

• Peak Expiratory Flow Rate (PEFR) – The fastest rate that one can force air out of their lungs is measured with a peak flow meter

Use of endoscope and other tools by pulmonologist (lung specialists) to diagnose and treat conditions in the lung and chest is known as Interventional Pulmonology. It’s relatively new and maturing medical sub specialty which deals with minimally invasive endoscopic and percutaneous procedures for diagnosis and treatment. The methods include all types of advanced diagnostic and therapeutic procedures like of bronchoscopy, thoracentesis, pleuroscopy and comprehensive evaluation of airway conditions.

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An obstructed or narrowed airway can result from a number of conditions, including a tumor. Interventional pulmonologists offer diagnostic and treatment services for all major lung problems, including comprehensive evaluations of:

• Abnormal chest X-rays

• Lung and Chest Cancer

• Chronic cough

• Hemoptysis - Coughing up blood

• Compressed airways

• Pleural Effusion – Liquid Around the lungs

• Persistent Respiratory Failure

• Airway stricture from benign and malignant causes

• Amyloidosis

• Congenital airway stenosis

• Endobronchial tumors

• Fibrosing Mediastinitis

• Granulomatosis with polyangiitis (Also Known as Wegener's granulomatosis)

• Recurrent Respiratory Papillomatosis

• Relapsing Polychondritis

• Tracheomalacia

• Tuberculosis

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At Yash Chest Centre, our interventional pulmonologists Dr. Vijay Narain Tyagi specializes in performing advanced, minimally invasive interventional procedures in the airways and chest cavity, including advanced bronchoscopic and pleuroscopic techniques. Interventional procedures results in faster recovery and lesser trauma with reduced risk of complications improving quality of life.

COPD is a disease that makes it hard to breathe due to narrowed airways. Group of lung conditions that cause breathing difficulties are

• Emphysema – caused by the damage of lungs air sacs

• Chronic Bronchitis –Prolonged inflammation of the airways

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The initial symptoms of COPD usually undergoes unnoticed in many people until it shows advanced stages. COPD get worse over time if not treated at early stages. An expert pulmonologist helps a person suffering from COPD with proper care and treatment and help them live an active life.

 

COPD or chronic obstructive pulmonary disease results in clogging and damage of lung alveoli (Balloon like tiny air sacs in lung) thus being unable to absorb oxygen. Symptoms of COPD are:

• Shortness of breath in everyday activities

• Wheezing: high-pitched whistling sound made while you breathe

• Chest tightness

• Constant coughing

• Producing a lot of mucus (sputum)

• Feeling tired

• Frequent colds or flu

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Severe COPD can make it difficult to perform routine works like walk, cook, clean house, or even bathe. Coughing up excess mucus and feeling short of breath may worsen. Advanced illness can also cause:

• Swollen legs or feet due to  fluid buildup

• Weight loss

• Less muscle strength and endurance

• A headache in the morning

• Blue or grey lips or fingernails (due to low oxygen levels)

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COPD is a common condition that mainly affects middle-aged or older adults who smoke. Many people don't realise they have it as it may not be diagnosed in them until it shows advanced stages. An expert pulmonologist can only help you in providing proper care and treatment

Nicotine/Tobacco addiction is one the leading causes of premature death worldwide. De-addiction treatments are primarily designed to advocate the disastrous effects by the use of tobacco, discouraging smoking, encouraging and assisting smoking patients to quit and efforts to curb smoking at various levels. Nicotine/Tobacco (Smoking) De-addiction Treatment centres play a vital role in helping patients to get rid of, the number one preventable cause of death that is Nicotine/Tobacco addiction.

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Effective Behavioral Treatments, Nicotine Replacement Therapy (NRT) and Oral Therapy are the results of understanding of neuropathology of nicotine addiction.

 

Behavioral Treatment includes behavioural counselling of patients by specialists for smoking cessation. Following a variety of approaches to smoking cessation behavioral counselling might take more than 8-9 sessions.

Another preventive approach is Cognitive Behavioral Therapy (CBT) which helps in identifying the triggers of smoking. The people, places and any other stressful situations that triggers urge to smoke is avoided in turn to avoid smoking.

Nicotine Replacement Therapy (NRT), is widely used along with behavioural treatments. NRT helps in dealing with difficult withdrawal symptoms and cravings that make giving up tobacco difficult. Nicotine replacement therapy reduces those symptoms and gradually helps in getting rid of Tobacoo addiction.

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Nicotine/Tobacco (Smoking) De-addiction Treatment needs a strong willpower to get rid of this addiction, lots of support from people around the patient and an experienced specialist to get rid of Tobacco addiction.

Sleep study also known as Polysomnography is used to diagnose sleep related breathing disorders such as obstructive sleep apnea (OSA). Sleep disorders are medical conditions that can affect people's health and life. It is characterized by frequent pauses of breath during sleep which leads to breathlessness.

 

Polysomnography is done at sleep disorders units within a hospital or at a sleep centre to records patients brain waves, the oxygen level in his/her blood, heart rate, breathing, eye and leg movements during the study. This helps to determine sleep stages and cycles to identify disruption in sleep patterns and its reasons.

Polysomnography is suggested by Doctors when the patient suffers from following conditions:

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• Sleep Apnea, is a condition in which breathing repeatedly stops and starts during sleep.

• Periodic Limb Movement, involves involuntary flexing and extending of ones legs while sleeping.

• Narcolepsy, results in overwhelming daytime drowsiness and sudden attacks of sleep.

• REM Sleep Behavior involves acting out dreams in sleep.

• Unusual Behaviors during sleep, as walking, moving around a lot need urgent attention and sleep study need to be performed on Doctor’s advice. 

• Chronic Insomnia is trouble falling asleep or staying asleep. Doctors attention is required as this might lead to unhealthy health conditions and general well being.

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During sleep our mind and body work to repair and rejuvenate it’s parts and restore energy, regulate hormones that are key to growth and development. Unchecked sleep disorders may lead to excessive daytime sleepiness, Stress, Fatigue, Obesity, High blood pressure, Heart disease, Heart attack, Diabetes, Increased risk of accidents, Morning headaches.

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A sleep study is a non-invasive, overnight exam that allows doctors to monitor their patient’s sleep and to see what's happening in their brain and body. At sleep centres, an EEG monitors  sleep stages and the cycles of REM and nonREM or NREM sleep, to identify possible disruptions in the pattern of sleep. This helps the Doctor to identify severity of the sleep disorder and possible course of action and medication.

Endobronchial ultrasound (EBUS) is a minimally invasive  and highly effective procedure to diagnose various lung disorders, including inflammation and other infections causing lung and thoracic tumors.

EBUS (endobronchial ultrasound) bronchoscopy, is performed by Pulmonologist to get local image of lungs and nearby lymph nodes without conventional surgery. EBUS is a technique using ultrasound along with bronchoscope to visualize airway wall and structures adjacent to it.

Both linear and radial EBUS is used to reach areas in lung that are generally inaccessible without surgery. Endobronchial ultrasound EBUS) is highly effective for critical biopsy procedures as biopsy of lymph nodes in mediastinum with the help of bronchoscope.

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Interventional pulmonology diagnostic capabilities include:

• Flexible bronchoscopy allows visualization of individual lobes or segment bronchi.

• Rigid bronchoscopy is primarily used to control the airway and larger lumen during complex endobronchial interventions

• Premalignant lesions are difficult to see with white light bronchoscopy. Autofluorescence bronchoscopy uses autofluorescent light which are help in detecting these premalignant lesions easily. . Autofluorescence bronchoscopy also comes handy while detecting precancerous lesions or early-stage lung cancer in people at high risk for lung cancer.

• Pleuroscopy uses an endoscope inserted into the chest cavity for diagnosis and management of pleural disease.

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Benefits of EBUS (endobronchial ultrasound) are:

• EBUS is performed under mild sedation or general anaesthesia and no incisions are required.

• Use of mild sedation and no incisions helps patients to recover fast and in many cases patients can go home same day

• It provides real-time imaging of the surface of the airways, blood vessels, lungs, and lymph nodes, which helps in deciding the severity of infection and in many cases helps in detecting early stage lung cancer

• The accuracy, speed and improved images of the areas difficult to reach allows the physician to evaluate the pathological condition of the affected areas fast with great accuracy and thus helps in deciding the correct course of action to deal with it.