Acrochordons and autoimmunity: Significance of preconceptional counseling

2020 ◽  
Vol 28 (4) ◽  
pp. 335-339
Author(s):  
Burcu Beksac ◽  
Hanife Guler Donmez ◽  
Murat Cagan ◽  
Canan Unal ◽  
Erdem Fadiloglu ◽  
...  
Keyword(s):  
Autoimmune Disease ◽  
Care Program ◽  
Autoimmune Disorder ◽  
Autoimmune Disorders ◽  
Control Group ◽  
Obstetric History ◽  
Skin Tags ◽  
Antibody Positivity ◽  
Preconceptional Care ◽  
Preconceptional Counseling

BACKGROUND: Acrochordons are benign hypertrophic lesions of the skin of which the pathophysiology is unclear. OBJECTIVE: This study aimed to examine the association of acrochordons with autoimmune disorders in patients with a poor obstetric history. METHODS: This retrospective cohort involved 350 female patients with poor obstetric history who were included in a preconceptional care program to investigate risk factors for obstetric complications. These patients were further investigated for the co-existence of autoimmune disorders (defined by either a diagnosis of autoimmune diseases or autoimmune antibody positivity) and acrochordons. RESULTS: An autoimmune disorder was present in 55.7% (195/350) of the patients. The rate of acrochordons was significantly higher in patients with autoimmune disorders (n= 195) compared to the control group (n= 155) (8.21% versus 2.58%, respectively) (p= 0.043). When the autoimmune disease positive (n= 58) and autoimmune antibody-positive (n= 137) groups were separately analyzed, acrochordons were found more frequently in the autoimmune disease group (p= 0.004). However, there was no statistically significant co-occurrence of autoimmune antibody positivity and the presence of skin tags (p= 0.135). CONCLUSION: There may be immune system-related biological mechanisms underlying the pathogenesis of acrochordons. Preconceptional counseling is beneficial for women with poor obstetric history and acrochordons.

Chronic Inflammatory Autoimmune Disorders Are a Risk Factor for Blood Group Alloimmunization in Transfused Patients

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4294-4294
Author(s):  
Alex B Ryder ◽  
Jeanne E Hendrickson ◽  
Christopher A. Tormey
Keyword(s):  
Autoimmune Disease ◽  
Blood Group ◽  
Conflicts Of Interest ◽  
Autoimmune Disorder ◽  
Autoimmune Disorders ◽  
Inflammatory Disorder ◽  
Transfusion Rate ◽  
Chi Square ◽  
Inflammatory Disorders ◽  
Chi Square Test

Abstract Background: Alloimmunization to red blood cell (RBC) antigens is a clinically-significant problem, but the mechanisms underlying antibody induction remain poorly understood. Data from murine models has suggested that inflammation can promote blood group alloimmunization. To our knowledge, only one group (Ramsey & Smietana, Transfusion 1995;35:582) has examined the influence of inflammation on RBC alloimmunization; however, study subjects were predominantly female, making it difficult to determine the contribution of inflammation towards transfusion-related alloimmunization. Thus, the aim of our study was to examine whether inflammation associated with chronic autoimmune disorders increases the risk for development of transfusion-related RBC alloantibodies in a primarily male patient cohort. Methods: The transfusion records of alloimmunized patients at a Veterans’ Affairs facility were extracted from a large database of individuals who underwent type and screen testing from 1961 through May, 2014. For alloimmunized patients, the following information was retrospectively collected: 1) demographic data including gender, 2) the number and specificity of alloantibodies reactive at 37°C and/or antihuman globulin phase, and 3) the presence of an underlying chronic inflammatory autoimmune disorder (and the specific diagnosis, as applicable). In addition, the records of 250 randomly-selected patients undergoing RBC administration were reviewed to establish the transfusion rate among individuals with chronic inflammatory autoimmune disorders. Results: Among all patients undergoing type and screen testing at our facility, 220 had one or more detectable alloantibodies. Patients with a chronic inflammatory autoimmune disorder constituted nearly 16% (35/220) of total alloimmunized individuals. These patients formed 50 total alloantibodies (1.4 antibodies per alloimmunized patient). Anti-D (n=10) and anti-K (n=10) were the two most common alloantibodies detected in this group, followed by anti-E (n=8) and anti-C (n=6). Men represented about 86% (30/35) of alloimmunized patients with an autoimmune disorder, indicating that the vast majority of detected antibodies resulted from transfusion rather than pregnancy. The most common autoimmune disorder among alloimmunized patients was psoriasis (9/33; 27%), followed by rheumatoid arthritis (6/33; 18%). Examination of the charts of randomly-selected patients who underwent RBC transfusion showed that 8.4% (21/250) had an underlying chronic inflammatory disorder. The ratio of alloimmunized patients with an autoimmune disease to those without one was significantly different than the ratio of transfused patients with an autoimmune disease to those without one (P=0.012, chi square test; P=0.018, chi square test with Yates’ correction for continuity). Conclusions: Patients with autoimmune diseases represented a substantial portion of individuals with transfusion-associated alloantibodies. Patients with chronic inflammatory disorders formed alloantibodies at nearly double the rate at which they were transfused. As such, precautionary interventions (e.g., extended phenotypic matching for K, E, and C antigens) may be warranted for patients with chronic inflammatory disorders. Disclosures No relevant conflicts of interest to declare.

scholarly journals 1548. Association of bacterial colonization in ulcerative lesions of the diabetic foot together with the cicatrization process

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S773-S775
Author(s):  
Alexander A Ozoria Loveras ◽  
Jacques Paré Espinal ◽  
David de luna ◽  
Noemi Acevedo
Keyword(s):  
Diabetic Foot ◽  
Bacterial Colonization ◽  
Healing Process ◽  
Foot Ulcer ◽  
Primary Source ◽  
Diabetic Foot Ulcer ◽  
Care Program ◽  
Antimicrobial Treatment ◽  
Control Group ◽  
Experimental Group

Abstract Background In 2018, a review of the scientific literature identifed biofilm studies in the past 3 years. Wherein, the role of the biofilm in the progression of the diabetic foot ulcer with the presence of biofilm is reviewed. As a result, tissue sampling is more effective than transcure, Levin, and aspiration. A study in Cuba evaluate the effectiveness of a new proposal for antimicrobial treatment in patients with diabetic foot infection in 2017. The method used was a experimental type of two groups. The control group, was treated with the treatment scheme proposed in the Comprehensive Care Program for the patient with diabetic foot ulcer (PAIPUPD). Instead, the other experimental group was treated according to the scheme based on the local microbial map. They used a random distribution. Using the Wagner classification, there were patients classificate with a grade of W2 (13% of patients), W3 (66%) and W4 (12%). The most frequent germs found were Staphylococcus aureus, Escherichia coli and Enterobacter sp. The experimental group required less days with hospitalization. Methods This is an observational study of primary source with a non-probability sample with 58 patients. Adult patients diagnosed with type 2 diabetes mellitus, with diabetic foot, Wagner classification 1, 2 and 3, who attended the healing area of the Institute of Diabetes of Santiago were included. After identifying the colonized pathogen, its cicatrization process was evaluate for four weeks. Results Of the total sample, 12.07% belonged to Wagner 1, 43.1% to Wagner 2 and 44.83% to the Wagner 3 classification. In the case of the Wagner 3 group, S. aureus and Pseudomona aeruginosa were present in 6 cases. Despite the infectious processes detected by the culture, the patients showed a successful cicatrization process after four weeks of evaluation. Graph 1: Isolated Microorganism Vs Wagner’s Degree (n=60) Graph 2: Gram positive microorganism vs. healing process per week in patients with diabetic foot (n=22) Graph 3: Gram-negative microorganism vs. healing process (n=33) Conclusion During the four weeks of clinical evaluation, more than 88% of patients progressed positively to clinical recovery, regardless of the type of bacteria colonized and/or their resistance to antibiotics. Disclosures All Authors: No reported disclosures

scholarly journals HMGB1, anti-HMGB1 antibodies, and ratio of HMGB1/anti-HMGB1 antibodies as diagnosis indicator in fever of unknown origin

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mingkun Chen ◽  
Li Zhu ◽  
Miao Xue ◽  
Rongrong Zhu ◽  
Liling Jing ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Autoimmune Disease ◽  
Serum Concentration ◽  
Malignant Tumor ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Healthy Control Group ◽  
Control Group ◽  
Elisa Kit ◽  
Healthy Control

AbstractTo evaluate the feasibility of serum HMGB1, anti-HMGB1 antibodies, and HMGB1/anti-HMGB1 ratio as a diagnosis indicator of initial clinical classification in patients with fever of unknown origin (FUO). Ninety-four patients with classical FUO and ninety healthy controls were enrolled in this study. The subjects’ clinical data and serum were collected. The serum concentration of HMGB1 was detected by a commercial HMGB1 ELISA kit, while the serum concentration of anti-HMGB1 antibodies were detected by an in-house built anti-HMGB1 antibodies ELISA kit and further confirmed by immunoblotting. According to the hospital diagnosis on discharge, ninety-four FUO patients were divided into four groups, Infectious disease subgroup, autoimmune disease subgroup, malignant tumor subgroup, and undetermined subgroup. The concentrations of HMGB1 in the infectious disease subgroup and autoimmune disease subgroup were higher than those in the malignant tumor subgroup, undetermined subgroup, and healthy control group. The concentration of anti-HMGB1 antibodies in autoimmune disease subtype group was higher than those in other subgroups as well as healthy control group. According to the distribution of HMGB1 and anti-HMGB1 in scatter plots of the patients with FUO, we found that the ratio of serum HMGB1/anti-HMGB1 is an ideal clinical indicator for differential diagnosis of different subtypes of FUO. The best cut-off was 0.75, and the sensitivity, specificity, and AUC were 66.67%, 87.32%, and 0.8, respectively. Correlation analysis showed that serum concentration of HMGB1 was moderately correlated with CRP in infectious diseases subgroup, and the serum concentration of anti-HMGB1 antibodies was strongly correlated with erythrocyte sedimentation rate in autoimmune disease subgroup. Our study had showed that serum HMGB1/anti-HMGB1 antibodies ratio can help clinicians identify FUO subtypes, thereby avoiding many unnecessary examinations and tests, and improving the effectiveness of clinical diagnosis and treatment of FUO.

Effectiveness of a Primary Care Program to Increase Physical Activity in People With Dementia and Their Family Caregivers (AFISDEMYF Study).

2021 ◽  
Author(s):  
Elena DE DIOS-RODRIGUEZ ◽  
María C PATINO-ALONSO ◽  
Susana GONZÁLEZ-SÁNCHEZ ◽  
Joana RIPOLL ◽  
Olaya TAMAYO-MORALES ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Primary Care ◽  
Systolic Blood Pressure ◽  
Family Caregivers ◽  
Intervention Group ◽  
Care Program ◽  
Control Group ◽  
People With Dementia ◽  
The Family

Abstract Aim: To evaluate the effectiveness of an intervention in primary health care designed to increase physical activity in people with dementia and their family caregivers.Methods: A cluster-randomized multicentre clinical trial was carried out.Participants: 140 people with dementia (median age 82 years;63.6% women) and 176 caregivers (median age 62 years ;72.7% women). Seventy patients and 80 caregivers were assigned to the Control Group (CG) and 70 patients and 96 caregivers to the Intervention Group (IG). The physical activity was measured with the pedometer and with the IPAQ-SF questionnaire. The intervention consisted of applying in primary care the program promoting physical activity (PEPAF) for 3 months. The changes observed at 6 months were analyzed. Results:In people with dementia, in the pedometer assessment a decrease was observed in both groups, but it was larger in the CG both in the total number step/day lower in the IG than in the CG and in the aerobic steps / day (52.89 vs -615.93). The activity reported with the IPAQ-SF decreased more in IG, both in the MET/min/week (-258.470 vs -148.23) and in the MVPA min/week. In caregivers the pedometer assessment showed that total steps/day increased more in the IG, as did aerobic steps/day (356.91 vs -12.95). The IPAQ-SF a smaller increase in global activity was declared in the IG than in the CG (545.25 MET/min/week vs 609.55), but the increase in vigorous activity was greater. No differences were found in changes in the functional status and the cognitive performances of people with dementia nor in the mental health in the caregivers, but systolic blood pressure, the Family APGAR and overload in the IG did improve.Conclusions: The results suggest that the intervention carried out may be effective on physical activity in both patients and caregivers. It can also improve systolic blood pressure, the Family APGAR and overload in caregivers. This is the first study to implement a primary care intervention aimed at simultaneously increasing physical activity in people with dementia and their relatives. These results reinforce the importance of using objective measures in clinical trials in people with dementia.Trial registration number: NCT 02044887.

The use of clinical case management for early stage Alzheimer' patients and their families

2000 ◽  
Vol 15 (5) ◽  
pp. 284-290 ◽  
Author(s):  
Paul Chu ◽  
Joy Edwards ◽  
Ron Levin ◽  
Jim Thomson
Keyword(s):  
Treatment Group ◽  
Case Management ◽  
Early Stage ◽  
Skill Training ◽  
Care Program ◽  
Disease Stage ◽  
Control Group ◽  
Management Service ◽  
Community Based Interventions ◽  
Training And Education

A number of studies have investigated the effectiveness of community based interventions to delay placement for persons with Alzheimer's disease (AD) and to ease caregiver burden, with mixed results. However, much of this research involved subjects who were in later stages of AD or the disease stage was not specified. Some researchers have suggested that the timing of interventions in these studies contributed to negative outcomes. This paper presents the results of a project which provided a comprehensive home care program to persons with early stage AD and their primary caregivers over a period of 18 months. Results indicated that caregivers in the treatment group felt less burdened at six months than caregivers in the control group and institutionalization was delayed for patients (with mild to moderate impairment) in the treatment group. These differences seem most attributable to the case management service provided to persons in the treatment group which featured supportive counseling, referral, skill training and education.

scholarly journals The Effects of Telemonitoring on Patient Compliance With Self-Management Recommendations and Outcomes of the Innovative Telemonitoring Enhanced Care Program for Chronic Heart Failure: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Hang Ding ◽  
Rajiv Jayasena ◽  
Sheau Huey Chen ◽  
Andrew Maiorana ◽  
Alison Dowling ◽  
...  
Keyword(s):  
Heart Failure ◽  
Randomized Controlled Trial ◽  
Chronic Heart Failure ◽  
Patient Compliance ◽  
Controlled Trial ◽  
Care Program ◽  
Self Management ◽  
Control Group ◽  
Randomized Controlled ◽  
Management Recommendations

BACKGROUND Telemonitoring enables care providers to remotely support outpatients in self-managing chronic heart failure (CHF), but the objective assessment of patient compliance with self-management recommendations has seldom been studied. OBJECTIVE This study aimed to evaluate patient compliance with self-management recommendations of an innovative telemonitoring enhanced care program for CHF (ITEC-CHF). METHODS We conducted a multicenter randomized controlled trial with a 6-month follow-up. The ITEC-CHF program comprised the provision of Bluetooth-enabled scales linked to a call center and nurse care services to assist participants with weight monitoring compliance. Compliance was defined a priori as weighing at least 4 days per week, analyzed objectively from weight recordings on the scales. The intention-to-treat principle was used to perform the analysis. RESULTS A total of 184 participants (141/184, 76.6% male), with a mean age of 70.1 (SD 12.3) years, were randomized to receive either ITEC-CHF (n=91) or usual care (control; n=93), of which 67 ITEC-CHF and 81 control participants completed the intervention. For the compliance criterion of weighing at least 4 days per week, the proportion of compliant participants in the ITEC-CHF group was not significantly higher than that in the control group (ITEC-CHF: 67/91, 74% vs control: 56/91, 60%; <i>P</i>=.06). However, the proportion of ITEC-CHF participants achieving the stricter compliance standard of at least 6 days a week was significantly higher than that in the control group (ITEC-CHF: 41/91, 45% vs control: 23/93, 25%; <i>P</i>=.005). CONCLUSIONS ITEC-CHF improved participant compliance with weight monitoring, although the withdrawal rate was high. Telemonitoring is a promising method for supporting both patients and clinicians in the management of CHF. However, further refinements are required to optimize this model of care. CLINICALTRIAL Australian New Zealand Clinical Trial Registry ACTRN12614000916640; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366691

scholarly journals A randomised, open label comparative study of hydroxychloroquine with betamethasone oral mini pulse in the management of patients with alopecia areata

2021 ◽  
Vol 10 (2) ◽  
pp. 187
Author(s):  
Jeyasudha Jambusayee ◽  
Kulur Mukhyaprana Sudha
Keyword(s):  
Alopecia Areata ◽  
Life Quality ◽  
Autoimmune Disorder ◽  
Study Groups ◽  
Pulse Therapy ◽  
The Body ◽  
Control Group ◽  
Study Group ◽  
Open Label ◽  
Significant Difference

Background: Alopecia areata is an autoimmune disorder causing patchy hair loss on scalp and other parts of the body and leading to poor self-esteem and anxiety in patients. Treatment with topical or systemic drugs like steroids or other immunosuppressants is associated with adverse effects. Hydroxychloroquine is an antimalarial drug, with T cell modulating function. This study was undertaken to assess the safety, efficacy and tolerability of Hydroxychloroquine in Alopecia areata compared to betamethasone oral mini pulse (OMP) therapy. Methods: 60 patients with alopecia areata were randomized into two groups of 30 each. Control group received tab. betamethasone 5 mg/day on two consecutive days of week for 12 weeks and Study group received tab. hydroxychloroquine 200 mg/day for 12 weeks. They were followed-up for further 12 weeks. Scale of alopecia tool, dermatology life quality index and global assessment at baseline, 12 weeks and 24 weeks were used to assess the outcome.Results: 94 patients were screened and 60 patients were included. All patients completed the study. At the end of 12 weeks, there was a statistically significant reduction in SALT and DLQI scores in both control and study groups. But at the end of 24 weeks, the study group showed an increase in the scores. Relapses were more in the study group. No significant difference in the incidence of adverse events was noted between the two groups.Conclusions: Hydroxychloroquine 200 mg/day is less efficacious in the management of alopecia areata in comparison to betamethasone oral mini pulse therapy.

scholarly journals Increased Autoimmunity in Individuals With Down Syndrome and Moyamoya Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Jonathan D. Santoro ◽  
Sarah Lee ◽  
Anthony C. Wang ◽  
Eugenia Ho ◽  
Deepti Nagesh ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Autoimmune Disease ◽  
Moyamoya Disease ◽  
Type I Diabetes ◽  
Autoimmune Disorder ◽  
Unknown Etiology ◽  
Type I ◽  
Moyamoya Syndrome ◽  
Retrospective Case ◽  
Children With Down Syndrome

Objective: To determine if elevated rates of autoimmune disease are present in children with both Down syndrome and moyamoya disease given the high rates of autoimmune disease reported in both conditions and unknown etiology of angiopathy in this population.Methods: A multi-center retrospective case-control study of children with Down syndrome and moyamoya syndrome, idiopathic moyamoya disease, and Down syndrome without cerebrovascular disease was performed. Outcome measures included presence of autoimmune disease, presence of autoantibodies and angiopathy severity data. Comparisons across groups was performed using the Kruskal-Wallis, χ2 and multivariate Poisson regression.Results: The prevalence of autoimmune disease were 57.7, 20.3, and 35.3% in persons with Down syndrome and moyamoya syndrome, idiopathic moyamoya disease, and Down syndrome only groups, respectively (p &lt; 0.001). The prevalence of autoimmune disease among children with Down syndrome and moyamoya syndrome is 3.2 times (p &lt; 0.001, 95% CI: 1.82–5.58) higher than the idiopathic moyamoya group and 1.5 times (p = 0.002, 95% CI: 1.17–1.99) higher than the Down syndrome only group when adjusting for age and sex. The most common autoimmune diseases were thyroid disorders, type I diabetes and Celiac disease. No individuals with idiopathic moyamoya disease had more than one type of autoimmune disorder while 15.4% of individuals with Down syndrome and moyamoya syndrome and 4.8% of individuals with Down syndrome only had &gt;1 disorder (p = 0.05, 95%CI: 1.08–6.08).Interpretation: This study reports elevated rates of autoimmune disease in persons with Down syndrome and moyamoya syndrome providing a nidus for study of the role of autoimmunity in angiopathy in this population.

THE IMPORTANCE OF PRE-MARRIAGE PRECONCEPTIONAL CARE AND THE COUNSELING ROLE OF MIDWIVES

2021 ◽  
Vol 6 (11) ◽  
pp. 79-85
Author(s):  
Sevil GÜNER ◽  
Birsen SAYDAM ◽  
Esin ÇEBER TURFAN ◽  
Neriman SOĞUKPINAR ◽  
Rabia EKTİ GENÇ
Keyword(s):  
Health Care Services ◽  
Sample Selection ◽  
Preventive Health Services ◽  
Lifestyle Behaviors ◽  
Factors Affecting ◽  
Care Services ◽  
Primary Health Care Services ◽  
Package Program ◽  
Preconceptional Care ◽  
Preconceptional Counseling

Introduction: Preconceptional care is an important opportunity to identify risk factors affecting the pregnancy process and to provide appropriate care. In this study; it was aimed to provide preventive health services related to reproductive health to couples who applied for marriage and to emphasize the importance of midwives in preconceptional care services. Method: The population of the descriptive study consisted of couples who applied to Izmir Bornova Municipality Marriage Office between June 15, 2016 and June 15, 2017. Sample selection was not made, all couples who agreed to participate and were given counseling formed the sample (n: 126). Data were collected through a questionnaire using face-to-face interview method, and their analyzes were presented in the SPSS 20.0 package program by making a percentage distribution. Results: The average age of women is 26.0±4.0 (min:18.0-max:42.0). It was determined that 91.2% of the participants planned pregnancy after getting married. 42.6% of those planning pregnancy use cigarette, 33.9% use alcohol, only 20.9% exercise regularly. 96.0% of the participants stated that consultancy should be given before getting married, 30.2% of them stated that this training should be given by experts and 19.0% by midwives. Discussion and Conclusion: In our study, where we evaluated the application for marriage as an opportunity and offered preconceptional counseling, it was determined that the participants planning pregnancy had risky lifestyle behaviors and wanted to receive formal training from experts. It is thought that preconceptional counseling, which will be given by midwives by expanding its scope within the scope of primary health care services, will contribute to harmony in marriage and the formation of healthy generations.

Effectiveness of Asthma Self-Care Program Through Mobile Line Application (SALA) on Lung Function among Asthma Patients in Angthong Hospital: A Randomized Control Trial

2021 ◽  
Vol 104 (2) ◽  
pp. 264-270
Keyword(s):  
Lung Function ◽  
Usual Care ◽  
Controlled Trial ◽  
Demographic Data ◽  
Intervention Group ◽  
Self Care ◽  
Care Program ◽  
Self Management ◽  
Control Group ◽  
Asthma Patients

Background: Asthma is a disease that causes a lot of suffering. It becomes a hurdle in everyday life. Asthma self-care program through mobile Line application (SALA) might be a good choice to help resolving this problem. Objective: To evaluate effectiveness of SALA program among asthma patients. Materials and Methods: The present study was a randomized controlled trial. The study sample consisted of 62 participants aged between 20 to 60 years with mild to moderate asthma. The study sample were randomly assigned to intervention plus usual care (intervention group, n=31) or usual care (control group, n=31) by computer generated. SALA program was sent to participants once a week for two months through their mobile phone, drug reminder appointment date for four months. The study period was six months. Clinical record form and Questionnaire were adapted to collect the demographic data and lung function via spirometer as FEV₁, FVC, FEV₁/FVC, PEFR, ACS, knowledge, attitude, and self-management. Mini Asthma Quality of Life (QOL) questionnaire was used to collect the data. Intention to treat (ITT), Repeated ANOVA, and General Linear model were statistical technique used to analyze the data. Results: Data from 60 asthma patients were available for analyses. The baseline characteristics of both groups were not significantly different. There were statistically significant mean differences in between the groups at three and six months. The mean difference in the following variables were FEV₁ 13.83 (5.01 to 22.65) FVC, 13.36 (2.62 to 24.09) FEV₁/FVC, 11.65 (4.8 to 18.49), PEFR 9.85 (0.03 to 19.67), ACS 2.45 (0.62 to 4.27), knowledge 2.64 (0.81 to 4.46), and self-management 4.26 (2.00 to 6.52). Conclusion: SALA improved knowledge, self-management, asthma status, and lung function among asthma patients. Keywords: Asthma, Self-care program, Mobile line application

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