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"Background: nowadays, specific IgE measurement has been conducted in Indonesia, however there is still lack of data regarding diagnostic test to detect inhalant allergen in patients with respiratory allergies.This study aimed to determine the accuracy of specific IgE test in diagnosing specific sensitization of inhalant allergen in patients with respiratory allergies.Methods: this was a cross sectional study in patients with respiratory allergies and part of epidemiology study regarding to specific IgE sensitization in Allergy-Immunollogy Division, Cipto Mangunkusumo Hospital, Jakarta within November-December 2016. Measurement of specific IgE sensitization using Immunoblot method (Euroline, Euroimmun AG, Germany). The tested allergen is house dust mites Dermatophagoides pteronyssinus (Der p), Dermatophagoides farinae (Der f), Blomia tropicalis (Blo t) and cockroach Blatella germanica (Bla g). The result is compared with gold standard, skin prick test. The diagnostic result includes sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-).Results: a total of 101 patients were enrolled; 77 (76.2%) were women. Patients mean age was 38.8 years old. Based on SPT, sensitization was highest for Blo t (76.2%), followed by Der p (70.3%), Der f (69.3%), and Bla g (41.6%). Specific IgE-sensitization was highest for Der f (52.9%), followed by Der p (38.2%), Blo t (33.3%) and Bla g (10.8%). Der p allergen had 50.7% sentivity, 90% specificity, 92.3% PPV, 43.5% NPV, 5.1 LR+ and 0.1LR-. Der f showed 71.4% sensitivity, 87.1% specificity, 82.6% PPV, 57.4% NPV, 5.5 LR+ and 0.3 LR-. Blo t allergen had 41.6% sensitivity, 91.7% specificity, 94.1% PPV, 32.8% NPV, 5.0 LR+, and 0.6 LR-. Bla g allergen had 23.8% sensitivity, 98.3% specificity, 90.9% PPV, 64.4% NPV, 14.5 LR+ and 0.8 LR-.Conclusion: serum specific IgE testing to common inhalant allergen in patients with respiratory allergy showed only low-to-moderate sensitivity, but high specificity and PPV. This new assay can be used to diagnose allergen sensitization in the population with high prevalence of TDR and cockroach."

"ABSTRAK Latar Belakang: Pemeriksaan IgE spesifik serum baru diperkenalkan di Indonesia, tetapi belum ada data uji diagnostik mengenai akurasinya dalam mendeteksi alergen tungau debu rumah dan kecoa pada pasien asma dan atau rinitis alergi. Tujuan: Tujuan penelitian ini adalah untuk mendapatkan akurasi diagnosis pemeriksaan IgE spesifik serum dalam mendiagnosis sensitisasi alergen Dermatophagoides pteronyssinus Der p , Dermatophagoides farinae Der f , Blomia tropicalis Blo t dan Blatella germanica Bla g pada pasien asma dan atau rinitis alergi.Metode: Penelitian ini adalah studi potong lintang pada pasien alergi pernapasan dan merupakan bagian dari studi epidemiologi mengenai sensitisasi IgE spesifik di Divisi Alergi-Immunologi, RS Cipto Mangunkusumo, Jakarta, antara September dan Desember 2016. Pengukuran sensitisasi IgE spesifik dilakukan dengan metode imunoblot Euroline , Euroimmun AG, Germany . Alergen yang diuji adalah Der p, Der f, Blo t, dan Bla g. Hasilnya dibandingkan dengan baku emas uji tusuk kulit. Uji diagnostik yang dilakukan meliputi sensitivitas, spesifisitas, positive predicitive value PPV , negative predictive value NPV , likelihood ratio positif dan negatif LR and LR- .Hasil: Serbanyak 101 pasien dilibatkan dalam studi, 77 76,2 di antaranya adalah perempuan. Rerata usia pasien adalah 38,8 tahun. Berdasarkan uji tusuk kulit, sensitisasi tertinggi yang didapatkan adalah terhadap Blo t 76,2 , disusul oleh Der p 70,3 , Der f 69,3 , dan Bla g 41,6 . Sensitisasi IgE-spesifik tertinggi ditunjukkan oleh Der f 52,9 , diikuti oleh Der p 38,2 , Blo t 33,3 dan Bla g 10,8 . Alergen Der p memiliki 50,7 sentivitas, 90 spesifisitas, 92,3 PPV, 43,5 NPV, 5,1 LR dan 0,1 LR-. Der f memperlihatkan 71,4 sensitivitas, 87,1 spesifisitas, 82,6 PPV, 57,4 NPV, 5,5 LR dan 0,3 LR-. Alergen Blo t menunjukkan 41,6 sensitivitas, 91,7 spesifisitas, 94,1 PPV, 32,8 NPV, 5,0 LR , dan 0,6 LR-. Alergen Bla g menghasilkan 23,8 sensitivitas, 98,3 spesifisitas, 90,9 PPV, 64,4 NPV, 14,5 LR dan 0,8 LR-.Kesimpulan: Pemeriksaan IgE spesifik serum dalam mendiagnosis sensitisasi alergen Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis, dan Blatella germanica pada pasien asma dan atau rinitis alergi memperlihatkan sensitivitas rendah sampai sedang, tetapi spesifisitas dan PPV yang tinggi.

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ABSTRACTBackground Serum specific IgE testing has recently been introduced in Indonesia, but diagnostic test has not been performed to know its performance to detect house dust mite and cockroach allergens in patients with allergic asthma and or rhinitis.Objective The objective of this study was to obtain diagnostic accuracy of serum specific IgE testing in diagnosing allergen sensitization to Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis, and Blatella germanica allergens in patients with allergic asthma and or rhinitis.Method This was a cross sectional study among patients with respiratory allergy and was part of a larger epidemiology study on specific IgE sensitization in the Division of Allergy Immunology, Cipto Mangunkusumo Hospital, Jakarta between September and December 2016. Specific IgE sensitization was measured using immunoblot method Euroline , EuroImmun AG, Germany . Allergens tested were Dermatophagoides pteronyssinus Der p , Dermatophagoides farinae Der f , Blomia tropicalis Blo t , and Blatella germanica Bla g . The results was compared to the standard skin prick test . Diagnostic test were performed and include sensitivity, specificity, positive predicitive value PPV , negative predictive value NPV , positive and negative likelihood ratio LR and LR .Results A total of 101 patients were enrolled 77 76.2 were women. Patients mean age was 38.8 years old. Based on SPT, sensitization was highest for Blo t 76.2 , followed by Der p 70.3 , Der f 69.3 , and Bla g 41.6 . Specific IgE sensitization was highest for Der f 52.9 , followed by Der p 38.2 , Blo t 33.3 and Bla g 10.8 . Der p allergen had 50.7 sentivity, 90 specificity, 92.3 PPV, 43.5 NPV, 5.1 LR and 0.1LR . Der f showed 71.4 sensitivity, 87.1 specificity, 82.6 PPV, 57.4 NPV, 5.5 LR and 0.3 LR . Blo t allergen had 41.6 sensitivity, 91.7 specificity, 94.1 PPV, 32.8 NPV, 5.0 LR , and 0.6 LR . Bla g allergen had 23.8 sensitivity, 98.3 specificity, 90.9 PPV, 64.4 NPV, 14.5 LR and 0.8 LR .Conclusion Serum specific IgE testing to Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis, and Blatella germanica allergens in patients with allergic asthma and or rhinitis showed only low to moderate sensitivity, but high specificity and PPV."

"ABSTRACTBackground: pollens from trees or grasses in Indonesia have a perennial distribution due to the tropical climate. However, pollen allergy has not been well studied. This study aimed to evaluate the profile of pollen IgE sensitization in respiratory allergic patients in Jakarta. Methods: this was a cross-sectional study in patients with a history of respiratory allergy in Jakarta, Indonesia between September and December 2016. Adult asthmatic patients aged 19-60 years were invited to undergo serum specific IgE testing at the Allergy and Immunology Clinic, Cipto Mangunkusumo Hospital, Jakarta. Patients were included if they showed at least one positive skin prick test with environmental allergens. Quantitative determination of specific IgE in serum was carried out by multiple allergosorbent (MAST) assays (Polycheck Allergy, Biocheck GmbH, Munster, Germany). Serum specific IgE levels of more than 0.35 kU/L or Class 1 was considered positive. Results: a total of 106 cases were eligible for analysis; 81 (76.4%) were women. Patients mean age was 38.8+12.1 (range 19-59) years old. 59.4% of patients have both asthma and allergic rhinitis. There are 9 (8.5%) patients positive for IgE-pollen sensitization; 8 among them showed sensitization to at least 2 pollens. Sensitivity to goosefoot pollen is the highest (5.7%), followed by rye pollen (4.7%), plantain pollen (4.7%), wall pellitory pollen (4.7%), and Bermuda grass pollen (3.8%). Conclusion: although most pollens tested are not originated from native plants to Indonesia, a small number of patients showed specific IgE-sensitizations. Allergic persons planning to travel to the endemic areas of the relevant pollen should be advised. A panel of pollen allergens from local plants is highly desired."

"Latar Belakang : Skin prick test SPT merupakan baku emas mendiagnosis sensitisasi alergen, namun memiliki keterbatasan. Pemeriksaan IgE spesifik merupakan pemeriksaan in vitro, nyaman dan tidak ada risiko anafilaksis.Tujuan: Mendapatkan akurasi pemeriksaan IgE spesifik serum metode ELISA dalam mendiagnosis sensitisasi alergen hirup pada pasien asma dan/atau rinitis alergi.Metode: Merupakan uji diagnostik dengan desain cross sectional pada pasien asma dan rinitis alergi di poliklinik Alergi-Imunologi FKUI-RSCM. Seratus pasien diperiksa IgE spesifik serum tungau debu rumah D.pterossinus, D.farinae, B.tropicalis , kulit anjing, kulit kucing dan kecoak dengan metode ELISA serta SPT sebagai baku emas mendiagnosis sensitisasi alergen tersebut. Sensitivitas, spesifisitas, nilai duga, dan rasio kemungkinan dari IgE spesifik serum dinilai untuk masing-masing alergen.Hasil: Sensitivitas IgE spesifik serum dalam mendiagnosis sensitisasi alergen tungau debu rumah berkisar 48-77 , dengan sensitivitas tertinggi 77 IK 95 66-86 pada D.farinae. Spesifisitas berkisar 64-95 , dengan spesifitas tertinggi 95 IK 95 76-99 pada B.tropicalis, serta nilai RK antara 2,1-11, dengan tertinggi untuk B.tropicalis. Sensitivitas mendiagnosis sensitisasi kecoak 12 IK 95 4,5-27 , namun spesifisitas 100 IK 95 92-100 , dengan RK . Spesifisitas mendiagnosis sensitisasi kulit anjing 89 IK 95 79-95 , namun senstitivitas 3 IK 95 1,5-17 , dengan RK hanya 0,29 IK 95 0,03-2,26 . IgE spesifik serum memiliki spesifitas 88 IK 95 77-95 dalam mendiagnosis sensitisasi kulit kucing, namun sensitivitas 10 IK 95 3,5-26 dan RK 0,9 IK 95 0,3-3,1 .Kesimpuan: Pemeriksaan IgE spesifik serum metode ELISA memiliki akurasi diagnostik yang sedang dalam mendiagnosis sensitisasi terhadap tungau debu rumah dan kecoak, namun akurasi rendah untuk kulit anjing dan kucingKata Kunci: Skin prick test IgE spesifik serum, Akurasi, Alergen hirup

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Background Skin prick test SPT is the gold standard to diagnose allergen sensitization, but has some limitations. Serum specific IgE SSIgE is in vitro test, comfortable and has no anaphylaxis risk.Aim To get the accuracy of SSIgE test using ELISA method in diagnosing inhalant allergens sensitization in asthma and or allergic rhinitis patients.Method This is diagnostic study with subjects were asthma and or allergic rhinitis patients. One hundreds patients had SSIgE test for house dust mites D.pterossinus, D.farinae, B.tropicalis , dog dander, cat dander and cockroach allergens and SPT as gold standard to diagnose allergen sensitization. Sensitivity, specificity, predictive value, and likelihood ratio of SSIgE were evaluated.Result To diagnose house dust mites sensitization SSIgE has 48 77 sensitivity, with the highest is for D.farinae 77 95 CI 66 86 , while specificity is 64 95 , with the highest is for B.tropicalis 95 95 CI 76 99 and LR around 2,1 11, with the highest is for B.tropicalis. Sensitivity of SSIgE to diagnose cockroach sensitization is 12 95 CI 4.5 27 , but has high specificity 100 95 CI 92 100 , and high LR . SSIgE has high specificity 89 95 CI 79 95 in diagnosing dog dander sensitization, but low sensitivity 3 95 CI 1.5 17 and low LR 0.29 95 CI 0.03 2.26 . To diagnose cat dander sensitization SSIgE has 88 95 CI 77 95 specificity, but low sensitivity 10 95 CI 3.5 26 and low LR 0.9 95 CI 0.3 3.1 Conclusion SSIgE test using ELISA method has moderate accuracy in diagnosing house dust mites and cockroach sensitization, but low accuracy for dog and cat dander sensitization.Keywords Skin prick test, Serum specific IgE, Accuracy, Inhalant Allergens"

"AbstrakPURPOSE:House dust mites (HDM) are major allergens that cause allergic rhinitis (AR). Allergen-specific subcutaneous immunotherapy (SCIT) has been shown to be clinically beneficial in many clinical trials. Such trials, however, are not reflective of all patient populations. The aim of this study was to describe the efficacy and safety of SCIT in routine clinical practice in Korean adults with AR sensitized to HDM.METHODS:We reviewed medical records of 304 patients with AR treated at an allergy clinic of a tertiary hospital using SCIT with aluminum hydroxide-adsorbed allergen extract targeting HDM alone or with pollens for at least 1 year from 2000 to 2012. Patients with asthma were excluded. Rates of remission, defined as no further requirement of maintenance medication, over time were determined by means of life tables and extension of survival analysis. Specific immunoglobulin E (IgE) levels to HDM were categorized into 6 classes.RESULTS:The mean time until achieving remission was 4.9±0.1 years, and the cumulative incidence of remission from AR was 76.6%. Severe AR (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.23-0.69; P=0.001), specific IgE levels to HDM ≥17.5 kU/L (OR, 1.85; 95% CI, 1.01-3.37; P=0.045), and duration of immunotherapy ≥3 years (OR, 7.37; 95% CI, 3.50-15.51; P<0.001) were identified as significant predictors of clinical remission during SCIT for patients with AR sensitized to HDM. Overall, 73 patients (24.0%) experienced adverse reactions to SCIT, and only 1 case of anaphylaxis (0.3%) developed.CONCLUSIONS:SCIT with HDM was found to be effective and safe for patients with AR. Specific IgE levels to HDM and a duration of SCIT ≥3 years may be predictors of clinical responses to SCIT in AR patients."

"ABSTRAKLatar Belakang: Asma alergi merupakan salah satu jenis fenotipe asma yang terbanyak, ditandai dengan adanya sensitisasi terhadap alergen lingkungan. Pada asma alergi terjadi respons inflamasi tipe 2 yang akan menghasilkan periostin yang dapat dideteksi dalam darah. Salah satu faktor yang mempengaruhi keterkontrolan asma adalah paparan alergen yang dapat bervariasi bergantung pada pola musim. Wilayah Indonesia sebagai benua maritim memiliki dua musim (hujan dan kemarau) berbeda dengan wilayah lain yang memiliki empat musim. Tujuan: Penelitian ini bertujuan untuk melihat perbedaan kadar periostin serum pada asma alergi terkontrol dan tidak terkontrol. Metode: Penelitian ini merupakan penelitian potong lintang dengan subjek penelitian adalah pasien asma alergi yang berobat ke poliklinik divisi Alergi Imunologi Klinik Rumah Sakit Dr Cipto Mangunkusumo bulan Januari-April 2017. Keterkontrolan asma dinilai dengan skor Tes Kontrol Asma sementara periostin serum digunakan sebagai penanda proses inflamasi Th2. Hasil: Dari 80 pasien asma alergi didapatkan rerata usia 39,7 tahun dengan proporsi perempuan lebih banyak (76%). Sebagian besar pasien memiliki riwayat rinitis alergi (73,8%) dan riwayat asma dalam keluarga (71%). Tungau debu rumah merupakan jenis alergen yang banyak memberikan sensitisasi. Kadar periostin serum pada subjek yang tidak terkontrol tidak berbeda dengan subjek yang terkontrol (209,78 ng/mL vs 627,66 ng/mL, p = 0,424) Simpulan: Tidak terdapat perbedaan kadar periostin pada kelompok asma alergi terkontrol dan tidak terkontrol.

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ABSTRACTBackground: Allergic asthma is the most common asthma phenotype, defined by the presence of sensitization to environmental allergens. In allergic asthma, following allergen exposure there will be an activation of T2-type inflammation producing periostin that can be detected from blood. Many factors can influence asthma control, including allergen exposure, which may vary greatly with climatic and seasonal changes. The Indonesia region as the Maritime Continent is characterized by a wet and a dry season which is different from other regions with four seasons. Objective: To see the difference of serum periostin level in uncontrolled and controlled allergic asthma. Methods: This is a cross sectional study using samples from allergic asthma patients who went to Allergy and Clinical Immunology Clinic, Dr. Cipto Mangunkusumo Hospital in January to April 2017. Asthma control was assessed clinically by using Asthma Control Test, while serum periostin was used as biological markers reflecting Th2 inflammation. Results: From 80 allergic asthma patients, the average of age was 39.7 years old with a greater proportion of women (76%). Most of the subjects had history of allergic rhinitis (73.8%) and positive family history of asthma (71%). House dust mites were the most common cause of sensitization. Serum periostin level in uncontrolled allergic asthma was not different from those in controlled allergic asthma (209,78 ng/mL vs 627,66 ng/mL, p = 0,424). Conclusions: There was no difference in the level of serum periostin in controlled and uncontrolled allergic asthma."

"Penelitian ini adalah penelitian berbasis komuniias untuk memperoleh gambaran kadar alergen tungau debu rumah (TDR) dan sensitisasi alergen sebagai faktor risiko asma. Penelitian ini merupakan studi potong lintang dengan responden 3.840 pelajar sekolah menengah pertama dari 19 sekolah yang dipilih secara acak dari 131 sekolah di Jakarta Pusat. Seinua responden mengisi kuesioner International Study on Asthma and Allergy in Children (ISAAC). Dari 3.840 responden, 288 (7,5%) digolongkan dalatn kelompok asma karena mempunyai riwayat mengi selama 12 bulan terakhir. Pada kelompok asma, 207 responden melakukan uji kulit dan 135 diambil sampel debu rumah. Dari 2.601 responden yang tidak memiliki riwayat asma atau atopi lain, dipilih secara acak 274 orang untuk uji kulit dan 165 di antaranya diambil sampel debu rumah. Kadar alergen TDR tidak berbeda bermakna antara kelompok asma maupun non-asma baik untuk Der pi, Der fl, rnaupun Grup I. Risiko asma terutama disebabkan oleh sensitisasi alergen TDR D.pteronyssinuss (rasio odds (OR):12,68, interval kepercayaan (Cl): 7,50-21,44), D.farinae (OR: 10,50, CI: 6,35-17,34), serta kecoak (OR-.5.57, Cf:3,44-9.0l). Perbedaan risiko asma tidak berhubungan dengan tinggi rendahnya kadar alergen TDR tetapi oleh sensitisasinya. Kesimpulannya, sensitisasi alergen TDR dan kecoak perlu diperhatikan dalam upaya menurunkan risiko dan prevalensi asma. (MedJ Indones 2006; 15:55-9).

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This study is a community-based study to get an overview about House Dust Mite (HDM) allergen level, allergen sensitization as risk factors of asthma. This is a cross-sectional study on 3,840 students from 19 junior high schools, aged 13-14 years. AH of the respondents filled out the International Study on Asthma and Allergy in Children (ISAAC) questionnaire. Of 3840 respondents, 288 (7.5%) were assigned to asthma group (experience wheezing during the last 12 months). The skin prick test was performed on 207 respondents and the house dust mite was collected from 135 respondents. Of 2601 respondents in non-asthma group, the skin prick test was randomly performed on 274 respondents and the house dust mite was collected from 165 respondents. There is no significant difference on HDM allergen concentration for Der pi, Derfl or Group I between asthma and control group. The risk of asthma was caused especially by sen D.pteronyssinus (crude odds ration (OR): 12.68, 95% confidence interval (Cl): 7.50-21.44), D.farinae (OR: 10.50, Cl: 6.35-17.34) and cockroach allergen {OR: 5.57, Cl:3.44-9.01). The risk for asthma was not correlated with the level of house dust mile allergens but its sensitization. In conclusion, sensitization to HDM and cockroach allergen should be concerned in order to reduce risk and prevalence of asthma. (MedJ Indones 2006; 15:55-9)."

"Metode : Penelitian ini adalah penelitian potong lintang yang bersifat deksriptif analitik untuk mengetahui proporsi rinitis alergi pada pasien asma periode Agustus sampai Oktober 2014. Pasien asma yang datang ke poliklinik Asma dinilai derajat asma dan derajat kontrol asma dengan menggunakan Asthma Control Test (ACT). Jika terdapat minimal 2 gejala rinitis alergi maka dilakukan pemeriksaan nasoendoskopi dan uji cukit kulit. Dari uji cukit kulit, apabila terdapat jenis alergen positif maka didapatkan proporsi rinitis alergi.Hasil. Dari 185 pasien asma yang memiliki dua atau lebih gejala rinitis alergi dan dilanjutkan dengan pemeriksaan nasoendoskopi serta uji cukit kulit adalah 67 orang. Didapatkan proporsi rinitis alergi pada pasien asma 54 orang (29,2%). Data karakteristik pasien asma meliputi jenis kelamin perempuan 77,3% lebih banyak dibandingkan laki-laki 22,7% dengan median usia 52 tahun. Hampir semua pasien menggunakan pembayaran BPJS 94,1% dengan riwayat alergi sebanyak 44,9%. Proporsi derajat asma stabil terbanyak persisten sedang 101 orang (54,6%) dan derajat asma terkontrol adalah terkontrol sebagian 47,0%. Dari sebaran gejala rinitis alergi yang terbanyak adalah bersin 46,5%, rinore 28,6%, dan hidung tersumbat 26,5%. Pada pemeriksaan nasoendoskopi, terdapat kelainan 28,6% dengan terbanyak septum deviasi 56,6%, konka pucat 50,9% dan konka edema 22,6%. Pemeriksaan uji cukit kulit 67 orang, didapatkan 54 orang positif dengan jenis alergen terbanyak positif adalah tungau debu rumah 38,8%. Proporsi derajat rinitis alergi sesuai kriteria ARIA terbanyak intermiten ringan dan persisten ringan 46,3%. Terdapat hubungan yang bermakna antara derajat rinitis alergi dengan derajat asma (p = 0,035). Hubungan antara derajat rinitis alergi dengan derajat kontrol asma juga bermakna (p = 0,006).Kesimpulan. Proporsi rinitis alergi pada pasien asma adalah 29,2% dengan jenis alergen terbanyak berdasarkan uji cukit kulit adalah tungau debu rumah. Terdapat hubungan bermakna antara derajat rinitis alergi dengan derajat asma dan derajat kontrol asma.

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Introduction : Asthma and rhinitis are two different entities are anatomical, physiological and clinical management but located in one airway. United Airway Disease (UAD) have hypothesized that inflammation of the upper and lower respiratory tract both a manifestation of a process of inflammation in the airways and this hypothesis is supported by evidence arising from the systemic relationship of the upper and lower respiratory tract. World Health Organization (WHO) issued a guidance entitled Allergic Rhinitis and it's Impact on Asthma (ARIA) 2001 which provides a comprehensive overview of the pathophysiology, diagnosis and treatment of allergic rhinitis in asthma patients. This study aims to knowthe allergic rhinitis proportion on those patients and related factors at Persahabatan Hospital.Methods : This is a cross-sectional study based on the descriptive and analytical to find out the allergic rhinitis proportion in asthma patients at the period August to October 2014. Those who came to asthma clinic evaluated for the degree of asthma control test (ACT). If there are at least two allergic rhinitis symptoms, nasoendoscopy examination and skin prick test should be done and if there is type of positive from skin prick test, the allergic rhinis proportion obtained.Results : From 185 asthma patients who participate, have two or more allergic rhinitis symptoms and have joined nasoendoscopy examination and skin prick test are 67 person. It is found that the allergic rhinitis proportion in asthma patients are 54 (29,2%) the characteristics data of asthma patients include female (77,3%) and more than male (22,7%) with a median age of 52 years. Almost all patients use BPJS payment (94,1%) with the allergic history (44,9%).. The proportion of the highest degree persistent stable asthma are 101 person (54,6%) and the degree of asthma control which is partially controlled is 47,0%. From the distribution of the most allergic rhinitis symptoms are sneezing (46,5%), rhinorrhea (28,6%) and nasal congestion (26,5%). In the nasoendoscopy examination, there are abnormalities (28,6%) with septum deviation (56,6%), pale turbinate (50,9%) and concha edema (22,6%). Examination of the skin prick test from 67 person, 54 person are positive with the most type of allergen caused by house dust mites (38,8%). The proportion of the allergic rhinitis degree based on ARIA criteria, mild intermittent and mild persistent (46,3%). There is a significant correlation between the degree of allergic rhinitis with the asthma degree (p = 0,035). The corellation between the degree of allergic rhinitis with the degree of asthma control was also significant (p = 0,006).Conclusion : The allergic rhinitis proportion in asthma patients is 29,2% and based on the skin prick test, the most type of allergensare the house dust mites. There is a significant association between the degree of allergic rhinitis with the asthma degree and the degree of asthma control."

"ABSTRAKPendahuluan: Faktor lingkungan seperti alergen dan polusi udara dapat memicu ataupun memperberat gejala asma akut serta menyebabkan persitens gejala asma terutama asma alergi. Telah banyak usaha dilakukan untuk mengurangi kadar alergen dalam udara. Salah satu caranya adalah dengan mempertahankan keseimbangan anion-kation sehingga terjadi denaturasi protein tungau debu rumah yang merupakan alergen utama. Kondisi keseimbangan anion-kation dalam udara ini serupa dengan kondisi alamiah hutan. Lingkungan yang serupa dapat dicapai menggunakan filter udara dengan ioniser sehingga tercapai keseimbangan anion-kation dalam udara. Apakah kondisi ini akan mempengaruhi kondisi inflamasi saluran napas dan fungsi paru pasien asma alergi belum pernah dibuktikan sebelumnya.Metode penelitian: Penelitian ini dilakukan dengan uji klinis silang (cross-over), terbuka, pada pasien-pasien asma alergi. Data subjek diambil secara mandiri oleh pasien dan pemeriksaan berkala di Poli Asma. PPOK RS Persahabatan sejak Desember 2011 sampai September 2012. Pemeriksaan FeNO menggunakan NIOX mino, uji fungsi paru (spirometri), serta penilaian ACT dilakukan setiap bulan di RS Persahabatan.Hasil Penelitian: Terdapat 36 pasien yang berhasil mengikuti penelitian sampai selesai, selebihnya mengundurkan diri. Terdapat enam subjek laki-laki dan 30 perempuan, rerata usia 42,72 tahun (18-63). Klasifikasi terbanyak adalah asma persisten ringan (19) diikuti dengan asma persisten sedang dan berat (10 dan 7). Perbandingan selisih nilai ACT akhir dengan nilai awal antara kelompok kontrol dengan perlakuan berbeda bermakna secara statistik (p=0,008) maupun secara klinis (rerata kenaikan 3,31 poin). Tidak didapatkan perbedaan yang bermakna secara statistik dalam nilai FeNO dan uji fungsi paru antara kedua kelompok pengamatan.Kesimpulan: Pada penelitian ini didapatkan peningkatan nilai asthma control test setelah penggunaan filter udara dengan ioniser namun tidak didapatkan perbedaan inflamasi saluran napas dan nilai faal paru. Penggunaan filter udara anion-kation seimbang dapat direkomendasikan pada pasien asma alergi.

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ABSTRACTIntroduction: Many attempts have been tried to reduce concentration of allergens which may precipitate acute asthma or cause persistence of symptoms especially in allergic asthma patients. One of the techniques used is air filter and ionizer which creates a balance anion-cation ambiance. Studies have showed that its use can reduce airborne allergen concentration. Indoor ionised air has been proven to cause protein denaturation of house dust mite allergen, one of the most prominent indoor allergen. Ionised air has been proved to cause protein denaturation of mite allergens. This condition is similar to the natural condition existing in uncontaminated natural forests. This condition may be achieved by using a commercially available air purifier and ionizer. Whether this condition affects airway inflammation and lung function test in allergic asthma patients is yet to be proven.Methods: This is a cross-over, unblinded, clinical trial, conducted in allergic asthma patients. Serial spirometry and FeNO measurements are performed monthly. Subjects are also asked to fill ACT for assement of asthma control. Subjects is observed for two months without using air filter in their bedrooms and two months using air filter in their bedrooms with a two weeks interval in between observation.Results: There were 50 patients enrolled in the beginning of this study but 14 dropped out while 36 completed the study. There were six male subjects and 30 female, averaging 42,72 (min 18, max 63). Most patients were mild persistent (n=30), followed by moderate ande severe persistent asthma (10 and 7, respectively). The difference between baseline and end of two months observation in control and treatment group was statistically and clinically significant (paired t-test, p=0,008, 3 points ACT increase). Although there was a trend of decreased FeNO and increased FEV1/predicted ratio, time series and multivariate analysis in both was not statistically significant.Conclusion: There was an increase of ACT score after air filter with ionizer usage but the change in FeNO and lung function test was not statistically significant. Air purifier can be recommended in allergic asthma patients to increase asthma control."