الفهرس 
ronchial AsthmaOnly 14 pages are availabe for public view
 |  | from | 124 |  |  |
| | | from | 124 | | |
Abstract
Asthma is a common chronic disorder of the airways that is characterized by variable and recurring symptoms, airflow obstruction, bronchial hyper-responsiveness, and an underlying inflammation. The interaction of these features of asthma determines the clinical manifestations and severity of asthma and the response to treatment.
Asthma guidelines used in the United States and internationally classify disease to 4 categories : Intermittent asthma , Mild persistent asthma , Moderate persistent asthma and Severe persistent asthma
Pathogenisis of bronchial asthma includes Bronchoconstriction,
Airway edema, Airway hyperresponsiveness then Airway remodeling
Asthma is one of the most common major non-communicable diseases and for many, has a substantial impact on quality of life.
300 million people have asthma worldwide
There is a large geographical variation in asthma prevalence, severity, and mortality. While asthma prevalence is higher in high income countries, most asthma-related mortality occurs in low-middle income countries
The prevalence of asthma in the Middle East is lower than most developed countries. However, there is not enough longitudinal data to estimate the trend over time.
Asthma can lead to premature death, hospital stays, reduced productivity and quality of life.
Overall, global asthma-related costs are high and significantly vary across countries, depending on several factors, such as the type of health system, financial resources on Public Health and methods of data collection.
Severe exacerbations of asthma are life-threatening medical emergencies, which are most safely managed in an acute care setting e.g. emergency department.
A brief history and physical examination should be conducted concurrently with the prompt initiation of therapy.
History should include time of onset and cause, severity of asthma symptoms, any symptoms of anaphylaxis, riskfactors for asthma-related death, all current reliever and controller medications
Physical examination The physical examination should assess signs of exacerbation severity, complicating factors and Signs of alternative conditions
Objective assessments are also needed by measurement of lung function, Oxygen saturation, Arterial blood gas measurements.
Treatments are administered concurrently to achieve rapid improvement which include: oxygen, Inhaled short-acting beta2-agonists, Systemic corticosteroids, Inhaled corticosteroids.
The aim of the study is to To assess knowledge, attitude and practice of Egyptian physicians about childhood asthma exacerbation treatment guidelines and to identify the barriers against application of guidelines in different hospital settings.
In this study a written questionnaire with different topics were added to achieve our study objective, this questionnaire was fulfilled by 200 pediatricians, all of them deal with childhood asthmatics.
Poor knowledge was found in 80.2% of participants, Poor practice was found in 59.4 % and poor attitude was found in 65.3% of them.
The main barriers against guideline application were found to be the external barriers followed by patient related barriers then personal barriers. while guideline related barriers were in the last rank.
There was no statistically significant difference between different academic degrees or different hospital types as regards knowledge, practice and different barriers against guidelines application.
There was positive statistically significant difference between different academic degrees as regards attitude towards guidelines, participants with the Bechelor degree had the best attitude towards guidelines followed by participants with Doctorate degree.
Conclusion
• Most of Egypyian pediatricians have poor knowledge, poor practice and poor attitude towards guidelines.
• Age of pediatrician, his academic degree and the type of hospital he is working in have no obvious correlation to their knowledge, practice and attitude towards guidelines.
• The main barriers against guideline application were found to be the external barriers followed by patient related barriers then personal barriers. While guideline related barriers were in the last rank.