Asthma is one of the most common chronic diseases in the world. Perhaps the most commonly discussed respiratory disease after the common cold. The word asthma is derived from a Greek work meaning 'breathlessness or panting" both of which accurately describe an attack of asthma.

"Among the Diseases whereby the Region of the breath is wont to be infested, if you regard their tyranny and cruelty, an Asthma (which is sometimes by reason of a peculiar symptom denominated likewise an Orthopnoea) doth not deserve the last place; for there is scarce any thing more sharp and terrible than the fits there of Breathing, whereby we chiefly live, is very much hindered by the assault of this disease, and is in danger, or runs the risk of being quite taken away."

-Thomas Willis, 1674 

An asthma attack leads to lung infection, tiredness and cough and it is not surprising that asthma is a leading medical cause of absenteeism of children from school and adults from work The attack can be seasonal when the pollen count is high in the atmosphere. An attack of asthma leads to breathing difficulties and the attack can be acute when it lasts for a short period or chronic when it lasts for days. The attack can also be mild or severe and a life threatening one.

An asthma attack leads to lung infection, tiredness and cough and it is not surprising that asthma is a leading medical cause of absenteeism of children from school and adults from work The attack can be seasonal when the pollen count is high in the atmosphere. An attack of asthma leads to breathing difficulties and the attack can be acute when it lasts for a short period or chronic when it lasts for days. The attack can also be mild or severe and a life threatening one.

The conservative estimates are that about 300 million people are suffering from the condition worldwide. In India, there are approx. 40 million who have the disease and the number is rising everyday. In recent decade there has been a global increase in the burden of the disease among both children and adults. This maybe due to westernization of lifestyles and increasing atmospheric pollution. By 2025.there are likely to be 400 million asthma sufferers worldwide. The more worrying aspect of the disease is that it accounts for about 1 in every 250 deaths worldwide and 90% of these deaths are preventable. Most deaths are due to delay in seeking help and sub-optimal long-term treatment strategies due to the lack of education and awareness about the disease.

Asthma is a condition in which the airways of the lungs become either narrowed or completely blocked, obstructing normal breathing. This obstruction of the lungs, however, is reversible, either spontaneously or with medication. That is why asthma is technically called Reversible Obstructive Airway Disease (ROAD). The basic abnormality causing asthma is the hyper responsive reaction of the body to specific and non-specific stimuli.

Air reaches the lung through the windpipe (trachea), which divides into two large tubes (bronchi), one for each lung. Each bronchi further divides into many little tubes (bronchioles), which eventually lead to tiny air sacs (alveoli), in which oxygen from the air is transferred to the bloodstream, and carbon dioxide from the bloodstream is transferred to the air.

Although the airways normally have the potential for constricting in response to allergens or irritants, the asthmatics airways are more prone to constriction due to increased response to allergens. This insult makes the airways more prone to infection leading to inflammation and swelling causing further constriction of the pipes. Infection also causes increased mucus production and this clogs the narrowed airways.

Once the airways have become obstructed, it takes more effort to force air through them and breathing becomes labored. This forcing of air through constricted airways can make a whistling sound, called wheezing. Irritation of the airways by excessive mucus may also provoke coughing.

Because exhaling through the obstructed airways is difficult, too much stale air remains in the lungs after each breath. This decreases the amount of fresh air which can be taken in with each new breath, so not only is there less oxygen available for the whole body, but more importantly, the high concentration of carbon dioxide in the lungs causes the blood supply to become acidic. This acidity in the blood may rise to toxic levels if the asthma remains untreated.

Common allergens associated with asthmatic responses are :

Foods : Nuts, peanuts, chocolate, eggs, citrus fruits, milk

Plants or plant products : Pollens, grasses, mold spores

Animal or insect materials : Dust mites, animal dangers, feathers, canine or feline saliva Numerous scientific studies have shown that avoidance of specific allergens in patients with asthma who have been previously sensitized will result in improved asthma symptoms and decreased medication requirements

When the respiratory system is working properly, the air we breathe passes in and out of the lungs through a network of airways. But for people with asthma, even a minor irritant will set off an immune response that can shut down the airways.

Asthmatic symptoms are usually quite variable, someone with asthma may go for periods of time without symptoms, and then suddenly have severe episodes for days at a time. The most common symptom is wheezing.

How can Asthma be treated ?

Remember asthma cannot be completely cured but can be prevented. Treatment of asthma can be divided into two broad categories:

Treatment of Acute attacks of asthma using quick-relief
medications.
Long Term treatment strategies

Treating an Acute attack of asthma -
The quick-relief medications work by relaxing bronchial smooth muscle and are called broncho-dilators. These can reverse an acute attack in a short time.

During an acute attack of Asthma the following should be done:

Always keep your blue inhaler with you.

Take a puff from the inhaler

Loosen any tight clothing and sit-up.

Open the windows of the room if room is warm and humid.

If no immediate improvement felt during an attack, continue to take one puff of inhaler every minute for 3 to 5 minutes or until symptoms improve.

If your symptoms do not improve in five minutes or if you are in doubt, call your doctor or visit the nearest hospital

It is important to recognize a life threatening attacks of asthma. This situation should be suspected if -

The reliever (blue) inhaler does not help.
The symptoms get worse (cough, breathless, wheeze, tight chest).
If you are too breathless to even speak

Long-term treatment strategies:
There are three broad strategies to follow:

Controlling the environmental impact on asthma
The first step in long-term asthma management is trying to control the environment in which you live. Although the environment cannot be changed totally but one can control its impact on our health. 

The following measures would lessen asthma attacks

World Asthma Day is observed on the first Tuesday in May. This year it falls on May 3. World Asthma Day is a organized by Global Initiative for Asthma (GINA) in association with World Health Organization and US National Heart, Lung and Blood Institute. The theme for 2005 is 'Unmet Needs of Asthma'. The primary goal of this day is to improve awareness about the disease among health care providers and workers,government officials , general public and all those under the grip of this disease.