Ahsan Waheed Rathore, Parveen Miraj, Tahir Masood Ahmed.
Childhood Asthma: Emerging patterns and precipitating factors.
Ann King Edward Med Uni Jan ;8(3):233-6.

Bronchial asthma in children has a varied presentation and diverse precipitating factors. The pattern is likely to be different in our part of the world where upper respiratory tract infections are very common. To document the common presenting symptoms and precipitating factors in confirmed patients with bronchial asthma in our set up. A tertiary referral center Mayo Hospital Lahore. All patients reporting to the Emergency Department, OPD and the Respiratory & Asthma Clinic of Mayo Hospital, Lahore, with respiratory symptoms suggestive of Bronchial asthma were assessed during a one-year period, from January 1999 to December 1999. Peak expiratory flow rate was measured in each patient to confirm the diagnosis of bronchial asthma. Detailed history and examination on a Proforma was recorded by an asthma-trained nurse and verified by the clinician. A total of 536 patients with respiratory symptoms suggestive of asthma were included in the study. Amongst them 472 (88.06%) were from Lahore while only 64 (11.94%) were from outside Lahore. The patients were mostly in the age range of 1-5 years (43.84%) and 5-15 years (47.58%). The common presenting symptoms of bronchial asthma in these children which wheeze, daytime cough, night cough, and shortness of breath with 96.83%, 98.88%, 74.81% and 65.49% distribution respectively. Other presenting symptoms included, chest pain (51.87%), exertional breathlessness (43.84%), limitation of activity (42.91%) and fever (68.10%). In 43,7% children there was an effect on education, while 72.76% patients had sleep disturbances due to the illness. The common contributing precipitating factors included, upper respiratory tract Infections (53.17%), dust (41.60%). food (52.43%) and cigarette smoke (36.57%). Other factors were exercise (34.89%), pollen (22.39%), animals/pets (18.28%), emotional stress (12.31%) and drugs (2.80%). Children with bronchial asthma present with varied symptoms most commonly wheeze, cough and shortness of breath. Upper respiratory tract infections are the commonest precipitating factor, making fever an important symptom. Food allergy and dust are other common precipitating factors. Insight into the spectrum of precipitating factors can help in better understanding of the diagnosis and treatment of the disease.

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