Chronic obstructive pulmonary disease (COPD) : refers to a group of lung diseases that block airflow and make breathing difficult. Emphysema and chronic bronchitis are the two most common conditions that make up COPD. Chronic bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. Emphysema occurs when the air sacs (alveoli) at the end of the smallest air passages (bronchioles) in the lungs are gradually destroyed. TREATMENT • Bronchodilators. These medications — which usually come in an inhaler — relax the muscles around your airways. This can help relieve coughing and shortness of breath and make breathing easier. Depending on the severity of your disease, you may need a short-acting bronchodilator before activities, a long-acting bronchodilator that you use every day, or both. Short-acting bronchodilators include albuterol (ProAir HFA, Ventolin HFA, others), levalbuterol (Xopenex), and ipratropium (Atrovent). The long-acting bronchodilators include tiotropium (Spiriva), salmeterol (Serevent), formoterol (Foradil, Perforomist), arformoterol (Brovana), indacaterol (Arcapta) and aclidinium (Tudorza). • Inhaled steroids. Inhaled corticosteroid medications can reduce airway inflammation and help prevent exacerbations. Side effects may include bruising, oral infections and hoarseness. These medications are useful for people with frequent exacerbations of COPD. Fluticasone (Flovent) and budesonide (Pulmicort) are examples of inhaled steroids. • Combination inhalers. Some medications combine bronchodilators and inhaled steroids. Salmeterol and fluticasone (Advair) and formoterol and budesonide (Symbicort) are examples of combination inhalers. • Oral steroids. For people who have a moderate or severe acute exacerbation, oral steroids prevent further worsening of COPD. However, these medications can have serious side effects, such as weight gain, diabetes, osteoporosis, cataracts and an increased risk of infection. • Phosphodiesterase-4 inhibitors. A new type of medication approved for people with severe COPD is roflumilast (Daliresp), a phosphodiesterase-4 inhibitor. This drug decreases airway inflammation and relaxes the airways. Common side effects include diarrhea and weight loss. • Theophylline. This very inexpensive medication helps improve breathing and prevents exacerbations. Side effects may include nausea, fast heartbeat and tremor. • Antibiotics. Respiratory infections, such as acute bronchitis, pneumonia and influenza, can aggravate COPD symptoms. Antibiotics help fight acute exacerbations. The antibiotic azithromycin prevents exacerbations, but it isn't clear whether this is due to its antibiotic effect or its anti-inflammatory properties.


Anxiety Disorder : DEFINITION Anxiety can be described as an uncomfortable feeling of vague fear or apprehension accompanied by characteristic physical sensations. It is a normal and often beneficial response to situations that humans perceive as threatening, frightful, or otherwise disturbing. PATHOPHYSIOLOGY A neurocircuit arising from the output pathways of the central nucleus of the amygdala is thought to mediate fear and anxiety responses in humans.Dysregulated or exaggerated output through various amygdala-related circuits may be a common element underlying the different anxiety disorders, but the specific type of dysfunction probably differs among the various disorders. Several neurotransmitter systems have been linked to the neurobiology of anxiety: the inhibitory amino acid, ?-aminobutyric acid (GABA); the monoamine neurotransmitters, serotonin and norepinephrine; the excitatory amino acid, glutamate; and the neuropeptides, cholecystokinin (CCK), corticotrophin-releasing factor (CRF), neuropeptide Y (NPY), and substance P.2,3 Much of the evidence for these biologic processes has come from research on drugs that are used either to treat anxiety or to induce anxiety. Discovery of the anxiolytic effects of benzodiazepines in the early 1960s marked the beginning of this era of research. However, the anxiety-reducing properties of alcohol and barbiturates were recognized long before that time.


Urticaria : Urticaria commonly referred to as hives, is a kind of skin rash notable for pale red, raised, itchy bumps. Hives might also cause a burning or stinging sensation. Hives are frequently caused byallergic reactions; however, there are many nonallergic causes. Most cases of hives lasting less than six weeks (acute urticaria) are the result of an allergic trigger. Chronic urticaria (hives lasting longer than six weeks) is rarely due to an allergy. Wheals (raised areas surrounded by a red base) from urticaria can appear anywhere on the surface of the skin. Whether the trigger is allergic or not, a complex release of inflammatory mediators, including histamine from cutaneous mast cells, results in fluid leakage from superficial blood vessels. Wheals may be pinpoint in size, or several inches in diameter. Angioedema is a related condition (also from allergic and nonallergic causes), though fluid leakage is from much deeper blood vessels in the subcutaneous or submucosal layers. Individual hives that are painful, last more than 24 hours, or leave a bruise as they heal are more likely to be a more serious condition calledurticarial vasculitis. Hives caused by stroking the skin (often linear in appearance) are due to a benign condition called dermatographic urticaria. Treatment Antihistamine diphenhydramine, Tricyclic antidepressants, hydrocortisone, fluocinonide, prednisone,


Pruritus : Pruritus or itch is defined as an unpleasant sensation of the skin that provokes the urge to scratch. Certain systemic diseases have long been known to cause pruritus that ranges in intensity from a mild annoyance to an intractable, disabling condition. Generalized pruritus may be classified into the following categories on the basis of the underlying causative disease: renal pruritus, cholestatic pruritus, hematologic pruritus, endocrine pruritus, pruritus related to malignancy, and idiopathic generalized pruritus. Antihistamines such as diphenhydramine,Corticosteroids such as hydrocortisone topical cream, Counterirritants, such as mint oil, menthol, or camphor, Local anesthetics such as benzocaine topical cream are the drug therapy options while Phototherapy is helpful for severe itching, especially if caused by renal failure. The common type of light used is UVB.


Dermatitis or eczema : Dermatitis or eczema is inflammation of the skin. It is characterized by itchy, erythematous, vesicular, weeping, and crusting patches. The term eczema is also commonly used to describe atopic dermatitis or atopic eczema. There is no known cure for eczema; with treatment aiming to control symptoms by reducing inflammation and relieving itching. Lifestyle, Moisturizers also can be used. If symptoms are well controlled with moisturizers, steroids may only be required when flares occur. Topical immunosuppressants like pimecrolimus and tacrolimus may be better in the short term and appear equal to steroids after a year of use.