Several studies reported the appearance of ASTHMA and autoimmune conditions in the same patient, but the clinical significance of this association was not yet assessed.One hundred ASTHMAtic PATIENTS were observed for one year evolution with death, severe exacerbations, intake of > 1000 micrograms of beclometasone or equivalent (high ICS) and FEV1 decline >100 ml, in relation with ANA (ELISA), sputum and blood eosinophilia (EO), NSAID intolerance, BMI >25, chronic rhinosinusitis, smoking status and FEV1 <30% predicted (low FEV1).After 1 year of observation, there were 5 deaths, 28 severe ASTHMA exacerbations requiring hospitalisations, 24 cases requiring high inhaled corticosteroid intake, and 19 PATIENTS with fast FEV1 decline (>100 ml/year). Multiple regression analysis pointed out several different independent risk factors for severe ASTHMA evolution: for death presence of ANA (P=0.037), NSAID intolerance (P<0.001) and low FEV1 (P=0.021); for evolution with severe exacerbations ANA (p=0.011), sputum EO (P<0.001), smoking (P=0.044) and NSAID intolerance (P=0.022); for high ICS intake ANA (P=0.036), sputum EO (P=0.026) and low FEV1 (P=0.006); for FEV1 decline >100 ml ANA (P=0.006), sputum EO (P=0.037), BMI>25 (P=0.046) and NSAID intolerance (P=0.017).The presence of ANA is an independent risk factor in ASTHMA for evolution with death, severe exacerbations, high inhaled corticosteroid intake and FEV1 decline >100 ml.

Background: ASTHMA is one of the most severe and life-threatening health problems, the better control of which is one of the main goals in ASTHMA management to be achieved by PATIENTS’,balanced participation in the treatment process. This study aimed to investigate ASTHMA control, perceived care, and health care participation in PATIENTS with ASTHMA. Materials and Methods: This descriptive-analytical study included 221 ASTHMAtic PATIENTS, who were selected using the convenience sampling method from those referring to pulmonary clinics in Kerman, Iran. The required data were collected using three questionnaires including ASTHMA Control Test (ACT), Perceived Care of ASTHMA Questionnaire (PCAQ), and Partners in Health Scale (PIH). The linear regression test was used to analyze the collected data with SPSS software version 21. Results: In this study, 14. 31, 42. 22, and 87. 33% of the PATIENTS had a favorable condition in ASTHMA control, perceived ASTHMA care, health participation, respectively. The disease duration was significantly associated with the level of perceived ASTHMA care. Moreover, perceived ASTHMA care had a significant relationship only with occupation. From another perspective, the relationship between marital status, level of education, city of residence, disease duration, and occupation with health care participation was significant. Conclusion: PATIENTS would have more control over ASTHMA if there were training programs underpinned by disease-based strategies and educational content regarding the risk factors of the disease, and the PATIENTS’,experience and knowledge of the disease were promoted. Furthermore, reinforcing selfcontrol and perceived ASTHMA care skills and involving PATIENTS in healthcare process would also enhance the disease control.

Introduction: ASTHMA is a chronic inflammatory airway disease. Genetic and environmental factors have been important role in the induction of ASTHMA. It's estimated that ASTHMA affect 2.7 to 35.4% of children (in average 13.4%) in Iran. The aims of this study to assess the costs of ASTHMA PATIENTS admitted in Boali Hospital in the North of Iran, Sari.Materials and Methods: This descriptive study was carried out in ASTHMA PATIENTS one to twenty years old that were admitted in the Boali Hospital in Sari, from 2008 to 2012. Out of 455 folders, 22 folders excluded, because they were incomplete registrations.Results: Out of 432 PATIENTS, 280 PATIENTS (64.81%) were male.349 PATIENTS were 1-5 years old (80.78%). Average annual cost in our ASTHMAtic PATIENTS was 1, 219, 064 Rials (Iran currency) ($ 121.9) per patient; 1.183.655 Rials ($ 118.3) for men and 1.284.789 Rials ($ 128.5) for female patient respectively.Conclusions: Our study showed ASTHMA disease has been significantly cost for patient, family and country.

Introduction: PATIENTS with ASTHMA experience high levels of stress. ASTHMA is a significant health problem in most parts of the world. Psychological therapy methods can play an essential role in reducing health-related disorders such as worry, rumination, and ASTHMA control. This study aimed to determine the effectiveness of metacognitive therapy on worry, rumination, and ASTHMA control in PATIENTS with ASTHMA. Methods: This study was quasi-experimental with a pre-test and post-test design with the control group. The study population was male PATIENTS with ASTHMA referred to specialized clinics in the private sector of Urmia city in the 2019 year. Several 24 PATIENTS, after reviewing the inclusion criteria, were selected by purposive sampling method and randomly with lottery replaced into two groups of experimental and control. The experimental group received ten 90-minute sessions (one session per week) of the metacognitive therapy, and the control group did not receive any training. Data were collected by questionnaires of worry and rumination and ASTHMA control test and analyzed in SPSS version 19 software. Results: The findings showed that the experimental and control groups did not significantly differ in age, marriage, education, and duration of illness (P > 0. 05). Also, based on every two groups in the pre-test phase did not significant difference in terms of worry, rumination, and ASTHMA control (P > 0. 05), but in the post-test stage, there were substantial differences in terms of all three variables (P < 0. 001). Also, the metacognitive therapy led to decreased worry and rumination and increased ASTHMA control in PATIENTS with ASTHMA (P < 0. 001). Conclusions: The results indicated the effectiveness of metacognitive therapy on decreasing worry and rumination and increasing ASTHMA control. Therefore, planning to use metacognitive treatment and other therapies is essential to improve healthrelated features in PATIENTS with ASTHMA.

2Background: ASTHMA is a chronic inflammatory disease of the airways. Various tests and questionnaires are designed to monitor the severity of ASTHMA and help the therapist and the health system prescribe the best treatment to control it. This study was designed to compare two methods ASTHMA Control Questionnaires (ACQ) and ASTHMA Control test-child (ACT-CHILD) in children with ASTHMA. Methods: This descriptive cross-sectional study was conducted on 92 children with ASTHMA referred to the Taleghani hospital, Gorgan, in 2022-2023. PATIENTS were in a range of age 4-16 years. ASTHMA control was evaluated and compared by two methods ACT-CHILD and ACQ. ACT-CHILD included one version for 4-11-year PATIENTS completed by their parents and another one for 12-16 –year PATIENTS completed by the PATIENTS. The clinical symptoms, age, gender and the parents' records related to ASTHMA were completed during the clinical interview. Data was analyzed using Chi-square and Spearman correlation tests. The degree of agreement between two questionnaires was determined using the Kappa coefficient. Results: 84 children aged 4-11 years (91. 3%) and 8 children aged 12-16 years (8. 7%) were included in the study. According to the ACT-CHILD, 40. 2% of children (n=37) had controlled ASTHMA, 44. 6% (n=41) had partially controlled ASTHMA, and 15. 2% (n=14) had uncontrolled ASTHMA. Based on the ACQ, controlled ASTHMA was observed in 18. 5% (n=17), partially controlled ASTHMA in 35. 8% (n=33), and uncontrolled ASTHMA in 45. 7% (n=42) of children. ASTHMA control results based on two questionnaires were significantly different from each other (P<0. 001). The agreement between the ACT-CHILD and ACQ methods in evaluating children's ASTHMA was at a weak level (P=0. 014, κ=0. 157), however, a significant negative correlation was observed between the scores of the ACT-CHILD and ACQ questionnaires (r=-0. 588, P>0. 001) which after categorizing based on age group, this correlation was confirmed only in children aged 4-11 years (r=-0. 627, P>0. 001). Conclusion: Our findings showed that there is a poor agreement between ACT-CHILD and ACQ results in the assessment of ASTHMA control. Further studies are recommended