Dr. P. Yugandhar m. D., Professor department of pulmonology

• OVERVIEW OF Bronchial Asthma

• DR.P.YUGANDHAR M.D.,
• PROFESSOR
• DEPARTMENT OF PULMONOLOGY
• ASRAM MEDICAL COLLEGE,
• PRAGNA CHEST CLINIC, R.R., PET ELURU

• “All that wheeze is not asthma
• All asthmatics do not wheeze”

A Chronic Inflammatory Disorder of the airways

• A Chronic Inflammatory Disorder of the airways
• Many cells and cellular elements play a role
• Chronic inflammation is associated with airway hyperresponsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing
• Widespread, variable, and often reversible airflow limitation

• GINA: Updated 2008

1.CLINICAL DIAGNOSIS OF ASTHMA IS MADE BY SYMPTOMS OF EPISODIC BREATHLESSNESS,WHEEZING,CHEST TIGHTNESS AND COUGH.

• 1.CLINICAL DIAGNOSIS OF ASTHMA IS MADE BY SYMPTOMS OF EPISODIC BREATHLESSNESS,WHEEZING,CHEST TIGHTNESS AND COUGH.
• 2.MEASUREMENTS OF LUNG FUNCTION BY SPIROMETRY/PEAKFLOW METER PROVIDE INFORMATION ABOUT THE SEVERITY,REVERSIBILITY AND VARIABILITY OF AIRFLOW OBSTRUCTION AND HELP TO CONFIRM DIAGNOSIS OF ASTHMA.
• 3.EXTRA MEASURES MAY BE REQUIRED TO DIAGNOSE ASTHMA IN CHILDREN <5yrs,ELDERLY AND OCCUPATIONAL ASTHMA.

• 5.MEASUREMENT OF ALLERGY STATUS CAN HELP TO IDENTIFY RISK FACTORS THAT CAUSE ASTHMA IN INDIVIDUAL PATIENTS.
• 6. FOR PATIENTS WITH SYMPTOMS CONSISTENT WITH ASTHMA, BUT NORMAL LUNG FUNCTION MEASUREMENT OF AIRWAY HYPERRESPONSIVENESS MAY HELP CONFIRM THE DIAGNOSIS.

The global prevalence ranges from 1%-18% of population in different countries

• The global prevalence ranges from 1%-18% of population in different countries
• According to World Health Organisation (WHO 2005) .. 300 million people suffer from Asthma
• In India, 57,000 deaths were attributed to Asthma in 2004 (WHO 2004)
• Seen as one of the leading cause of morbidity and mortality in rural India (Smith 2000)
• World Health Organization. The global burden of disease: 2004 update. Geneva, WHO, 2008.
• Smith KR. National Burden of disease in India from indoor air pollution. 2000. Proc Natl Acad Sci USA. Nov 21, 97(24). 13286-93.

• J Managed Care Pharm. 2003;9(6):534-43

• J Managed Care Pharm. 2003;9(6):534-43

• J Managed Care Pharm. 2003;9(6):534-43

Estimated Number of Obstructive Airway Disease Patients in India

• Estimated Number of Obstructive Airway Disease Patients in India

• 1. Murthy KJR, NCMH Background Papers – Burden of Diseases in India, 2008

• 1. Murthy KJR, NCMH Background Papers – Burden of Diseases in India, 2008

• 1. Murthy KJR, NCMH Background Papers – Burden of Diseases in India, 2008

• 1. Murthy KJR, NCMH Background Papers – Burden of Diseases in India, 2008

Risk Factors

• Risk Factors
• (for development of asthma)

• INFLAMMATION

• Airway
• Hyperresponsiveness

• Airflow Obstruction

• Risk Factors
• (for exacerbations)

• Symptoms

• Source: Peter J. Barnes, MD

• Asthma Inflammation: Cells and Mediators

• Source: Peter J. Barnes, MD

• Mechanisms: Asthma Inflammation

• Source: Peter J. Barnes, MD

• Asthma Inflammation: Cells and Mediators

• Gawchik SM et al. Role of antileukotriene agents in asthma therapy. JAOA, Vol 100. No1, Jan 2000.

1.COPD

• 1.COPD
• 2.LVF(CARDIAC ASTHMA)
• 3.LOCALISED NARROWING OF MAJOR AIRWAYS-TUMOR OR TRACHEAL STENOSIS
• 4.FUNCTIONAL OBSTRUCTION OF UPPER AIRWAY-ESPECIALLY IN YOUNG WOMEN(HYPERVENTILATION SYNDROME AND PANIC ATTACKS)
• 5.VOCAL CORD DYSFUNCTION.

1.CHRONIC RHINO SINUSITIS

• 1.CHRONIC RHINO SINUSITIS
• 2.GASTRO ESOPHAGEAL DISEASE
• 3.TUBERCULOSIS
• 4.CYSTIC FIBROSIS
• 5.CILIARY DYSKINESIAS
• 6.FOREIGN BODY ASPIRATION
• 7.CONGENITAL MALFORMATIONS AND ANAMOLIES OF THE RESPIRATORY TRACT.
• 8.CONGENITAL HEART DISEASE