Lung diseases in Pakistan

Prof Dr Saulat Ullah Khan, a Pulmonologist at Rasheed Hospital Lahore talks about common lung diseases in Pakistan

SN: Which lung diseases are common in Pakistan?sni

Common lung diseases here include asthma, COPD, ILD (phaipron mai jaala ana), pneumonia, TB, lung cancer, occupational lung disease and pulmonary vascular disease. Lung diseases are so common that two third patients come with these problems in a family physician’s clinic. Chest infections or common cold and flu are the most common. Though diseases have intensified but with better treatment, survival rates have improved.sni

SN: What causes them?sni

Tobacco use is the foremost reason. It does not only involve cigarette smoking but bidi, cigar, sheesha and huqa too. Chewed tobacco like betel nut (chalia, supari), paan, paan masala, gutka, naswar etcetera are also harmful. Tobacco has almost 4000 chemicals which not only damage the lungs but other body parts too.sni

It causes respiratory problems like bronchitis (daimi khansi), pneumonia, TB, heart attack, heart rhythm issue and high blood pressure. Moreover, smoking slows down blood circulation causing paralysis, kidney failure, acidity and digestive problem. Also leads to staining of fingers, hearing and vision issues, weak bones, wrinkles and infertility and even affects pregnancy.sni

SN: People do not prioritize health, therefore quitting smoking becomes harder. Your comment on this?sni

The greatest reason to lung cancer is smoking so it must be discouraged completely. But quitting smoking is hard in our culture. People are ready to compromise with the quality of life over death and disease, considering it to be inevitable. People keep smoking and once they are diseased they realize how harmful it was. It is therefore important not to develop the habit in the first place, especially at a young age.sni

Addiction makes it difficult to quit the habit. But of course, everything is possible once you commit yourself. A smoker’s life becomes miserable in the end when lungs constrict and increases his suffering. The struggle of quitting is better than the lifelong misery smoking has on health. Moreover, the habit is not only harmful for the individual himself but also for the people sitting around as they take in secondhand smoke. For instance, if a father smokes, his child will also be affected.sni

SN: What measures should be taken to encourage people to quit?sni

We should educate people especially youngsters about it. Effects of smoking are not immediate therefore people think nothing can happen to them. Moreover, smoking advertisements should be banned. And everyone needs to play their role at community level by boycotting and discouraging people to smoke openly. Social boycott of smoking and smokers in Europe have produced positive results. We can save our generations through this.sni

SN: Other than smoking, what other reasons are responsible for lung diseases?sni

Poverty, malnutrition, and poor housing conditions where people are forced to live in congested places are responsible for developing lung diseases. Also, poor sanitation, inadequate health facilities and urbanization are to be blamed.sni

SN: What is the difference between flu and influenza?sni

Their symptoms overlap therefore patients have problem distinguishing between them. Although both are viral but there are some major differences. Flu and cold is not severe, nobody dies from it and it is self-limiting. The patient may get better within a week. Moreover, fever and severe headache do not come with common flu. Patient only sneezes, has blocked nose, cough and hoarse throat.sni

Influenza on the other hand is rapid and demands treatment. Its symptoms include stomach cramps, loose motions, joint and muscle pain, weakness, vomiting and nausea. Death rate due to influenza is high. Flu however, can only cause complications in elderly with respiratory or other issues like diabetes, heart problem, and in people above 60 years. Influenza becomes even more dangerous for such people. It leads to pneumonia which eventually becomes the cause of death.sni

SN: What should be done to prevent influenza?sni

Since influenza can cause serious complications especially in elderly, it is important to get vaccinated on time. Vaccines can also be given to diabetics and patients with heart problems and weak immune system.sni

SN: What causes shortness of breath?sni

Shortness of breath does not only occur in asthmatics. It is a symptom of many other diseases such as COPD and heart disease etcetera. It therefore becomes important to identify the problem. X-rays and other lung tests are done to know the cause. It can also be a psychological issue. In young girls, shortness of breath occurs in hysteria too.sni

SN: Is allergy the cause of asthma?sni

Asthma is caused due to blockage of the air passages. It commonly happens due to allergy but many other factors add up later. It can also run in the family. Identifying the triggers is really important. Household dust, mud and dirt, pollen grains, spray polish, perfumes, change in weather, humidity and animal skin can be some triggers. Animals keep rubbing their skin and the particles mix with the air causing asthma. Treatment is essential for this condition and inhaler proves to be the best option as it goes directly to the lungs.sni

SN: Do oral medicines work in a similar way?sni

Oral medicines have side effects though they were the first treatment option in the past. But the modern concept is that the medicine should reach the affected area directly. And this limits the side effects too. This can be done through inhaler. Inhaler is not medicine but a technique to take the drug. It is a device or pump in which medicine is inserted. As tablets and syrups go to stomach, similarly, inhaler medicine goes to lungs.sni

SN: Any precautions in taking medicine through inhaler?sni

Yes, you should gargle after taking inhaler as the steroids present in your mouth can be absorbed and affect you. An inhaler works within 15 minutes. But patients usually do not follow doctor’s instructions while using it and therefore do not get the appropriate benefits. Hence, stop using it.sni

There are two types of inhaler medicine. One is used for getting quick relief and the other is to prevent the next attack. It is the fastest and the most effective cure to the problem. Inhaler does not cause dependency, as thought by many. It is not the last, but actually the first treatment option for asthma. So, if your inhaler does not work then go to your doctor and learn the proper way of using it.sni

SN: We hear people saying ‘phaipron mai paani paar gaya’ (water in lungs). Why does it occur?sni

An individual is prone to the problem if blood pressure and sugar levels are not controlled, and a patient has heart, kidney or liver failure. With heart problem it becomes an emergency situation in which the heart fails gradually. TB of the lungs which is an infection also causes the problem. The condition can occur at any age.sni

SN: Does TB occur only in the lungs?sni

There are two types of TB; one is of lungs and the other can occur in any part of body, also known as extra pulmonary. Almost 70 percent of people have TB of the lungs. Extra pulmonary includes TB of the glands, intestine, bones and joints, urinary system, etcetera. The germs are extremely tiny and remain in the air when a patient sneezes or coughs. They then enter another body through breathing. Over 90 percent people have these germs but affect those with weak immune system.sni

If a patient coughs for more than three weeks and keeps losing weight, then he must visit the doctor for tests. TB was once incurable but today it is curable with medicines and proper treatment. Being chronic in nature, its treatment takes times. So be patient and complete the course. As leaving the course at any time can be harmful.sni

SN: What are the dos and don’ts for TB patients?sni

Patients usually stop eating once they are diagnosed with TB. Although they should not. It can cause weakness. Do not avoid any kind of food. Eat a normal healthy diet that includes milk, eggs, vegetables, meat, etcetera. Smoking however, should be avoided. The patient should keep a handkerchief while coughing or sneezing. And avoid spitting here and there. It should be kept closed in a bin and then disposed off in a gutter. It only takes two to three weeks to kill TB germs if these precautions are followed along with taking proper medicine. There is no need to separate crockery or utensils of the patient.sni

SN: Can lung diseases be prevented?sni

Certainly, lung diseases can be prevented with certain precautions. Following the appropriate way to use medicine, keeping a handkerchief while coughing or sneezing and quitting smoking and tobacco use can prevent the disease.sni

SN: What is COPD?sni

Chronic obstructive pulmonary disease occurs due to inflammation of the lungs which makes it difficult for the patient to breathe causing failure of the lungs. It is irreversible. On average, it kills around 20 lakh patients every year. Around 79 lakh people suffer from it in Pakistan alone. Its treatment is lifelong. To prevent it, stop smoking and keep away from environmental pollution.sni

SN: Can exercise and diet play a role in maintaining lung health?sni

Exercise is extremely essential for everyone as a healthy individual has higher chances of disease resistance. And balanced diet is equally important. In respiratory disease, people usually avoid eating yoghurt, milk, and rice thinking they produce mucus, which is wrong. There is no relation of food with respiratory disease unless having food allergy. Chemicals in tinned foods and artificial food colors however, should be avoided.sni

SN: What does ‘rasiha jam jana’ refer to?sni

This happens when mucus gets thick and is unable to be secreted. Lack of water causes it to thicken. Therefore, keep yourself hydrated when suffering from cold and flu.sni

Health is precious. Take care of it. In case you get sick or catch a disease, try to get to the root cause. Do not ask people around you about the cure or treatment as they tell their own experiences. Only go to an authentic doctor for consultation. Medicines that are prescribed should be used regularly according to the prescription. Avoid restricting your diet and using antibiotics unnecessarily.sni