Browsing by Author "Lamichhane, Buddhi Sagar"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Publication Comparison of Asthma Control Test and GINA based assessment in Nepalese population: A cross-sectional study(Nepalese Respiratory Society, 2024) Dhungana, Ashesh; Lamichhane, Buddhi Sagar; Shrestha, Prajowl; Shrestha, Deepa Kumari; Niroula, DeepaAbstract: Introduction: Asthma has a high age adjusted mortality in low- and middle-income countries like Nepal, which is preventable. Asthma control test (ACT) and GINA based assessment are the two most used tools to monitor effectiveness of the treatment. Utility these tools have not been evaluated in patients with asthma in Nepal. Objective: This study aims to compare the agreement between ACT and GINA assessment tools in Nepalese population. Methods: In a cross-sectional observational study, patients aged more than 18 years diagnosed as asthma at least three months prior were included. Active smokers and those with concomitant other respiratory disorder were excluded. ACT translated to native Nepali language was self-administered by the patient. GINA assessment of asthma control was recorded by the physician. Patients were classified as having well controlled, partially controlled and poorly controlled asthma by using both the tools. Spearman’s correlation coefficient was used to evaluate the agreement between the ACT and GINA based classification. Results: A total of 56 patients were included into the study. The mean age was 39 ± 12 years and the median duration of symptoms was 39.5 (IQR = 25.5-53.5) months. Using the GINA recommended asthma control tool, the number of patients with well controlled, partially controlled and poorly controlled asthma were 21 (38%), 24 (43%) and 11 (20%) respectively. Using the ACT scores, 35 (63%), 11 (20%) and 10 (18%) patients had well, partially, and poorly controlled asthma respectively. Both ACT and GINA score had a good agreement in classifying poorly controlled asthma. ACT and GINA scores had a weak positive yet statistically significant correlation (Spearman’s rho= 0.752, p= 0.019). Conclusions: ACT and GINA based assessment tools have good agreement to identify poorly controlled asthma in patients with asthma in Nepal.Publication Role of Fractional Exhaled Nitric Oxide for Monitoring Bronchial Asthma(Nepal Health Research Council, 2024) Lamichhane, Buddhi Sagar; Dhungana, Ashesh; Shrestha, Prajowl; Thapa, Kamal Raj; Shrestha, Deepa KumariBackground: Monitoring during treatment of asthma is usually done by various clinical tools, spirometry, sputum eosinophils and fractional exhaled nitric oxide. Fractional exhaled nitric oxide is a simple and noninvasive tool and has a good agreement with asthma control test score. This study aims to correlate fractional exhaled nitric oxide with asthma control test score. Methods: This cross-sectional study was conducted at National Academy of Medical Sciences, Bir hospital, Chest unit, Department of Medicine, over a duration of six months. Patients aged more than 18 years with bronchial asthma diagnosed at least three months prior were included into the study. Those with recent severe exacerbations, known other chronic respiratory disease and smokers were excluded. Asthma control test score was obtained at baseline. All included patients underwent fractional exhaled nitric oxide measurement followed by measurement of Forced vital capacity(FVC) Forced expiratory volume in one second (FEV1) and FEV1/FVC ratio. Results: Forty patients with a mean age of 40.5±11.1 years were included in the study. Majority were females (65%) and the median duration of symptoms was 24 months (Interquartile range= 18-60). Mean fractional exhaled nitric oxide level was 27.8 (±16.0) parts per billion (ppb) and asthma control test score was 19.3 (±4.7). Mean fractional exhaled nitric oxide levels were significantly different across different severity (well controlled, partially controlled and poorly controlled) of asthma (p=0.013). The mean fractional exhaled nitric oxide values and total asthma control test score shows statistically significant negative correlation (Pearson correlation coefficient (r) = -0.462, p=0.003). Asthma control test and FeNO values guided the change of inhaled steroid dose in 17 of the 40 patients. Conclusion: Fractional exhaled nitric oxide can be used when available, along with asthma control test for monitoring control and adjusting the inhaled steroid dose in asthma. Keywords: Asthma control test (ACT); bronchial asthma; Fractional exhaled nitric oxide (FeNO).