Monaldi Archives for Chest Disease最新文献

{"title":"Cross-sectional study of pulmonary hypertension among patients with chronic obstructive pulmonary disease.","authors":"Carishma Sheela, Srishankar Bairy, Ajither P A, Suresh Koolwal, Eldhos Jacob","doi":"10.4081/monaldi.2025.3534","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3534","url":null,"abstract":"<p><p>The prevalence graph of chronic obstructive pulmonary disease (COPD) in India is escalating significantly. Pulmonary hypertension (PH) is one of the most important complications of COPD, leading to worsened clinical progression. Various studies have predicted the correlation of PH with the degree of airflow obstruction in COPD, but the association between PH and the ABCD stage of COPD, as per the recent Global Initiative for Chronic Lung Disease (GOLD) criteria, is still ambiguous and underexplored. Thus, we aim to correlate the association of PH with the updated staging of COPD. This prospective study followed 100 COPD patients diagnosed based on spirometry and clinical symptoms over a 1-year period. The severity and staging of COPD were determined according to GOLD classification criteria. Screening two-dimensional echocardiography was performed to assess PH. The association between PH and COPD staging was analyzed. Among the 100 subjects with COPD, the mean age was 60.6±7.8 years, and 70% were male. Based on disease staging, 23 patients (23%) were classified as stage A, 25 (25%) as stage B, 13 (13%) as stage C, and 39 (39%) as stage D. PH was present in 72 patients: 25 (25%) had mild PH, 26 (26%) had moderate PH, and 21 (21%) had severe PH. A significant association was observed between the stages of COPD and the severity of PH. PH is a major complication in COPD, leading to poor prognosis. Therefore, incorporating early cardiac screening in all COPD patients may assist in assessing prognosis, morbidity, and mortality.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of counseling in maintaining blood sugar control in patients with pulmonary tuberculosis and diabetes mellitus.","authors":"Preeyati Chopra, Vidhu Mittal, Nidhi Girdhar, Vishal Chopra, Kranti Garg","doi":"10.4081/monaldi.2025.3418","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3418","url":null,"abstract":"<p><p>Diabetes mellitus (DM) has emerged as an important comorbidity associated with tuberculosis (TB). Both diseases are known to affect each other's course. There has not been much data on the impact of frequent blood sugar monitoring and counseling in patients with TB and DM. A study was therefore conducted to assess the effects of these measures on glycemic control, radiological improvement, and treatment outcomes. A total of 50 sputum-positive pulmonary TB and DM patients were enrolled and divided into 2 groups (A and B) of 25 patients each. Blood sugar monitoring in both groups was done at the initiation of treatment, at the end of the intensive phase (IP), and at the end of the continuation phase (CP), and they were counseled for glycemic control. Additionally, group A patients were counseled weekly in the IP and biweekly in the CP for glycemic control. Group B patients were provided with glucometers and told to record blood sugars weekly during the IP and biweekly in the CP. The radiological improvement was measured using the TIMIKA score, and treatment outcome was assigned based on end CP sputum conversion. The mean age of groups A and B was 52.96±11.06 years and 51.6±13.05 years, respectively. The differences between the mean fasting blood sugar (FBS) and TIMIKA scores of the two groups at treatment initiation, end IP, and end CP were statistically non-significant (p=0.986, 0.70, and 0.650, and p=0.190, 0.156, and 0.214, respectively). When the two groups were compared for changes in mean FBS status and TIMIKA score from start to end IP, end IP to end CP, and start to end CP, the changes were again statistically non-significant (p=0.171, p=0.076, p=0.541, and p=0.892, p=0.691, p=0.461, respectively). The final treatment outcomes of the two groups were also similar (p=1.000) Counseling of patients with TB and DM was found to be similar to frequent blood glucose monitoring, as no statistically significant differences in the two groups concerning improvement in blood sugar levels, radiological changes, and treatment outcomes were found. It is hence proposed that dedicated counseling sessions are effective and should be a part of routine care in TB patients with DM.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of different field tests in relation to balance, daily living activities, and quality of life in pulmonary hypertension.","authors":"Ozge Ertan Harputlu, Goksen Kuran Aslan, Buket Akıncı, Ahmet Kaya Bilge, Murat Inanc, Gulfer Okumus","doi":"10.4081/monaldi.2025.3308","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3308","url":null,"abstract":"<p><p>Assessment of exercise capacity is useful in monitoring patients and planning a rehabilitation program for subjects with pulmonary hypertension (PH). No study has investigated the relationship of different field tests, except for the six-minute walk test (6MWT), with balance, activities of daily living (ADL), and quality of life (QoL) in subjects with PH. This study aimed to investigate the relationship of different field tests with balance, ADL, and QoL in subjects with PH. This study was a prospective cross-sectional study. A total of 27 subjects who were diagnosed as having PH were included in the study. Field tests were the 6MWT, the Incremental Shuttle Walk Test (ISWT), and the Endurance Shuttle Walk Test (ESWT). Balance assessment was performed using the Timed Up and Go Test (TUG). ADL was evaluated using the London Chest Activities of Daily Living Scale, and QoL was evaluated using emPHasis-10. TUG was the significant predictor of 6MWD and ISWT walking distance (ß=-0.590, p=0.001, ß=-0.600, p=0.001). The emPHasis-10 score significantly predicted ESWT time (ß=-0.667, p<0.001). Submaximal and maximal exercise capacity were related to balance in subjects with PH, and lower endurance capacity was related to decreased QoL. This study suggests that submaximal and maximal exercise capacity were related to dynamic balance in subjects with PH, and lower endurance capacity was related to decreased QoL. ISWT can be considered a safe and practical tool to assess maximum exercise capacity.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic utility of flexible bronchoscopy in smear-negative and atypical lung infections: identifying tuberculosis, fungal, and non-tuberculous mycobacteria infections and malignancy.","authors":"Adarsha Ps, Srishankar Bairy, Smitha Bhat, Vaishnavi Prakash, Meghana M","doi":"10.4081/monaldi.2025.3562","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3562","url":null,"abstract":"<p><p>Fiber-optic bronchoscopy (FOB) plays a crucial role in the diagnosis and management of various pulmonary diseases by offering direct visualization of the airways and enabling targeted sampling for microbiological and histopathological evaluation. This study aimed to assess the clinical, radiological, microbiological, and histopathological profiles of patients undergoing FOB. A retrospective analysis of 103 participants who underwent the procedure over one year was conducted. After obtaining informed consent, demographic and clinical information was recorded, and relevant radiological findings were noted. The procedure was performed under local anesthesia. In all cases with inconclusive sputum evaluation, bronchoalveolar lavage (BAL) was conducted, with additional brushing and biopsy performed in selected participants. The collected samples were analyzed to determine the underlying etiology. Among the 103 individuals studied, 52.4% were female, with a mean age of 54.82 years, and the majority (82.5%) were over 40 years old. Cough was the most common symptom (73.78%), followed by breathlessness. The frequent comorbidities included diabetes (27.18%) and hypertension (18.4%). Radiological patterns commonly included consolidation (59%) and cavitary lesions (30.1%). On bronchoscopy, secretions (67%) and inflamed mucosa (26%) were the most frequent findings. BAL cultures were positive in 48% of cases, with Klebsiella being the predominant organism. Tuberculosis was confirmed in 32% of the cases. Histopathology confirmed malignancy in 5.8%, mainly adenocarcinoma. In 24.2% of participants, the procedure was inconclusive. Overall, FOB was found to be a safe and valuable tool in diagnosing a spectrum of pulmonary conditions, especially in smear-negative tuberculosis, fungal and atypical infections, and malignancies, aiding targeted therapy and better clinical outcomes.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study to assess the utility of forced expiratory volume in 1 second/forced expiratory volume in 6 seconds in diagnosing obstructive airway disease.","authors":"Vardhan Garg, Manoj Kumar, Rakhee Khanduri, Varuna Jethani, Sushant Khanduri, Rahul Kumar Gupta","doi":"10.4081/monaldi.2025.3280","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3280","url":null,"abstract":"<p><p>According to the Global Initiative for Chronic Obstructive Lung Disease criteria, the ratio of forced expiratory volume in the 1st second (FEV1) and forced vital capacity (FVC) is required to diagnose chronic obstructive pulmonary disease. However, it becomes difficult for all patients to meet the proper criteria. Hence, replacing FVC with forced expiratory volume after 6 seconds (FEV6) can help patients get results early with fewer complications. This study was done to assess whether the FEV1/FVC can be replaced with FEV1/FEV6. A year-long observational cross-sectional study was conducted from January 2022 to January 2023. A total of 227 patients were enrolled from the respiratory medicine department. Demographic details and data from spirometry were recorded. Receiver operating characteristic (ROC) curves were created using the data analysis results. The diagnostic utility of FEV1/FVC and FEV1/FEV6 in the diagnosis of obstructive airway disease was examined. Results obtained in the study showed the average FEV6 was 2.05 with a 0.71 standard deviation. An r² value of 0.967 (p<0.05) indicated a substantial association between the FEV1/FEV6 and FEV1/FVC ratios. An ROC curve was used to show that FEV1/FEV6 could diagnose FEV1/FVC<70%; the area under the curve was 0.987 (95% confidence interval: 0.971-1.000). It has been found that 0.705 is the ideal cut-off value, resulting in 100% sensitivity and 98.2% specificity. To conclude the study, there was a substantial association between FEV1/FVC and FEV1/FEV6 in the diagnosis of obstructive airway illness. Using FEV1/FEV6, an ROC curve was created, and an ideal cut-off of 0.705 was shown to detect obstructive airway disease. Numerous lives can be saved, and prognoses can be improved by using the FEV1/FEV6 study to identify obstructive airway illnesses more easily, improve compliance, and manage them early.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive profiling of <i>KRAS</i> mutations in lung cancer using droplet digital polymerase chain reaction.","authors":"Reena Kishore, Sonam N Kille, Rhea Kishore, Rajesh Venkataram, Srividya Arjuna, Gunimala Chakraborty, Giridhar B Hosmane, Anirban Chakraborty","doi":"10.4081/monaldi.2025.3190","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3190","url":null,"abstract":"<p><p>With rising cases of lung cancer worldwide, liquid biopsies are becoming increasingly popular as clinically relevant potential non-invasive alternatives to tissue-based biopsies. The principle of partitioning utilized by the droplet digital polymerase chain reaction (ddPCR) makes it a highly sensitive technique for detecting rare tumor-derived mutations in blood. The presence of KRAS mutations is a negative prognostic marker for tyrosine kinase inhibitor (TKI) therapy in lung cancer; hence, profiling of major KRAS mutations before treatment is very crucial for the success of TKI therapy. This study was aimed at profiling three major KRAS mutations, namely G12D (GGT→GAT), G12V (GGT→GTT), and G13D (GGC→GAC) in lung cancer patients using ddPCR. ddPCR assays that rely on probe-based chemistry were standardized for KRAS G12D, KRAS G12V, and KRAS G13D mutations using cfDNA extracted from the patient's blood. To determine the concordance, blood-derived cfDNA and tumor DNA were compared using ddPCR. A positivity rate of 81.67% for KRAS mutations was observed in the cohort analyzed. KRAS mutations in the cfDNA from blood were effectively detected by ddPCR even at low fractional abundance. Moreover, a comparison of blood-derived cfDNA and tumor-derived genomic DNA-based analysis revealed a concordance of 66.67%, suggesting tumor heterogeneity as the probable reason for the lack of total concordance between the data. This study highlights the usefulness of ddPCR as a prospective clinical tool in oncology and liquid biopsy using blood cfDNA. It can be considered a better alternative to tissue biopsies and mutation profiling of candidate genes, particularly those that are linked to therapeutic response to TKIs.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agreement between the one-minute sit-to-stand test and the six-minute walk test in assessing exercise capacity in patients with interstitial lung disease.","authors":"Akshaya Moorthy, Prasanta Raghab Mohapatra, Sourin Bhuniya, Manoj Kumar Panigrahi, Shakti Kumar Bal, Mahismita Patro, Anand Srinivasan, Subarna Acharya, Shashank Kumar, Amanpreet Kaur","doi":"10.4081/monaldi.2025.3577","DOIUrl":"10.4081/monaldi.2025.3577","url":null,"abstract":"<p><p>The six-minute walk test (6-MWT) assesses functional exercise capacity in interstitial lung disease (ILD), providing key prognostic and functional insights. Logistical challenges, such as space and time limitations, limit its clinical use. The one-minute sit-to-stand test (1-MSTST) has emerged as a practical, space- and time-efficient alternative reflecting similar functional capacity. This study examined 1-MSTST and 6-MWT agreement in ILD patients and their correlations with pulmonary function tests and physiological responses. A prospective observational study was conducted on patients diagnosed with ILD at a tertiary care center. Patients underwent both 6-MWT and 1-MSTST at baseline, with follow-ups at 3 and 6 months. The agreement between these two tests was assessed using Lin's concordance correlation coefficient (CCC). Secondary outcomes included correlations with pulmonary function parameters, such as forced vital capacity (FVC) and diffusion lung capacity for carbon monoxide, and physiological responses, including oxygen desaturation, heart rate variation, blood pressure variation, and perceived exertion measured by the Modified Borg Dyspnea Score. They were assessed using the Spearman correlation coefficient. A total of 59 patients completed the study. At baseline, a moderate agreement between 1-MSTST and 6-MWT was observed (CCC=0.37), which improved over time with CCC values of 0.49 at 3 months and 0.54 at 6 months, indicating increasing concordance. Both tests demonstrated similar oxygen desaturation responses and Borg score variations, highlighting their utility in detecting exercise-induced hypoxemia. While 6-MWT showed significant correlations with FVC (r=0.34, p=0.009) and peak expiratory flow rate (PEFR, r=0.39, p=0.002), 1-MSTST exhibited weaker associations with lung function parameters. The 1-MSTST is a feasible and practical alternative to the 6-MWT for assessing exercise capacity in ILD patients, particularly in resource-limited settings where space and time constraints hinder using the 6-MWT. Its ease of implementation and ability to detect exercise-induced desaturation make it a valuable tool for routine clinical assessment and follow-up of ILD patients.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment practices of childhood pneumonia: the perspective of caregivers. A community-based study in West Bengal.","authors":"Satyajeet Raj, Sarika Palepu, Arkapal Bandyopadhyay, Farhad Ahamed, Gitismita Naik, Vikash Kumar Rai","doi":"10.4081/monaldi.2025.3150","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3150","url":null,"abstract":"<p><p>Pneumonia, an acute lower respiratory infection, is the single largest infectious cause of death in children worldwide. In this study, we aimed to assess the treatment practices of parents/caregivers for the management of pneumonia in children under 5 years of age in a rural community of West Bengal and to determine the associated causal factors. About 200 children were randomly selected by the multi-stage sampling method from two health and wellness centers. Data was collected in Epicollect and analyzed with STATA 17. Logistic regression analysis was used to evaluate the risk factors associated with childhood pneumonia. The mean (± standard deviation) age of the mother was 28±4.63 years, and for the father, it was 34.61±5.59 years. Most of the families belonged to the middle and lower middle class, and in around half of the families, overcrowding was present. Around 71% of children were delivered by a lower section cesarean section (LSCS), 12% of them were preterm, and 24% were of low birth weight. The majority of children were exclusively breastfed and also immunized for their age. About 66 children (33%) had acute illness in the last 3 months, and 132 (66%) in the last 6 months. In this study, 41% (n=82) of children had pneumonia in the last 6 months. All of them availed some sort of treatment, mainly (62.2%) from private practitioners, followed by government health facilities (25.61%). Around 90% of the families adopted home remedies like traditional herbs (42.5%), followed by tepid sponging (36.9%), etc. Around 62.2% of families were very satisfied with the treatment. The caste of family, mode of delivery (LSCS), low birth weight, family history of respiratory disorder, and family history of smoking were found to be significantly associated with childhood pneumonia (p<0.05). Knowledge of parents/caregivers was satisfactory in the present study, and all children received some form of treatment for pneumonia.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal-maternal complications due to pregnancy-acquired tuberculosis: a narrative review of the literature.","authors":"Waleed Razzaq Chaudhry, Sana Altaf, Cara Mohammed, Sofia Fuerte","doi":"10.4081/monaldi.2025.3126","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3126","url":null,"abstract":"<p><p>Tuberculosis (TB) during pregnancy can cause certain deleterious effects to both the mother and the fetus, leading to significant morbidity and mortality. The risk of TB rises significantly during pregnancy due to dampening of the immune response in females and certain factors yet to be studied. Since pregnant females are ruled out of clinical trials due to their pregnancy status, not much clinical data is available on how to combat TB in them or about the clinical safety and efficacy of certain drugs. Hence, not only is it important to make pregnant females vital study participants of clinical trials, but also to enhance their knowledge regarding the disease so that they may timely access quality care. It is also important to facilitate these TB-positive pregnant females through the introduction of gender-sensitive policies that are more exclusive and allow access to quality TB control programs that provide timely care, nutritional support, and quality and supportive management.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Global Initiative for Asthma guideline approaches to asthma control in adolescents aged 12 and above.","authors":"Danish Abdul Aziz, Werdah Viquar","doi":"10.4081/monaldi.2025.3444","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3444","url":null,"abstract":"<p><p>The Global Initiative for Asthma (GINA) guidelines for asthma management in children and adolescents aged 12 years and older present two treatment tracks. Track 1, the preferred option, involves as-needed low-dose inhaled corticosteroids (ICS) combined with formoterol. Track 2 involves as-needed ICS with a short-acting β-agonist for step 1 and low-dose maintenance ICS for step 2. This study aimed to compare the effectiveness of Track 1 and Track 2 in managing asthma in pediatric patients aged 12 years or older. This was a retrospective study that was conducted at Aga Khan University Hospital in Karachi, Pakistan, from January 1, 2022, to December 31, 2023. The study included children and adolescents aged 12 years or older, diagnosed with asthma exacerbations, who were discharged on reliever therapy following the GINA guidelines for steps 1 and 2. Patients were followed for re-admission within 30 days, emergency room (ER) visits, annual admissions, length of stay, and the need for intensive care. Pulmonary function tests (PFTs) were performed at 1 week and 3 months post-discharge. A total of 90 patients were enrolled and divided into Track 1 (n=43) and Track 2 (n=47). Track 1 patients had significantly fewer readmissions (4.65% vs. 19.15%, p=0.036), fewer ER visits (1.69±1.31 vs. 2.8±1.37, p<0.001), and fewer hospital admissions (1.37±0.85 vs. 2.1±0.84, p<0.001). Track 1 patients also required less intensive care (9.3% vs. 27.66%, p=0.034). PFTs showed greater improvement in forced expiratory volume in one second (FEV1) and the FEV1/forced vital capacity ratio for Track 1 compared to Track 2 at three months (p=0.026 and p<0.001, respectively). The study found that treatment with as-needed ICS/formoterol (Track 1) was more effective in managing asthma compared to the alternative treatment strategies in Track 2.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}