Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive lung disease (COLD), chronic obstructive airway

disease (COAD), chronic airflow limitation (CAL) and chronic obstructive respiratory disease (CORD), Is the co-occurrence of chronic bronchitis and emphysema, a pair of commonly coexisting diseases of the lungs in which the airways become narrowed. A progressive disease that makes it hard to breathe. "Progressive" means the disease gets worse .[1] This leads to a limitation of the flow of air to and from the lungs, causing shortness of breath. In clinical practice, COPD is defined by its characteristically low airflow on lung function tests.[2] In contrast to asthma, this limitation is poorly reversible and usually gets progressively worse over time. In England, an estimated 842,100 of 50 million people have a diagnosis of COPD; thus, approximately 1 person in 59 is diagnosed with COPD at some point in their lives.[3] over time. Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. Long-term exposure to other lung irritants, such as air pollution, chemical fumes, or dust, also may contribute to COPD. In emphysema, the walls between many of the air sacs are damaged, causing them to lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced. In chronic bronchitis, the lining of the airways is constantly irritated and inflamed. This causes the lining to thicken. Lots of thick mucus forms in the airways, making it hard to breathe. Most people who have COPD have both emphysema and chronic obstructive bronchitis. Thus, the general term "COPD" is more accurate. COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself. Most of the time, COPD is diagnosed in middle-aged or older people. The disease isn't passed from person to personyou can't catch it from someone else. COPD has no cure yet, and doctors don't know how to reverse the damage to the airways and lungs. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease. COPD is caused by noxious particles or gas, most commonly from tobacco smoking, which triggers an abnormal inflammatory response in the lung.[4][5] The inflammatory

response in the larger airways is known as chronic bronchitis, which is diagnosed clinically when people regularly cough up sputum. In the alveoli, the inflammatory response causes destruction of the tissues of the lung, a process known as emphysema. The natural course of COPD is characterized by occasional sudden worsenings of symptoms called acute exacerbations, most of which are caused by infections or air pollution. The diagnosis of COPD requires lung function tests. Important management strategies are smoking cessation, vaccinations, rehabilitation, and drug therapy (often using inhalers). Some patients go on to require long-term oxygen therapy or lung transplantation.[4] Worldwide, COPD ranked as the sixth leading cause of death in 1990. It is projected to be the fourth leading cause of death worldwide by 2030 due to an increase in smoking rates and demographic changes in many countries.[6] COPD is the fourth leading cause of death in the U.S. and the economic burden of COPD in the U.S. in 2007 was $42.6 billion in health care costs and lost productivity.[7][8] Emphysema Main article: emphysema Lung damage and inflammation of the air sacs (alveoli) results in emphysema. Emphysema is defined as enlargement of the air spaces distal to the terminal bronchioles, with destruction of their walls.[13] The destruction of air space walls reduces the surface area available for the exchange of oxygen and carbon dioxide during breathing. It also reduces the elasticity of the lung itself, which results in a loss of support for the airways that are embedded in the lung. These airways are more likely to collapse causing further limitation to airflow. The effort made by patients suffering from emphysema during exhalation, causes a pink color in their faces, hence the term commonly used to refer to them, "Pink Puffers". There are two types of emphysema: 1- Centrilobular: focal enlargement of air spaces around the bronchioles 2- Panlobular: enlargement of all air spaces (around bronchioles and in the periphery)

PART I. DEMOGRAPHIC PROFILE a. Age 6-8 9-11 12- 14 15-17

b. Sex MALE FEMALE

c. Religion Roman Catholic Born Again Others

d. Grade level Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6

e. Number of siblings None 1-3 4-6 7-9 10 and above

f. Family Monthly income 1,999 & below 2,0003,000 4,0005,999 6,0007,999 8,0009,999 10,000 above

PART II. HEALTH HISTORY a. Weight 5-10kg 11-15kg 16-20 kg 21-25kg 26-30 kg

b. Height 2-3 feet 4-5 feet

c. Immunization status