Clinical study of bronchial asthma in children aged 5 to 12 years with special reference to peak expiratory flow rate


  • Srinivasa K. Department of Pediatrics, MVJ Medical College & Research Hospital, Bangalore, Karnataka, India
  • Ushakiran C. B. Department of Pediatrics, Mysore Medical College& Research Hospital, Mysore, Karnataka, India
  • Sudha Rudrappa Department of Pediatrics, Mysore Medical College& Research Hospital, Mysore, Karnataka, India



Bronchial asthma, PEFR, Bronchodilator


Background: Asthma is one of the most common chronic diseases worldwide imposing a substantial social burden on both children and adults. Over the last 20 years its prevalence has considerably increased, especially among children. The aim of present study is to study the clinical features of bronchial asthma and to assess objective response of PEFR to bronchodilator therapy.

Methods: After taking detailed history, clinical examination, the PEFR was recorded in fifty symptomatic bronchial asthma children between 5-12 years of age group before and after salbutamol nebulization. They were compared with PEFR values of normal children from same population in same age group, height range, weight range and sex.

Results: Among Fifty cases studied, maximum number (44%) of cases of asthma was found in the age group of 11-12 years with male: female ratio 1.77:1. Cough and wheeze were predominant symptom and was present in all cases (100%). Cold air in 24 (48%) cases, URTI in 15 (30%) cases, dust in 8 (16%) cases and cold food in 3 (6%) cases were found to be important precipitating factors. There was significant reduction in PEFR (L/min) in study group as compared with control group. The percentage of improvement in PEFR was 21.3% after bronchodilator therapy which is statistically significant (P<.000).

Conclusions: Significant improvement in PEFR following bronchodilator therapy indicates its usefulness in monitoring the response to treatment of asthma and however serial recording of PEFR is recommended for better management and control of asthma in childhood.


Global Intiative for Asthma, Global strategy for Asthma Management and prevention, National Institute of Health, Updated 2012, National Heart, Lung, and Blood institute Revised, 2002.

Liv AH, Spahn JD, Leung DYM. Childhood Asthma. In Nelson Textbook of pediatrics 17th Edition, Editor Behrman R.E. Kliegman R.M., Janson HB, Philedelphia, WB Saunders company. 2004:760-78.

Singh V. Bronchial Asthma in API textbook of Medicine, 7th Edition, Editor Shah S.N. Paul M.A. National Book Depot, Mumbai. 2003:291.

National Institute of Health, National Heart, Lung and Blood Institute. National Asthma Education and prevention programme. Export panel Report 2: Guidelines for the Diagnosis and Management of Asthma. 1997:1143.

Perks WH, Tams IP, Thampson DA, Prowse K. An evaluation of mini Wright Peak Flow Meter. Thorax. 1979;34:79-81.

Oldman HG, Bevan MM, McDermott M. papers comparison of new miniature Wright peak flow meter with the standard Wright Peak Flow Meter. Thorax. 1989;34:807-9.

Morgan WJ, Martinez FD. Risk Factors for Developing wheezing and Asthma in childhood. PCNA. 1992;39(6):1185-203.

Celedon JC, Soto-Quiros ME, Silver man EK, Hanson LA, Weiss ST. Risk factors for childhood asthma in costa Rica. American College of Chest Physian. 2001;120:785-90.

Lee YL, Lin YC, Hsiue TR, Hwang BF, Guo YL. Indoor and outdoor environmental exposures, parental atopy, and physian-diagnosed asthma in Taiwanese schoolchildren. Pediatrics. 2003;112(5):e389.

Singh M. The burden of asthma in children: an Asian perspective. Pediatric Respiratory Reviews. 2005;6(1):14-9.

Aligne CA, Auinger P, Byrd RS, Weitzman M. Risk factor for pediatirc asthma. Contribution of poverty, race and urban residence. American journal of respiratory critical care Medicine. 2000;162:878-7.

Overview of pathogenesis of asthma. National Asthma Education and Prevention program, Expert Panel Report: guidelines for the diagnosis and management of asthma, 2002.

Chakravarthy S, Singh RB, Swaminathan S, Venkatesan P. Prevalence of Asthma in urban and rural children in Tamil Nadu. Natl Med J India. 2002;15(5):260-3

Paramesh H. Epidemiology of Asthma In India India J Pediatr. 2002:69:309-12.

Roldaan AC, Mansural N. viral respiratory infection in asthmatic children staying in mountain resort. Eur J Respir Dis. 1982;63:140.

Ratageri Vinod H, Kabra S.K, Dwivedi S.N, Seth V. Factors associated with severe asthma, Indian pediatrics. 2000;37:1072-82.

Tomac N, Demirel F, Acun C, Ayoglu F. prevalence and risk factor for childhood asthma in Zonguldak, Turkey. Allergy Asthma proc. 2005;26(5):397-402.

Bener A, Jonahi IA, Sabbah A, Genetics and environmental risk factors associated with asthma in schoolchildren. Allergy immunol (Paris). 2005;37(51):163-8.

Blair H. Natural history of childhood asthma,20 years follow up. Archives of disease in childhood. 1997 ; 52 : 613- 619.

Penard-Morand C, Raherison C, Kopferschmitt C, Caillaud D, Lavaud F, Charpin D, et al. Prevalence of food allergy and its relationship to asthma and allergic rhinitis in schoolchildren. Allergy. 2005;60(9):1165-71.

Ulrik CS. peripheral Eosinophil count as a marker of disease activity in Intrinsic and extrinsic Asthma. Clinics Expert Allergy. 1993;25:820-7.

Mueller G, Eigen H. Pediatric Pulmonary function testing in Asthma, PCNA. 1992;39(6):1243-57.

John K, Ptaff MD, Wayne J, Morgan MD. Pulmonary Function in Infants and children. Respiratory Medicine I. PCNA. 1994;41(2):401-25.

Slieker MG, Van der Ent CK, The diagnostic and screening capacities of peak expiratory flow measurements in the assessment of airway obstruction and bronchodilator response in children with asthma. Monaldi Arch Chest Dis. 2003;59(2):155-9.

Brand PL, Duiverman EJ, postma DS, Waalkens HJ, Kerrebijn KF, Van Essen-Zandvliet EE. Peak flow variation in childhood asthma: relationship to symptoms, atopy, airways obstruction and hyperresponsiveness. Dutch CNSLD Study Group. Eur Respir J. 1997;10(6):1242-7.






Original Research Articles