ashtma

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Asthma a Common Disease INTRODUCTION Background Bronchial asthma is a chronic inflammatory disorder of airways. It is a major public health problem and important cause of morbidity and mortality. It is widely distributed but variable in the prevalence. Around 300 million people in the world currently have asthma. It is estimated that there may be an additional 100 million people with asthma by 2025 (Masoli, et al. 2004). In Bangladesh, according to First National Asthma Prevalence Study (NAPSI 1999) about 7 million- people (5.2% of - population) are suffering from current asthma (at least three episodes of asthma attack in last 12 months). Unfortunately, majority of these patients are in 1-15 years of age group that is 7.4% of total pediatric population of our country is suffering from asthma. The disease causes physical, emotional and financial sufferings for patients leading to deleterious effect on the overall socio-economic structure of the country. Asthma accounts for about 1 in every 250 deaths worldwide although modern management, which obviously includes patient education, can prevent 80% of such death. The economic cost of asthma is considerable both in terms of direct medical costs (such as hospital admissions and cost of pharmaceuticals) and indirect medical costs (such as loss of work-time and premature death). Over 18 million working days are lost due to asthma each year (Masoli, et al. 2004). The diagnosis of asthma is a clinical one; there is no confirmatory diagnostic blood test, radiographic or histopathlogical investigation. In some people the diagnosis can be corroborated by suggestive changes in lung function tests. The clinical diagnosis of asthma is not always simple. Some of the symptoms of asthma are shared with diseases of other systems. People with asthma may suffer form a variety of symptoms, none of which is specific for asthma. These are: wheeze, chest tightness, shortness of breath and cough. The aims of treatments are, to abolish symptoms, to restore normal or best possible longterm airway function, to reduce the risk of severe attacks, to enable normal growth to occur in children, to minimize absence from school or, employment, patient and family participation, avoidance of identified causes where possible, use of lowest effective doses of convenient medications minimizing short-term and long-term side effects (Compton et al 2000). Acute asthma represent 4% of all emergency department visit involving about 2 million people to 25% of the emergency department visit for acute asthma result in hospitalization. About 20-30% of the patient initially managed and discharged from emergency department have relapse. Globally an increase in the asthma mortality has been noticed over the past 15 years. From 1984 the national hospitalization in USA rate for asthmatic children increased


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