Background: The ongoing war in Ukraine, particularly the escalation of hostilities in the Sumy region since August 2024, has significantly disrupted civilian life. This study investigates the impact of increased military activity on asthma control and psychological well-being among patients with persistent asthma. Methods: A prospective observational study was conducted at the Sumy Regional Clinical Hospital from May to October 2024. Forty-nine patients with persistent asthma (28 females, 21 males) and 21 healthy controls (13 females, 8 males) were assessed at two time points: May/June and September/October 2024. Clinical parameters included the Asthma Control Test (ACT), forced expiratory volume in one second (FEV 1), blood eosinophils, and total IgE. Psychological status was assessed using the Hospital Anxiety and Depression Scale (HADS). Statistical analysis was performed using IBM SPSS Statistics 30.0. Results: Anxiety and depression levels increased significantly in all participants between May/June and September/October, with female asthma patients showing the most pronounced differences compared to healthy controls. A significant negative correlation was found between anxiety scores and both FEV 1 and ACT results (p < 0.001), indicating that higher anxiety was associated with poorer asthma control. No significant changes were observed in eosinophil counts or IgE levels. Depression scores showed no significant correlation with clinical asthma parameters. Conclusion: The escalation of warfare-related stressors in the Sumy region is associated with increased anxiety and reduced asthma control, particularly in women. These findings highlight the critical need for integrated medical and psychological support for individuals with chronic respiratory diseases in conflict zones. Addressing anxiety may be key to improving asthma outcomes during prolonged crises.

BACKGROUND: Nasal nitric oxide (nNO) a noninvasive indicator for eosinophilic airway inflammation, has not been adequately studied in different types of rhinitis. The aim of this study was to compare nNO levels between allergic (AR) and non-allergic rhinitis (NAR). METHODS: Patients were included based on their chronic nasal symptoms. Total nasal symptoms score (TNSS) were evaluated. nNO was measured transnasally with a flow of 5ml/s from the nostril with an NO analyzer (NIOX MINO; Aerocrine, Sweden). Results were evaluated as parts per billion (ppb). RESULTS: 443 patients (277 F/166 M) - 337 with AR (76%) and 106 with NAR (24%) - were assessed. Patients with AR had significantly higher TNSS, more severe disease, and longer duration of disease compared to NAR group. Allergic rhinitics had significantly higher nNO levels than NAR (370 ppb vs 290 ppb) (p=0.001). Likewise, significant differences were observed in female gender, in patients with BMI≥25 kg/m² and those without sinusitis between the two groups. When nNO were further evaluated in comorbid asthma, patients with AR wo/asthma had the highest TNSS and had significantly higher nNO level (p<0.001). NAR+A group, with the longest duration of rhinitis, was significantly older and had the lowest nNO level (p<0.001). CONCLUSIONS: This study showed that nNO levels were significantly higher in AR patients than NAR. Although there is no recommended standard threshold for nNO, this study confirmed the utility of nNO in differentiating AR and NAR in addition to its known fast and non-invasive advantages.