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"Penelitian kegunaan makrolid pada asma eksaserbasi menunjukkan bahwa di samping memiliki efek antimikroba, makrolid juga memiliki aktivitas sebagai imunomodulator. Penelitian ini bersifat kuasi-eksperimental untuk menilai efek klaritromisin yang diberikan secara intravena dilanjutkan terapi oral klaritromisin pada 37 pasien asma eksaserbasi akut yang disebabkan infeksi saluran napas selama periode Januari sampai dengan Desember 2005. Pasien asma akut ringan dan sedang yang memenuhi kriteria diberikan klaritromisin intravena 2 x 500 mg selama maksimal 5 hari dilanjutkan klaritromisin oral 2 x 500 mg selama 7 hari. Dilakukan evaluasi perbaikan klinis sesuai skor serangan asma, dan arus puncak ekspirasi (APE). Sesudah 10 hari, hasil pengobatan menunjukkan perbaikan signifikan perbaikan skor serangan asma dan APE pagi dan sore sebelum dan sesudah pengobatan pada 35 subjek yang diteliti, sedangkan hari sulih didapatkan kurang dari 3 hari pada 21 subjek dan 3-5 hari pada 14 subjek. Kuman yang paling banyak ditemukan adalah golongan S. β-haemolyticus dan Streptococcus sp. Disimpulkan bahwa pengobatan dengan klaritromisin intravena yang dilanjutkan secara oral dapat memberikan perbaikan gejala klinis dan nilai APE pada eksaserbasi asma akibat infeksi saluran napas.

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Abstractn addition to its antimicrobial activity, macrolides have an immunomodulatory effect that may be beneficial to patients with asthma. This quasi-experimental study aimed to determine the effect of intravenous clarithromycin followed by oral administration in 37 patients with acute exacerbations asthma caused by respiratory tract infection during January - December 2005. Patients with mild to moderate exacerbations of asthma with respiratory tract infection meeting the inclusion and exclusion criteria were given intravenous clarithromycin 2 x 500 mg/day for not more than 5 days and followed by oral clarithromycin 2 x 500 mg/day for 7 days. Outcome variables were improvement of clinical symptoms according to the asthma exacerbation score and peak expiratory flow rate (PEFR). After 10 days, treatment resulted significant improvement in total asthma exacerbation score and morning PEFR in 35 patients enrolled this project. Based on clinical improvement and laboratory findings, the number of days required for intravenous clarithromycin was less then 3 days for 21 subjects, 3-5 days in 14 subjects. The most common causative pathogens were S. β-haemolyticus and Streptococcus sp. It was concluded that clarithromycin improved clinical symptoms and PEFR in exacerbation of asthma caused by respiratory tract infection. "

"Penelitian kegunaan makrolid pada asma eksaserbasi menunjukkan bahwa di samping memiliki efek antimikroba,makrolid juga memiliki aktivitas sebagai imunomodulator."

"Bronchial asthma : a guide for practical understanding and treatment, sixth edition, is a fully updated version of a widely respected classic on the diagnosis and management of asthma. Discussing the disorder in all relevant patient groups, including a variety of patient subpopulations, this invaluable title continues to emphasize the definition, medications, and practical use of asthma treatment plans. Importantly, this comprehensive reference also discusses the common side effects found in the full range of medications used for asthma treatment. "

"Terapi penyakit asma dengan inhaled corticosteroid (ICS) dosis tinggi yang berjangka panjang berpotensi menimbulkan efek samping. Salah satu pendekatan yang dapat dilakukan adalah menggunakan senyawa turunan tumbuhan sebagai alternatif. Fisetin merupakan senyawa flavonoid yang menunjukkan berbagai efek farmakologis. Hambatan utama keberhasilan terapi dengan fisetin adalah bioavailabilitas yang rendah dan lipofilisitas yang tinggi. Beberapa pendekatan digunakan untuk meningkatkan bioavailabilitas obat dengan lipofilisitas tinggi, yaitu menggabungkan obat ke dalam matriks lipid. Solid lipid microparticles (SLM) adalah metode mikroenkapsulasi obat ke dalam lipid yang memungkinkan pelepasan obat terkendali, peningkatkan stabilitas obat, dan tetap aman bagi tubuh. Penelitian ini bertujuan untuk mendapatkan formulasi solid lipid microparticle fisetin dry powder inhalation fisetin berbasis lipid Glyceryl tristearate serta surfaktan Poloxamer 188 dan Tween 80 sebagai obat terapi inhalasi penyakit asma. Pada penelitian ini, peneliti telah mengamati variasi kandungan obat, konsentrasi surfaktan, dan kecepatan putar. Serbuk inhalasi menghasilkan ukuran 1,2 – 4 µm dan menunjukkan 34% antiinflamasi pada konsentrasi 1.000 ppm. Selain itu, persentase yield formulasi berada dalam rentang 81 – 96%, drug loading 2 – 5%, dan entrapment efficiency 82 – 87%. Profil pelepasan menunjukkan sistem pelepasan sustained release. Formulasi yang terbaik adalah FIS6 dengan variasi kandungan obat, surfaktan, dan kecepatan putar paling tinggi.

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Long-term high-dose inhaled corticosteroid (ICS) for asthma therapy has the potential to cause side effects. One approach that can be taken is to use plant-derived compounds as an alternative. Fisetin is a flavonoid compound that exhibits various pharmacological effects. The main obstacle to successful therapy with fisetin is its low bioavailability and high lipophilicity. Several approaches are used to increase the bioavailability of drugs with high lipophilicity is to incorporate the drug into the lipid matrix. Solid lipid microparticles (SLM) is a method of microencapsulating drugs into lipids that allows the drug to be released slowly, improves drug stability, and remains safe for the body. This study has obtained a fisetin SLM formulation as dry powder inhalation with Glyceryl Tristearate as lipid as well as Poloxamer 188 and Tween 80 as the surfactants. The dry powder inhalation is in the form of inhaled therapy drugs for asthma. This study also observes variations in drug content, surfactant concentration, and rotational speed. The inhalation powder has a particle size ranged 1,2 – 4 µm and showed 34% anti-inflammatory at a concentration of 1,000 ppm. In addition, the yield is in the range of 81 – 96%, drug loading is 2 – 5%, and entrapment efficiency is 82 – 87%. The winning profile shows the sustain release pulmonary drug delivery profile. The best formulation is FIS6 with the highest variation of drug, surfactant, and rotational speed."

"Latar belakang: Asma merupakan penyakit ditandai peradangan saluran napas kronik. Satu dari tiga kasus tidak memberikan respon adekuat. Modalitas alternatif terapi  asma adalah magnesium inhalasi. Inhalasi magnesium memiliki efek samping sistemik minimal. Oleh karena itu, peran magnesium inhalasi perlu diteliti lebih lanTujuan: Penelitian bertujuan untuk mengetahui efektivitas dan keamanan pemberian magnesium inhalasi pada pasien dewasa mengalami  asma akut.Metode: Penelusuran literatur dilakukan dua peneliti independen melalui: PubMed/ MEDLINE, Google Scholar, ProQuest, dan Cochrane dengan kata kunci “magnesium inhalasi” dan “serangan asma” dalam bahasa Inggris dan Indonesia. Pencarian manual dan snowballing dilakukan di portal data nasional. Studi yang dimasukkan adalah uji acak terkontrol mengenai perbandingan magnesium inhalasi dengan terapi standar pada serangan asma akut. Penilaian efektivitas berdasarkan parameter readmisi, tanda vital, perbaikan klinis, serta fungsi paru, sedangkan keamanan berdasarkan parameter efek samping. Protokol telaah sistematis didaftarkan pada PROSPERO.Hasil: Lima artikel diikutsertakan dalam telaah sistematis. Dua artikel diikut-sertakan menilai aspek  readmisi. Tiga studi  menilai hubungan magnesium terhadap tanda vital pasien. Dua studi menilai tingkat keparahan penyakit dan perbaikan klinis. Studi menunjukkan tidak terdapat hubungan bermakna pemberian magnesium inhalasi pada aspek readmisi pasien (RR 1; IK 95% 0.92 - 1,08; p= 0,96), dan saturasi oksigen (MD  1,82; IK 95%: -0.89 - 4.53; p= 0.19). Ada penurunan bermakna laju napas pasien  (MD -1,72; IK 95% -3,1 -0.35; p= 0.01), dan perbaikan gejala pada pasien  (RR 0.29; IK95% 0.18 - 0.47; p <0.001). Ada peningkatan bermakna efek samping pasien magnesium inhalasi (HR 1.56; IK 95% 1.05 – 2.32; p= 0.32). Efek samping relatif ringan  berupa hipotensi dan rasa mual. Kesimpulan: Magnesium inhalasi memperbaiki  klinis pasien asma terutama gejala, laju napas, dan fungsi paru.  Magnesium inhalasi dikatakan aman jika diberikan pada pasien, namun hati-hati penggunaan pada pasien hipotensi.

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Background:  Asthma is a disease characterized by chronic airway inflammation. Asthma occurs to many people worldwide. One third of asthmatic case did not respond adequately to standard therapy (Short Acting Beta Agonist, Anticholinergic, Corticosteroid). One of alternative treatment of asthma is inhaled magnesium.  Theoretically, inhaled magnesium is thought to have less systemic side effect and could act directly to respiratory tract. However, the role of inhaled magnesium therapy is not established yet.

Objective: This review is made to evaluate the effectiveness and safety of nebulized magnesium in adult with acute asthma attack.

Methods: Literature search was conducted by two independent investigators through online databases: PubMed/MEDLINE, Cochrane, ProQuest, and Google scholar using the keywords “inhaled magnesium” and “asthma” in English and Indonesian. Manual searches and snowballing were carried out through national data portals and medical faculty e-libraries. Journal articles included in this study are randomized controlled trials that observed inhaled magnesium in adult with acute asthma attack. All the protocol of this systematic review has been registered in PROSPERO.

Result: There are five articles included in this review. Two of them evaluate the effect of magnesium in term of readmission, three of the studies measures effect of magnesium in vital sign, and two of them evaluate the effect of magnesium in term of severity of asthma There is no significant difference in readmission rate and oxygen saturation in magnesium group compared to control (RR 1; 95% CI 0.92 to 1,08; p= 0,96 and MD 1,82; 95% CI -0.89 to 4.53; p= 0.19, respectively). There is significant reduction of respiratory rate and clinical severity in magnesium (MD -1,72; 95% CI   -3,1 to 0.35; p= 0.01, RR 0.29; 95% CI 0.18 to 0.47; p <0.001, respectively). There was a higher risk of side effect in magnesium group (HR 1.56; 95%CI 1.05 to 2.32; p= 0.03). However, the side effect is relatively mild such as hypotension and nausea.

Conclusion: Inhaled magnesium improves clinical outcome for patient with asthma attack especially lung function, improvement of clinical outcome, and lung function. Moreover, Inhaled magnesium is considered safe to be given to asthmatic patient. However, the inhaled magnesium is given with caution in patient with hypotension."

"Penyakit pernapasan kronis menjadi salah satu penyakit tidak menular yang paling umum di seluruh dunia. Asma merupakan salah satu penyakit pernapasan kronis yang banyak diderita oleh masyarakat. Penyakit ini seringkali dikaitkan dengan beban yang besar. Asma yang tidak terkontrol berhubungan dengan peningkatan pengeluaran, peningkatan utilisasi pelayanan kesehatan dan penurunan produktivitas. Kondisi penyakit asma yang kronis memerlukan peranan pasien dalam pengendalian penyakit. Hal tersebut dapat dimungkinkan melalui adanya self-management. Perkembangan teknologi di masa kini dapat dimanfaatkan melalui penggunaan mHealth untuk mendukung penerapan self-management asma. Penelitian ini menggunakan metode literature review. Pencarian studi dilakukan dengan menggunakan online database yaitu PMC, ScienceDirect, dan LinkSpringer. Terdapat 13 studi yang termasuk ke dalam penelitian ini. Hasil penelitian ini menunjukkan bahwa sebanyak 11 studi menghasilkan perubahan positif yang signifikan dalam pengendalian asma yang dapat diketahui melalui asthma control, kualitas hidup, penggunaan SABA, symptom free days, dan CACG symptom benchmark. Selain itu, terdapat 4 studi yang menghasilkan perubahan positif dalam meningkatkan kepatuhan mengonsumsi obat. Sehingga, dapat dikatakan bahwa penggunaan mHealth efektif dalam penerapan self-management asma.

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Chronic respiratory diseases are becoming one of the most common non-communicable diseases worldwide. Asthma is one of the chronic respiratory diseases that many people suffer from. This disease is often associated with a large burden. Uncontrolled asthma is associated with increased spending, increased utilization of health services and decreased productivity. Chronic asthma conditions require the patient's role in Disease Control. This can possible through self-management. Technological developments in the present can be utilized through the use of mHealth to support the implementation of asthma self-management. This study uses the literature review method. Study searches were conducted using online databases namely PMC, ScienceDirect, and LinkSpringer. There are 13 studies included in this study. The results of this study showed that a total of 11 studies resulted in significant positive changes in asthma control that can be known through asthma control, quality of life, use of SABA, symptom free days, and CACG symptom benchmark. In addition, there are 4 studies that produce positive changes in improving adherence to asthma medication. Thus, it can be said that the use of mHealth is effective in the application of asthma self-management."

"ABSTRAKAsma merupakan gangguan inflamasi kronis di jalan napas dengan prevalensiyang cukup tinggi. Asma dapat terjadi pada semua usia, diperkirakan 300 jutaorang menderita asma diseluruh dunia dan tahun 2025 diperkirakan mencapai 400juta pasien asma. Prevalensi asma di Provinsi Kalimantan Tengah melebihi angkanasional dan kota Palangkaraya termasuk daerah dengan prevalensi asmatertinggi. Prevalensi asma dipengaruhi oleh banyak faktor seperti keturunan sertalingkungan. Penelitian ini bertujuan untuk menganalisis hubungan tingkatkepadatan kecoa di rumah tangga dan faktor risiko lainnya yang dapat memicuasma. Penelitian menggunakan desain Case control. Sampel terdiri dari 58sampel untuk kasus dan 58 sampel untuk kontrol berusia 12-45 tahun. Hasilpenelitian menunjukkan variabel-variabel yang berhubungan dengan kejadianasma adalah kepadatan kecoa, riwayat atopi, sensitifitas terhadap makanan, polusiudara, kondisi cuaca, kondisi sanitasi rumah tangga, jarak rumah dari jalan rayadan memiliki hewan peliharaan. Sedangkan karakteristik individu sepertipendidikan, pekerjaan serta jenis bahan bakar memasak tidak berhubungandengan kejadian asma. Kesimpulannya tingkat kepadatan kecoa berhubungandengan kejadian asma setelah dikontrol variabel karakteristik individu dan faktorlingkungan. Penderita agar menjaga kebersihan dan sanitasi rumah yang baik,sehingga tidak menjadi habitat perkembangbiakan vektor kecoa dan sedapatmungkin menghindari faktor-faktor risiko yang dapat memicu terjadinya asma.

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ABSTRACTAsthma is a chronic inflammatory disease in the airways with highly prevalence.Asthma can occur at any age, 300 million people estimated suffering asthma inthe world and by 2025 there will be 400 million. Asthma prevalence in CentralKalimantan Province exceeds the national number. Furthermore, Palangkaraya isthe highest one. The prevalence of asthma is influenced by many factors such asheredity and the environment. This research aimed to analyze the relationship ofcockroach density in households and other risk factors that can trigger asthma.This research is using Case control design which consisted of 58 samples for thecases and 58 samples for the controls aged 12-45 years. Results showed cockroachdensity, atopy history, food sensitivity, air pollution, weather, householdsanitation conditions, home distance from highways and pet ownership wereassociated with the incidence of asthma. While education, occupation and types ofcooking fuel were not associated. In conclusion, the cockroach density is relatedto the incidence of asthma after controlled by variable characteristics ofindividuals and environmental factors. Patient is sugessted to maintain goodhygiene and sanitation, so would not become the habitat of cockroach and avoidrisk factors that can trigger asthma."

"Pengantar: Senam Asma Indonesia (SAI) sudah diketahui mampu menurunkan gejala-gejala asma dan meningkatan fungsi paru pada penderita asma. Studi ini bertujuan untuk mempelajari korelasi antara durasi SAI dan faktor lainnya yang mempengaruhi skor Asthma Control Test (ACT) pada anggota Klub Asma RSUP Persahabatan.Metode: Data penelitian didapatkan dengan meminta 28 penderita asma yang juga anggota Klub Asma RSUP Persahabatan untuk menjawab dua kuesioner yaitu kuesioner ACT dan informasi personal mereka mengenai lama durasi SAI, umur, jenis kelamin, dan riwayat merokok.Hasil dan Diskusi: Durasi SAI, dengan median 33 bulan (1-360), berkorelasi bermakna positif dengan skor ACT (p=0.022). Faktor lainnya yang berkorelasi bermakna juga dengan skor ACT adalah umur (p=0.020), berasosiasi positif juga, dan jenis kelamin (p=0.002) dengan laki-laki memiliki skor ACT yang lebih baik. Riwayat merokok tidak menunjukan korelasi yang bermakna dengan skor ACT (p=0.816) karena tidak ada subjek perokok aktif.Konklusi: Di antara anggota Klub Asma RSUP Persahabatan, median dari skor ACT mereka adalah 20(12-23) yang berarti bahwa mereka terkontrol sebagian. Durasi SAI mereka berkorelasi secara positif dengan skor ACT, orang yang sudah lebih lama melakukan SAI memiliki skor ACT yang lebih baik. Selain itu, ditemukan semakin tua subjek semakin baik skor ACT subjek tersebut. Subjek laki-laki didapatkan memilik skor ACT yang lebih baik dari perempuan. Riwayat merokok yang hanya terdiri dari bukan perokok dan mantan perokok tidak berpengaruh terhadap skor ACT.

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Introduction: Indonesian Asthma Gymnastics (IAG) exercise has been associated with reducing asthmatic symptoms and increase lung function in asthmatic patient. This study aims to understand the correlation between the duration of IAG exercise and other factors that might affect to the Asthma Control Test (ACT) score amongst RSUP Persahabatan Asthma Club members.

Method: The data is obtained by asking 28 asthmatic RSUP Persahabatan Asthma Club members to answer two questionnaires which are the ACT questionnaire and their personal information questionnaire regarding their duration of exercise, age, gender and smoking history.

Result and Discussion: The duration of IAG exercise, with median of 33 months (1-360), is significantly correlated by positive association with ACT score (p=0.022). Other factors that are significantly correlated as well with ACT score are age (p=0.020), also positively correlated, and gender (p=0.002) with males having better ACT score than females. Smoking history does not exhibit a significant correlation with ACT score (p=0.816) as there is no subject who is an active smoker.

Conclusion: Among RSUP Persahabatan Asthma Club members, the median of their ACT score is 20(12-23) which is translated to partially controlled. Their IAG exercise duration is significantly and positively correlated with ACT score that indicates people who have been engaging IAG exercise longer shows better ACT score. Besides, ACT score is also higher as the subject is older. Males has better ACT score compared to females. Smoking history, however, which comprised only of non-smoker and former smoker does not show significant correlation with ACT score."

"Smoking has detrimental effects on asthma sympom control and response to treatment and is prevalent among astma patients in South Korea. The aim of study is to determine the prevalence of smoking among asthma patients in South Korea and to compare the medication regimens of astma patients who do and do not smoke. Methods: A cross-sectional survey was conducted from August 2010 to January 2011. Participating physicians (N=25) recorded demographic and clinical data on all astma patients presenting during the study period (N=2,032), and then recruited a subset of patients (N=500) for the survey such that half were self-reported current smokers. Recruited patients were between the ages of 18 and 60. In South Korea, physicians are well aware of the smoking status of their patients. However smoking status did not affect the prescribed medication regimens of this population of asthma patients."