Primary care respiratory journal : journal of the General Practice Airways Group
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Pakistan has a population exceeding 160 million. Communicable diseases remain the most important health problem in Pakistan, with non-communicable diseases and injuries comprising a quarter of all deaths. ⋯ The WHO's Global Alliance against Chronic Respiratory Diseases (GARD) is expected to be launched in 2008. This will be a platform for strengthening primary care respiratory activities with the involvement of the International Primary Care Respiratory Group (IPCRG). Various non-governmental organisations have plans to promote awareness regarding all aspects of allergy, asthma, COPD, and other chronic respiratory diseases, in the future.
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The 2008 BTS/SIGN British Guideline on the management of asthma provides comprehensive updated evidence-based guidance on asthma management for healthcare professionals. This primary care-focussed summary has been produced to aid dissemination and implementation of the key guideline messages into primary care. The section on diagnosis emphasises the new integrated symptom-based approach with clinicians using their deductive skills to determine the probability that the patient has asthma. ⋯ Personalised asthma action plans for guided self management should be provided and used when levels of asthma control change. There are sections on difficult asthma and the treatment of exacerbations and acute severe asthma. Various outcome measures for auditing the quality of asthma care are discussed.
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Multicenter Study Controlled Clinical Trial
The use of microspirometry in detecting lowered FEV1 values in current or former cigarette smokers.
COPD is an underdiagnosed disease. This study was undertaken to assess the value of microspirometry in detecting reduced FEV1 values in cigarette smokers, i.e., subjects at high risk for COPD. ⋯ Microspirometry finds a considerable number of smokers or ex-smokers with reduced FEV1 values. Microspirometry is quick to perform. All smokers with reduced microspirometry FEV1 values would benefit from smoking cessation, and all patients with reduced FEV1 values need to be considered for full spirometry to confirm if they actually have COPD.
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Prolonged cough is a frequent problem in the community. Several studies in the school setting have found that as many as 4.8% to 10.4% of children suffer from prolonged cough. There is no consensual definition of prolonged cough. ⋯ In absence of signs of specific underlying illness, coughing is generally a self-limiting condition. Symptomatic treatments have not yet been proven to be effective, and many of them may cause serious side effects. Their use should therefore be limited.