Characteristics of Acute Asthma Patients Based on Visits to The Emergency Unit and Treatment Costs in Jakarta Islamic Hospital Pondok Kopi

Proper handling of asthmatics can maintain the patient's quality of life. Visits of asthmatic patients to the Emergency Department (ER) indicate uncontrolled asthma and a marker of risk for future asthma exacerbations. Uncontrolled asthma can increase health costs, the risk of hospitalization, and can also cause death. This research at to determine the relationship of acute asthma patients who visit the emergency department with costs of treatment. Analytical descriptive research with cross-sectional study design. The population of this study was acute asthma sufferers who went to the emergency department of RSIJ Pondok Kopi in the period August 1, 2016 – August 1, 2017, and all of the population was used as a sample of 35 people. Data collection is done by studying the documentation of medical record data. The results showed 32.4% of respondents aged 41-49 years, 62.9% were female and had a high school education level (SMA), 40% of respondents were housewives (IRT), 65.7% had acute asthma. moderate, and the most precipitating factor is respiratory tract infection. Most visits to the ER were 30 patients (85.7%) with 1 visit and not accompanied by complications. The results of the highest treatment costs ranged from Rp. 300,000 – Rp. 400,000 as many as 22 patients (62.9%) with guaranteed treatment used were non-BPJS. The costs incurred by each acute asthma patient with 1 visit to the ER are lower than 2 times or more than 2 visits. It was also found that the number of acute asthma patients with complications was greater in costs than those without complications.

COVID-19-Related Pneumonia in an Adolescent Patient with Allergic Asthma

Background. The latest coronavirus infection due to SARS-CoV-2, which started in China in December 2019, was announced as a pandemic by the World Health Organization (WHO) in March 2020. All epidemiological data so far show us that SARS-CoV-2 infection is less serious in children than in adults. Allergic asthma, the most common chronic disease in children, is usually not to be related to greater risk or severity for COVID-19 in pediatric populations. Although reports/research on asthma and COVID-19 in children have thus far been comforting, when coming across an asthma patient with any lower airway infection, attention should be given to evaluate their asthma control level and the possibility of SARS-CoV-2 infection. Case Report. Here, we report a rare adolescent case of COVID-19-related pneumonia development with underlying asthma. A 16-year-old male patient has been followed up by the pediatric allergy outpatient clinic with the diagnosis of asthma for the last 5 years. He was thought to have typical clinical and laboratory findings for SARS-CoV-2 infection combined with underlying pediatric (allergic) asthma. Pulmonary CT showed findings consistent with COVID-19-related pneumonia. He was discharged after 1 week when all his complaints regressed, his examination became normal, and 5-day favipiravir treatment was completed. Conclusion. When a physician comes across an asthma patient with any lower airway infection, attention should be given to evaluate their asthma control level and possibility of SARS-CoV-2 infection.

The Role of Biologics in the Management of Asthma in the Pediatric Patient

The management of pediatric patients with asthma continues to be a major health issue. For many patients, traditional therapies have been very effective, but for a large number of patients asthma remains poorly controlled. This leads to significant morbidity and impairment to quality of life. Recently, several new biologics, as well as new dosage forms of combination inhaled drugs, have been made available for use adding to the armamentarium of therapy for specific asthma phenotypes. Biologics have shown promise in the more difficult to manage asthma patient. Approved in children, omalizumab, an anti–immunoglobulin E (anti-IgE) antibody, has been available for several years. New agents, like mepolizumab and benralizumab, directed against interleukin (IL) 5, have indications for children >6 and >12 years of age, respectively. Dupilumab, an IL-4– and IL-13–directed antibody, has been studied as well in eosinophilic asthma, with positive results. A thorough understanding of the clinical data of these agents is key, as they may greatly improve the quality of life in children with difficult-to-manage asthma.

The Spatio-temporal Epidemiology of Asthma Patient Visits in Relation to Meteorological Parameters and Air Pollution Factors as a Result of Seasonal Change in Songkhla Province

Objective: To investigate the demographic characteristics, seasonal variations, effects associated with air pollution, and geographic morbidity of asthma in Songkhla.Material and Methods: This research conducted a time series analysis of secondary data from 1 January, 2013 to 31 December, 2017. The distributed lag non-linear model was employed to analyze associations between air pollutants and daily asthma outpatient visits, and the Bayesian hierarchical modelling was used to map asthma morbidity spatiotemporally.Results: A total of 250,127 asthma diagnoses corresponding to 36,761 patients were found in the medical records. Most asthma outpatients were female (61.1%); males (1-5 years) constituted the majority of individuals during the first peak, while females (40-50 years) predominated the second peak. The trend analysis revealed a seasonal variation in the number of asthma outpatient visits; the highest rates were during the June-December period. The regression coefficient analysis revealed carbon monoxide (CO), nitrogen dioxide (NO2 ), relative humidity, and visibility to have the most significant positive effect on asthma, while the cos (wind direction) had the highest negative effect/impact. Significant associations were found between outpatient gender and age and CO, NO2 , sulfur dioxide, ozone, and particulate matter less than 10 micron. The Hat Yai and Central districts of Songkhla province were identified as morbidity hotspots.Conclusion: The number of asthma-related outpatient visits increased during the rainy season. Asthma affected primarily young boys and middle-aged women in this province, and they constitute the most sensitive group to air pollutants such as CO and NO2 and meteorological conditions like relative humidity and visibility. The highest morbidity rates were found in urbanized habitats.

Identification of Novel Gene Expression Patterns and Genetic Mechanisms in Asthma affected Patients Treated with Budesonide

Aim: To identify the significant genes and pathways involved in asthma patients and asthma-affected patients treated with Budesonide is the aim of our research. Materials and Methods: DNA microarray analysis for asthma has been performed and significant DEGs are identified. Up-regulated genes and down-regulated genes were identified by GEO2R analysis. Gene-Gene interaction was predicted using the STRING. Gene Ontology was analyzed by using the STRING and FunRich. Hub genes were observed by using CytoHubba plugins of Cytoscape. Results: By analyzing GEO2R, 22 genes were upregulated genes and 16 genes were downregulated genes. We have obtained the gene comprising 28 nodes and 8 edges with an estimating clustering coefficient of 0.25 in pHBECs with not treated and pHBECs treated with Budesonide. Gene ontology has shown the 27 genes located in the large intestine as a COSMIC analysis more than other analyses. By using the CytoHubba plugin of Cytoscape, identified MMP3, TSLP, POSTN, ETS1, and SAA1 as hub genes. Conclusion: Due to this limitation, the medications that are brought into the market are not site-directed, and rather they showed random inhibitory actions. So we have developed a computational pipeline to identify the significant novel genes and novel pathways involved in the asthma patient and asthma-affected patient treated with Budesonide.