02 May 2004	Sunday	11 Rabi-ul-Awwal 1425

KARACHI, May 1: World Asthma Day is being observed on Tuesday (May 4) with the burden of approximately 200 million patients globally and more than 10 million patients in Pakistan , and amid an annual increase of 5 per cent in such cases.

Medical experts, while talking to PPI, observed that prevalence of asthma was high both in adults and children, but it might emerge at any stage of life. Its prevalence was increasing day by day due to adoption of western lifestyle, pollution, urbanization, modernization, use of carpets, curtains, genetic predisposition, exposure to allergy in intrauterine life.

Head of Chest Medicine at the Jinnah Post-graduate Medical Centre Dr Nadeem Rizvi said that asthma prevalence had reached at 19 per cent during the last decade and studies showed an annual nine per cent increase in the number of such cases in Pakistan.

He said that major reasons for prevalence of asthma were genetic predisposition, exposure to allergy in intrauterine life through wide use of carpets, sofas and furniture carrying dust mites. The disease may hit children during early infancy.

"Parents must not resort to smoking in presence of young children and women, and if anyone finds symptoms of asthma for fist time, he should think about the possibility of occupational asthma because people are working in heavily polluted workplaces without any protective gears," Dr Nadeem said.

Asthma is not curable, but it is a controllable disease. A lot of people visit quacks in hope of getting cured, but they would get only strong dozes of oral steroids only to add their serious side effects to the disease.

He said that two types of treatment were easily available i.e reliever drug and controller drug. While the reliever drug should be taken only when required, the controller drug could be used on regular basis to prevent recurrent exacerbation.

"It is unfortunate that a majority of asthmatic patients does not take the controller medicine regularly, and thus continues to suffer repeated attacks which aggravates the problem," he said.

Both the types of medicines should be taken preferably through inhaler as a small amount of drug is required to produce desirable effect without causing any significant side effects.

"But again it is unfortunate that myths and misconceptions are attached to the use of inhaler. People say the inhalers an addictive, it is the last treatment of asthma, it should not be used during pregnancy, etc. All these views are without any grounds," he added.

He pointed out that in public sector hospitals, inhalers were not routinely available to poor asthmatic patients. "Indoor and outdoor pollution can be reduced by removing carpets and curtains, and keeping a minimum number of items in bed rooms. Regular cleaning and washing all bedding with warm water may also reduce the risk," he said.

Chest specialist at Vallika Social Security Hospital, Site, Dr Syed Zafaryab said that industrial workers, like those in cotton and marble industries and tanneries, were at great risk of occupational asthma due to non-availability of proper ventilation, masks, clean workplaces and environment, etc.

Assistant Prof of Chest Medicines at the JPMC Dr Nasir Hussain said that the International Study on Asthma and Allergy, conducted in 2001, showed that prevalence rate of asthma was 20 per cent in the children in the age group of 6-15 years, while the rate was 13 per cent in 1995 as transpired during a study that time.

"There are two main types of asthma - one early asthma, which may occur in childhood, and the other late onset asthma, which people can suffer after the age of 35 years." Major reasons of the increase in the prevalence of asthma is heavy environmental pollution and the under-treatment patients or patients with an undiagnosed disease.

He said that the study also attributed emergence of asthma to an increase in the use of junk food by children as another reason.

"People have not accepted use of medicine through inhaler which is first line treatment in the world," he observed, and said that asthma could be prevented by keeping house clean; making a minimum use of carpet, curtains and sofas; ensuring a reduction in environmental pollution; and refraining from smoking in presence of women and children.

Consultant Pulmonology, Liaquat National Hospital, Dr Mohammad Hussain said that asthma prevalence appeared higher in urban areas than rural areas and it was controllable.

He said that symptoms of asthma might be like dry cough, difficult breathing, whistling in breathing, and repeated occurrence of flu in children.-PPI