Health Related Quality of Life and its Associated Factors Among Adults Living with Asthma Attending at Selected Public Hospitals in North-Western, Ethiopia: A Multi-Centered Cross- Sectional Study

Background: Asthma is a major public health challenge with most of the patients are not diagnosed and treated appropriately. Health related quality of life is an important measure of health outcomes of asthmatic patient that reflects the impact of an illness and its treatment from the patient’s perspective. Hence, the aim of this study was to assess the health-related quality of life and its determinants among asthmatic patient at selected public hospitals in northwestern, EthiopiaMethod: A multicenter facility based cross-sectional study was conducted in North-Western Ethiopia, from May to July, 2021. A systematic random sampling technique was employed to include 409 study participants. Simple and multivariable linear regressions were conducted to determine variables that are the independent predictors of health-related quality of life. A p-value of <0.05 was considered statistically significant.Result: A total of 409 patients were included in the final analysis and more than half (59.2%) of subjects had good quality of life. Concerning to determinants of health-related quality life, asthma control score (β=0.14, P<0.001), insurance user (β=0.15, P=0.04), high role of patient enablement (β= 0.39, P<0.001), belief to asthma medication (β= (-0.23), P=0.001), health care provides non-adherence to guideline (β= (-0.30), P<0.001) and being house wife (β= (-0.21) P=0.04) were some of significant predictor of health-related quality of life of asthmatic patient.Conclusion: The health-related quality of life among adults with asthma was largely dependent to the level of asthma control. Socio- demographic, clinical, health care related and medication related, variables were significantly health related quality of life. Therefore, our study highlights multifaced interventions including comprehensive asthma education along with an integrated treatment plan to improve asthma control and quality of life.

Literature Review : Penerapan Teknik Pernafasan Buteyko Terhadap Penurunan Frekuensi Kekambuhan Asma Pada Pasien Asma Bronkhial

One of the non-pharmacological therapies to reduce the frequency of asthma recurrence is the Buteyko breathing technique. The study aimed to describe the application of the Buteyko breating technique in asthmatic patients. The study applied Literature Review design. Three articles were obtained from google scolar website, with the keywords “Bronchial Asthma,” “Asthma Recurrence,” and “Buteyko Breathing Technique”. All these three articles were fulltext articles, published in 2014-2021. The result of the Literature Review of the two articles, based on the average value bevore the intervention was 2,74 and after the intervention was 1,66 and one of the articles did not explain the avarge value. The study approved that Buteyko Breathing Technique can be an alternative intervention to reduce the frequency of asthmatic patients. Furthermore, healthcare providers were suggest to educate their patients to do so.Keywords: Asthma Recurrence, Asthmatic Patient, Buteyko Breathing Technique AbstrakSalah satu terapi non farmakologis untuk menurunkan frekuensi kekambuhan Asma adalah teknik pernafasan Buteyko. Penelitian ini bertujuan untuk menggambarkan penerapan teknik pernafasan Buteyko pada pasien Asma berdasarkan Literatur Review. Desain Karya Tulis Ilmiah berupa Literatur Review dengan jumlah artikel tiga yang diambil dari laman jurnal google scolar dengan kata kunci “Asma Bronkhial,” “Kekambuhan Asma,” dan “Teknik Pernafasan Buteyko” berupa artikel fulltex, terbit tahun 2014-2021. Hasil Literatur Review dari kedua artikel berdasarkan nilai rata-rata sebelum intervensi yaitu 2,74 dan sesudah intervensi menjadi 1,66 dan salah satu artikel tidak menjelaskan nilai rata-rata. Kesimpulannya adalah teknik pernafasan Buteyko dapat menurunkan frekuensi kekambuhan asma pada pasien asma. Saran bagi tenaga kesehatan hendaknya mengedukasi tentang teknik pernafasan Buteyko sebagai alternatif untuk menurunkan frekuensi kekambuhan asma pada pasien asma.Kata kunci: Asma Bronkhial, Kekambuhan Asma, dan Teknik Pernafasan Buteyko

Acute Mania as an Essential Contributor for Failed Extubation in an Asthmatic Patient: A Case Report

Failed extubation is not uncommon in intensive care unit and are known to have high morbidity outcomes. The predictors are well-established and known to intensivist, but the complexity is to identify the contributors of these predictive factors. The failure to treat the contributing factors hampered the effort towards successful extubation. To the best of our knowledge, this is the first reported case of acute mania as the essential contributor for failed extubation. This case report illustrates on how an acute mania state prompting an exacerbation of asthmatic attack due to the physical and emotional hyperarousal that ultimately led to the failed extubation.

Phenobarbitone Induced Toxic Epidermal Necrosis in a Young Patient - A Rare Clinical Presentation: A Case Report and Brief Review of the Literatures

Background: Toxic epidermal necrolysis (TEN)/ Stevens-Johnson syndrome (SJS) is the spectrum of severe, acute, mucocutaneous, Ig E mediated hypersensitivity reaction; universally related to different drugs. Phenobarbitone is known to cause hypersensitivity reactions with benign pattern; ranging from a mild to moderate rashes but not life-threatening reactions such as TEN/SJS. Little is known about TEN in asthmatic patient. To the best of our knowledge, this is the first case of Phenobarbitone-induced TEN in a young asthmatic patient from the sub Saharan African. Case report: We report a 14-year-old right handed asthmatic male patient who presented with extensive blister skin eruptions involving the whole body including mouth ear canal later followed by skin exfoliation associated with low grade fever, sore throat, and dysphagia. The hypersensitivity skin reaction developed two weeks after initiation of Phenobarbitone of 100mg twice daily for a new onset generalized tonic clonic seizure. The exfoliation also involved oral and Conjunctival mucosa; with estimated 65% body surface area involvement; hence the diagnosis of Toxic epidermal necrosis was made. The Laboratory investigations were relevant for mild leucocytosis, prolonged prothrombin time, and reduced albumin. Phenobarbitone was discontinued and replaced with clonazepam; and the patient was managed with fluids replacement, IV antibiotics, twice daily wound care, analgesics, and naso gastric tube feeding. On subsequent days in intensive care unit (ICU), the patients’ clinical condition started improving; the skin lesion also started to heal and exfoliate in most of the affected skin surface areas, and the patient was discharges improved after ten days of ICU care.Conclusion: In summary, the present case describes, a 14-years-old young child with history of allergy in a form of asthma and new onset seizure disorder; and developed toxic epidermal necrosis following exposure to Phenobarbitone. This case also highlighted the benign prognosis observed in paediatrics population with TEN.