Introduction: Airway foreign body (AFBs) is the most common emergency for ENT-HN (Ear, Nose, Throat-Head Neck) that requires immediate treatment. The gold standard management for AFBs is a bronchoscopy performed under general anesthesia (GA). Objective: This study aims to determine the profile of AFBs patients who underwent bronchoscopies with GA at Dr. Soetomo General Hospital Surabaya from January 2018 – December 2019. Methods and Materials: This is a descriptive, retrospective study that uses data from medical records. Microsoft Excel was used to analyze the data. 22 patients met the inclusion criteria. Results: The most common ages were 11 to 20-year-olds (73%), 55% were female, and 45% were male. The patients were from outside (73%) and inside (27%) Surabaya. As much as 67% of the sampled patients had coughs and 23% were symptomless. The foreign bodies found were pins (67%), clipboard nails (14%), and nuts (9%). These AFBs were located in the left main bronchus (45%), trachea (32%), and right main bronchus (18%), and in 5% of these cases, the AFBs could not be located. The duration between the event and the bronchoscopy was mostly less than 1 day (54%), 2 days (32%), and 3 days (14%). Most cases (90%) were without AFBs complications, but some had obstruction (5%), and hemoptysis (5%). Most patients also had an uncomplicated bronchoscopy (81%), however, some suffered lesions (14%) and bleeding (5%). A majority of the patients were also ASA I (68%), and the remainder were classified as ASA II (18%), and III (14%). The premedication drugs administered were fentanyl (41%), and a combination of fentanyl and midazolam (41%). Meanwhile, the most frequently maintained anesthetic agent was Isoflurane+O2 (27%). Most patients also did not have any comorbid factors (85%), but some had anemia (5%), obstruction (5%), as well as obesity followed by sputum retention and hypernatremia (5%). Conclusion: Most AFB patients who underwent bronchoscopy under GA were 11-20 years old, female, and had a cough as a clinical symptom. Most AFBs were pins at the left main bronchus. The duration between the incident and the bronchoscopy was less than 1 day. There were also mostly no complications of AFBs and bronchoscopies. The most common physical status in patients was ASA I, with fentanyl only or fentanyl and midazolam as a premedication drug. The most common agent used to maintain the anesthesia was a combination of isoflurane and O2. Most patients also had no comorbid factors for GA.

Highlights1. Heart failure preserved ejection fraction increases the mortality rate every year.2. Definitive therapy for HFpEF is not well identified.3. Crocus sativus phytochemical has anti-inflammatory and cardioprotective effects due to iNOS and PDE-9 inhibition. AbstractBackground: Heart failure preserved ejection fraction (HFpEF) is a complex disease associated with metabolic disease as a risk factor. A previous study found an association between iNOS and PDE-9 with inflammation and myocardial fibrosis in HFpEF. Objective: This study aimed to identify the potential phytochemicals of Crocus sativus (Saffron) that can inhibit protein iNOS and PDE-9 based on a molecular docking study. Material and Method: A total of fifty phytochemicals were obtained from Dr. Duke’s Phytochemical Database and IJAH IPB. Those phytochemicals were screened by using the PyRx application and followed with Lipinski’s Rule of Five screening by using SWISS Adme. Ten phytochemicals with lowest binding energy for each protein were docked and visually analyzed using Autodock 4.2 and BIOVIA Discovery Studio Visualizer 2016. Results: The best binding energy between protein-phytochemicals were -9.17 kcal/mol and -8.55 kcal/mol for iNOS and -9.17 kcal,/mol and -9.08 kcal/mol for PDE-9. Conclusion: Delphinidine and malvidin are the recommended inhibitors against iNOS and PDE-9 and must be investigated in further research.