Keya R Lahiri
Professor and Head Department of Paediatric Medicine Seth GS Medical College and KEM Hospital Mumbai
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Bronchial Asthma in Children: A Clinical, Diagnostic & Management Primer
© 2003, Keya R Lahiri
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition : 2003
Publishing Director : RK Yadav
9788180610790
Typeset at JPBMP typesetting unit
This maiden venture “Bronchial Asthma in Children—A Clinical, Diagnostic and Management Primer” is specially dedicated to my father, Mr. GP Lahiri. My father has been the driving force behind all my achievements and also my inspiration in all my academic pursuits.
My sister, Dr Karobi Lahiri deserves special mention. I have always admired her unparalled acumen, commitment and zest and just her presence and optimism will assist me in future endeavours.
I wish to pay my respect to my teachers Late Dr PM Udani, Dr. AG Desai, Dr PW Kandoth and Dr. MD Shah. They have been instrumental in shaping my future and I shall always remember them with reverence.
7Foreword
Asthma is a serious global health problem. People of all ages in countries throughout the world are affected by this chronic airway disorder that can be severe and sometimes fatal. Prevalence of asthma is increasing everywhere, specially amongst children.
While there are many general textbooks on respiratory disorders of childhood, it is remarkable that this is the only book of its kind dedicated to childhood asthma. Dr Lahiri is a leading paediatric pulmonologist of this country with vast experience as regards asthma in children and relevant research. The author has done a commendable job in providing a comprehensive textbook on childhood asthma entitled “Bronchial Asthma in Children: A Clinical, Diagnostic & Management Primer. This book would be of immense help for the undergraduates, postgraduates, practising paediatricians, general practitioners and pulmonologist. As the topic unfolds, it is evident that the pathogenesis, initial assessment of an asthmatic child, categorisation, principles of asthma exacerbations have been aptly and lucidly described. The subject of chronic persistent asthma and its follow up has been given a practical and an innovative touch. It is interesting to know that special emphasis has been laid on control measures for environmental factors and patient education. This definitely reflects the best of current thinking about proper approach to this reversible disorder. It would be a fine reference material on this vast topic.
I am confident that this book will gain the reputation of being the Bible of “Childhood Asthma” in the days to come by.
Dr Uday B Nadkarni
md, dch, dnb,
Senior Specialist
Paediatric Intensivist & Pulmonologist
In Charge of Paediatric Chest Clinic
Division of Child Health
Royal Hospital, Muscat
9Preface
A comprehensive and practical review of Bronchial Asthma in Children has been the need of the day and the more I read and delivered lectures on this topic, it dawned on me that it was indeed necessary to address this subject for the students and practitioners. The approach to asthma in children is simple and practical provided one realises that each child's therapy should be individualised and tailored after categorising him and grading his/her severity at every stage of follow up.
It is mandatory to clinch a reactive airway diagnosis, start appropriate therapies, monitor and follow up into adolescence.
I have tried to highlight the essential aspects of this disease and as the topic unfolds, one would realise the petility of one's fears in the management of this very treatable ailment.
It must be realised that asthma is a clinical diagnosis clinched further on by PEF, monitored by PEF and pulse oximetry and a range of inhalation modes at your disposal with minimal side effects. It is a reversible disease and needs early diagnosis to lessen morbidity.
I am grateful to Jaypee Brothers Medical Publishers (P) Ltd, and their dedicated staff for this publication.