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CLASSIFICATION OF ASTHMA as mild, moderate or severe is important when decision about its management has to be made. In 1991 the National Heart, Lung and Blood Institute (NHLBI) of U.S.A., released comprehensive guidelines for diagnosing and managing asthma. This report, prepared under chairman Prof. Al Sheffor of Harvard Medical School, set gold standard for treating asthma. The recommendations of NHLBI report were based on classifying asthma according to its severity into the following categories.
Chronic Mild Asthma
Chronic Moderate Asthma
Chronic Severe Asthma
Using such a classification makes it easier for the doctor to develop, and for the parents to understand a treatment programme. However, there is no single test which can precisely classify the severity of the condition. A combination of assessment of symptoms and the measurement of lung function gives a useful indication of the severity of the condition.
In most cases parents as well as healthcare professionals underestimate the severity of attacks. More often than not, this results largely from failure to use lung function test measurements in making an assessment. If a severe attack is not recognized and treated appropriately it can be fatal. It is also important to remember that children with even mild asthma, can have an acute attack of severe asthma. Factors which are associated with a higher risk of mortality are: a previous history of acute life-threatening attacks, hospitalization in the previous year, psycho-social problems, recent reduction or cessation of corticosteroid therapy and non-compliance with recommended medical therapy.  It can Asthma is a highly variable disease and its incidence fluctuates. Therefore, NHLBI, USA report gives recommendations which are based on a stepwise approach, the doses and frequencies of medications are increased or decreased according to the severity of the attack.
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