Bronchial asthma is a chronic respiratory condition characterized by inflammation and airway narrowing, causing recurring episodes of wheezing, coughing, shortness of breath, and chest tightness. In this presentation "Bronchial asthma" has been described including their causes, risk factors, management, etc. For more information, please contact us: 9779030507.

1. BRONCHIAL ASTHMA
अस्थमा / दमा
S. K. Jindal
Professor and Head
Department of Pulmonary Medicine
Postgraduate Institute of Medical Education and Research, Chandigarh
Jindal Chest Clinic, Chandigarh

2. Asthma
Chronic Inflammatory (allergic) disorder of airways characterized
by Episodic, Reversible bronchospasm (i.e narrowing of
airways) resulting from an exaggerated broncho-constrictor
response to various stimuli (triggers)

4. Prevalence of asthma
Globally, asthma affects 10% children & 5%-7% adults. Highest in NZ, Low in Fiji ~ 1%
India: Prevalence between 2-3% of population.
Very high total burden.
Adults
Chowgule 1998 Mumbai M 3.8%; W 3.4%
Jindal 2000 Chandigarh M 4%; W 1.27%
Aggarwal 2006 Multi-centre M 2.2%, W 2.6%
Jindal 2012 Multi-centre 2.1%
Children
Chhabra 1998 Delhi Current 11.6%
Gupta 2001 Chandigarh Boys 2.6%, Girls 1.9%
Respir symptoms 31%

5. Bikaner
Ahmedabad
Mumbai
Bangalore
Chennai
Secunderaba
d
Nagpur Kolkata
Kanpur
Chandigar
h
Trivandrum
Guwahati
Delhi
Shimla
Berhampur
Mysore
INSEARCH: Indian Study on Epidemiology of Asthma,
Respiratory symptoms and Chronic bronchitis
Aggarwal 2006 Multi-centre M 2.2%, W 2.6%
Jindal 2012 Multi-centre 2.1%

6. लक्षण Symptoms
 साांस में तकलीफ  Breathlessness
 खाांसी  Cough
 छाती से आवाज, सीटियाां  Wheezing
 बलगम  Sputum
 छाती में ददद  Chest pain
 रात में नीांद न आना  Sleep difficulties
 गांभीर स्स्थटत  Serious disease

7. Factors Influencing Occurrence of asthma
1. Genetic : Heredity (36-60%)
2. Environmental influences
• Exposure to allergens
• Early exposure
• Smoking and pollution
• Infections and infestations
3. Foods and nutrition
4. Infant feeding

8. कारण Triggers
 सांक्रमण  Infections
 घास क
े पराग कण  Grass Pollens
 धूल, धुआां, कीडे  Dust, smoke, insects
 तांबाक
ू का धुआां  Tobacco Smoke
 मानटसक तनाव  Mental stress
 व्यायाम, खेलक
ू द  Exercise, sports
 दवाएां  Drugs
 तापमान में पररवतदन  Temperature change

9. Tobacco Smoking

10. IndoorAir Pollution
1. Biomass Fuel Combustion
2. Environmental Tobacco Smoke (ETS)
3. Others:
• Environmental
• Biological (bacterial, fungal)
• Construction related
• Consumer products
• House dust (etc.)

11. PASSIVE SMOKING
Environmental Tobacco Smoke Exposure
Second-hand smoking, Involuntary Smoking
In-Utero Exposure
Maternal smoking or Maternal ETS exposure
(Tertiary smoking)
Risk of development of Poorer lung function Asthma ?
Others (COPD)

12. दमे का उपचार How to manage
 दवाएां : इनहेलर, गोटलयाां,
इांजेक्शन
 Drugs: Inhalers, Tablets,
Injections
 कारणोां से बचना  Avoid Triggers
 एलजी का इलाज  Treatment of allergy

13. Anti-asthma Drugs
I. Controllers
• Glucocorticoids – Inhaled/Systemic
• Inhaled long acting -2 agonists
• Oral theophyllines
• Leukotriene receptor antagonists
• Cromones
• Oral long acting -2 agonist
II. Relievers
• Rapid acting  2 agonists
• Oral glucocorticoids
• Inhaled anti-cholinergics
• Oral short acting 2 agonists

15. इनहेलर क्ोां? Why inhalers?
 कम खुराक  Minimal dose
 शारीररक प्रभाव नहीां  No systemic effect
 जल्दी सुधार  Early relief
 कम नुकसान  Few harms

18. From: www.use-inhalers.com

19. दमे से बचना Avoiding asthma
 कारणोां से दू र रहना  Avoid triggers
 जल्द से जल्द इलाज  Early treatment
 गलतफहमी से बचे  No misconceptions

20. घर पर क्ा करें?
What to do at home?
 धूल एकत्र करने वाली
वस्तुओां से दू र रहे
 Keep away from dust
gathering articles
 धूम्रपान न करें  Do not smoke
 धुएँ से दू र रहे  Keep away from smoke
 झडाई और सफाई में  Safe dusting and cleaning
 पालतू जानवरोां से दू र रहे  Keep away from pets

21. दौरे की स्स्थटत में Acute attack
 टहम्मत रखे  Do not panic
 अनदेखा नहीां करें  Do not ignore
 डॉक्टर की बताई दवाएां ले  Take prescribed drugs
 इनहेलर में वृस्ि करें  Increase inhalers
 खुद स्टेरॉयड या
एां िीबायोटिक न ले
 Do not take steroids or
antibiotics yourself
 डॉक्टर से सलाह करें  Consult your doctor

22. टकन लोगोां को पता होना चाटहए Who all should know
 शुभटचांतक, टमत्र एवां
 Well wishers, friends and
relatives
 स्क
ू ल में अध्यापक  School teachers
 दफ्तर में सहयोगी  Colleagues at work
 ससुराल  “In-laws”

23. गलत भ्ाांटतयाां Wrong ideas
 सांक्रामक रोग  Infectious
 दैवीय शाप  Curse
 इनहेलर की आदत  Habit forming inhalers
 स्थायी इलाज  Permanent cure

24. क
ु छ टवशेष स्स्थटतयाां Special situations
 खाने की टवटभन्न चीजें  Things to eat
 व्यायाम और खेलक
ू द  Exercise and games
 शादी और गभादवस्था  Marriage / pregnancy
 अन्य रोग: मधुमेह, रक्तचाप,
आटद
 Other diseases like
diabetes, hypertension

25. दमा एवां शादी Asthma and marriage
 टनयटमत इलाज  Regular Treatment
 ससुराल में जानकारी  Knowledge of ‘in-laws’
 गभादवस्था में इलाज  Pregnancy - treatment
 नवजात टशशु में स्तनपान  Lactation in newborn
 बच्चे में दमा  Asthma in children

26. महत्वपूणद टवषय Important issues
 इलाज या टनयांत्रण  Cure or control
 दवाइयाां या बचाव
 Drugs versus
avoidance
 स्वास्थ्य और दीघादयु पर प्रभाव
 Effects on health and
longevity

28. AsthmaAction Plan Zones
Green Zone: All Clear/Breathing Good/Go
• No asthma symptoms and/or
• Peak flow 80-100% Predicted or Personal best
Yellow Zone: Caution/Slow Down
• Some asthma symptoms and/or
• Peak flow 50-80% Predicted or Personal best
Red Zone: Medical Alert/Stop
• Severe asthma symptoms and/or
• Peak flow < 50% Predicted or Personal best

29. Some top achievers with asthma
दमे को पराटजत कर सफलता क
े
टशखर पर पहांचने वाले क
ु छ लोग

30. SUMMARY
• Asthma is a common and important health problem.
• It is important to look for triggers/ causes of asthma for an effective control.
• Airway inflammation, a prominent feature in asthma, needs to be targeted
with effective medication (primarily inhalational) to
• achieve asthma control.

31. THANK YOU