Chronic /Allergic Bronchitis

60 yrs nonsmoker male presented with cough dyspnea fever since last 10 days. cough not responding to treatment. spo2 94% bil wheezing heard. comment on cxray.

*Behroza* - (Qinna, Baarzad, Darakht Sanobar) Botanical Name- _Pinus roxburgii_ Pinus longifolia is an unani plant for the treatment of digestive disorder, intestinal worms, fever, localized swelling, gynecological disorders and skin diseases. Latin name- Pinus longifolia Roxb., Syn. Pinus roxburghii Family- Pinaceae, Sarala Kula Morphology of Pinus longifolia / Pinus roxburghii: Pinus longifolia is tall tree attaining a height of 40-60 meters and diameter about 2-3 meters. The bark of the tree is 3-6 cm thick with brownish red color sap wood is white to creamy white. Heartwood is red in color & turn reddish brown on exposure. Annual rings & dark streaks denoting longitudinal resin canals are very conspicuous. The fresh wood has a resinous odor. Bark is rough. Leaves are needle like, pointed 15-30 inches long, bent towards ground and are bright green in color. The flowers are yellow or rarely purple in color, 1-5 cm long. The male cones are about 13cm long & female cones 10-20 cm long, ovoid in shape. The seeds are 2 to 3cm long which is winged wings membranous. Corrects blgham and sawda Hot and dry in potency Part used- Stem powder, Oil, Bark, resin, Pharmacology: Wood is aromatic antiseptic, stimulant diaphoretic. It stimulates liver, used in digestive disorder, gall stones, helminthiasis especially tape worms, peptic ulcer, typhoid fever & intestinal obstruction, chronic bronchitis, gangrene of lungs etc Uses Calorific,Anti infamatory,laxative,carminative(Riyah ko kharij)Expectorent Blghm ko rakhhekh kerti Anti septic *****Expulsion of placenta and foetus Idrar haiz (humool ka istemal) ikhraj janeen,metritis, Nafeh khas : wermo ko tehleel aur haiz jaari krta Musleh :roughan e banafsha Mashoor murakabat:merham safaid The oil extracted from the tree of behroza is used for cleaning the wound and applied over the area affected with localized inflammation. So acts like ...betadene**** Powder of the stem of Pinus longofolia in a dose of 2-3 g is used to treat fever and intestinal worms. The powder of the bark is applied as paste to treat skin diseases like ringworm, eczema etc. The powder of the bark or the cold infusion prepared using the bark of the plant is used to treat cough and asthma. Oil extracted from the plant is administered 1-2 drops in the ear canal to treat pain and inflammation of the area. Cold infusion prepared from the bark of the Pinus longofolia is given in a dose of 25-30 ml to treat diarrhea and leucorrhea. In condition of indigestion, 2-3 g of behroza bark powder is given with 2-3g of pepper powder as part of treatment. In condition of sciatica, the oil of behroza is applied with Sesame oil

C/o- cough with sputum shortness of breath during exertion wheezing heard.

44 yr old lady ,not a k/c/o DM/HT/Dyslipidemia c/o dyspnoea on exertion for the past 3 yrs along with 10% weight gain. On examination bilateral pitting pedal edema present more so on the right leg (photo attached) vitals are stable and all the systemic examinations normal. Also attaching the photo of her dry,coarse skin,mostly due to hypothyroidism P.s:Can pedal edema be severe enough to cause medial deviation of the toes??(photo attached) If not what are the reasons for it??

ABC OF : DIFFERENCES BETWEEN COPD VS ASTHMA. MAY BE USEFUL. ** In some respects, the changes in the body that cause shortness of breath are similar between COPD and ASTHMA....... But a number of other COPD-ASTHMA differences set the two conditions apart.......  COPD is an umbrella term used to diagnose people who have chronic bronchitis, emphysema, or a combination of both....... *** CHARACTERISTICS OF ASTHMA :- ASTHMA is a CHRONIC INFLAMMATORY DISORDER OF the AIRWAYS that leads recurrent episodes of SYMPTOMS such as WHEEZING, BREATHLESSNESS, CHEST TIGHTNESS and COUGHING, which COMMONLY occur at NIGHT OR in the EARLY MORNING.  These flare up periods are associated with TRIGGERS that cause obstruction of the airways, which is USUALLY REVERSIBLE. DIAGNOSIS of asthma most COMMONLY occurs DURING CHILDHOOD, in individuals that have a history of dry cough in the night, ALTHOUGH it can present AT ANY AGE....... *** CHARACTERISTICS OF COPD :- COPD is a disease characterized by the PROGRESSIVE OBSTRUCTION OF the AIRWAYS that leads to a REDUCTION IN AIRFLOW and RESPIRATORY FUNCTION. These CHANGES ARE NOT COMPLETELY REVERSIBLE and inhaled noxious particle or gases, such as CIGARETTE smoke, are associated as RISK FACTORS for the condition. DIAGNOSIS of COPD usually occurs in OLDER ADULTS with a HISTORY OF SMOKING or CHRONIC EXPOSURE TO OTHER INHALED IRRITANTS....... ***** There is SOME OVERLAP BETWEEN THE TWO CONDITIONS and it is estimated that APPROXIMATELY 40% of PATIENTS WITH COPD ALSO SUFFER FROM ASTHMA........ HOWEVER, there are SOME DISTINCT DIFFERENCES BETWEEN THE TWO CONDITIONS, IN THEIR PATHOPHYSIOLOGY, PRESENTATION of symptoms AND the OPTIMAL MANAGEMENT PLANS.......