for www.dnbpediatrics.com

1. STUDY OF PEFR IN BRONCHIAL
ASTHMA
- ANTHROPOMETRIC CORRELATION
Dr.Sushmita Ghosh,
DNB Final Year,
JLNHRC
BHILAI
dnbpaediatrics.blogspot.in

2. INTRODUCTION
 Bronchial Asthma derived from ancient greek
word meaning panting
dnbpaediatrics.blogspot.in
 Paroxysmal and reversible obstruction of airways
 Public health problem
 Commonest chronic medical condition in children
 Acute severe asthma can be life threatening and
disease causes significant morbidity

3. AIMS & OBJECTIVES
 Measurement of PEFR in asthmatic children
during acute exacerbation
 Comparison of PEFR:prebronchodilation &
postbronchodilation
 Correlation of PEFR with height & chest
circumference
 Comparison of the data with the control
group dnbpaediatrics.blogspot.in

4. MATERIAL & METHODS
 Prospective study
 Duration of study:-1 yr
 Hospitalized children with
bronchial asthma in age group
6-14 yrs
 Measurement of
PEFR:prebronchodilation and
10-15 mts after
bronchodilation
 Comparison with PEFR of
normal children in same age
group FERRARI’S PEAK EXPIRATORY FLOW METER
 Correlation with height and
chest circumference
 Statistical analysis of
observations
dnbpaediatrics.blogspot.in

5. Measurement of PEFR pre-
&postbronchodilation
dnbpaediatrics.blogspot.in

6. OBSERVATION
dnbpaediatrics.blogspot.in

7. AGE WISE DISTRIBUTION(Cases,n=41)
2
5 14 yrs
No.of patients 5 13 yrs
4
1 6
12 yrs CASES
11 yrs
5
10 yrs
5
5 9 yrs
4 8 yrs
7 yrs
0 1 2 3 4 5 6 7 6 yrs
AGE of patients
AGE WISE DISTRIBUTION(Control,n=403)
32
14 yrs
59
AGE of patients
45 13 yrs
59 12 yrs
CONTROLS 1 50
11 yrs
39
50 10 yrs
40 9 yrs
35 8 yrs
7 yrs
0 10 20 30 40 50 60 70
6 yrs
No.of patients
dnbpaediatrics.blogspot.in

8. CASES
SEX DISTRIBUTION(Cases,n=41)
0.7 65.80%
0.6
PERCENTAGE
0.5
0.4 34.20% MALES
0.3 FEMALES
0.2
0.1
0
MALES FEMALES
SEX DISTRIBUTION(CASES)
FEMALE,
34.20%
male
female
MALE 65.8%
dnbpaediatrics.blogspot.in

9. TYPE OF ASTHMA
6
5 4
MOD.PERSISTENT
MOD.PERSISTENT
4
TYPE
MILD PERSISTENT
3
3 MILD PERSISTENT MILD INTERMITTENT
2
1 34
MILD
INTERMITTENT
0 10 20 30 40
NO.OF PATIENTS
TYPE OF ASTHMA
7%
10%
MILD INTERMITTENT
MODERATE PERSISTENT
MILD PERSISTENT
83%
dnbpaediatrics.blogspot.in

10. BRONCHIAL ASTHMA
BRONCHIAL REVERSIBILITY
0.9
0.8
0.7
% OF PEFR
0.6
0.5 PREBRONCHODILATION
0.4 POSTBRONCHODILATION
0.3
0.2
0.1
0
1 4 7 10 13 16 19 22 25 28 31 34 37 40
PATIENTS
dnbpaediatrics.blogspot.in

11. dnbpaediatrics.blogspot.in

12. COMPARISON of PEFR of CASES & CONTROLS
500
400
PEFR(L/min)
prebronchodilation
300
postbronchodilation
200
control
100
0
1 2 3 4 5 6 7 8 9
HEIGHT 100,110,120,130,140,150,160,170,180 cms)
dnbpaediatrics.blogspot.in

13. CONTROLS
SEX DITRIBUTION(Control,n=403)
0.6 56.07%
0.5 43.92%
PERCENTAGE
0.4
MALE
0.3
FEMALE
0.2
0.1
0
MALES FEMALES
SEX DISTRIBUTION(CONTROL)
43.92%
MALE
FEMALE
56.07%
dnbpaediatrics.blogspot.in

14. GROUPS- A(6,7,8 yrs)
B(9,10,11 yrs)
C(12,13,14 yrs)
SEX DISTRIBUTION(Groups)
160
140
120
76 58
100 55
FEMALE
NO.
80
MALE
60
40 70 73 79
20
0
A B C
GROUPS
dnbpaediatrics.blogspot.in

15. GROUP A
Ht-PEFR correlation(n=125)
300
250
PEFR(L/min)
200
male
150
female
100
50
0
100-109 110-119 120-129 130-139 140-149
Height(cms)
dnbpaediatrics.blogspot.in

16. GROUP B
Ht-PEFR correlation(n=149)
400
350
300
PEFR(L/min)
250
male
200
female
150
100
50
0
120-129 130-139 140-149 150-159 160-169
HEIGHT(cms)
dnbpaediatrics.blogspot.in

17. GROUP C
Ht-PEFR correlation(n=137)
500
400
PEFR(L/min)
300 male
female
200
100
0
130-139 140-149 150-159 160-169 170-179 180-189
HEIGHT(cms)
dnbpaediatrics.blogspot.in

18. GROUP A
CHEST CIRCUMFERENCE-PEFR correlation(n=125)
250
200
PEFR(L/min)
150 MALE
100 FEMALE
50
0
40-49 50-59 60-69
CHEST CIRCUMFERENCE(cms)
dnbpaediatrics.blogspot.in

19. GROUP B
CHEST CIRCUMFERENCE-PEFR correlation
350
300
PEFR(L/min)
250
200 MALE
150 FEMALE
100
50
0
50-59 60-69 70-79 80-89 90-99
CHEST CIRCUMFERENCE(cms)
dnbpaediatrics.blogspot.in

20. GROUP C
CHEST CIRCUMFERENCE-PEFR correlation
450
400
350
PEFR(L/min)
300
250 MALE
200 FEMALE
150
100
50
0
50-59 60-69 70-79 80-89 90-99
CHEST CIRCUMFERENCE(cms)
dnbpaediatrics.blogspot.in

21. RESULTS
 Statistical analysis(paired t-test) was
applied to see difference in PEFR after
bronchodilation
 was found to be highly significant
p<0.001
dnbpaediatrics.blogspot.in

22. RESULTS
 Each group subjected to Groups A B C
statistical analysis,correlation
coefficients of height & chest
circumference with PEFR Ht-PEFR M-0.962 M-0.925 M-0.963
estimated F-0.995 F-0.972 F-0.887
 Significance noted at p=0.05 (p=0.05) (p=0.05) (p=0.05)
for all except for Group B male
chest circumference- PEFR
correlation CC- M-0.961 M=0.355(p M-0.962
PEFR F-0.934 =0.4) F-0.991
 Regression equations-
(p=0.05) F-0.874 (p=0.05)
Ht(y=3.5x-230.85)
(p=0.05)
CC(y=3.68x+26.58)
dnbpaediatrics.blogspot.in

23. CONCLUSION
 There was significant improvement in
PEFR after bronchodilation which was
comparable to studies done by-
-K.Najafizadeh et al,2007
-terzano et al,2007
-P.Aggarwal et al,2006
dnbpaediatrics.blogspot.in

24. CONCLUSION
 There was significant correlation of height and
chest circumference with PEFR in both sexes
and in all age groups which was comparable to
studies by-
-P.Sitarama Raju et al,2003,2004,2005
-Olamewaju DM et al,1991
-Pande JN et al,1997
 PEFR was found to be higher in male children
contrary to few studies where PEFR was found
to be equal in both sexes in childhood.
dnbpaediatrics.blogspot.in

25. RECOMMENDATIONS
 Patient and parent education:
Teach skills to self monitor PEFR and manage
asthma
 Use of preventors in home management
of asthma
 PEFR measurement in school health
programmes
dnbpaediatrics.blogspot.in

26. ACKNOWLEDGEMENT
 Dr.G.Malini,Sr.DD(Guide)
 Dr.Omesh Khurana,Jt.DMHS
 Dr.Uma Chaturvedi,HOD,DMHS
Dr.R.Shukla(Jt.DMHS)

Visit
 Dr.S.M.Dewangan,Jt.DMHS
 Dr.A.Verma
dnbpaediatrics.blogspot.in
 Dr.N.S.Thakur
 Dr.S.Saha
 Dr.Motghare
 Dr.P.N.Agarwal
 Dr.Meera Bamania
 Dr.M.R.Soni
 Dr.Biswal
 Dr.S.Panda
 All my seniors & colleagues

27. Visit
dnbpaediatrics.blogspot.in
For dnb learning material and
discussions
THANK YOU