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Book Reviews Indian Pediatrics 2001; 38: 1075 |
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Childhood Asthma - A Rational Approach to Management. |
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Authors : J.N. Sharma, G.R. Sethi. Indian Academy of Pediatrics, Assam State Branch, Guwahati, Pages 44, Price Rs. 30.00. In recent years, a good understanding of the pathophysiology and clinical pattern of childhood bronchial asthma has evolved. Extensive clinical research on the application of inhaled drugs, particularly steroids, and the universal availability of inhalation devices has enabled development of consensus regarding the various aspects of management, making it easier for physicians to follow uniform guidelines. ‘Childhood Asthma- a rational approach to management’ is a concise booklet aimed at guiding clinicians on the practical aspects of asthma care. The information is presented in a clear and systematic manner. A brief description of the definition, pathogenesis and diagnosis of asthma is followed by an outline of the assessment of the severity of asthma and categorization into mild intermittent, mild persistent, moderate persistent and severe persistent disease. Stepwise approach to management including supportive therapy is covered in short chapters on chronic and acute asthma, and an algorithm for handling difficult and poorly controlled asthma is included. A brief account of inhaled therapy and delivery systems is also provided along with tips related to their selection and use. The management protocols recommended in the book are standard and straightforward, and will simplify the clinician’s approach to the patient. The practical utility of the book is enhanced by its brevity and clarity of expression, and the well-presented flow charts. The choice of inhalation devices in the different age groups is mentioned but other differences in approach towards drug therapy in infants/small children and older children in the long-term management of asthma could have been more clearly outlined. The table on drugs and dosage is quite appropriate, and could have incorporated oral drugs tabulated elsewhere. In the next edition it would be pertinent to include practical guidelines for managing acute and chronic asthma in a peripheral/small clinic setting and to highlight low-cost alternatives in the choice of drugs and devices for patients who cannot afford expensive therapy. The booklet promises to be a useful and handy desktop ready reference for practicing pediatricians and residents. It would also benefit medical students and nurses to grasp the essentials of management of a disease as common and important as childhood asthma. Daljit Singh, |
