MyMedR

Fulltext The role of general practitioners in home oxygen therapy

Khoo SB

Malays Fam Physician, 2007;2(2):58-63.

Recommendation of oxygen therapy must include clear indication and benefits of its use, appropriate prescription, vigilant monitoring and appropriate methods of delivery. Home oxygen therapy is expensive, inconvenient and cumbersome; it should be recommended only if benefits outweigh the disadvantages and adverse effects of oxygen. GPs play an important supportive and supervisory role in the use of long-term oxygen therapy (LTOT) to improve mortality of patients with chronic hypoxaemia. Prescription of short burst oxygen therapy (SBOT) for palliation of breathlessness is without clear evidence of its efficacy. GPs can prescribe SBOT when other secondary causes of breathlessness are excluded or treated, when breathlessness is not relieved by other treatments and if an improvement can be documented in patients.

Matched MeSH terms: Oxygen Inhalation Therapy*

Principles of inhalation therapy for asthma

Leong KC

Family Physician, 1993;5:11-15.

Matched MeSH terms: Inhalation

Inhaled anaesthetic gas for severe bronchospasm at the emergency department

Adi O, Apoo FN, Fong CP, Ahmad AH, Roslan NL, Khan FA, et al.

Am J Emerg Med, 2024 Jan;75:179-180.

PMID: 37487778 DOI: 10.1016/j.ajem.2023.07.027

Matched MeSH terms: Anesthetics, Inhalation*

Change in endotracheal tube cuff pressure during nitrous oxide anaesthesia: a comparison between air and distilled water cuff inflation

Ahmad NL, Norsidah AM

Anaesth Intensive Care, 2001 Oct;29(5):510-4.

PMID: 11669433

In this prospective, randomized controlled trial, changes in endotracheal tube cuff pressure were studied in 60 patients undergoing elective surgery under general anaesthesia with nitrous oxide and oxygen. The cuffs were inflated with either air or distilled water. The mean pressure in the air-filled cuffs increased steadily throughout the procedure, reaching 47.5 +/- 7.3 cmH2O at one hour compared with 31.6 +/- 2.4 cmH2O mean pressure in the water-filled cuffs. The pressure and the rate of rise in cuff pressure were significantly lower (P<0.05) in the water-filled cuffs throughout the hour of study. When an endotracheal tube cuff is distended with water, the rise in cuff pressure during nitrous oxide anaesthesia is lower than that of an air-filled cuff.

Matched MeSH terms: Anesthesia, Inhalation*; Anesthetics, Inhalation*

Fulltext Brain laryngeal mask--study in 50 spontaneously breathing patients

Reddy SV, Win N

Singapore Med J, 1990 Aug;31(4):338-40.

PMID: 2255930

Brain laryngeal mask (BLM) was used to assess its suitability in 50 spontaneously breathing patients by one lecturer and 4 Medical Officers. Insertion of the laryngeal mask was successful at the first attempt in 42 patients, second attempt in 7 and third attempt in one. The incidence of airway obstruction secondary to downfolding of the epiglottis, which was corrected by reinsertion, was 16%. Post-operative complications included clenching of teeth in 5 patients, vomiting in 2 and excessive salivation in 3. The incidence of sore throat was 10%.

Matched MeSH terms: Anesthesia, Inhalation/instrumentation*; Anesthesia, Inhalation/methods

Fulltext Home oxygen therapy

Lim KG

Med J Malaysia, 2001 Jun;56(2):141-2.

PMID: 11771072

Matched MeSH terms: Oxygen Inhalation Therapy*

The first anaesthetic in the straits settlements (Singapore, Penang and Malacca)--1847

Lee YK

Br J Anaesth, 1972 Apr;44(4):408-11.

PMID: 4555711

Matched MeSH terms: Anesthesia, Inhalation/history*

Fulltext A Review of Polychlorinated Biphenyls (PCBs) Pollution in the Air: Where and How Much Are We Exposed to?

Othman N, Ismail Z, Selamat MI, Sheikh Abdul Kadir SH, Shibraumalisi NA

Int J Environ Res Public Health, 2022 Oct 26;19(21).

PMID: 36360801 DOI: 10.3390/ijerph192113923

Polychlorinated biphenyls (PCBs) were widely used in industrial and commercial applications, until they were banned in the late 1970s as a result of their significant environmental pollution. PCBs in the environment gained scientific interest because of their persistence and the potential threats they pose to humans. Traditionally, human exposure to PCBs was linked to dietary ingestion. Inhalational exposure to these contaminants is often overlooked. This review discusses the occurrence and distribution of PCBs in environmental matrices and their associated health impacts. Severe PCB contamination levels have been reported in e-waste recycling areas. The occurrence of high PCB levels, notably in urban and industrial areas, might result from extensive PCB use and intensive human activity. Furthermore, PCB contamination in the indoor environment is ten-fold higher than outdoors, which may present expose risk for humans through the inhalation of contaminated air or through the ingestion of dust. In such settings, the inhalation route may contribute significantly to PCB exposure. The data on human health effects due to PCB inhalation are scarce. More epidemiological studies should be performed to investigate the inhalation dose and response mechanism and to evaluate the health risks. Further studies should also evaluate the health impact of prolonged low-concentration PCB exposure.

Matched MeSH terms: Inhalation Exposure/analysis

Fulltext Endoscopic treatment of glottic stenosis secondary to caustic injury with silastic keel placement: a case report

Balachandran R, Rahmat O

Med J Malaysia, 2011 Jun;66(2):152-3.

PMID: 22106701

The use of an endoscopic approach for the division of glottic webs or stenosis has been reported in the literature and has been mainly confined to the anterior commisure. We report a rare case of caustic injury to the upper aerodigestive tract that resulted in extensive web formation along the membranous vocal cord which was successfully treated with endoscopic lysis of the adhesions and the use of a silastic sheet keel as a stent.

Matched MeSH terms: Burns, Inhalation/complications*; Burns, Inhalation/pathology; Burns, Inhalation/therapy

Sevoflurane induction in acute airway obstruction

Chiu CL, Delilkan AE

Hosp Med, 1998 Oct;59(10):828.

PMID: 9850310

Matched MeSH terms: Anesthesia, Inhalation*; Anesthetics, Inhalation*

Safety and health risk assessment methodology of dermal and inhalation exposure to formulated products ingredients

Raslan R, Hassim MH, Chemmangattuvalappil NG, Ng DKS, Ten JY

Regul Toxicol Pharmacol, 2020 Oct;116:104753.

PMID: 32745583 DOI: 10.1016/j.yrtph.2020.104753

Consumers are commonly exposed to numerous chemical ingredients found in various formulated products especially household and personal care products. Therefore, identification of hazardous ingredients contained in those products should be performed at the early stages of product design to reduce the high cost of redesigning the products at the final stage. Thus, a systematic safety and health risk assessment methodology is required for the product formulation design. In this work, a two-step index-based methodology is presented to estimate the severity of the hazards and the magnitude of risks. In Tier 1 assessment, potential hazards of the ingredients were identified by following the Product Ingredient Safety Index (PISI). The basic toxicology information of ingredients was required for this assessment. In Tier 2 assessment, the extent of risks of the ingredients via dermal and inhalation exposure routes were evaluated. At this stage, the concentration of ingredients and the amount of exposure were considered. The value of Margin of Exposure (MOE) was used as an indicator in the development of Product Ingredient Exposure Index (PIEI). To demonstrate the proposed methodology, a case study on the evaluation of potential hazards and the risks from ingredients used in personal care product formulations were performed.

Matched MeSH terms: Inhalation Exposure

Fulltext Helium gas inhalation as a suicide technique

Sarjit Singh, Siti Nidzwani Mohamad Mahdi

Malaysian Journal of Medicine and Health Sciences, 2018;14(1):65-67.

MyJurnal

Helium gas inhalation for suicide is a relatively new technique and practically unheard of in Malaysia. The internet has helped spread this technique rapidly across the globe. We report a case of helium gas inhalation as a suicide attempt in Malaysia. Such a case offers a diagnostic challenge upon presentation. Simple techniques of ensuring adequate oxygenation can help in treatment of such cases.

Matched MeSH terms: Administration, Inhalation

Fulltext Hazards of complementary and alternative medicine

Chong VH, Yaakub AB

Singapore Med J, 2007 Jun;48(6):592; author reply 593.

PMID: 17538765

Matched MeSH terms: Oxygen Inhalation Therapy; Smoke Inhalation Injury/etiology*; Smoke Inhalation Injury/therapy

Early Oxygen Therapy may be Beneficial to Patients with COVID-19 and Underlying Pulmonary Diseases

Kow CS, Ramachandram DS, Hasan SS

J Asthma, 2023 Feb;60(2):422-423.

PMID: 35315746 DOI: 10.1080/02770903.2022.2056701

Matched MeSH terms: Oxygen Inhalation Therapy

Fulltext Perceptions, attitudes, and behaviors of asthma patients towards the use of short-acting β2-agonists: A systematic review

Loh ZC, Hussain R, Balan S, Saini B, Muneswarao J, Ong SC, et al.

PLoS One, 2023;18(4):e0283876.

PMID: 37079594 DOI: 10.1371/journal.pone.0283876

BACKGROUND: Short-acting β2-agonists (SABA), the most potent and rapid-acting relievers are commonly used to provide quick relief of asthma symptoms. However, there is an increasing concern regarding the misuse of SABA medicines.

OBJECTIVE: This qualitative systematic review aims to determine, evaluate, and summarize the perceptions, attitudes, and behaviors towards the use of SABA from the patients' perspectives.

METHODS: The databases searched included PubMed, Scopus, PsycINFO, CINAHL, and Cochrane database. Original research articles reporting the perceptions, attitudes, or behaviors of asthma patients towards the use of SABA, which was available as full text, published in the English language between the year 2000 and February 2023 were included in the review. Commentaries, letters to editor, review articles, and conference proceedings were excluded.

RESULTS: A total of five articles were included. Six overarching themes were obtained: (1) perceptions on health status; (2) perceptions and attitudes towards the impact of asthma; (3) perceptions towards asthma control; (4) perceptions towards asthma knowledge; (5) risk perceptions; (6) perceptions, attitudes, and behaviors towards the use of SABA.

CONCLUSION: Despite the fact that SABA could rapidly alleviate asthma symptoms, SABA over-users were less likely to describe their health status and asthma control as 'excellent'. Most SABA over-users did not know that frequent SABA usage would worsen their asthma control, and they exhibited psychological linkage towards the use of SABA. Collaborative efforts between policymakers, healthcare professionals and patients are warranted to reconstruct SABA prescribing practice and usage.

Matched MeSH terms: Administration, Inhalation

Fulltext Home oxygen therapy for children with chronic lung diseases

Norzila MZ, Azizi BHO, Norrashidah AW, Yeoh NM, Deng CT

Med J Malaysia, 2001 Jun;56(2):151-7.

PMID: 11771074

Summary: Home oxygen therapy programme is new in Malaysia. This programme enables children with respiratory insufficiency to be discharged home early.
Materials and Methods: Long term oxygen therapy was initiated using an oxygen concentrator in patients who i) remained hypoxic while breathing room air, ii) experienced desaturations of more than 20% during sleep as seen in patients with severe laryngomalacia and obstructive sleep apnoea syndrome and iii) had pulmonary hypertension with or without polycythemia. The median with first and third quartile values are presented for the quantitative variables.
Results: A total of 71 patients mainly children with bronchopulmonary dysplasia (BPD) (32) and bronchiolitis obliterans (12) were discharged home on this programme. The median age at which home oxygen was initiated in children with BPD was 5.0 (Q1:2 Q3:8) months. The median total duration of oxygen requirement for BPD was 8.0 (Q1:5, Q3:12) months. The median duration of home oxygen dependency was 3.5 (Q1:3, Q3:6) months. However children with bronchiolitis obliterans required longer duration of oxygen therapy compared to children with BPD i.e. median duration of 28 months (Q1:14.5 Q3:66). In other respiratory conditions the mean duration of supplemental oxygen varies some of which may be life long.
Conclusions: This paper has shown the importance of home oxygen program in children with respiratory disorders. It has significantly shortened hospital stay and thus saves hospital costs and prevents prolonged separation from the family.

Matched MeSH terms: Oxygen Inhalation Therapy*

Breakthrough analysis of continuous fixed-bed adsorption of sevoflurane using activated carbons

Ang TN, Young BR, Taylor M, Burrell R, Aroua MK, Baroutian S

Chemosphere, 2020 Jan;239:124839.

PMID: 31726519 DOI: 10.1016/j.chemosphere.2019.124839

The inhalational anaesthetic agent - sevoflurane is widely employed for the induction and maintenance of surgical anaesthesia. Sevoflurane possesses a high global warming potential that imposes negative impact to the environment. The only way to resolve the issue is to remove sevoflurane from the medical waste gas before it reaches the atmosphere. A continuous adsorption study with a fixed-bed column was conducted using two commercial granular activated carbons (E-GAC and H-GAC), to selectively remove sevoflurane. The effect of bed depth (Z, 5-15 cm), gas flow rate (Q, 0.5-6.0 L/min) and inlet sevoflurane concentration (C0, ∼55-700 mg/L) was investigated. E-GAC demonstrated ∼60% higher adsorption capacity than H-GAC under the same operating conditions. Varying the levels of Z, Q and C0 showed significant differences in the adsorption capacities of E-GAC, whereas only changing the C0 level had significant differences for H-GAC. Three breakthrough models (Adams-Bohart, Thomas, and Yoon-Nelson) and Bed-depth/service time (BDST) analysis were applied to predict the breakthrough characteristics of the adsorption tests and determine the characteristic parameters of the column. The Yoon-Nelson and Thomas model-predicted breakthrough curves were in good agreement with the experimental values. In the case of the Adams-Bohart model, a low correlation was observed. The predicted breakthrough time (tb) based on kinetic constant (kBDST) in BDST analysis showed satisfactory agreement with the measured values. The results suggest the possibility of designing, scaling up and optimising an adsorption system for removing sevoflurane with the aid of the models and BDST analysis.

Matched MeSH terms: Anesthetics, Inhalation/analysis*

Second-hand smoke in public spaces: how effective has partial smoke-free legislation been in Malaysia?

Abidin EZ, Hashim Z, Semple S

Asian Pac J Cancer Prev, 2013;14(11):6845-50.

PMID: 24377615

BACKGROUND: This study was performed to gather data on second-hand smoke (SHS) concentrations in a range of public venues following the implementation of partial Smoke-Free Legislation in Malaysia in 2004.

MATERIALS AND METHODS: PM2.5 was measured as a marker of SHS levels in a total of 61 restaurants, entertainment centres, internet cafes and pubs in Kuala Lumpur, Malaysia.

RESULTS: Under the current smoke-free laws smoking was prohibited in 42 of the 61 premises. Active smoking was observed in nearly one-third (n=12) of these. For premises where smoking was prohibited and no active smoking observed, the mean (standard deviation) indoor PM2.5 concentration was 33.4 (23.8) μg/m3 compared to 187.1 (135.1) μg/m3 in premises where smoking was observed The highest mean PM2.5 was observed in pubs [361.5 (199.3) μg/m3].

CONCLUSIONS: This study provides evidence of high levels of SHS across a range of hospitality venues, including about one-third of those where smoking is prohibited, despite 8 years of smoke-free legislation. Compliance with the legislation appeared to be particularly poor in entertainment centres and internet cafes. Workers and non-smoking patrons continue to be exposed to high concentrations of SHS within the hospitality industry in Malaysia and there is an urgent need for increased enforcement of existing legislation and consideration of more comprehensive laws to protect health.

Matched MeSH terms: Inhalation Exposure/analysis*; Inhalation Exposure/legislation & jurisprudence; Inhalation Exposure/prevention & control

Sevoflurane for dental extraction in children with Tetralogy of Fallot

Chiu CL, Wang CY

Paediatr Anaesth, 1999;9(3):268-70.

PMID: 10320610

Two children with Tetralogy of Fallot presented for dental extraction. Anaesthesia was induced rapidly and smoothly by inhalation of sevoflurane. We discussed the advantages of sevoflurane as an induction agent as compared to halothane in these children.

Matched MeSH terms: Anesthesia, Inhalation*; Anesthetics, Inhalation/administration & dosage*

Review of inhalable nanoparticles for the pulmonary delivery of anti-tuberculosis drugs

Ramachandran S, Prakash P, Mohtar N, Kumar KS, Parumasivam T

Pharm Dev Technol, 2023 Dec;28(10):978-991.

PMID: 37937865 DOI: 10.1080/10837450.2023.2279691

Tuberculosis is an airborne disease caused by the pathogen, Mycobacterium tuberculosis, which predominantly affects the lungs. World Health Organization (WHO) has reported that about 85% of TB patients are cured with the existing 6-month antibiotic regimen. However, the lengthy oral administration of high-dose anti-TB drugs is associated with significant side effects and leads to drug resistance cases. Alternatively, reformulating existing anti-tubercular drugs into inhalable nanoparticulate systems is a promising strategy to overcome the challenges associated with oral treatment as they could enhance drug retention in the pulmonary region to achieve an optimal drug concentration in the infected lungs. Hence, this review provides an overview of the literature on inhalable nano-formulations for the delivery of anti-TB drugs, including their formulation techniques and preclinical evaluations between the years 2000 and 2020, gathered from electronic journals via online search engines such as Google Scholar and PubMed. Previous in vitro and in vivo studies highlighted that the nano-size, low toxicity, and high efficacy were among the factors influencing the fate of nanoparticulate system upon deposition in the lungs. Although many preclinical studies have shown that inhalable nanoparticles increased therapeutic efficacy and minimised adverse drug reactions when delivered through the pulmonary route, none of them has progressed into clinical trials to date. This could be attributed to the high cost of inhaled regimes due to the expensive production and characterisation of the nanoparticles as well as the need for an inhalation device as compared to the oral treatment. Another barrier could be the lack of medical acceptance due to insufficient number of trained staff to educate the patients on the correct usage of the inhalation device. Hence, these barriers should be addressed satisfactorily to make the inhaled nanoparticles regimen a reality for the treatment of TB.

Matched MeSH terms: Administration, Inhalation

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