Metered-Dose Inhalers: Contemporary Technologies, Industrial Development, Regulatory Considerations, and Emerging Trends | Chapter 8 | Pharmaceutical Science: New Insights and Developments Vol. 9

 

Background and objective: Metered-dose inhalers (MDIs) remain fundamental to the management of asthma and chronic obstructive pulmonary disease (COPD) due to their portability, dosing accuracy, patient convenience, and cost-effectiveness. Despite advances in inhalation therapy encompassing formulation science, device engineering, and regulatory frameworks, MDIs continue to occupy a central role in clinical practice and pharmaceutical development.

 

Objectives: This chapter provides a comprehensive and critical overview of contemporary MDI technologies, including conventional pressurised MDIs, breath-actuated devices, and non-pressurised soft mist inhalers (SMIs). Key aspects addressed include operating principles, formulation and propellant considerations, device design, aerosol performance, and dose delivery characteristics. The chapter further evaluates recent technological advancements, clinical benefits, and persistent challenges, including patient adherence, environmental sustainability, and dose reproducibility. Industrial and regulatory perspectives influencing inhalation product development and commercialisation are also discussed.

 

Methodology: This chapter is based on a structured critical review of current scientific, technical, and industrial literature related to MDI development and performance. Peer-reviewed research articles, review papers, pharmacopeial standards, and regulatory guidance documents were systematically analysed to capture advances in formulation science, device technology, regulatory expectations, and sustainability initiatives. Authoritative guidance from regulatory agencies such as the U.S. Food and Drug Administration (FDA), the European Medicines Agency (EMA), and the International Council for Harmonisation (ICH) was examined to contextualise development and compliance requirements. Particular emphasis was placed on device engineering, aerosol generation and characterisation, formulation device interactions, and the application of quality-by-design (QbD) principles across product development, manufacturing, and lifecycle management.

 

Conclusions: MDIs remain indispensable in the long-term treatment of asthma and COPD; however, their continued clinical relevance depends on effectively addressing challenges related to patient misuse, adherence, and the environmental impact of hydrofluoroalkane (HFA) propellants. Future progress in MDI technology will require an integrated, multidisciplinary approach that combines advances in formulation science, environmentally sustainable propellant alternatives, and user-centred device design. From a regulatory and quality standpoint, critical performance attributes such as aerodynamic particle size distribution, emitted dose uniformity, extractables and leachables assessment, and robust in vitro-in vivo correlations will remain essential for ensuring product safety and therapeutic efficacy. Alignment with evolving regulatory expectations, supported by risk-based design strategies and QbD-driven development, will be pivotal in advancing next-generation MDIs that are clinically effective, patient-friendly, and environmentally responsible. Emerging trends and future research directions are highlighted to provide a forward-looking framework for researchers, clinicians, and industry stakeholders in inhalation drug delivery.

 

 

Author(s) Details

Chinna Reddy Palem
Formulation R&D, Asphar Research Labs Pvt. Ltd., IDA, Balanagar, Hyderabad-500037; Telangana, India.

 

Sridhar Gumudevelli
Product Development, Ascent Pharmaceuticals Inc., 400S. Technology Drive, Central Islip, NY 11722, USA.

 

 

Please see the book here :- https://doi.org/10.9734/bpi/psnid/v9/6886

How to Achieve Visualization of Obscure Drug Inhalation Stages in Inhalation Therapy? | Chapter 11 | Disease and Health Research: New Insights Vol. 4

 

The drug inhalation stage in inhalation therapy is crucial but often obscure. Information on how to inhale the drug is usually conveyed to the patient using ambiguous verbal expressions, such as “strongly,” “deeply,” and “slowly.” Patients typically determine the best method of drug inhalation based on their interpretation and understanding of verbal instructions. Consequently, direct intervention to provide optimal inhalation guidance for individual patients remains challenging, which can affect disease control. This has remained largely unexplored until now.

 

The Tokico Inhalation Monitor TM (TIM) was developed to address the unpredictability of the drug inhalation stage. The TIM can simultaneously measure inhalation flow rate, duration, and total volume, displaying these metrics on the screen in real time. This chapter demonstrates how TIM can visualize obscure drug inhalation stages and illustrates the effects of inhalation instructions using this device.

 

Author (s) Details

Hiroyuki Ohbayashi
General Incorporated Association, Academy of Inhalation Therapeutic Methods (AIMs), Japan.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v4/1840

Examining the Link between Arginase Ι and Bronchial Asthma | Chapter 8 | Disease and Health: Research Developments Vol. 6

Background: Asthma is a chronic lung disease that affects 300 million people worldwide. Allergic asthma is a disease of airway inflammation and hyperresponsiveness. Asthma occurs by activating IgE, a receptor that bears mast cells and basophils, and the triggering factor for this is the inhalation of an allergen when it binds to complementary IgE. And this leads to lung infiltration by eosinophils, neutrophils, then activated (M 2) macrophages and (TH2) lymphocytes, which are inflammatory triggers and all these increase mucus production, which leads to mucosal edema, smooth-muscle hyperresponsiveness, and airway hyperresponsiveness (AHR) due to exposure to e.g. histamine and methacholine.

Objective: The aim of this study was to detect the arginase Ι (ARG I) enzyme in asthma patients, and clarify its role, in addition to examining the relationship of this enzyme with bronchial asthma.

Methods: Blood samples were collected from 100 patients from Department of Medicine in Rizgary Hospital in Erbil City, in addition to intact 100 volunteers; the introduced questionnaire was filled out on the basis of type-induced asthma, duration of the disease, age of the patients, gender, family history, and allergy condition, Serum was separated to perform Enzyme-linked immunosorbent assay (ELISA) in Medical Research Center to examine the association of ARGΙ with bronchial asthma. By ARG activity we can measure the conversion of arginine to ornithine and urea. By using a quantitative colorimetric assay at 490 nm, employing a QuantiChrom arginase assay kit (Bioassay Systems).

Results: Our results depicted the association between ARGΙ and bronchial asthma: based on their age, significant elevation of serum arginase level was observed in the patients ≥81 years old, with mean value (100.16±19.77^c), p-value (0.000); also the duration of asthma ≥20 years (82.48±38.81^c), p-value (0.01) were remarkably affected; this significance was found in those with types of induced asthma and with allergy condition. However non-significant difference in the frequency of abnormal serum arginase levels was observed in those patients that have a family history of asthma disease and gender of the patients. This finding demonstrated a remarkable association of ARG Ι in the development of asthma at p > 0.05.

Conclusion: The ELISA results indicated that ARG I and bronchial asthma are remarkably correlated. Patients with asthmatic symptoms have a high level of ARG Ι (> 40 IU/L).

 

Author (s) Details

 

Ashti Mohammad Amin Sai
Molecular Biology Department, Medical Research Center / Hawler Medical University, Kurdistan, Iraq.

 

hmed Abdulqader Al-Naqshband
Bacteriology Department, Rizgary Teaching Hospital / Ministry of Health, Kurdistan, Iraq.

 

Yasin Kareem Amin
Medical Research Center / Hawler Medical University, Kurdistan, Iraq.

 

Rebwar Jalal Ali
Biochemistry Department, Medical Research Center / Hawler Medical University, Kurdistan, Iraq.

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrd/v6/4419

Respiratory Complications in Pregnancy: Maternal and Neonatal Outcomes from a Retrospective Analysis | Chapter 4 | Achievements and Challenges of Medicine and Medical Science Vol. 12

Introduction: The frequency and significance of acute and chronic respiratory disorders in pregnant women have increased in recent years. Pregnant women with respiratory conditions, ranging from asthma to adult respiratory distress syndrome, should be promptly diagnosed and treated. Clinicians must have an understanding of cardiopulmonary physiology to promptly recognize and treat pregnant women with respiratory conditions ranging from asthma to adult respiratory distress syndrome. Significant changes are seen in respiratory parameters as pregnancy progresses.

Aim: The aim of this study is to determine the prevalence of respiratory diseases in pregnancy in a tertiary healthcare hospital and assess the maternal and perinatal outcomes in pregnant women with respiratory disease and complications.

Materials and Methods: This study was a retrospective record study, which analyzed various respiratory diseases in pregnancy and their effects on the perinatal outcome. Hospital documents of pregnant women who delivered in the institution during the years 2015–2019 were studied. Pregnant women with respiratory complications in pregnancy including new onset/or exacerbations of preexisting respiratory diseases like asthma, acute bronchitis, acute respiratory distress syndrome (ARDS), and pneumonia were noted. Data were analyzed using the SPSS version 16 after it was manually entered in Microsoft Excel. Pearson’s Chi square and Fisher’s exact test were used as the tests for significance, and a value <0.05 was considered significant.

Results: The study identified 214 pregnant women with respiratory complications over a period of 5 years. The overall incidence was 2.3%; 94.4% were 20–35 years of age, and 82.2% delivered at term gestation (37–40 weeks). Respiratory complications like infective, restrictive, and obstructive lung diseases were seen. Bronchial asthma exacerbations in 155 (72%), respiratory tract infections (upper and lower respiratory tract infections) in 23 (10.7%), acute bronchitis in 16 (7.5%), ARDS in 8 (3.7%), pleural effusion in 3 (1.4%), tuberculosis in 2 (0.9%) and OSA in 1 (0.5%) were seen. A total of 3.2% had intensive care unit (ICU) admissions, and there was 1.4% maternal mortality. The following observations were made in women with respiratory complications: a higher incidence of preeclampsia in 31 (14.4%), an increased rate of lower segment cesarean sections (LSCS) in 99 (46.2%), intrauterine death (IUD) in 12 (5.6%), and poor Apgar scores as well as neonatal intensive care unit (NICU) admissions in 99 (46.3%) women.

Conclusion: Respiratory illnesses in pregnancy pose more risk to the mother than to the fetus. Close monitoring of the antenatal period with pulmonary function testing increases the chance of a good pregnancy outcome. Mothers with respiratory diseases should be screened antenatally as the chances of preterm and intrauterine growth restriction (IUGR) are high in the fetus. Close monitoring of the antenatal period with pulmonary function testing increases the chance of a good outcome of the present pregnancy.

 

Author (s) Details

Shashikala Karanth
Department of Obstetrics and Gynaecology, St. Johns Medical College and Hospital, Bengaluru, Karnataka, India.

 

Christy Vijay
Department of Obstetrics and Gynaecology, St. Johns Medical College and Hospital, Bengaluru, Karnataka, India.

 

C Jaya Sibi Mol
Department of Obstetrics and Gynaecology, St. Johns Medical College and Hospital, Bengaluru, Karnataka, India.

 

Nirupama Vijaykumar
Department of Obstetrics and Gynaecology, St. Johns Medical College and Hospital, Bengaluru, Karnataka, India.

 

Uma Devaraj
Department of Pulmonary Medicine, St. Johns Medical College, Bengaluru, Karnataka, India.

 

Chaitanya Harita Balakrishnan

Department of Medicine, St. Johns Medical College and Hospital, Bengaluru, Karnataka, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v12/3785

Two Large Blind Spots in Inhalation Therapy for Asthma and COPD | Chapter 14 | Advanced Concepts in Pharmaceutical Research Vol. 3

 Regardless of diligent breathing instructions at various dispassionate settings, patient devotion to inhaled drugs is generally weak in the treatment of asthma and chronic opposing pulmonary disease (COPD). This is cause two large breach still prevail in inhalation analysis that a majority is ignorant of. A large break is in the lack of awareness of how to control two together types of adherence present in breathing therapy; the added is that the inhalation process based on the subjects' interpretation and understanding of spoken instructions, is obscure. This phase identifies these two blind spots and discusses by what method they can be tried.

Author(s) Details:

Hiroyuki Ohbayashi,
Academy of Inhalation Methods (Gifu), Syureikai, Tohno Chuo Clinic, Tohno Chuo Clinic (Gifu), Fujita Medical College, School of Medicine (Aichi), Mizunami City, Gifu 509-6134, Japan.

Please see the link here: https://stm.bookpi.org/ACPR-V3/article/view/12758

Investigations Pertaining to the Field of Pharmacognosy Concerning Coleus rotundifolius L. | Chapter 4 | Recent Trends in the Study of Botanical Research Volume - 1

 Coleus rotundifolius L., a member of the Lamiaceae family, is recognized by its vernacular name "Patharchur" in Hindi. It presents as a sizable succulent perennial herb, characterized by its aromatic qualities. The plant's leaves have historically found application in diverse medicinal contexts such as malarial fever, hepatopathy, renal and vesicle calculi, cough, chronic asthma, bronchitis, hiccough, anthelmintic purposes, colic pain, and convulsions. The present paper undertakes a comprehensive investigation of the pharmacognostic attributes pertaining to the leaves, stems, and roots of C. rotundifolius, encompassing an array of distinct parameters.

Author(s) Details:

Pratima Patel,
S.G.S. Govt. Autonomous P.G. College, Sidhi (M.P.), A.P.S. University, Rewa, India.

Mohammad Salim,
S.G.S. Govt. Autonomous P.G. College, Sidhi (M.P.), A.P.S. University, Rewa, India.

Jay Singh Patel,
S.G.S. Govt. Autonomous P.G. College, Sidhi (M.P.), A.P.S. University, Rewa, India.

Please see the link here: https://stm.bookpi.org/RTSBR-V1/article/view/12451

Some Candles Emit Materials Hazardous for Human Health and are Indoor Air Pollutants | Chapter 12 | Current Innovations in Disease and Health Research Vol. 1

 The purpose concerning this research was to carefully study the somewhat chemicals presented by burning paraffin-based candles and equate the results by burning candles made from another beginning specifically from soybean. This research work is completed activity in order to prove that blazing paraffin candles in enclosed environment hopeful enormously hazardous, then it would be certainly necessary to avoid it. Various projectiles for weaponry produced by blazing candles under normal condition were identified utilizing a Perkin-Elmer TurboMass GC/MS system equipped accompanying a NIST Library of compounds; also Shimadzu GC-2010 smoke chromatograph and QP-2010s quadruple mass spectrometer. The chromatograms of diffusion products of miscellaneous candles were tested for hazardous diffusions. Variety of hazardous materials were presented from burning paraffin candles with those were benzene and toluene all of which are quite hazardous for human health. The EPA has classified benzene as popular human carcinogen for all routes of uncovering. The principal effect of toluene exposure is central central nervous system depression. Petroleum-based candles caused various alkanes, alkenes, alcohols, benzene, toluene, naphthalene, and additional chemicals, while soybean-based candles were apparently clean that produced no observable peaks. Apparently, blazing petroleum located candled produce unwanted matters some of which are contaminants and would be dangerous to inhale for a longer range.

Author(s) Details:

Ruhullah Massoudi,
Department of Biological and Physical Sciences, South Carolina State University, South Carolina, United States.

Amid Hamidi,
Department of Biological and Physical Sciences, South Carolina State University, South Carolina, United States.

Please see the link here: https://stm.bookpi.org/CIDHR-V1/article/view/11187

Determining the Activity of Periostin and Interleukin-13 among Asthmatics in Compared to Healthy People in Southern India | Chapter 8 | Novel Aspects on Pharmaceutical Research Vol. 4

 This affiliate assess to acquire the reference advantage of serum Periostin and IL-13 levels in healthy cold Indian adult population and to equate the reference range of Periostin and IL-13 accompanying that of the asthmatics on inhalational corticosteroids. Asthma is described as a never-ending inflammatory condition moving the airways consisting of a cellular component developing in airway swelling, and smooth muscle energetic-responsiveness in reaction to direct or indirect provocation leading to bronchoconstriction. Indirect provocation, such as that of exercise, result in the release of instigative mediators from cells present in the ventilating pipe contributing to light wind obstruction. This potential cohort study was administered among individuals old 25 to 65 years. The sample proportion was calculated seeing alpha – 5%; capacity – 80%; Since it was a follow up study, the regret rate was kept at 20%. Based on this, 50 healthy things and 50 asthmatics were enrolled in this place study, The study subjects were classification into two groups, viz asthmatics and active controls by subjecting ruling class to pulmonary function test and by following the GINA guidelines. . The middle (IQR) baseline level of Serum Periostin among control group and in asthmatics was 13.2 (8.8-28.1) ng/ml and 16.7 (10.9-20.7) individually. Also, the median (IQR) standard level of Serum IL-13 among active individuals and with asthmatics was 42.9 (37.8-52.4) pg/ml and 73.5 (60.0-91.1) pg/ml respectively, that was statistically significant. There was significant dissimilarity between the antitoxin IL-13 levels between two together the groups. Various studies that have been tried to find the link between the IL-13 and asthma have allowed conflicting results. Few studies have shown IL-13 as a fragment that is being the reason for the raised IgE levels and hyperreactivity inasmuch as few studies have shown IL-13 to have either a guarding role or no union in the pathogenesis of asthma. The obtained criterion values of Serum IL-13 and Periostin could be of dispassionate utility in asthmatics. The genuineness of the data acquired from this study can be proven out on larger study societies. The study can be conducted considerably and values, so obtained maybe clinically utilized in point in a direction refractory asthma and accordingly change the management strategy.

Author(s) Details:

G. R. Sathya,
Department of Physiology, Pondicherry Institute of Medical Sciences, Ganapathichetikulam, Puducherry -605014, India.

Priscilla Johnson,
Sri Ramachandra Medical College & Research Institute, SRIHER, Porur, Chennai - 600116, India.

Subhasis Das,
Department of Physiology, Pondicherry Institute of Medical Sciences, Ganapathichetikulam, Puducherry -605014, India.

B. Rajagopalan,
Sri Ramachandra Medical College & Research Institute, SRIHER, Porur, Chennai - 600116, India.

D. Rekha,
Department of Physiology, Pondicherry Institute of Medical Sciences, Ganapathichetikulam, Puducherry -605014, India.

Lavanya Sekhar,
Sri Ramachandra Medical College & Research Institute, SRIHER, Porur, Chennai - 600116, India.

M. Manikandan,
Department of Community Medicine, Pondicherry Institute of Medical Sciences, Ganapathichetikulam, Puducherry -605014, India.

Please see the link here: https://stm.bookpi.org/NAPR-V4/article/view/11006

Children with Asthmatic Exacerbation Influences of Different Phenotypes| Chapter 1 | Perspective of Recent Advances in Medical Research Vol. 5

 Asthma exacerbations are outlined as an acute or subacute worsening of syndromes and lung function concerning the usual conditions of the patient. Asthma is a assorted disease and various phenotypes have been identified.Objective: To see the epidemiological and clinical profile of pediatric inmates hospitalized for unable to respire normally exacerbations in a highly complex metropolitan emergency room.Methods: A retrospective explanatory study that included all children old between 4 to 14 age with a diagnosis of intensification or asthmatic crisis sick in one period period was performed. The dispassionate records were reviewed, and mathematical and clinical history particularly directed to identified various phenotypes and comorbidities were analyzed.Results: Fifty unable to respire normally children met the addition criteria. Prior to treatment, 66% had moderate asthma, and 10% had severe asthma. Persistent rhinitis was found in 66%, and 40% had a annals of at least one former hospitalization for asthma attacks, place 20% had been hospitalized accordingly in the last year and 18% had not completely one previous regimen in the ICU or CPU. Only 70% of the patients had a earlier established diagnosis of asthma and 28% had able compliance with two together treatment and attendance at healing controls. On admission, 20% were obese. In 54% of the cases, individual or both persons reported smoking all along the research period. Symptoms duration superior to admission was inferior 24 hours in 40% of the patients, and 34% could be delineated with doubtful asthma. Twenty two percent of the patients were conceded to the ICU or CPU, of which 45% started their symptoms in less than 24 hours and 36% more can be defined as bearing unstable asthma.Conclusions: We raise a group of patients who, in spite of not presenting syndromes and apparent clinical signs of harsh asthma, some of them accompanying a history of premature hospitalizations, suddenly presented an unable to respire normally exacerbation that progressed in a few hours with respiring failure and requiredadmission to hospital ICU or CPU. Further description is necessary for the instruction, management, and personalized situation of this group cause they resemble a different phenotype earlier described as type II labile asthma in men.

Author(s) Details:

Isabel Gárate,

Children´s Hospital Dr. Exequiel González Cortés, Santiago de Chile, Chile.

Guido Girardi,

Department of Pediatrics, School of Medicine University of Chile, Santiago de Chile, Chile.

María Angélica Pérez,

Department of Pediatrics, School of Medicine University of Chile, Santiago de Chile, Chile.

Arnoldo Quezada,

Department of Pediatrics, School of Medicine University of Chile, Santiago de Chile, Chile.

Please see the link here: https://stm.bookpi.org/PRAMR-V5/article/view/9137

Asthma exacerbations are outlined as an acute or subacute worsening of syndromes and lung function concerning the usual conditions of the patient. Asthma is a assorted disease and various phenotypes have been identified.Objective: To see the epidemiological and clinical profile of pediatric inmates hospitalized for unable to respire normally exacerbations in a highly complex metropolitan emergency room.Methods: A retrospective explanatory study that included all children old between 4 to 14 age with a diagnosis of intensification or asthmatic crisis sick in one period period was performed. The dispassionate records were reviewed, and mathematical and clinical history particularly directed to identified various phenotypes and comorbidities were analyzed.Results: Fifty unable to respire normally children met the addition criteria. Prior to treatment, 66% had moderate asthma, and 10% had severe asthma. Persistent rhinitis was found in 66%, and 40% had a annals of at least one former hospitalization for asthma attacks, place 20% had been hospitalized accordingly in the last year and 18% had not completely one previous regimen in the ICU or CPU. Only 70% of the patients had a earlier established diagnosis of asthma and 28% had able compliance with two together treatment and attendance at healing controls. On admission, 20% were obese. In 54% of the cases, individual or both persons reported smoking all along the research period. Symptoms duration superior to admission was inferior 24 hours in 40% of the patients, and 34% could be delineated with doubtful asthma. Twenty two percent of the patients were conceded to the ICU or CPU, of which 45% started their symptoms in less than 24 hours and 36% more can be defined as bearing unstable asthma.Conclusions: We raise a group of patients who, in spite of not presenting syndromes and apparent clinical signs of harsh asthma, some of them accompanying a history of premature hospitalizations, suddenly presented an unable to respire normally exacerbation that progressed in a few hours with respiring failure and requiredadmission to hospital ICU or CPU. Further description is necessary for the instruction, management, and personalized situation of this group cause they resemble a different phenotype earlier described as type II labile asthma in men.

Asthma exacerbations are outlined as an acute or subacute worsening of syndromes and lung function concerning the usual conditions of the patient. Asthma is a assorted disease and various phenotypes have been identified.Objective: To see the epidemiological and clinical profile of pediatric inmates hospitalized for unable to respire normally exacerbations in a highly complex metropolitan emergency room.Methods: A retrospective explanatory study that included all children old between 4 to 14 age with a diagnosis of intensification or asthmatic crisis sick in one period period was performed. The dispassionate records were reviewed, and mathematical and clinical history particularly directed to identified various phenotypes and comorbidities were analyzed.Results: Fifty unable to respire normally children met the addition criteria. Prior to treatment, 66% had moderate asthma, and 10% had severe asthma. Persistent rhinitis was found in 66%, and 40% had a annals of at least one former hospitalization for asthma attacks, place 20% had been hospitalized accordingly in the last year and 18% had not completely one previous regimen in the ICU or CPU. Only 70% of the patients had a earlier established diagnosis of asthma and 28% had able compliance with two together treatment and attendance at healing controls. On admission, 20% were obese. In 54% of the cases, individual or both persons reported smoking all along the research period. Symptoms duration superior to admission was inferior 24 hours in 40% of the patients, and 34% could be delineated with doubtful asthma. Twenty two percent of the patients were conceded to the ICU or CPU, of which 45% started their symptoms in less than 24 hours and 36% more can be defined as bearing unstable asthma.Conclusions: We raise a group of patients who, in spite of not presenting syndromes and apparent clinical signs of harsh asthma, some of them accompanying a history of premature hospitalizations, suddenly presented an unable to respire normally exacerbation that progressed in a few hours with respiring failure and requiredadmission to hospital ICU or CPU. Further description is necessary for the instruction, management, and personalized situation of this group cause they resemble a different phenotype earlier described as type II labile asthma in men.

Author(s) Details:

Isabel Gárate,
Children´s Hospital Dr. Exequiel González Cortés, Santiago de Chile, Chile.

Guido Girardi,
Department of Pediatrics, School of Medicine University of Chile, Santiago de Chile, Chile.

María Angélica Pérez,
Department of Pediatrics, School of Medicine University of Chile, Santiago de Chile, Chile.
Arnoldo Quezada,
Department of Pediatrics, School of Medicine University of Chile, Santiago de Chile, Chile.

Please see the link here: https://stm.bookpi.org/PRAMR-V5/article/view/9137

Current Advances in Geography, Environment and Earth Sciences Vol. 8| Chapter 6 | Current Advances in Geography, Environment and Earth Sciences Vol. 8

 Indoor air characteristic is an essential component of sustainable housing. To build sustainable backgrounds, health dangers to a degree mould and other allergens, explosion pollutants, volatile basic compounds, radon, lead, and asbestos must be prevented. Ways of doing so include the use of water-governed building foundations, ground drainage, able ventilation, informed collection of equipment for space adapting and water heating, material selections, and sub-slab the act of providing or changing the air. Lead and asbestos are issues in the rehabilitation of earlier homes, and they are dealt with utilizing well-established best practises. The aim of this study is to examine indoor environmental poisons, their effects on human fitness, and ways to avoid and weaken exposure. Materials used for this purpose contain books, journal publications, and WWW resources.  The occupancy of asthma triggers in houses has enhance a more important indoor material concern, which will be debated in greater detail.

Author(s) Details:

Joseph Laquatra,
Department of Human Centered Design, Cornell University, USA.

Please see the link here: https://stm.bookpi.org/CAGEES-V8/article/view/8686

Nanomedicine Delivery System: A Recent Promise for Better Control of Asthma| Chapter 4 | Current Practice in Medical Science Vol.10

 The asthma is the most widely recognized ongoing incendiary sickness triggers from smoking, dust vermin, poisons, bothers, pet dander, dust, food-borne allergens, molds, exercise and others. This respiratory problem is overall ineffectively controlled utilizing allergen-explicit immunotherapy, chemotherapeutic specialists and glucocorticoids which generally show serious secondary effects in the patient's body. Non-clinical medicines being utilized as correlative medicines incorporate needle therapy, breathing activities and others in the administration of asthma. This correspondence momentarily refreshes on the reforming modest nanotechnology that guarantees a beam of trust with extraordinary potential and possibility in treating and controlling asthma.

Author(s) Details:

Shanthala P.
Department of Food Technology, Kuvempu University, India.

Please see the link here: https://stm.bookpi.org/CPMS-V10/article/view/8064

Determinants of Low Quality of Life in Asthmatic Adult Patients in South Jordan | Chapter 15 | Current Practice in Medical Science Vol. 2

The major goal of the current study was to determine the factors that contribute to low overall QoL and its four components—symptoms, daily activity restrictions, emotional difficulties, and environmental stimuli exposure—in clinically confirmed asthmatics. Asthma is a chronic condition that can cause physical, emotional, and social problems for sufferers, which has a significant influence on their quality of life. Therefore, it is crucial to evaluate the quality of life (QoL) of asthmatic patients in order to support them in maintaining illness management. 93 adult asthma patients, both atopic and non-atopic, between the ages of 14 and 71 who had received treatment for their ailment participated in a cross-sectional survey that was used to gather the data for the current study. The Juniper Mini-AQLQ (1999) was used to evaluate asthma-related quality of life, while the Asthma Control Questionnaire (ACQ) was used to measure asthma control. The differences between mean values were evaluated using either the student's t-test or the ANOVA test. To determine the relationship between asthma management and quality of life, parametric Pearson correlations were used. The pollens may intensify and last for a long time, but home dust mite allergens only linger in the air in low levels when turbulence is formed, lowering the total quantity of allergen inhaled. These findings may be connected to varying allergen levels and duration in the environment.

Author(s) Details:

Eman Albataineh,

Department of Microbiology and Immunology, Faculty of Medicine, Mutah University, Al-Karak, Jordan.

Enas Al-Zayadneh,

Department of Pediatrics, School of Medicine, University of Jordan, Jordan.

Mohammad Ahmad Abu-Lubad,

Department of Medical Microbiology and Immunology, Mutah University, Faculty of Medicine, Karak, Jordan.

Areej Altarawneh,

Albasheer Hospital, Amman, Jordan.

Ibrahim Aldmour,

Al-Karak Governmental Hospital, Al-Karak, Jordan.

Please see the link here: https://stm.bookpi.org/CPMS-V2/article/view/7354

Essential Pediatric Immunopathology | Chapter 02 | New Horizons in Medicine and Medical Research Vol. 2

 The immune system is responsible for defence, vigilance, and homeostasis. Immunodeficiency, allergy, and autoimmune illnesses are caused by pathological changes in the immune system. Immunodeficiencies occur when the immune system is unable to generate a sufficient response to hostility from the outside environment. Allergies occur when the immune system encounters and perceives an environmental factor as an aggressor, resulting in an excessive response. An aggressive response to the body's own structures is developed in autoimmune disorders. Multiple origins and effector pathways are implicated in these various pathogenic immune response changes. The information in this text is intended for non-specialist physicians. The goal of this chapter is to provide a brief overview of the clinical characteristics, diagnosis, and treatment of the most common immunopathological illnesses in children and adolescents.

Author(S) Details

Arnoldo Quezada
Department of Pediatrics, School of Medicine University of Chile, Santiago, Chile.

David Martinez
Department of Pediatrics, School of Medicine University of Chile, Santiago, Chile.

Luis Lira
Police Hospital (Hoscar), Santiago, Chile.

View Book:- https://stm.bookpi.org/NHMMR-V2/article/view/6122

The Effect of Pregnancy on the Treatment of Asthma Patients with COVID-19 | Chapter 8 | Issues and Developments in Medicine and Medical Research Vol.10

 COVID-19 is a virus that affects the respiratory system, throat, nose, and lungs, causing serious lung illness and death. Infections can aggravate the symptoms of asthmatic sufferers. The severity and prognosis of asthma in pregnant women with underlying illnesses like diabetes are likely to be devastating.

Presentation of a Case: We discuss the case of a COVID-19-infected asthmatic pregnant woman who was admitted to two Iranian hospitals. The patient's symptoms included dry coughs, dyspnea, inability to talk, numbness, and weariness. The initial examination revealed a body temperature of 37.9°C, oxygen saturation (SPO2) of 91%, partial pressure of oxygen (Pao2) of 25mm Hg, respiratory rate (RR) of 20 breaths/minute(b/m), blood pressure of 100/60 mmHg, pulse of 80 beats per minute (bpm), and foetal heart rate (FHR) of 167 beats per minute. The pregnancy was ended by caesarean section (C/S) due to foetal tachycardia, and a healthy infant with normal anthropometric parameters was born. Leukopenia, as well as elevated levels of C-reactive protein and erythrocyte sedimentation rate, were present in our patient. After 8 days, our patient was discharged in good general condition after receiving supportive treatment as well as antibiotic and antiviral therapy.
Conclusions: Despite having underlying disease and infection with COVID-19, the patient's health improved after 8 days in the hospital and had a favourable clinical outcome.

Author(s) Details:

Alireza Jashni Motlagh,
Department of Pediatrics, School of Medicine, Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran.

Sara Esmaelzadeh,
Department of Midwifery, School of Medicine, Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran.

Ozra Parhizkar,
Midwifery Ward, Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran.

Leili Salehi,
Department of Health Promotion and Education, School of Health, Research Center for Environmental Determinants of Health, Alborz University of Medical Sciences, Karaj, Iran.

Please see the link here: https://stm.bookpi.org/IDMMR-V10/article/view/5821

Study on the Evolving Nature of Asthma and Contemporary Management of Respiratory Disorder | Chapter 5 | Highlights on Medicine and Medical Science Vol. 15

 Asthma is a complex and heterogeneous illness that typically develops in childhood and is characterised by coughing, wheezing, and rapid airway response to a variety of environmental stimuli. Bronchial allergies encompass a wide range of manifestations and endotypes.

Asthma immunopathogenesis involves a large number of immune cells, as well as the airway epithelium and both innate and adaptive immunological components. In order to cure asthma, you must first understand its immunology.

Asthma is becoming a major global public health issue. The annual prevalence of severe asthma attacks in adults is estimated to range from 1% to 21%, with over 20% in children aged 6–7 years.

Asthma prevalence varies greatly across the globe, ranging from 0.2 percent to 21.0 percent in adults and from 2.8 percent to 37.6 percent in children aged 6 to 7. New asthma phenotyping and endotyping, as well as better patient classification utilising machine learning and big data, have significantly improved asthma treatment outcomes in both children and adults.

In severe asthma, several research groups have produced cluster analyses of phenotypes and endotypes. These clusters indicate the importance of disease heterogeneity in asthma and point to differences in pathophysiologic mechanisms that distinguish these groups.

Serum immunoglobulin, fractional excretion of nitric oxide, and blood eosinophils are some of the biomarkers for asthma. For the treatment of severe asthma, the Food and Drug Administration has approved five biologicals.

Author (s) Details

Andrew Kiboneka
Department of Paediatrics, Case Hospital, Uganda.

View Book :- https://stm.bookpi.org/HMMS-V15/article/view/2466

Study and Monitoring the Prevalence of Asthma among School Children in Gaborone, Botswana | Chapter 8 | Challenges in Disease and Health Research Vol. 6

 Background: Asthma prevalence is high (> 10%) in developed countries, and while data for most of Africa is still lacking, rates in developing countries are rising as they become more westernized. Asthma is the world's 14th most important chronic disease in terms of prevalence, extent, and duration of disability, affecting 334 million people of all ages. The prevalence in Africa has been reported to range from 18% in Kenya to 20% in South Africa. In Gaborone, Botswana, we investigated the prevalence of asthma in schoolchildren. Methods: This was a cross-sectional descriptive study. The ISAAC method was used. A proportionate size random sample of two age groups of children (13-14 year olds and 6-7 year olds) was systematically enrolled in ten schools. The schools were chosen using a table of random numbers. A sample size of 924 people (462 from each group) was sufficient to achieve a precision of 3% around our estimated prevalence of asthma of 10% with 95% confidence, assuming a 20% non-response rate. The International Study of Childhood Asthma and Allergies (ISAAC) A questionnaire was used to collect data. Asthma was defined by the ISAAC criteria as wheezing in the previous 12 months. The data was entered into Microsoft Excel and then analyzed with SPSS version 23. Results: Asthma (wheezing in the previous 12 months) was present in 16.5 percent (194/1175) of the participants. Asthma (wheezing in the previous 12 months) was found in 15.9 percent of 6-7 year olds and 16.8 percent of 13-14 year olds. The prevalence of school type was 22.3 percent in private schools and 14.5 percent in public schools. Asthma severity was associated with older children, 13-14 years old. When compared to the younger children 6-7 years, the older children reported more limited speech due to wheezing (OR=2.0, 95 percent CI =1.034, 3.9, pvalue=0.043), ever had asthma (OR=1.5, 95 percent CI=1.031, 2.3, p-value=0.034), and wheezing during exercise (OR=3.4, 95 percent CI=2.5, 4.9, p-value=0.001). Students in private schools had more wheezing symptoms. They were more likely to have ever wheezed (OR=2.2, 95 percent CI=1.7,2.9, p-value 0.0001), wheezed in the previous twelve months (have asthma) (OR=1.7, 95 percent CI=1.2,2.4, p-value = 0.001), ever had asthma (OR=2.4, 95 percent CI=1.7,3.5, p-value 0.0001), and wheezed during exercise (OR=1.8, 95 percent CI=1.4,

Conclusion: Asthma is very common among Gaborone, Botswana, schoolchildren, with older children experiencing more severe asthma symptoms. Private schools had a higher prevalence of asthma than public schools. More research is needed in Botswana to investigate the prevalence of asthma in rural and urban areas.

Author(s) Details

Andrew Kiboneka
Department of Paediatrics & Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana.

Michael Levin
Allergy Division, Department of Paediatrics & Child Health, University of Cape Town and Red Cross Memorial Children’s Hospital, South Africa.

Thembisile Mo salakatane
Department of Paediatrics & Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana.

Ishmael Makone
Department of Paediatrics & Adolescent Health, Princess Marina Hospital, Gaborone, Botswana.

Eric Wobudeya
Directorate of Paediatrics & Child Health, Mulago National Referral Hospital, Kampala, Uganda.

Boikanyo Makubate
Department of Mathematics & Computational Sciences, Botswana International University of Science & Technology Palapye, Botswana.

Russell Hopp
Division of Allergy/Immunology, Creighton University Medical Centre, Omaha, Nebraska, USA.

Loeto Mazhani
Department of Paediatrics & Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana.

Shiang-Ju Kung
Division of Allergy & Immunology, Children’s Hospital of Philadelphia, Pennsylvania, USA.

View Book :- https://stm.bookpi.org/CDHR-V6/article/view/1668

Monitoring the Risk Factors Associated with Asthma among Saudi Adults in Najran | Chapter 11 | Challenges in Disease and Health Research Vol. 5

Context: Asthma is a respiratory condition that affects individuals of all ages. Over the last few decades, its prevalence in Saudi Arabia has increased. The goal of this study was to explore common asthma-related risk factors among Saudi adults in Najran between December 2016 and October 2017. In addition to another 184 healthy people as a control group, the research population was one hundred and eighty four patients who were over 18 years of age and who were diagnosed with definite asthma (cases), which balanced the cases in terms of age and sex. A questionnaire was completed by instances as well as by controls as a data collection tool. It consisted of data that included environmental factors that could be possible risk factors for asthma, including personal, family and indoor factors. The mean case and control ages were respectively 21.3 (± 16.5) and 21.7 (± 16.8) years, respectively. There were 108 (58.7 percent) males in each group, alongside 76 (43.3 percent) females. There was no substantial correlation between the incidence of asthma and the degree of education and the P-value >0.05 of indoor plants. On the other hand, multivariate logistic regression analysis found that family history (OR=5.01 and CI=2.09-8.42), using sprays of insecticides or air fresheners (OR=8.5, CI=2.34-11.09), as well as rhinitis (OR=4.76, CI=2.19-6.45) were substantially correlated with asthma incidence. Additionally, active or passive smoking was significantly correlated with asthma among adults in Najran (P-value = 0.041 and 0.012). Based on the findings obtained, it was concluded that there are various trends of risk factors for asthma, those factors seem to play a significant role and are likely to contribute to the severity of this burden. It has been concluded that the most risk factors for developing asthma among Saudi adults are family background, smoking, allergic rhinitis and smoking. Further studies have been recommended for the investigation of other causes. In addition, health education services are widely recommended for educating people about risk factors, preventive measures, early detection and careful management.

Author(s) Details

N. K. Elfaki
Department of Community Health Nursing, Nursing College, Najran University, Saudi Arabia.

A. Y. Shiby
Department. of Medical-Surgical Nursing, Nursing College, Najran University, Saudi Arabia.

View Book:- https://stm.bookpi.org/CDHR-V5/issue/view/7

Scientific Elaboration of Evidence-based Focused Approach for Fulfillment of Aims: Experiences of an Asthma Clinic | Chapter 12 | Challenges in Disease and Health Research Vol. 2

 

In this chapter the effectiveness of asthma clinic providing comprehensive care based has been
evaluated on the best available scientific evidence. This study was conducted in a tertiary care
hospital having a devoted asthma clinic for the comprehensive management and data of cases
managed from July 2014 to June 2016. Outcome measures were treatment direction, asthma control,
emergency visits, and hospitalizations. 260 children were treated over a 2-year period. The effects of
focused approach with progressive expertise lead to statistically significant benefits over the two
successive years from July 2014 to June 2015 and July 2015 to June 2016. These were in: (i)
Treatment direction: Cases requiring stepping up of treatment decreased from 36.49% to 17.24%
(relative risk [RR]: 0.473 [95% confidence interval {CI}: 0.249-0.895]); p=0.01229, (ii) asthma control:
Cases with not well-controlled asthma decreased from 16.44% to 7.02% (RR 0.427: [95% CI: 0.199-
0.914]); p=0.045, (iii) emergency department visits decreased from 35.62% to 21.05% (RR 0.591:
[95% CI: 0.39-0.897]), p=0.00766, (iv) hospitalizations decreased from 16.44% to 5.26% (RR 0.32:
[95% CI: 0.135-0.757]), p=0.00462. Establishing an asthma clinic and progressive expertise leads to
significant beneficial results.

Author (s) Details

Dr. Col Sunil Jain
Department of Pediatrics, Command Hospital (CC), Lucknow, Uttar Pradesh, India.

Dr. Col Rajeev Kumar Thapar
Department of Pediatrics, Command Hospital (CC), Lucknow, Uttar Pradesh, India.

Maj Abhishek Mallick
Department of Pediatrics, Command Hospital (CC), Lucknow, Uttar Pradesh, India.

Sudhanshu Tiwari
Department of Pediatrics, Command Hospital (CC), Lucknow, Uttar Pradesh, India.

Dakhane Yogesh
Department of Pediatrics, Command Hospital (CC), Lucknow, Uttar Pradesh, India.

Y. V. Abhijith
Department of Pediatrics, Command Hospital (CC), Lucknow, Uttar Pradesh, India.

View Book :- http://bp.bookpi.org/index.php/bpi/catalog/book/260