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BRONCHIAL ASHTHMA Bronchial asthma is a heterogeneous disease, usually characterised by chronic inflammatory disease of the airways. It is defined by history of dyspnoea, cough, chest tightness and wheezing, which vary over time and in intensity, together with variable expiratory airflow limitation. It results from narrowing of the airways produced by a combination of muscle spasm, mucosal oedema and viscid bronchial secretion. The airflow limitation is generally reversible spontaneously or with treatment. Role of allergens • The allergens responsible for asthma enter the body through various routes: • Inspired air (house dust, pollen, feather, animal dander, fungal spores, etc.). • Ingestion (allergens in fish, egg, milk, yeast and wheat). Previous exposures to these allergens will have stimulated the formation of IgE. Hence, subsequent exposure to these specific allergens will result in an anaphylactic antigen-antibody reaction in the bronchi. This causes the release of pharmacologically active substances from cells in the bronchial wall, which provoke bronchial constriction and inflammatory reaction, leading to symptoms. Severe acute asthma (status asthmaticus) • It is a condition in which severe airway obstruction and asthmatic symptoms persist despite the initial administration of standard acute asthma therapy. • Severe dyspnoea and unproductive cough. • Patient adopts an upright position fixing the shoulder girdle to assist the accessory muscles of respiration. • Physical signs on general examination include sweating, central cyanosis, tachycardia and pulsus paradoxus. Chronic asthma • Symptoms are usually chronic unless controlled by appropriate therapy. • Symptoms like chest tightness, wheeze and breathlessness occur on exertion. • Episodes of spontaneous cough and wheeze occur during the night. • Repeated attacks of "severe acute asthma" are common. • Chronic cough with mucoid sputum, punctuated by recurrent attacks of purulent expectoration from frank infection, is a common feature of chronic asthma. At times, it becomes difficult to distinguish it from chronic bronchitis. Management of bronchial asthma Goals of asthma management are: To achieve good control of asthma symptoms and maintain normal activities. To minimise future risk of exacerbation, fixed airflow limitation and medication side effects. Management of bronchial asthma can be discussed under the following broad headings: 1. Avoidance of allergens. 2. Modification of risk factors for exacerbation. 3. Ayurvedic rasayan therapy for avoid recurrence 4. Ayurvedic herbal Drug therapy to control or suppresS clinical manifestations. 5.Kantakari Awaleh, Vyaghriharitaki awaleh, Agasti haritaki awaleh Ayurvedic panchakarma vaman, virechan, basti , nasya, dhupan etc give best result to asthmatic patient