Volume. 35, No. 2 july. 2011 - The Chest and Heart Association of ...

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Chest & Heart Journal Vol. 35, No.-2, July 20113 TB epidemiological profile. Revised onDecember 2010, [on line], Available at :http://www.who.int/tb/data4 De Cock KM & Wilkinson D. (1995)Tuberculosis control in resource poorcountries: alternative approaches in the eraof HIV. Lancet; 346:675-6775 National Guideline and Operational Manualfor Tuberculosis Control, 4thEdition.Tuberculosis Control Programe, 2009pp-19.6 Hamid Salim A, Aung KJ, Hossain MA, VanDeun A. (2006) Early and rapid microscopybaseddiagnosis of true treatment failure andMDR-TB. Int J Tuberc Lung Dis; 10(11); 1248–1254.7 International Union against Tuberculosis andLung Disease (IUATLD), 2005]. Tuberculosisbacteriology, priorities and indications in highprevalence countries: position of the technicalstaff of the Tuberculosis Division of theInternational Union Against Tuberculosis andLung Disease. Int J Tuberc Lung Dis; 9:355–361.8 Tsukiyama F, Katoh M, Matsuo Y. (1984)Modification of the fluorescent stainingmethod for mycobacterial cells. Hiroshima JMed Sci; 33: 293–295.9 Standard operative procedure. World HealthOrganization.2007, Geneva, Switzerland.10 Kantor IND, kim SJ, Frieden T, Laszlo A,Luelmo F, Norval P, Rieder H, ValenzuelaP, Weyer K.(1998) Laboratory service intuberculosis control, Geneva, World HealthOrganization. (WHO/TB/98.258).pp.16-31(part-II) & 9-59 (part-III).11. Harada S, Numata N. (1992) Application ofFDA/EB staining for the detection of viableor non-viable mycobacteria in clinicalspecimens. Kekkaku; 67: 113–117.12 Kvach JT, Veras JR. (1982) A fluorescentstaining procedure for determining theviability of mycobacterial cells. Int J Leprosy;50: 183–192.106
Chest & Heart JournalVol. 35, No. 2, July 2011REVIEW ARTICLEAsthma in Pregnancy – An OverviewMd.Abdul Qayyum 1 , Naimul Haque Sammi 1 , Nowsheen Sharmin Purabi 2 , Biswas AkhtarHossain 1 , Abu Raihan 1 , Rezaul Islam 3 , AKM Mustafa Hossain 4 , PMM Hiron 5Abstract:Backgrond:Asthma is an important chronic disorder of the airways withsignificant morbidity and mortality. Around 300 million people currently haveasthma.It is estimated that there may be an additional 100 million people withasthma by 2025. According to First National Asthma Prevalence Study(NAPS)1999 , in Bangladesh about 7 million people (5.2% of the population) are sufferingfrom current asthma (at least three episodes of asthma attack in last 12months).Asthma accounts for about 1 in every 250 deaths worldwide,althoughmodern management ,which obviously includes patient education,can prevent80% of such deaths. Asthma has been reported to affect 3.7 to 8.4% of pregnantwoman in the USA making it potentially the most common serious medicalproblem to complicate pregnancy.Maternal asthma increases the risk of perinatalmortality , preeclamsia ,preterm birth, and low birth weight infants,while bettercontrolled asthma is associated with decreased risks.Discussion: Asthma in pregnancy is often under-recognized and sub-optimallytreated. The course of asthma during pregnancy is variable – it improves , remainsstable, or worsens in similar proportions of women. Asthma during pregnancyfollows the rule of one-third ,that is one-third asthmatics become worse, one-thirdremains same and one-third improves. The exact mechanism behind this is notknown .It is common to experience some breathlessness near the end of thepregnancy,this is related to the size of the fetus and the pressure it puts on thediaphragm.The risk of an asthma exacerbation is high immediately postpartum.Acute asthma attacks can result in dangerously low fetal oxygenation , poor asthmacontrol is associated with pre-eclampsia as well as greater rates of caesarean section,pre-term delivery ,intra-uterine growth retardation and low-birth weight .Womenwith well-controlled asthma during pregnancy ,however, have outcomes as goodas those in their non-asthmatic counterparts .Triggers should be controlledmeticulously during pregnancy.They can influence the probability of giving birthto a wheezy baby. Active and passive smoking should also be avoided at this time.It increases the chances of wheezing in the new born .Woman with severe oruncontrolled asthma are at higher risk for pregnancy complication and adversefetal outcome than woman with well-controlled asthma Recent evidence basedguidelines have concluded that it is safer for pregnant women with asthma to betreated pharmacologically than to continue to have asthma symptoms exacerbation.Conclusion: All asthma medicines have been shown to be absolutely safe forboth the the mother and the baby. Inhaled route is always preferred.Acute attackof asthma is very rare in labor, perhaps due to endogenous steroidproduction.Asthma medications may enter the breast milk but the concentrationis extremely small and do not have any adverse effects on the baby.[Chest & Heart Journal 2011; 35(2) : 107-112]1. Assistant professors –NIDCH, Mohakhali, Dhaka2. Registrar, Gynaecology department,Anowar Khan Modern Medical College, Dhanmomdi ,Dhaka3. Registrar,Medicine ,NIDCH, Mohakhali, Dhaka4. Director ,NIDCH, Mohakhali, Dhaka5. Professor and former director,NIDCH,Mohakhali,DhakaCorrespondence to: Md.Abdul Qayyum, Assistant professors –NIDCH, Mohakhali, Dhaka
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