DIAGNOSIS AND TREATMENT OF ASTHMA IN PAEDIATRICS
Prashant Chandrwal*
ABSTRACT
Asthma is one of the serious allergic diseases and the most common chronic childhood disease in developed country.[1] It has been characterized by increased responsiveness of the tracheobronchial tree to a multiplicity of stimuli[2-4], increased infiltration of various inflammatory cells especially eosinophils into the airway, epithelial damage, airway smoothmuscle hypertrophy[5], constriction, variable airway obstruction usually associated with inflammation in the conducting airways of the lungs[6] and mucous hypersecretion in the bronchiolar walls of the lung.[7] The word 'asthma' is derived from the Greek meaning ' panting' or 'labored breathing'. Asthma is chronic inflammatory of airways in which many cells and cellular elements play a role, in particular, mast cells, eosinophils, T lymphocytes, macrophages, neutrophils and epithelial cells. Asthma is critically dependent on a series of cell adhesion molecule- mediated interactions between vascular endothelium and leukocytes[8], leading to symptoms[9] and elevation in total serum IgE.[10] It is manifested physiologically by widespread narrowing of the air passages and clinically by paroxysms of dyspnoea, cough, wheezing and tightness, provoked by one or more triggers such as physical exertion and airway irritants (cold, dry air, smoke, etc.).[4-10] It is an episodic disease, with acute exacerbations interspersed with symptom-free periods. Typically, most attacks are short-lived, lasting minutes to hours, and clinically the patient seems to recover completely after an attack. However, there can be a phase in which the patients experience some degree of airway obstruction daily. This phase can be mild, with or without superimposed severe episodes, or can be much more serious, with severe obstruction persisting for days or weeks; the latter condition is known as “acute severe asthma”.
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