Asthma knowledge, attitude, and self-efficacy in Iranian asthmatic patients

Worldwide, numerous people of all ages and ethnicities experience asthma. The achievements of current medical regimens for patients frequently depend on three factors: 1] knowledge of patients regarding this disease, 2] patient's attitude about asthma, including willingness to collaborate with the therapeutic group for disease control, and 3] patient's self-efficacy for controlling asthma. Therefore, this study examined the relationship between knowledge, attitudes, and self-efficacy with socio-economic factors in Iranian asthmatic patients during 2006 - 2008. Participants consisted of 120 adults referred to Milad Hospital, Tehran, Iran during 2006 to 2008 whose physicians diagnosed their asthma. Socio-demographic factors such as sex, age, education level, occupation, marital status, family history of asthma, disease costs, and period of sickness were reviewed. Assessments of knowledge, attitudes and self-efficacy were performed by the Persian version of an international standard questionnaire [KASE-AQ]. Data were analyzed by SPSS version 14. Among respondents, only 9 [7.5%] patients had good knowledge about asthma, 108 [90%] patients had a suitable attitude about their asthma and 103 [85.3%] patients had proper self-efficacy. We found a significant association between self-efficacy and attitude in asthmatic patients [P<0.05]. Although specific knowledge about asthma is low, however, favorable attitudes toward asthma create opportunities to intervene and improve asthma management among patients. However, the use of educational tools depends on patients' educational levels. Therefore, we recommend elevating asthma knowledge

Evaluation of humoral immune function in patients with bronchiectasis

Bronchiectasis is a chronic debilitating condition characterized by abnormal dilated thickwalled bronchi. To investigate humoral immune function in bronchiectatic patients, this study was performed. Forty patients with established diagnosis of bronchiectasis, who were referred from two tertiary care pulmonology centers in Tehran, were investigated in this study. Immunoglobulin isotypes concentrations and IgG-subclasses were measured by nephelometry and enzymelinked immunosorbent assay [ELISA] methods, respectively. All patients received unconjugated pneumococcal vaccine, and blood samples were taken before and 21 days after vaccination. Specific antibodies against whole pneumococcal antigens were measured using the ELISA method. Fifteen [37.5%] out of 40 patients were diagnosed to have defects in antibody mediated immunity including 5 [12.5%] patients with immunoglobulin class deficiency [2 with common variable immunodeficiency and 3 with IgA deficiency], 3 [7.5%] with IgG subclass deficiency and 7 [17.5%] patients had Specific antibody deficiency [SAD] against polysaccharide antigen despite normal levels of serum immunoglobulins and IgG subclasses. Our study along with several other studies confirmed that all patients with bronchiectasis should undergo thorough immunological evaluation in order to identify the presence of the underlying immunologic defect. This evaluation should include serum immunoglobulins, IgG subclasses concentrations and also determination of serum antibodies against pneumococcal antigens. Early diagnosis and appropriate treatment will prevent the subsequent complications and improve quality of life of affected individuals

Factors affecting patients' compliance to metered-dose inhaler drugs in two asthma clinics in Tehran, Iran

Asthma affects an estimated 300 million people worlwide. Poor compliance with the prescribed medication leads to increased morality and morbidity. Various determinants of compliance have been described. The purpose of this study was to determine factors that can influence patients' compliance with prescribed Metered Dose Inhaler drugs. 179 patients with diagnosis of asthma were selected from two asthma clinics in Tehran. 160 of them met the inclusion criteria. Collected data consisted of patients' demographic data, asthma symptoms and severity, medical history of patients and their attitude towards asthma control and using drugs. Compliance was assessed by four questions regarding using metered Dose Inhaler drugs. There was a significant correlation between compliance and patient's literacy level, attitude about using drugs, and their knowledge about asthma [p=0.012, p=0.0001, p=0.001 respectively]. However there was significant negative correlation between symptom control score and compliance [r=-0.270, p=0.004]. Other factors including sex, patients' attitude about asthma control and severity of asthma did not show any significant relation. There are four major factors influencing the patients' compliance: level of literacy, attitude towards asthma management, knowledge about asthma, and symptom control. The negative relation between compliance and symptom control may be caused by patients' inadequate knowledge towards continuing treatment after improvement in their conditions. The study emphasizes on the importance of enhancing the patients' compliance. This could be done by providing patients with adequate information about their disease and treatment

Association between asthma severity and obesity in two asthma clinics in Tehran

The prevalence of both obesity and asthma has increased in recent years. Thus we decided to investigate the relation between obesity and asthma severity. We undertook a cross-sectional study in outpatient asthma clinics of 2 tertiary hospitals in Tehran. Obesity was defined as a body mass index greater than 30. Asthma severity was defined by using the Guide for Asthma Management and Prevention 2004 guidelines, according to patients' clinical and/or spirometerical parameters. Active cigarette smoking patients and patients with a history of other lung diseases were excluded. A total of 116 individuals, aged 16-83 years with a mean age of 46.57 +/- 15.05 years, met the entry criteria. There were 73 females and 43 males. The prevalence of obesity in our study population was 29.3%. The Spearman correlation coefficient between asthma severity and body mass index was r= 0.275 [p= 0.001]. Mean body mass index of females and males were 28.95 +/- 5.41 and 25.17 +/- 4.17, respectively. Mean body mass index of females with asthma was significantly higher than males [p< 0.0001]. The odds ratios for obesity were 8.650, 8.746, and 22.491 for mild, moderate and severe persistent asthma, respectively, compared to patients with mild intermittent asthma. With increasing asthma severity, we observed higher occurrence of obesity in adults. The association of asthma severity with obesity suggests that obesity may be a potentially modifiable risk factor for asthma or asthma exacerbation

Inflammatory pseudotumor of the lung: report of four adult cases

Inflammatory pseudotumors of the lung are rare and may produce diagnostic and therapeutic dilemma for the clinicians, pathologists, and surgeons. Herein, we reported on four patients with this uncommon disease. They were three men and one woman with a mean age of 37 years [range: 20 - 50]. Three cases were symptomatic, complaining of cough, expectoration of sputum, hemoptysis, and chest pain. Three had solitary pulmonary nodule [SPN] and one had a tumor-like mass in chest X-ray films. Wedge resection was performed for the first three cases. With suspicion of lung cancer, pneumonectomy was carried out for the last patient. The overall survival was 100%. There was no operative or postoperative complications/death or recurrence within 5 - 10 years of follow-up. All of them had benign appearances, which was proven by pathologic examination. Inflammatory pseudotumors of the lung are rare. Most behave in a benign fashion. It may increase slowly in size and sometimes has an aggressive behavior. Frozen section may be used during the operation for the diagnosis. According to pathologic examination, complete resection is safe and leads to excellent survival

Study of carbon monoxide [CO] level in ambient air of Tabriz streets

Background: Air pollution with its gaseous and particulate material is important factor in induction and aggravation of different illnesses especially pulmonary and cardiovascular diseases. Carbon monoxide [CO] is one of the gases which is produced mainly from combustion of motor vehicles. It has high affinity for hemoglobin, causing acute and chronic toxicities and deleterious cardio-pulmonary effects

Material and Methods: We measured CO concentration [ppm] with Compur Monitox Plus CO, GmbH in the streets of Tabriz at different times of the day [working/ holiday] and also in different seasons. For each target point, 4 measurements and overall 1536 measurements were taken

Results: The mean concentration of CO was 15.6 +/- 0.87ppm with 25.34ppm in the summer and 7.89ppm in the fall. [p <0.001]. In holidays the mean value of CO was 10.8 ppm compared with on 16.66ppm working days. [p=0.002].The highest concentration at different times during a fortnight was 20.72ppm in the afternoon and the lowest was 11.12 ppm at midnight. [p <0.001]. The highest recorded value was 105 ppm in the Bazaar area next to the central bus station

Conclusion: Drivers and people walking or working in crowded areas of Tabriz are exposed to high concentration of CO. This may cause acute and chronic CO poisoning with its related health hazards. This may be very important in patients with decreased cardio-pulmonary reserve