Ganesapandian, P (2012) The Role of Hereditary Propensity, Environmental Factors and the Possible Phenotypic Association in Physician Diagnosed Asthma. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION: Childhood asthma has emerged perhaps as the commonest chronic medical problem treated by pediatricians all over the world. What was originally thought to be a disorder affecting only adults has emerged as a very significant problem affecting child‘s lifestyle and day-to-day activities including schooling, sports and recreation. It is responsible for significant social, economic and psychological impact on the family.(1) An estimated 1.9 disability adjusted life yrs (DALYs) are lost every year due to asthma per thousand children under 15 yr of age in India.(2) The incidence of asthma is increasing alarmingly in the past few decades. Inspite of the intense research efforts, the etiology of asthma and the reason for the increasing trend in prevalence have yet to be established. The exact etiology of asthma is not precisely known. The cause may be multifactorial. The hereditary propensity and environmental trigger factors play a significant role in the possible etiology and in the course of the disease process. Hence the study on hereditary and environmental factors will be useful especially in our population. AIM OF THIS STUDY: To study the role of hereditary propensity and environmental factors in physician diagnosed asthma. To correlate the phenotypes of asthma (atopic and nonatopic) with inflammatory cells observed in the bronchoalveolar lavage (BAL) fluid. DISCUSSION: Asthma is a disease characterized by variability of airflow obstruction and episodic occurrence of symptoms in individual patients ('attacks'). It is also a disease which varies in prevalence and severity within populations, between countries, and over time. The environment, in terms of chemical and biological air pollutants, is much more clearly related to the provocation of asthma attacks and to asthma severity than it is to the induction of the asthmatic state and the prevalence of asthma where the genes are related to the causation of asthma. Genetic factors influence susceptibility to the development of asthma regardless of the environment whereas environmental exposures may also influence to some degree the susceptibility to asthma in the absence of genetic predisposition (13). In our study, 250 asthmatic children and 250 nonasthmatic children were taken as cases and controls respectively. Among them 52% were males and 48% were females with nearly equal distribution with slight male preponderance where S. Hasan Arshad et al(21) and other studies (22,23,24,65) observed that asthma prevalence is higher in males than females. Though there was no gender difference observed in two earlier studies(25,26) these studies followed a different methodology and the former was carried out a longtime ago. The male predominance may be related to a greater degree of reduced tone of airways in males compared to females(27) in early childhood. But one study has revealed the female preponderance(28). Out of them 52.8% were found in the age group of 4-8yrs , where as 47.2% were found in 9-12yrs of age(29). In our study, males dominate in the age group of 4-8yrs where as females start to dominate in 9-12yrs of age(28). But this picture does not clearly depict the prevalence in age groups as the children less than 4 years were not included in this study. CONCLUSION: This study reinforces that asthma has multifactorial aetiology. Our results confirm the hypothesis that the mechanism underlying this phenomenon is complex, without a single factor that could be identified as the principal cause. Ultimately it is inferred that asthma is due to interaction between the genetic and environmental factors. The role of risk factors in our study correlate well with the previous literatures. In our study, the following factors are independently related to the risk of developing asthma. 1. Personal atopy, 2. Family H/O asthma, 3. Cold air allergy, 4. Cooking with wood Measures to reduce exposure to environmental allergens and irritants and to eliminate barriers to access to health care are likely to have a major positive impact. Both atopic(eosinophilic) and nonatopic(neutrophilic) asthmatic patients respond well to inhalational corticosteroids. But followup is necessary in neutrophilic variety.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Role ; Hereditary Propensity ; Environmental Factors ; Possible Phenotypic Association ; Physician Diagnosed Asthma |
| Subjects: | MEDICAL > Paediatrics |
| Depositing User: | Ravindran C |
| Date Deposited: | 13 Apr 2018 11:41 |
| Last Modified: | 13 Apr 2018 11:41 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6997 |
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