Alternative Turmeric and Calamansi Leaves as

Nebulizer

CHAPTER 1

PROBLEM AND ITS BACKGROUND

Introduction

Asthma prevalence has grown considerably during the past 40 years, rising by 50% every

ten years, affecting 300 million people worldwide. Asthma affects 10% of people in the United

States and Canada. Hospital admissions for asthma are under-diagnosed and under-treated, and

most of these patients are young children. Asthma is thought to be a factor in over 180,000 deaths

each year, with people over 45 accounting for the majority of these fatalities. Patients in Western

nations bear a cost price ranging from $300 to $1,300 annually, with severe cases bearing a

disproportionate financial burden. In order to deal with the increasing burden, the Global

Initiative for Asthma has created a six-point patient management strategy that emphasizes patient

education, treatment strategies, and continual contact with patients and health care professionals.

(Braman, 2006). Approximately 21 million Filipinos have put the Philippines second in the

asthma mortality in the world across all ages. This record made the Global Initiative for Asthma

(GINA) 2020 offer a new approach to asthma management which includes rescue medications

that would accommodate patient’s needs as well as their self-titration strategies. (Business

Mirror, 2020)

Turmeric, a native plant in the ginger family, is grown in Southeast Asia, primarily in

India. Its rhizome is used as a culinary spice and traditional medicine. Historically, turmeric was

used in Ayurveda and other Indian medical systems. Today, it is promoted as a dietary

supplement for various conditions, including arthritis, digestive disorders, respiratory infections,

allergies, liver disease, and depression. Turmeric is a common spice and a major ingredient in

curry powder, with curcumin being a major component. Turmeric dietary supplements are made

from the dried rhizome and typically contain a mixture of curcuminoids. Turmeric is also made

into a paste for skin conditions. (Turmeric, n.d.) Turmeric may aid in the treatment of asthma,

Alternative
Turmeric and Calamansi Leaves as Nebulizer
pulmonary and cystic fibrosis, lung cancer or damage, and chronic obstructive pulmonary

disease, according to a 2017 medical review, despite the paucity of clinical data. Because

curcumin functions as both an antioxidant and an anti-inflammatory, several studies have

demonstrated that it has advantageous heart health qualities. Turmeric may thin the blood, lower

cholesterol, and stop arteries from narrowing. This may provide a layer of defense against various

cardiovascular issues. Additionally, it could lessen the impact of many heart injury kinds.

Turmeric's anti-inflammatory and antioxidant qualities are thought to help treat the symptoms of

lung disorders that have been present for a long time. (Huizen, 2023)

Coughing may be treated using nebulizers. Keep in mind that a cough is a symptom, not an

illness, of another condition. To keep the airways open, the body uses coughing to eliminate

mucus, allergies, or irritants. Nebulizers are designed to swiftly and effectively administer drugs

to the lungs while allowing for regular breathing. This is especially useful for treating kids who

might find it challenging to utilize inhalers since they need experience. Nebulizers can be

purchased as portable or tabletop units. While portable nebulizers can be battery-operated and are

simple to pack, home nebulizers often require plugging in before use. Nebulizers and the

necessary medication need to be prescribed, so speak with your doctor about your treatment

options. (Millan, 2023b). Asthma and other respiratory problems can be treated with herbs and

natural products, according to traditional medicine. However, there is still a lack of synthetic

medications that can treat all phases and targets of asthma. There is evidence that some herbal

remedies can reduce symptoms and slow the spread of illness. These plants have demonstrated a

range of biological actions that are specific to their targets, including bronchodilation, mast cell

stabilization, anti-anaphylactic, anti-inflammatory, antispasmodic, anti-allergic,

immunomodulatory, and inhibition of mediators like leukotrienes, lipoxygenase, cyclooxygenase,

platelet activating, phosphodiesterase, and cytokines. According to their potential mechanisms of

action, these discoveries are categorized in this research, and it is suggested that polyherbal

formulations, which include different herbs acting at various points along the pathophysiological

cascade of asthma, be used for both prevention and therapy.(Mali & Dhake, 2011).

Alternative
Turmeric and Calamansi Leaves as Nebulizer
Theoretical Framework

Curcumin Attenuates Pulmonary Inflammation in Lipopolysaccharide Induced

Acute Lung Injury in Neonatal Rat Model by Activating Peroxisome Proliferator-

Activated Receptor γ (PPARγ) Pathway

This study investigated the therapeutic effect of curcumin in neonatal acute lung

injury (ALI) induced by lipopolysaccharide (LPS) and its associated molecular

mechanisms. They used an animal model of ALI, administered curcumin and a PPARγ

inhibitor (BADGE), and evaluated various parameters.

Results showed that curcumin improved lung function, reduced lung edema, and

decreased inflammatory markers in ALI rats. It also upregulated the PPARγ/HO1

signaling pathway, which was suppressed in ALI. Curcumin's beneficial effects were

impaired when the PPARγ inhibitor was used, suggesting that curcumin alleviated ALI

by inhibiting inflammation through the PPARγ/HO1-regulated HMGB1/RAGE pro-

inflammatory pathway. Cheng et al. (2018)

Conceptual Framework

The Conceptual Framework illustrated the study’s progression. For better

understanding the researchers chose the Input-Process-Output (IPO) diagram as the

study’s paradigm.

Alternative
Turmeric and Calamansi Leaves as Nebulizer
 PROCESS
INPUT • Mix the OUTPUT
turmeric and
•Water calamansi leaf • Alternative
•Turmeric extract. Turmeric and
•Calamansi • Add a small bit Calamansi
leaves of water. Leaves as a
•Calamsi • Place the Nebulizer
turmeric and
calamansi
mixture in the
hose.
Then, preheat the
kettle.

Research Paradigm

The diagram above shows the progression of the experiment that the researchers carried

out. In order to understand about the key procedures involved in producing the raw

ingredients for a cost-effective nebulizer, the researcher first manufactured the chemicals

as their input before gathering the data. The researchers came to the conclusion that

nebulized turmeric and calamansi leaves are advantageous for asthma sufferers.

Alternative
Turmeric and Calamansi Leaves as Nebulizer
Statement of the Problem

This study aims to determine the effects of Turmeric with Calamansi as the

medication of the alternative nebulizer on the health of people with mild respiratory tract

infections. To obtain all the necessary information, the research sought to answer these

following questions:

1. What is the way Turmeric and Calamansi can be utilized as a nebulizer

substitute?

2. What products will be used as a way to filter the Turmeric with Calamansi in the

kettle?

3. What are the effects of using Turmeric with Calamansi as an alternative

nebulizer in terms of the following factors below?

a. Health

b. Socio-economic status

c. Accesibility

4. What are the potential and prospective benefits of this alternative strategy for

those who suffer from mild respiratory conditions?

Alternative
Turmeric and Calamansi Leaves as Nebulizer
Significance of the Study

Patients with Respiratory illnesses - Alternative nebulizers can be used to

deliver treatments like bronchodilators or corticosteroids to people with asthma, chronic

obstructive pulmonary disease (COPD), cystic fibrosis, bronchitis, or other chronic

respiratory illnesses.

Health professionals - Medicine bridges bridges the gap between science and

society. Health professionals will benefit from this study as it gives them an alternative

way to treat their asthma patients while being easily accessible and affordable.

The school - The school can use this remedy as help to improve or lessen the

symptoms of asthma if there is a suspected case. This also gives the school a basis for

future plans of action in the future to improve their health care system.

Future Researchers - Future studies can utilize this study as a reference.

Scope and Delimination of the Study

The general intent of this comprehensive study is to provide informations

regarding the ways to deal with asthma in the most convenient way possible, with a focus

on providing an alternative for asthma medication. The primary objective of this study is

to identify different factors relating to the assessment of patients on the alternative

nebulizer.

Alternative
Turmeric and Calamansi Leaves as Nebulizer
 In particular, this study provides innovative techniques and strategies on how can

the remote areas develop a distinguished medical system amidst their lack of medical

devices for asthmatic patients. This research aims to focus solely on the effects of

Turmeric and Calamansi leaves as an alternative nebulizer for the accessibility of asthma

patients in remote areas around REINA district.

Definition of Terms

To have a better understanding of the study, the researchers chose to operationally

define some of the following terms to clarify the study.

Calamansi leaves - Calamansi leaves are the green leaves from the calamansi tree, often

used in cooking and traditional medicine for their citrusy flavor and potential health

benefits.

Honey - It is made by several bees from the nectar of flowers. May improve your heart

health.

Kettle - This is a cooking utensil, Used to vaporize the turmeric with honey.

Nebulizer - A machine that turns liquid medicine into a mist you can breathe in to help

with lung problems like asthma or COPD.

Socio-economic status - It is the Individual status of asthmatic peoples.

Turmeric- A yellow spice used in cooking and as a potential natural remedy for health

issues.

Alternative
Turmeric and Calamansi Leaves as Nebulizer
 CHAPTER II

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter contains a summary of gathered information and data from different

related studies and literature, both local and foreign, This summary is where supportive

details and information that serve as the backbone of the variable stated in the current

study lies within. The researchers used the thematic approach where the reviews of

related literature are organized around the topic or issue, rather than the progression of

time (Alabama Libraries, 2019).

TURMERIC

According to this study, asthma affects over 23 million people in the United

States and 262 million globally, and poorly controlled asthma can lead to significant

health problems and an increased risk of mortality. The condition involves complex

inflammatory processes that activate immune cells. Curcumin, the active compound in

turmeric, has shown anti-inflammatory effects in pulmonary diseases in both laboratory

and clinical studies. (Grow et al, 2021)

This particular study aimed to conduct the first meta-analysis on the efficacy of curcumin

supplementation in asthma. Researchers searched for eligible studies on asthma up to

June 30, 2021, and included any human clinical trials that assessed the effects of

Alternative
Turmeric and Calamansi Leaves as Nebulizer
curcumin on asthma symptoms and lung function. The analysis covered a total of 1,216

studies, with eight studies reviewed and data from three of them included in the meta-

analysis. The participants were mostly female, with an average age of 39.23 years.(Grow

et al, 2021)

The results showed that curcumin supplementation led to an improvement in forced

expiratory volume in one second (FEV1%) compared to control groups. However, the

impact of curcumin on overall asthma symptoms was inconclusive, and safety data was

reported in only two trials.(Grow et al, 2021)

In conclusion, the study suggests that curcumin supplementation may offer a slight

improvement in lung function (FEV1%) in asthma, but the findings are limited due to the

small number of studies, sample sizes, methodological issues, inconsistent reporting, and

potential bias in the included studies. More high-quality clinical trials with larger sample

sizes are necessary to better assess the effectiveness of curcumin supplementation in

asthma treatment. (Grow et al, 2021)

Turmeric, a spice commonly used in Indian cuisine, has been found to have several health

benefits. It can reduce symptoms of hay fever, improve indigestion, reduce depression,

lower cholesterol levels, prevent liver damage from alcohol consumption, prevent

swelling and sores during cancer treatment, reduce pain in knee osteoarthritis, and reduce

itching caused by various conditions .

However, its effects on cholesterol levels are conflicting, and the effectiveness of

turmeric products is unknown. Turmeric extracts may also help prevent inflammation and

sores in the mouth during cancer radiation treatment. And it is possibly ineffective for

Alzheimer’s illness. Taking curcumin, a substance found in turmeric, orally does not

appear to alleviate Alzheimer’s disease symptoms gastric ulcers. Stomach ulcers do not

appear to get better when turmeric is taken orally . (TURMERIC: Overview, Uses, Side

Effects, Precautions, Interactions, Dosing and Reviews, n.d.)

Alternative
Turmeric and Calamansi Leaves as Nebulizer
Turmeric is generally safe when taken by mouth, with products containing up to 8 grams

of curcumin daily providing up to 2 months of benefits. However, it can cause mild side

effects like stomach upset, nausea, dizziness, or diarrhea . It is also safe when applied to

the skin as a mouthwash or an enema . (News-Medical.net, 2018)

However, turmeric is not recommended for use during pregnancy, as it may cause

menstrual periods or stimulate the uterus. It is also not safe for breastfeeding, as there is

insufficient information on its safety during this period. It can worsen gallbladder

problems, slow blood clotting, and potentially cause hormone-sensitive conditions like

breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroid. It is also

not recommended for use in cases of liver disease or surgery . (News-Medical.net, 2018)

CALAMANSI AND CALAMANSI LEAVES

This research aims to develop a perfume that is both gentle on the senses and eco-

friendly. It does this by substituting the harmful chemicals often found in conventional

perfumes with a fruit extract from Calamansi (Citrofortunella microcarpa), which is

abundant in Southeast Asia. Calamansi is a cost-effective and environmentally

sustainable choice since it's easy to cultivate. This natural scent isn't just pleasant; it also

has the potential to improve moods and neutralize unpleasant odors. The objective is to

create an affordable perfume with a citrus aroma that's safe for both the environment and

people's well-being, all while utilizing a readily available local resource. This approach

holds promise for addressing both fragrance and sustainability concerns. (Research Paper

- Calamansi (Citrofortunella Microcarpa) Fruit Extract as Perfume, n.d.)

Additionally, Citrus, a plant known for its various health benefits and pharmacological

effects, has been widely studied. Among the citrus varieties, calamansi (Citrus

microcarpa Bunge) has been identified for its antibacterial properties. This research's goal

Alternative
Turmeric and Calamansi Leaves as Nebulizer
is to analyze the chemical composition of the essential oil extracted from calamansi fruit

peels and leaves. The essential oil was obtained through water distillation, and its

chemical compounds were identified using GC-MS (Gas chromatography–mass

spectrometry). Antibacterial activity was assessed using diffusion and dilution methods.

According to a study made by Husni et al. (2021), the GC-MS results revealed that the

primary components in calamansi peel essential oil are D-limonene (29.52%), (R)-(+)-

citronellal (13.76%), 3-isopropenyl-5,5-dimethyl-cyclopentene (8.88%), γ-terpinene

(7.30%), citronellol (6.90%), and α-terpineol (4.61%). In contrast, calamansi leaves

contain citronellal (25.74%), citronellol (12.94%), 3-carene (8.43), and β-phellandrene

(4.89%).

The essential oil from both calamansi peels and leaves exhibited antibacterial activity

against MRSA, S. aureus, S. mutans, P. aeruginosa, and E. coli. In the diffusion method,

the peel essential oil displayed moderate to strong inhibitory effects, while the leaf

essential oil demonstrated very strong inhibitory effects. In the dilution antibacterial

activity test, the lowest MIC (Minimum Inhibitory Concentration) for fruit peel essential

oil was 0.39%, and for leaf essential oil, it was 0.2%. Overall, the results suggest that the

antibacterial potential of calamansi leaves is higher than that of the peels. (Husni et al.

2021)

ASTHMA

Asthma presents a significant global health and socioeconomic challenge, impacting over

300 million people worldwide. This condition is characterized by airway inflammation,

resulting in airway hyper responsiveness, blockages, excessive mucus production, and

changes in airway structure. The presence of airway inflammation in asthmatic patients

has been observed since the 19th century. With advances in immunology and molecular

biology, there has been a comprehensive examination of the inflammatory cells and

substances involved in the development of asthma.(Kudo et al., 2013)

Alternative
Turmeric and Calamansi Leaves as Nebulizer
Furthermore, it's now known that the remodeling of the airways, including thickening of

the airway walls, has profound effects on how the airways function and contributes to the

chronic progression of the disease. The process of epithelial to mesenchymal transition

plays a crucial role in this remodeling. These changes result in persistent inflammation

and histological alterations in the airway walls, including increased basement membrane

thickness, collagen buildup, and smooth muscle enlargement. As a consequence of

airway inflammation and remodeling, the airway walls thicken, and this leads to

increased airway smooth muscle mass, which gives rise to asthma symptoms. (Kudo et

al., 2013)

In addition, According to the World Health Organization (WHO), 12% of Philippine

population of 90 million have asthma; and according to the Global Asthma Report,

approximately 11 million or 1 out 10 Filipinos are suffering from asthma, yet 98 percent

of Filipino asthma patients continue to lack proper treatment.

ALTERNATIVE NEBULIZER

According to Rodriguez (2023), A nebulizer is a breathing machine used to to address

respiratory issues like those brought on by asthma or chronic obstructive pulmonary

illness. It converts a liquid medication, usually a bronchodilator like albuterol, into a mist

that can be easily and painlessly inhaled. This is effective as it relaxes the breathing

muscles and permits easier airflow into and out of the lungs while allowing mucus in the

lungs to soften up. These benefits of nebulizer treatment aid to lessen and avoid

wheezing, shortness of breath, coughing, and tightness in the chest.

This can be utilized with a small mask that is put over the face while the patient breathes

normally. Nebulizers are more preferred than any other effective alternatives because of

Alternative
Turmeric and Calamansi Leaves as Nebulizer
how it can provide breathing relief more quickly and completely. This is because since

Instead of taking just a few deep breaths, the patient inhales the medication as a mist over

the course of about 20 minutes. Because the course of treatment is longer, the nebulizer

offers a welcome respite of easier breathing with a more significant outcome. Nebulizers

can also be used as a treatment when a patient needs a large dose of inhaled medication,

such as during an episode of acute asthma, pneumonia or chronic obstructive pulmonary

disease (COPD).

Nebulizer treatment may also come in different kinds and sizes, some require electrical

outlets, some can be plugged into a car cigarette lighter, and others are incredibly small

and portable, allowing them to be carried around anywhere which made it beneficial for

unforeseen asthma attacks. (P. Bansal, 2023)

As connected above, This research aims to develop a perfume that is both gentle on the

senses and eco-friendly. It does this by substituting the harmful chemicals often found in

conventional perfumes with a fruit extract from Calamansi (Citrofortunella microcarpa),

which is abundant in Southeast Asia. Calamansi is a cost-effective and environmentally

sustainable choice since it's easy to cultivate. This natural scent isn't just pleasant; it also

has the potential to improve moods and neutralize unpleasant odors. The objective is to

create an affordable perfume with a citrus aroma that's safe for both the environment and

people's well-being, all while utilizing a readily available local resource. This approach

holds promise for addressing both fragrance and sustainability concerns.

CHAPTER III

METHODOLOGY OF EXPERIMENTAL RESEARCH

Alternative
Turmeric and Calamansi Leaves as Nebulizer
This chapter provides a detailed definition of the research methodology used to conduct

the study. The investigators explicate the methods utilized to collect, organize, and

evaluate pertinent data and information in order to investigate the study's goals and

inquiries. There is an explanation and justification provided for the research design,

research instruments, data sources, data collection procedures, data display strategies, and

analytical techniques employed.

Research Design/ Project Design

An experimental design, which is frequently employed in clinical trials and medical

research, was employed in this quantitative study. According to Azbar et al. (2016),

experimental design is a type of process analysis in which certain elements are chosen in

order to get the desired answers of interest, or, conversely, the effects of different

independent factors on a dependent component are ascertained. The product was tested

on several human subjects who volunteered to participate. Purposive sampling was

utilized by the researchers to choose the respondents. The intentional selection of a

participant based on their personal attributes is known as purposeful sampling. Since it is

nonrandom, neither underlying theories nor a predetermined participant count are

required (Etikan et al., 2016).

RESEARCH LOCALE

The study will be conducted in the remote areas of General Nakar, the first-class

municipality in the province of Quezon, Philippines. The test and monitoring of the

respondents will be held in their respective households.

The researchers chose to conduct the study in this town due to its existing remote

areas, in which residents have poor accessibility to medical assistance, which explains

why this is the best place to effectively use the product. This will not only be beneficial

Alternative
Turmeric and Calamansi Leaves as Nebulizer
for people’s health, but it will also enhance the socioeconomic development of the

community.

General Nakar is the largest municipality in the entire Quezon Province in terms of land

area. It is well-known for being the center of biodiversity in Luzon, which showcases the

growth in organic agriculture, green tourism, and disaster relief. However, despite the

various improvements in the community, there are still certain locations that are being

left behind on the regional economic progress, which makes the area inaccessible to

necessities, particularly when it comes to health essentials that are unavailable in their

area due to their rural locations, which are distant from the few official clinics of the

town. This is the best reason why the researchers will conduct the study in this location.

List of Raw Materials

Figure 1. Turmeric Powder

As depicted in figure 1, Turmeric

powder is a pivotal component utilized

for the purpose of ameliorating or

alleviating the respiratory tract of an

individual.

Figure 2. Salt

As depicted in figure 2, the

significant significance of salt in

Alternative
Turmeric and Calamansi Leaves as Nebulizer
our experiment, as it serves the purpose of eliminating pathogens, such as bacteria and

viruses, that trigger asthma attacks. Inhaling salt particles induces bronchodilation,

resulting in the expansion of airway passages and facilitating improved respiratory

function. Additionally, it effectively removes particles that contribute to the constriction

of your airway.

Figure 3. Calamansi Leaves

As depicted in figure 3, The

Calamansi leaves will function as a

means to eliminate and diminish the

potent aroma emitted by the turmeric

powder.

Figure 4. Calamansi

As depicted in figure 4, Calamansi

will also function as the agent that

diminishes and eliminates the

powder.

Alternative
Turmeric and Calamansi Leaves as Nebulizer
Figure 5. Water

As depicted in the figure 5, In addition to the

inclusion of calamansi juice, water serves as

an additional component for amalgamating all

the ingredients to be utilized.

Figure 6. Knife

As depicted in figure 6, a knife is a tool designed for

cutting, featuring a sharp blade and a handle. It is

typically used for tasks such as slicing, chopping, and

peeling.

Figure 7. Stove

As depicted in figure 7, a stove is a kitchen appliance

used for cooking food. It typically consists of a heating

element or burners fueled by gas or electricity, along

with a surface for placing cooking utensils.

Alternative
Turmeric and Calamansi Leaves as Nebulizer
Figure 8. Bowl

As depicted in figure 8, a bowl is a

circular and deep container commonly

employed for serving and consuming

food.

Figure 9. Mortal and pestle

As depicted in figure 9, the mortar

serves as a bowl-shaped vessel,

while the pestle acts as a weighty,

blunt instrument employed for

crushing, grinding, or blending

substances inside the mortar.

Alternative
Turmeric and Calamansi Leaves as Nebulizer
Figure 10. Beaker and glass rod

As depicted in figure 10, a beaker

serves as a heat-resistant vessel for

measuring various substances,

accommodating both liquid and

solid samples, and a glass rod is

employed to stir liquids or

suspensions.

Figure 11. Spoon

As depicted in figure 11, a spoon is a tiny, shallow-

bowled kitchen instrument with a handle that can be used

for measuring, ladling, stirring, and eating, among other

things.

Figure 12. Hose

Alternative
Turmeric and Calamansi Leaves as Nebulizer
As depicted in figure 12, a hose is a flexible hollow tube designed to carry fluids from

one location to another. The shape of a hose is usually cylindrical.

Figure 13. KN95 mask

As depicted in figure 13, KN95 mask is a

type of respiratory protective device

designed to achieve a close facial fit and

efficient filtration of airborne particles.

Procedures on how the alternative Nebulizer will work:

Step 1:

extract the curcumin from the turmeric

Step 2:

add calamansi leaves and calamansi extracts to the turmeric

Step 3:

add a pinch of salt and 5ml of water

Step 4:

put the mixture into the container then let it boil

Step 5:

inhale the smoke emitted by the turmeric and calamansi mixture

Alternative
Turmeric and Calamansi Leaves as Nebulizer