International network for natural sciences – research journal
  • mendeley icon
  • linkedin icon
  • google plus icon
  • twitter icon
  • google scholar icon
  • facebook icon

Assessment of asthma causes identified by spirometry in Lahore, Pakistan

By: Syed Shahid Imran Bukhari, Zulfiqar Ali

Key Words: ma, FEV1, FVC, Obstruction, Restriction, Spirometry.

Int. J. Biosci. 17(6), 202-217, December 2020.


Certification: ijb 2020 0105 [Generate Certificate]


This study was done to find out the causes of asthma in population of Lahore, Pakistan. Total of 2003 subjects from 9 administrative towns of Lahore, Pakistan were divided into 3 groups; G1 (normal), G2 (asthmatics with obstruction) and G3 (asthmatics with restriction) for spirometry over 1-year period (July, 2018-2019) at Jinnah hospital, Lahore using (Spirolab, IPX1FCC ID: TUK-MIR045 Roma-Italy). From 2003 subjects, 400 were randomly selected for questionnaire study consisting normal (n=200) and asthmatics (n=200). There were 60% records from male patients and 40% from female patients between the age limit of 07-104 years. Questionnaire depicted that more than 90% asthmatic subjects feel wheezy; 50% people did not have heredity asthma but had attached kitchen and bath; 60% people had complicated life style and joint family system; have pets, cockroaches, carpets and molds; more than 60% subjects use gas stove in their indoor. Data was analyzed using x2 tests for questionnaire and Pearson’s correlation coefficient (r) using SPSS (v.22). FVC and FEV1 < 80% of value and FEV1/FVC ratio < 70% were considered asthmatic. There was positive correlation between age (p<0.05) and FVC among G1 and G2. Age and prevalence of asthma were significantly positively correlated (p<0.05) in G3. G2 & G3 showed forces expiratory volume in 1 second (FEV1) or peak expiratory flow (PEF) < 60%. FVC was significantly correlated positively (p<0.05) with asthma prevalence. There was significantly positive correlation (p<0.05) for asthma prevalence. Various factors under this study impair life quality of asthmatics.

| Views 19 |

| Views 19 |

Assessment of asthma causes identified by spirometry in Lahore, Pakistan

Akinbami LJ, Schoendorf KC. 2002. Trends in childhood asthma: prevalence, health care utilization, and mortality. Pediatrics 110, 315-322.

Alam K, Trautmann T, Blaschke T, Majid H. 2012. Aerosol optical and radiative properties during summer and winter seasons over Lahore and Karachi. Atmospheric Environment 50, 234-245.

Al-Dousri AM. Al-Wahdi J. 2012. Dust fallout in northern Kuwait, major sources and characteristics. Kuwait Journal of Science 39(2A), 171-187.

Amato GD, Vitale C, Martino AD, Viegi G, Lanza M, Molino A. 2015. Effects on asthma and respiratory allergy of climate change and air pollution. Multidisciplinary Respiratory Medicine 10(39), 70-76.

Andrew S, Sean B, Stuart G, Lynette S, Michel D, Carol RS. 2012. Major complications, mortality and resource utilization after open abdominal surgery. Annals of Surgery 255(5), 821-829.

Asthma Clinical Research Network. 2006. History and organi­zation.

Asthma UK. 2008. Key Facts and statistics.

Aurora P, Stocks J, Oliver C. 2004. Quality control for spirometry in preschool children with and without lung disease. American Journal of Respiratory and Critical Care Medicine 16, 1152-1159.

Ayubi E, Safari S. 2017. Bias in association between FEV1/FVC% predicted at 7 years and asthma-chronic obstructive pulmonary disease overlap syndrome. American Journal of Respiratory and Critical Care Medicine 196(1), 39-46.

Bergen VVS, Verberne AA, De-Jongste JC, Pijinburgm MW. 2014. Asthma control questionnaires in the management of asthma in children: review. Pediatric Pulmonology 50(2), 202-208.

Bloom B, Dey AN. 2004. Summary Health Statistics for U.S. Children: National Health Interview Survey 10(227), 2006.

Bridevaux PO, Gerbase MW, Probst-Hensch NM, Schindler C, Gaspoz JM, Rochat T. 2008. Long-term decline in lung function, utilization of care and quality of life in modified GOLD stage 1 COPD. Thorax 63, 768-774.

British Thoracic Society-Scottish Intercollegiate Guideline Network. 2008. British Guideline on the Management of Asthma. Thorax 63(4), 1-121.

Broeders MEAC, Sanchis J, Levy ML, Crompton GK, Dekhuijzen PNR. 2009. On behalf of the ADMIT Working Group. The ADMIT series Issues in Inhalation Therapy. 2) Improving technique and clinical effectiveness. Primary Care Respiratory Journal 18, 76-79.

Buffels J, Degryse J, Heyrman J, Decramer M. 2004. Office spirometry significantly improves early detection of COPD in general practice. Chest 125(4), 1394-1399.

Chae EJ, Kim TB, Cho YS, Park CS, Seo JB, Kim N. 2011. Airway measurement for airway remodeling defined by post-bronchodilator FEV1? FVC in asthma: investigation using inspiration-expiration computed tomography. Allergy Asthma and Immunology Research 3(2), 111-117.

Chavannes N, Schermer T, Akkermans R. 2004. Impact of spirometry on GPs’ diagnostic differentiation and decision making. Respiratory Medicine 98, 1124-1130.

Dales RE, Vandemheen KL, Clinch J. 2005. Spirometry in the primary care setting: influence on clinical diagnosis and management of airflow obstruction. Chest 128, 2443-­2447.

De Marco R, Accordini S, Anto JM, Gislason T, Heinrich J, Janson C. 2009. Long-term outcomes in mild / moderate chronic obstructive pulmonary disease in the European community respiratory health survey. American Journal of Respiratory and Critical Care Medicine 180, 956-963.

Diaz-Lobato S, Mayoralas S, Buffels J. 2004. Underuse of spirom­etry in primary care. Chest 126, 1712.

Eaton T, Withy S, Garrett J, Mercer J, Whitlock RM, Rea HH. 1999. Spirometry in primary care practice: the importance of quality assurance and the impact of spirometry workshops. Chest 116, 416-423.

Engman LH, Bornehag CG, Sundell J. 2007. How valid are parents’ questionnaire responses regarding building characteristics, mouldy odour, and signs of moisture problems in Swedish homes. Scandinavian Journal of Public Health 35, 125-132.

Fassl BA, Noky FL, Stone BL, Srivastava R, Simon TD, Uchida DA. 2012. The joint commission children’s asthma care quality Measures and Asthma Readmissions. Pediatrics 130(3), 482-491.

Ferguson GT, Enright PL, Buist AS. 2000. Office

spirometry for lung health assessment in adults: a consensus statement from the National Lung Health Education Program. Chest 117, 1146-1161.

Global Initiative for Asthma (GINA). 2006. Global Strategy for Asthma Management and Prevention.

Global Initiative for Asthma (GINA). 2007. Global Strategy for Asthma Management and Prevention.

Guyatt GH, Juniper EF, Feeny DH. 1997. Children and adult perceptions of childhood asthma. Pediatrics 99, 165-168.

Haczku A, Reynold A, Panettieri J. 2010. Social distress and asthma; the role of corticosteroid intensity. Journal of Allergy and Clinical Immunology 125(3), 550-558.

Janson S, Weiss K. 2004. A national survey of asthma knowledge and practices among specialists and primary care physicians. Journal of Asthma 41(3), 343-348.

Jindal SK, Wahi PL. 1991. Pulmonary function laboratory in the tropics: needs, problems and solutions. Lung Biology In Health and Disease 523-542.

John MB, Schuemann B, Fuhlbrigge AL, Hollis BW, Strunk RB, Zeeiger RS. 2010. Serum vitamin D levels and severe asthma management programe study. Journal of Allergy and Clinical Immunology 126(1), 52-58.

Johns DP, Burton D, Walters JA, Wood-Baker R. 2006. National survey of spirometer ownership and usage in general practice in Australia. Respirology 11, 292-298.

Juniper E, Gruffydd-Jones K, Ward S. 2007.

Developing an interviewer-administered version of the asthma control question­naire (ACQ) for children f 10 years. European Respiratory Journal 30(51), 382.

Juniper EF, Bousquet J, Abetz L, Bateman ED. 2006. Identifying ‘well-controlled’ and ‘not well-controlled’ asthma using the Asthma Control Questionnaire. Respiratory Medicine 100, 616-21.

Juniper EF, Svensson K, Mork AC. 2005. Measurement properties and interpretation of three shortened versions of the asthma control questionnaire. Respiratory Medicine 99, 553-558.

Kaminsky DA, Marcy TW, Bachand M, Irvin CG. 2005. Knowledge and use of office spirometry for the detection of chronic obstructive pul­monary disease by primary care physi­cians. Respiratory Care 50(12), 1639-1648.

Khan AA, Tanzil S, Jmali T, Shahid A, Naeem S, Sahito A. 2014. Burden of asthma among children in a developing megacity: childhood asthma study, Pakistan. Journal of Asthma 51(9), 174.

Krieger J, Jacobd DE, Ashly PJ, Baeder A, Chew JL, Dearborn D. 2014. Housing interventions and control asthama related indoor biologic agents: a review of the evidence. Journal of Public Health Management Practices 16(5), 11-20.

Krieger J. 2010. Home is where the triggers are increasing asthma control by improving the home environment. Pediatric Allergy Immunology and Pulmonology 23(2), 23-26.

Lange P, Marrot JL, Vestbo J, Olsen KR, Ingebrigstsen TS, Dahl M. 2012. Prediction of clinical course of chronic obstructive pulmonary diseases, using new gold classification: a study of general population. American Journal of Respiratory and Critical Care Medicine 86(10), 990.

Magnoni SM, Latorrre M, Bettoncelli G, Sanchez-Herrero MG, Lopez A, Calvo E. 2017. Asthma control in primary care: the results of an observational cross sectional study in Italy and Spain. World Allergy Organization Journal 10(13), 1-7.

Malinovschi A, Fonseca Jacinto T, Alving Kjell A, Janson C. 2013. Exhaled nitric oxide levels and blood eosinophils counts independently associate with wheeze and asthma events in national health and nutrition examination survey subjects. Journal of Allergy and Clinical Immunology 132(4), 821-827.

Mannino DM, Buist AS, Vollmer WM. 2007. Chronic obstructive pulmonary disease in the older adult: what defines abnormal lung function? Thorax 62, 237-41.

Manuel AR, Matheson MC, Tang CS, Granell R, Ang W, Hui J. 2014. Genome wide association analysis identifies 11 risk variants associated with the asthma with hay fever phenotype. Journal of Allergy and Clinical Immunology 133(6), 1564-1571.

Melbye H, Drivenes A, Dalbak LG, Leinan T, Hoogh-Henrichson S, Ostrem A. 2011. Asthma chronic obstructive pulmonary disease or both. Diagnostic labeling and respiratory in primary care patients aged 40 years or more. International Journal Chronic Obstructive Pulmonary Diseases 6, 597-603.

Miller MR, Hankinson J, Brusasco V. 2005. Standardization of spirometry. European Respiratory Journal 26(2), 319-338.

Minov J, Karadzinska-Bislimovska J, Vasilevska K, Nelovska K, Risteka-Kuc S, Stoleski S. 2012. Smoking among macdonian workers five years after the anti-smoking campaign. Arhiv Za Higijenu Rada I Toksikologiju 63, 207-213.

Moore WC, Mayer DA, Wenzel SE, Teaguew G, Li H, Li X. 2010. Identification of asthma phenotypes using cluster analysis in the severe.American Journal of Respiratory Critical Care

Medicine 181(4), 315-323.

Yawn BP, Enright PL, Lemanske Jr RF, Israel E, Pace W, Wollan P, Boushey H. 2007. Spirometry can be done in family physicians’ offices and alters clinical decisions in management of asthma and COPD. Chest 132(4), 1162-8.

Nafees AA, Fatmi Z, Kadir MM. Sathiakumar, N. 2013. Patterns and predictors for respiratory illness and symptoms and lungs function among textile workers in karachi Pakistan. Occup Environ Med 2013; 70(2):372-377.

National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines or the Diagnosis and Management of Asthma. Bethesda, MD: Natl Inst Health Publication 08, 4051.

O’Dowd LC, Fife D, Tenhave T, Panettieri RA. 2003. Attitudes of physicians toward objective measures of airway function in asthma. The American Journal of Medicine. 114(5), 391-396.

Osuntogun AA, Arriaga RI. 2010. Physician usage of tech­nology and opportunities for continuous care management of pediatric asthma patients. International Conference on Perrasive Computing Technologies Health care 20, 1-6.

Paramesh, H. 2002. Epidemiology of asthma in India. Indian J Pediatrics 69(4), 309-312.

Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd, SS. 2004. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. American Journal of Respiratory Critical Care Medicine 163, 1256-76.

Poels PJP, Schermer TRJ, Jacobs A. 2006. Variation in spirometry utilization between trained general practi­tioners in practices equipped with a spirometer. Scand Journal of Primary Health Care 24, 81-87.

Raghunath AS, Innes A, Norfolk L. 2006. Difficulties in the interpretation of lung function tests in the diagnosis of asthma and chronic obstructive pulmonary disease. Journal of Asthma 43, 657-660.

Rasheed A, Aneja VP, Aiyyer A, Rafique U. 2015. Measurement and Analysis of Fine Particulate Matter (PM2.5) in Urban Areas of Pakistan. Aerosol Air Quality Research 15(2), 426-439.

Reddel HK, Taylor DR, Bateman ED. 2009. An Official American Thoracic Society/European Respiratory Society Statement: Asthma Control and Exacerbations: Standardizing Endpoints for Clinical Asthma Trials and Clinical Practice. American journal of respiratory and critical care medicine 180, 59-99.

Reinero CR. 2011. Advances in the understanding of pathogenesis and diagnostics and therapeutics for feline allergic asthma. The Veterinary Journal 190(1), 28-33.

Rhee CK, Yoon H, Hyoung HK, Yoo KH, Kim YS, Lee SW, Park YB. 2014. Medical utilization and cost in patient with overlap syndrome of chronic obstructive pulmonary disease and asthma. Journal of Chronic Obstructive Pulmonary Diseases 11(2), 163-170.

Schermer TR, Jacobs JE, Chavannes NH. 2003. Validity of spirometric testing in a general practice population of patients with chronic obstructive pulmonary disease. Thorax 58, 861-866.

Shah SI, Arooj F. 2019. Outdoor Air Quality as Influenced by Vehicular Exhaust in Metropolitan City of Lahore, Pakistan. Pakistan Journal of Scientific & Industrial Research Series A: Physical Sciences 62(3), 190-196.

Sidra S, Ali Z, Sultan S, Ahmed S, Colbeck I, Nasir ZA. 2015. Assessment of airborne micro flora in the indoor micro-environments of residential houses of Lahore, Pakistan. Aerosol and Air Quality Research 15(6), 2385-2396.

Smith KR, Samet JM, Romieu I. 2000. Indoor air pollution in developing countries and acute lower respiratory infections in children. Thorax 55, 518-532.

Sun YX, Sundell J, Zhang Y F. 2007. Validity of building characteristics and dorm dampness obtained in a self-administrated questionnaire. Sci Total Environ 387, 276-282.

Tasai CH, Huang JH, Hwang BF, Lee YL. 2010. Household environmental tobacco smoke and risks of asthma, wheeze and bronchitis symptoms among children in Taiwan. Respir Res 11(11), 9921-9925.

Tashkin DP, Cooper CB. 2004. The role of long-acting bronchodilators in the management of stable COPD. Chest 125, 249-259.

Thomas M, Gruffydd-Jones K, Stonham C, Ward S, Macfarlane T. 2009. Assessing 67 asthma control in routine clinical practice: use of the Royal College of Physicians ‘3 Questions’. Primary Care Respiratory Journal 18, 83-88.

Thomas SD, Whitman S. 1999. Asthma hospitalizations and mortality in Chicago: an epidemiologic overview. Chest 116, 135S-141S.

UN, 2019. World Population prospects 2019. Pakistan Metro Area Population 1950-2020.

Van Schayck CP, Loozen JMC, Wagena E, Akkermans RP, Wesseling GJ. 2002. Detecting patients at a high risk of developing COPD in general practice: cross-sectional case finding study. BMJ 324, 1370-1375.

Vaz Fragoso CA, Concato J, McAvay G, Van Ness PH, Rochester CL, Yaggi HK, Gill TM. 2010. Chronic obstructive pulmonary disease in older persons: a comparison of two spirometric defi­nitions. Respiratory Medecine 104(8), 1189-96.

Vollmer WM, Gislason T, Burney P, Enright PL, Gulsvik A, Kocabas A, Buist AS. 2009. Comparison of spirometry criteria for the diagnosis of COPD: results from the BOLD study. European Respiratory Journal 34, 588-97.

Wadson SJ, Sanford AW. 2013. Personalized medicine and asthma diagnosis/ management. Current Allergy and Asthma Reports 13(1), 118-129.

Wadsworth SJ, Sandford AJ. 2013. Personalized medicine and asthma diagnostic medicine/ management. Current Allergy and Asthma Reports 13(1), 118-129.

Walker PP, Mitchell P, Diamantea F. 2006. Effect of primary care spirometry on the diagnosis and management of COPD. European Respiratory Journal 28, 945-952.

Yawn BP, Enright PL, Lemanske RF Jr. 2007. Spirometry can be done in family physi­cians’ offices and alters clinical decisions in management of asthma and COPD. Chest 132(4), 1 162-11.

Yeatts K, Davis KJ, Sotir M, Herget C, Shy C. 2003. Who gets diagnosed with asthma, frequent wheeze among adolescents with and without a diagnosis of asthma? Pediatrics 111, 1046 -1054.

Yoos HL, Kitznian H, MeMullen A, Henderson C, Sidora K. 2002. Symptom monitoring in childhood asthma: a randomized clinical trial comparing peak expiratory flow rate with symptom monitoring. Annals of Allergy Asthma and Immunology 88, 283-91.

Yun TJ, Jeong HY, Lee HR, Arriaga RI. Abowd GD. 2010. Assessing asthma management practices through in-home technology probes. Pervasive Computing Technologies Healthcare 1-9.

Zheng XH, Qiang H, Zhao YL. 2013. Home risk factors for childhood pneumonia in Nanjing, China. Chinese Science Bulletin 58, 4230-4236.

Syed Shahid Imran Bukhari, Zulfiqar Ali.
Assessment of asthma causes identified by spirometry in Lahore, Pakistan.
Int. J. Biosci. 17(6), 202-217, December 2020.
Copyright © 2020
By Authors and International Network for
Natural Sciences (INNSPUB)
innspub logo
english language editing
    Publish Your Article
    Submit Your Article
Email Update