Medical Advisor Journals

Friday, February 5, 2016

The Fascinate and Curable smoothie of Green Tea, Tomato and Blueberry for Prevention and Treatment of Cataract

Green tea has been a precious drink in traditional Chinese culture and used exceptional in socialization for more than 4000 thousand years. Due to its commercial values and health effects, green tea now has been cultivated all over the world in suitable climate. Its phytochemical (-)-epigallocatechin gallate (EGCG), attenuate the oxidative stress causes of proteins presented in ocular lens of that related to the development of cataract(1).

In cultured human lens epithelial cells under hyperglycemia, (-)-Epigallocatechin gallate (EGCG), exhibited the potential protective effect against diabetic cataract formation in against the HLEB-3 cells from high glucose-induced apoptosis(2).
In diabetic cataracts, with green and black teas given at 1.25% in the drinking water to streptozotocin-induced diabetic rats for 3 months, Dr. Vinson JA and Dr. Zhang J. said," teas retard the development of diabetic cataracts by a hypoglycemic effect that in turn inhibits the biochemical indicators of pathology"(3).

Tomato is a red, edible fruit, genus Solanum, belongs to family Solanaceae, native to South America. Because of its health benefits, tomato is grown world wide for commercial purpose
and often in green house. Its major sources of phytochemical and vitamin is associated to reduce risk for cataract(4).

Carotenoids, another major constituents in tomato, in a total of 1802 women aged 50 to 79 years in Iowa, Wisconsin, and Oregon expressed a 23% lower prevalence of nuclear cataract in older women(5).

Dr, Christen WG and colleagues at the Harvard Medical School, in a study of in 39,876 female health professionals said, " higher dietary intakes of lutein/zeaxanthin and vitamin E from food and supplements were associated with significantly decreased risks of cataract."(6).

Resveratrol, a dominant compound found in blue berry also exhibited protective effect on lens epithelial cell apoptosis in diabetic cataract rat(7) and long-term diabetic complications causes of diabetic cataract(8).

The antioxidant also exerted strong anti oxidative stress-related lenticular disorders such as cataract formation in either physiologic (5%) or chronic hyperoxic (40%) oxygen conditions(9), according to the Duke University Medical Center.

The discovery of the combination of Green Tea, Tomato and Blueberry through pre clinical trial and studies may form a cornerstone for production of a natural and curable in prevention and treatment of cataract in aging population without inducing adverse effects.

People who are at higher risk to develop cataract due to aging, chronic illness should drink at least 2 servings daily. Elderly with the disease should drink the smoothie as much as they can, depending to digestive and liver toleration.

All Forms of Arthritis are Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Back to General health http://kylejnorton.blogspot.ca/p/general-health.html

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References

(1) EGCG prevents tryptophan oxidation of cataractous ocular lens human γ-crystallin in presence of H2O2 by Chaudhury S1, Ghosh I1, Saha G2, Dasgupta S3(PubMed)

(2) [(-)-Epigallocatechin gallate regulates expression of apoptotic genes and protects cultured human lens epithelial cells under hyperglycemia].[Article in Russian] by Ye P, Lin K, Li Z, Liu J, Yao K, Xu W.(PubMed)

(3) Black and green teas equally inhibit diabetic cataracts in a streptozotocin-induced rat model of diabetes by Vinson JA1, Zhang J.(PubMed)

(4) Association of vitamin A and β-carotene with risk for age-related cataract: a meta-analysis by Wang A1, Han J2, Jiang Y2, Zhang D3.(PubMed)

(5) Associations between age-related nuclear cataract and lutein and zeaxanthin in the diet and serum in theCarotenoids in the Age-Related Eye Disease Study, an Ancillary Study of the Women's Health Initiative by Moeller SM, Voland R, Tinker L, Blodi BA, Klein ML, Gehrs KM, Johnson EJ, Snodderly DM, Wallace RB, Chappell RJ, Parekh N, Ritenbaugh C, Mares JA;CAREDS Study Group; Women's Helath Initiative.(PubMed)

(6) Dietary carotenoids, vitamins C and E, and risk of cataract in women: a prospective study by Christen WG1, Liu S, Glynn RJ, Gaziano JM, Buring JE.(PubMed)

(7) Protective effect of resveratrol on lens epithelial cell apoptosis in diabetic cataract rat by Wang HM1, Li GX2, Zheng HS3, Wu XZ3.(PubMed)

(8) Therapeutic potential of resveratrol in diabetic complications: In vitro and in vivo studies by Ciddi V1, Dodda D2.(PubMed)

(9) Resveratrol prevention of oxidative stress damage to lens epithelial cell cultures is mediated by forkhead box O activity by Li G1, Luna C, Navarro ID, Epstein DL, Huang W, Gonzalez P, Challa P.(PubMed)

Most Common Diseases of elder: Chronic obstructive pulmonary disease (COPD) (Respiratory Disease): Treatment In traditional Chinese medicine perspective

Kyle J. Norton(Scholar and Master of Nutrients, all right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

1. Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules and Yi-Qi Zi-Shen granules
In the study to evaluate the efficacy and safety of the comprehensive therapy based on the three common TCM patterns in stable COPD patients, conducted by The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, found that based on the TCM patterns, Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules and Yi-Qi Zi-Shen granules have beneficial effects on measured outcomes in stable COPD patients over the 6-month treatment and 12-month follow-up, with no relevant between-group differences in adverse events(58).

2. Bu-Fei Yi-Shen granule combined with acupoint sticking therapy
In the study to evaluate the efficacy and safety of traditional Chinese herbal medicine, the Bu-Fei Yi-Shen granule combined with acupoint sticking therapy in patients with stable COPD. found that Bu-Fei Yi-Shen granule combined with acupoint sticking therapy showed beneficial effects for patients with stable COPD in the measured parameters over the 4-month treatment period and 6 months follow-up, with no relevant between-group differences in adverse events(59).

3. Warm needling therapy
In the study to observe the effects on chronic obstructive pulmonary disease (COPD) in the stable phase treated with warm needling therapy and Seretide and make the comparison of improvements between two therapies in terms of the clinical symptoms and life quality, found that Warm needling therapy improves the pulmonary function of the patients with COPD in the stable phase, releases clinical symptoms and improves life quality. Its effects are similar to those of Seretide(60).

4. Tanreqing injection
In the study to explore the effects of Tanreqing injection, a traditional Chinese herbal preparation for clearing heat and resolving phlegm, in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) by improving airway inflammation and airway mucus hypersecretion, researchers at the West China Hospital, Sichuan University found that Tanreqing injection can improve TCM signs and symptoms in AECOPD patients, and the mechanism maybe due to the decrease of serum levels of IL-8 and NE and improvement of IL-10 level(61).

The Delicious Cooked Spinach, Tomato, Orange and Sweet Potato for Prevention and Treatment of Preeclampsia

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.

Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post

Nominated for shorty award over last 4 years

Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

The smoothie for prevention and treatment of preeclampsia

Yield: 2 servings (about 8 ounces each)

1/2 cup cooked spinach

1/2 cup tomato

1/2 cup sweet potato

1 cup orange juice

1. Place all ingredients in a blender and puree about 1 minute

2. Blend on high speed about 1 minute or until the mixture is thick and the ice is well crushed.

3. Serve immediately

The finding of a natural source for treatment of preeclampsia has been running into many obstacles, many ingredients showed initially with promising result in animal studies have not produced same potentials in large sample size and mutli centers human trials.

Preeclampsia a condition in pregnancy with expression of high blood pressure, sometimes with fluid retention and proteinuria. According to the joint study led by Bharati Vidyapeeth University women with PE are associated to increase oxidative stress right from 16 to 20 weeks of gestation(1). Study suggested the implication of concentrations of increased free fatty acid (FFA), and decreased activity of antioxidant enzyme in placenta may contribute to oxidative damage levels(2) in placental mitochondria in women with PE)(3). Levels of vitamin C(orange) and E(Sweet Potato) were significantly negative for overall preeclampsia(4).

Dr. Basaran A and professors at the ACIBADEM Kayseri Hospital said, "supplementation of vitamins C and E(May be used) for the prevention of preeclampsia or other pregnancy induced hypertensive disorders"(5).

The effectiveness of Cooked Spinach, Tomato, Orange and Sweet Potato may serve as cornerstones of pharmaceutical target for further studies in production of a potential medication for prevention and treatment of Preeclampsia with little or no adverse effects.

People who are at high risk of Preeclampsia due to family history,..... should drink at least one serving daily and people with Preeclampsia should drink the smoothie as much as they can, depending to digestive toleration.
Life style and dietary patter change are recommended.

All Forms of Arthritis are Curable

You Can Eliminate Osteoarthritis

By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination

Holistic System In Existence That Will Show You How To

Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer

Refeneces
(1) Increased oxidative stress from early pregnancy in women who develop preeclampsia By D'Souza V1, Rani A1, Patil V1, Pisal H1, Randhir K1, Mehendale S2, Wagh G2, Gupte S3, Joshi S1.(PubMed)
(2) [Relationships between concentrations of free fatty acid in serum and oxidative-damage levels in placental mitochondria and preeclampsia].[Article in Chinese] by Yan JY1, Xu X.(PubMed)
(3) The association between maternal antioxidant levels in midpregnancy and preeclampsia. by Cohen JM1, Kramer MS2, Platt RW2, Basso O3, Evans RW4, Kahn SR5.(PubMed)
(4) Maternal Antioxidant Levels in Pregnancy and Risk of Preeclampsia and Small for Gestational Age Birth: A Systematic Review and Meta-Analysis by Cohen JM1, Beddaoui M2, Kramer MS3, Platt RW3, Basso O4, Kahn SR1.(PubMed)
(5) Combined vitamin C and E supplementation for the prevention of preeclampsia: a systematic review and meta-analysis by Basaran A1, Basaran M, Topatan B.(PubMed)

Thursday, February 4, 2016

The Practical Smoothie of Green Tea and Grape for Reduced Risk and Treatment of Chlamydia

Kyle J. Norton(Scholar, Master of Nutrients, All right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

The smoothie for people with Chlamydia and high risk of the disease

Yield: 2 servings (about 8 ounces each)
1 1/2 cups grape
1 cup green tea drink (Make from 4 grams of green tea, a slice of ginger and a cup of hot water lipped for 5 minutes, and let cool to room temperature)

1. Place tall ingredients in a blender and puree about 1 minute
2. Blend on high speed about 1 minute or until the mixture is thick and the ice is well crushed.
3. Serve immediately

The finding of a natural source for reduced risk and treatment of Chlamydia with no adverse effects has encountered many obstacles, many ingredients showed initially the promising result in animal studies have not produced same potentials in either large sample size and mutli centers human trials.

Chlamydia is a common bacterial infection (STI) in humans caused by the bacteria Chlamydia trachomatis. According to the recent reports of some well known institutions, The ingredient of natural sources, including green tea(1) may process of clinical values and promising potential for pharmaceutical use for production of next generation medicine for reduced risk and treatment of Chlamydia with little or no adverse effects.

Green tea has been a precious drink in traditional Chinese culture and used exceptional in socialization for more than 4000 thousand years. Due to its commercial values and health effects, green tea now has been cultivated all over the world in suitable climate. According to the National Institute of Infectious Diseases, green tea polyphenols showed antichlamydial activity against Chlamydia trachomatis D/UW-3/Cx and L2/434/Bu in vitro(1).
Also in vitro, its polyphenols also exerted anti Chlamydia trachomatis and C. pneumoniae effects of Chlamydial strains, C. trachomatis D/UW-3/Cx and L(2)/434/Bu, and C. pneumoniae AR-39 and AC-43 strains(2).

Resveratrol is a phytochemical in the class of Stilbenoids, found abundantly in grape, a woody vines of the genus Vitis, belongings to the family Vitaceae, native to southern Turkey. Its antioxidant resveratrol also expressed anti Chlamydia pneumoniae effect through anti the infection in promotion of the accumulation of low-density lipoproteins into macrophages, thus facilitating foam cell formation(3), according to the Sapienza University.

In the study of resveratrol and curcumin against Chlamydia-primed THP-1 cells, Dr. Deby-Dupont G and colleagues at the University of Liège insisted, the combination treatment reduced inflammation process of atherosclerosis through attenuated respiratory burst linked to an increased NADPH oxidase (NOX) activity(4).

Furthermore, in resistance bacteria, the resveratrol tetramer (-)-hopeaphenol inhibited 3 types of different gram-negative bacteria and reduced cell entry and subsequent intracellular growth of Chlamydia trachomatis(5).

The discover of simple smoothie through research and studies with potential effect in reduced infection and infection caused by the bacteria Chlamydia trachomatis may act as a cornerstone to produce a medicine based completely in natural sources without inducing adverse effects.

People who are at increased risk of Chlamydia due to family history, immune weakening....should drink at least one cup daily and people with Chlamydia should drink the smoothie as much as they can, depending to digestive and liver toleration.

References

(1) Biosynthesized tea polyphenols inactivate Chlamydia trachomatis in vitro by Yamazaki T1, Kishimoto T, Shiga S, Sato K, Hagiwara T, Inoue M, Sasaki N, Ouchi K, Hara Y.(PubMed)
(2) In vitro inhibitory effects of tea polyphenols on the proliferation of Chlamydia trachomatis and Chlamydiapneumoniae by Yamazaki T1, Inoue M, Sasaki N, Hagiwara T, Kishimoto T, Shiga S, Ogawa M, Hara Y, Matsumoto T.(PubMed)
(3) Resveratrol in Chlamydia pneumoniae-induced foam cell formation and interleukin-17A synthesis by Di Pietro M1, De Santis F, Schiavoni G, Filardo S, Sessa R.(PubMed)

(4) Resveratrol and curcumin reduce the respiratory burst of Chlamydia-primed THP-1 cells by Deby-Dupont G1, Mouithys-Mickalad A, Serteyn D, Lamy M, Deby C.(PubMed)
(5) The resveratrol tetramer (-)-hopeaphenol inhibits type III secretion in the gram-negative pathogens Yersinia pseudotuberculosis and Pseudomonas aeruginosa by Zetterström CE1, Hasselgren J, Salin O, Davis RA, Quinn RJ, Sundin C, Elofsson M.(PubMed)

Most Common Diseases of elder: Chronic obstructive pulmonary disease (COPD) (Respiratory Disease):Treatment In herbal medicine perspective

Sources
(1) http://respiratory-research.com/content/13/1/116/abstract
(53) http://www.ncbi.nlm.nih.gov/pubmed/21062330
(54) http://www.ncbi.nlm.nih.gov/pubmed/21718484
(54a) http://www.ncbi.nlm.nih.gov/pubmed/21146973
(55) http://www.ncbi.nlm.nih.gov/pubmed/17479778
(56) http://agelessherbs.com/chinese-herbs/copd-asthma-lung/

Wednesday, February 3, 2016

The Tomato, Sunflower Seed and Orange Juice for Reduced Risk and Treatment of Darier's disease (DAR)

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

The Incredible and Effective smoothie for reduced risk and treatment of Darier's disease (DAR)

Yield: 2 serving (about 8 ounce each)
1 1/2 cups tomato
1/4 cup sunflower seed
1 cup organic orange juice

1. Place all ingredients in a blender and puree about 1 minute
2. Blend on high speed about 1 minute or until the mixture is thick and the ice is well crushed.
3. Serve immediately

The finding of a natural source for treatment of Bowen's disease (BD) has been running into many obstacles, many ingredients showed initially with promising result in animal studies have not produced same potentials in either large sample size and mutli centers human trials.

Darier disease is a skin condition characterized by wart-like blemishes on the body due genetic mutation of an autosomal dominant disorder induced immunologic functions aggression to its own tissues(4). The most common sites for blemishes are the scalp, forehead, upper arms, chest, back, knees, elbows, and behind the ear(1), affecting affects both men and women

It is hard to believe that some ingredients ignored by the pharmaceutical companies for treatment of Darier's disease (DAR) is now believe to be effectively in form of natural sources. Tomatoes(2), Sunflower seed, may be next generation of potential ingredients in induced the occurrence of skin disorder caused by genetic mutation of an autosomal dominant, namely Darier's disease (DAR) but also is used in treatment of people with the disorder, recent studies of renowned institution suggested.

Tomato is a red, edible fruit, genus Solanum, belongings to family Solanaceae, native to South America. Because of its health benefits, tomato is grown world wide for commercial purposeand often in green house. Its derivative retinoids, a class of chemical compounds found abundantly in tomato may be used for treatment of due to its effectiveness in decreased number of desmosomes and other cellular attachments and conspicuous microvillous changes of cell surface in separated basal cells up to 5 months(2).

In a study of a total of 5 patients with Darier's disease treated with systemic retinoid therapy, showed to decrease the number of white blood cell and T-cells, normalized cell production in stimulated production of T cell, and decreased the lymphocyte responses to cell division causes of Darier's disease(2).

Dr. Günther S., said, "....68 patients suffering from palmar/plantar hyperkeratoses of different etiology, small doses of vitamin A acid (retinoic acid) topically applied, produced a striking improvement in hypertrophic lichen planus of palms or soles"(6) and in the concerns of the use of high dosage of vitamin A and retinoids, for treatment of Darier's disease, he also said, "The use of vitamin A is limited by its toxicity, but vitamin A acid being less toxic could be an important therapeutic advance in follicular keratoses"(5).

Sunflower is a genus of Helianthus, belongings to the family Asteraceae andnative to the Americas. It seeds are usually classified by the difference of their husks and considered as healthy snack in many cultures. It is one of most healthy foods containing highest amount vitamin E in comparison to other food sources with potential use in prevention and treatment of Darier's disease (DAR) according to Dr. Ayres S(7).
According to the study of synergism of vitamins A and E with dermatologic applications, in animal model, adding vitamin E to the diet restored the vitamin A serum level to normal effectively control three dermatologic conditions involving a defect in keratinization, namely, keratosis follicularis (Darier's disease), pityriasis rubra pilaris, and acne vulgaris(8).

Orange, a species of Citrus Sinensis, belongings to the family Rutaceae and native to the Southeast Asia is round citrus fruits with finely-textured skins, orange in color and one of most popular fruits in the world. Its vitamin C derivative, ascorbic acid has been found effectively for prevention and treatment of Darier's disease(9)in patient ultraviolet exposure to the onset of Darier's disease(10).

Rich sources of vitamin A, E and C found in tomato, sunflower seed and orange processed a potential benefit for reduced risk and treatment of Darier's disease (DAR). The smoothie containing these ingredients in high amount should also mimic the similar effects in chronic use.
People at higher risk of Darier's disease (DAR) due to genetic mutation causes of immune disorder should drink at least one serving daily and people with the disease should drink as much as they can, depending to the toleration of digestive system.

References
(1) Darier disease: A fold (intertriginous) dermatosis by Engin B1, Kutlubay Z2, Erkan E2, Tüzün Y2.(PubMed)
(2) Treatment of Darier's disease with an oral aromatic retinoid (Ro 10-9359): a clinical and light and electron microscopic study by Lauharanta J, Niemi KM, Lassus A.(PubMed)
(3) Cell-mediated immunity in Darier's disease: effect of systemic retinoid therapy by Soppi AM, Soppi E, Eskola J, Jansén CT.(PubMed)
(4) Darier's disease: a partially immunodeficient state by Jegasothy BV, Humeniuk JM.(PubMed)
(5) Vitamin A acid in Darier's disease by Günther S.(PubMed)
(6) [Therapeutic effect of vitamin A acid (retinoic acid) in various forms of palmar/plantar hyperkeratoses: experimental studies on 68 patients].[Article in German] by Günther S.(PubMed)
(7) Darier's disease with salivary gland obstruction: synergistic therapy with vitamins A and E suggested by S Ayres(PMC)
(8) Synergism of vitamins A and E with dermatologic applications by Ayres S Jr, Mihan R, Scribner MD.(PubMed)
(9) Induction of Darier's disease by repeated irradiation by ultraviolet B; protection by sunscreen and topicalascorbic acid by Heo EP1, Park SH, Yoon TJ, Kim TH(PubMed)
(10) Successful treatment of combination therapy with tacalcitol lotion associated with sunscreen for localizedDarier's disease by Abe M1, Yasuda M, Yokoyama Y, Ishikawa O.(PubMed)

Most Common Diseases of elder: Chronic obstructive pulmonary disease (COPD) (Respiratory Disease):Treatment In conventional medicine perspective

Respiratory Disease
Respiratory Disease is defined as medical conditions which affect the breathing organ and tissues including Inflammatory lung disease, Obstructive lung diseases, Restrictive lung diseases, Respiratory tract infections, trachea, bronchi, bronchioles, alveoli, the nerves and muscles breathing , etc,.
Chronic obstructive pulmonary disease (COPD))is the third leading cause of death in the United State.

Types of Chronic obstructive pulmonary disease (COPD)

1. Emphysema, a type of Chronic obstructive pulmonary disease (COPD), is defined as a long term and progressive condition cause of shortness of breath but depending to the stage of lung function as a result of damage to tissues of the air sacs (alveoli) in the lungs. In the study of 63 patients with stable COPD (spirometric GOLD stages 2–4) and 17 age- and comorbidity-matched controls, researchers found that in contrast to asthma, COPD is characterised by elevated concentrations of both BDNF and TGF-beta1 in serum. The stage-dependent association with lung function supports the hypothesis that these platelet mediators may play a role in the pathogenesis of COPD(1). In some cases, but rarely, Emphysema is caused by Alpha-1 antitrypsin deficiency emphysema.

2. Chronic bronchitis
Chronic bronchitis is a chronic inflammation of the lung’s bronchi cause of the increased production of mucus in the lung of that leading to difficult breathing.

The Treatment

In conventional medicine perspective
F1.1. Therapies
1. Incentive spirometry
In the study of a total of 27 consecutive patients (mean age, 68.4 +/- 7.9 years; 26 males) admitted for COPD exacerbations, found that the use of IS appears to improve arterial blood gases and health-related quality of life in patients with COPD exacerbations, although it does not alter pulmonary function parameters(36).

2. Oxygen therapy
Majority of patients in Oxygen therapy have chronic obstructive pulmonary disease (COPD). The multicenter Nocturnal Oxygen Therapy Trial and the smaller Medical Research Council study identified LTOT as an intervention that improved survival in patients with COPD or chronic respiratory failure, approximately doubling survival at 19 months in patients who were adherent to oxygen(37).

3. Bronchodilators
The aim of Bronchodilators is to decrease the resistance in the respiratory airway and increase airflow to the lungs
a. Short-acting bronchodilators
In the study to clarify the additive efficacy of short-acting β(2)-agonists (SABA) or muscarinic antagonists (SAMA) on dynamic hyperinflation and exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) who had been treated with long-acting bronchodilators, showed that he additive efficacy of the two drugs was analyzed. Inhalation of SABA and SAMA improved airflow limitation and dynamic hyperinflation in stable COPD patients who had been treated with LAMA. Inhalation of SABA decreased respiratory resistance and the difference in respiratory resistance at 5 Hz and 20 Hz. On the whole, the additive efficacy of SABA on airflow limitation and dynamic hyperinflation was superior to that of SAMA(38).

b. Long-acting bronchodilators
In an overview of the clinical studies evaluating the safety and efficacy of inhaled aclidinium bromide, a novel long-acting anticholinergic bronchodilator, for the treatment of COPD, showed that clidinium bromide has effects on relevant COPD outcome measures, including level of FEV(1), similar to other long-acting bronchodilators, and therefore seems to have the potential for a significant role in the future management of moderate to severe COPD(35).

c. Side effects of Bronchodilators medicine are not limit to headache, Nervousness, Trembling and shaking, Etc., depending to types of medicine.

4. Phosphodiesterase-4 (PDE4) inhibitors
a. Phosphodiesterases (PDE) are a family of enzymes responsible for the metabolism of the intracellular second messengers cyclic AMP and cyclic GMP. According to the study by GKT School of Biomedical Science, King’s College London, Targeting PDE with selective inhibitors may offer novel therapeutic strategies in the treatment of various conditions, and in the context of respiratory disease these include asthma and chronic obstructive pulmonary disease (COPD)(39). Other study indicated that While there is a wide distribution of these enzymes throughout the body, it is of interest that inflammatory cells thought to participate in the pathogenesis of inflammatory diseases including asthma and chronic obstructive pulmonary disease (COPD), preferentially express PDE4(40).

b. Side effects are not limit to Nausea, Emesis, and related general intestinal problems.

5. Corticosteroids are most frequent used sontrollers in preventing inflammaory airways in asthma patients and COPD.
a. Inhaled corticosteroids
According to the study by University of Nevada School of Medicine, in the review of review is to compare and contrast the newer inhaled corticosteroid (ICS) ciclesonide with older ICSs, showed that once-daily administration of ICSs is generally not as effective as twice-daily. Continuous administration of ICSs does not change the natural history of asthma in either children or adults. Long-term administration of medium dose ICSs does not increase the risk of cataracts or osteopenia in children and young adults(41). Others in the study of Dry powder inhaler (DPI) devices to assess the proportion of patients with asthma or chronic obstructive pulmonary disease (COPD) with significant bronchoobstruction who do not have inspiratory flows necessary for the adequate use of dry powder inhaler (DPI) devices Diskus and Turbuhaler. showed that significant proportion of patients with asthma or COPD with significant bronchoobstruction do not exhibit satisfactory inspiratory flows for the use of dry powder inhaler (DPI) devices (Diskus < Turbuhaler)(42).

b. Oral or intravenous corticosteroids
In the study of 47 patients, 30 females, 17 male, 24 received oral prednisolone and 23 received IV hydrocortisone. At baseline the oral and IV groups were similar (mean, SD) in age (38.3, 12.8 vs 37.3, 12.9, P=0.80) and initial percent predicted (PP) PEF (61, 16.7 vs 69, 13.0, P=0.11). After 72 h both groups had similar improvements in PEF (27%, 26 vs 27%, 19, P=0.96), researchers at the Department of Respiratory and Sleep Disorders Medicine, Western Hospital, found that Corticosteroids administered orally and IV had similar efficacy in the treatment of adults hospitalised with acute asthma(43).

c. Side effects
a.1. psychiatric side effects include mania, depression and mood disturbances within the first two weeks of corticosteroid therapy(44).
2. Short side effects include cutaneous effects, electrolyte abnormalities, hypertension, hyperglycemia, pancreatitis, hematologic, immunologic, and neuropsychologic effects. and Long-term corticosteroid use may be associated with more serious sequel, including osteoporosis, aseptic joint necrosis, adrenal insufficiency, gastrointestinal, hepatic, and ophthalmologic effects, hyperlipidemia, growth suppression, and possible congenital malformations(45).

6. Other medication
6.1. Expectorants
a. Expectorants is the types of medicine used to assist the clearance of mucus from the airways, lungs, bronchi, and trachea. In the study to to determine if treatment with mucolytics reduces the frequency of exacerbations, days of disability, or both, in participants with chronic bronchitis or chronic obstructive pulmonary disease, or both.Secondary objectives: to determine if mucolytics lead to an improvement in lung function or quality of life and to determine the frequency of adverse effects associated with mucolytics, showed that in participants with chronic bronchitis or COPD, treatment with a mucolytic may produce a small reduction in acute exacerbations, but may have little or no effect on the overall quality of life. The effects on exacerbations shown in early trials were larger than those found in the more recent studies(46).Others in the study of group 1 ascoril (10 ml tid), group 2 salbutamol (200 mcg two inhalations tid) plus bromhexin (8 mg tid) for 10 days.indicated that ascoril is most efficacious and safe for the treatment of mild or moderately severe COPD and elimination of its exacerbation. The early prescription of this therapy permits to avoid hospitalization and expensive therapy(47).
b. Side effects are not limit to Nausea, Gastrointestinal Distress, Sleep Complications,Drowsiness, Etc.

6.2. Methylxanthines
a. Methylxanthines represent a unique class of drugs for the treatment of asthma. At lower serum concentrations, theophylline is a weak bronchodilator but retains its capacity as an immunomodulator, anti-inflammatory, and bronchoprotective drug(48). In the study to evaluate the addition of methylxanthines to standard treatments in patients presenting with acute exacerbations of chronic obstructive pulmonary disease (COPD), researchers at the indicated that the available data do not support the use of methylxanthines for the treatment of exacerbations of chronic obstructive pulmonary disease. Potential benefits of methylxanthines for lung function and symptoms were generally not confirmed at standard levels of significance(49).
b, Side effects are not limit to nausea and vomiting, and non-significant increases in tremor, palpitations, and arrhythmias, etc.

F.1.2. Surgery
Surgeries may be the only options for the patient with end-stage COPD, and suffering severe symptoms
1. Lung volume reduction surgery
In the study to to evaluate whether favorable short-term results in term of functional outcome and survival following lung volume reduction surgery persist for longer periods, showed that LVRS can lead to a very long survival (10 years or more) in a small subgroup of patients, with improvement of pulmonary functional data. Some preoperative data (upper lobe distribution of emphysema and pulmonary arterial pressure) appear to predict survival. Lung transplantation can be offered to these patients, showing a trend to improved life expectancy(50).

2. Bullectomy
Bullectomy is the surgical removal of a bullae (greater than 1 cm) which is an air pocket in the lung with an aim to help COPD patients breathe better. A bullectomy may be considered for giant bullae, defined by a volume greater than a third of a hemithorax(51).

3. Lung Transplantation
Patients who are less than 65 years old with end-stage COPD but suffering severe symptoms with no other significant disease may be considered for lung transplant. It offers the greatest functional benefits but also involves considerable risks(51)

According to the study Washington University, St Louis, Missouri, unfortunately, most emphysema patients are poor candidates for any surgical intervention. A meticulous selection process is favoured in which indications and contraindications are considered and the best solution is devised for each patient. Patients with giant bullae filling half the thoracic volume and compressing relatively normal adjacent parenchyma are offered bullectomy; those with hyperinflation, heterogeneous distribution of destruction, forced expiratory volume in 1 second (FEV(1)) >20%, and a normal carbon dioxide tension (PCO(2)) are offered LVRS; and patients with diffuse disease, lower FEV(1), hypercapnia, and associated pulmonary hypertension are directed towards transplantation. Using these criteria, few patients are serious candidates for surgical procedures. Combinations of LVRS and lung transplantation, either simultaneously or sequentially, are possible but rarely necessary(52).