Assessment of growth in bronchial asthma

The aim of this study was to assess the effect of uncontrolled long standing asthma without corticosteroid therapy on the growth of pre-pubertal Egyptian children. This was an analytical study conducted at Damietta university hospital Two groups of patients suffering from uncontrolled moderate [n=30] or severe [n=18] asthma were compared for their physical and skeletal growth with a control group [n=30]. All enrolled children were followed up for 1 year. At enrollment the following investigations were performed: CBC, serum IgE, tuberculin test, chest x-ray and x-ray of lift hand and wrist [also at end of the study]. At start and end of the study, no statistically significant differences were detected between the 3 study groups regarding growth indicators [weight for height [W/H] and height for age [H/A] percent of median reference]. The percent of change in growth parameters [weight, height, BMI, upper segment lower segment ratio] were comparable from beginning to end of the study and the differences between groups were not statistically significant. At start and end of the study, bone age was delayed among asthmatic children than controls [p=0.00 each of them]. Both severe and moderate asthma groups were associated with lower standard deviation scores of bone age than controls group and the differences between groups were statistically significant [p=0.00 at start and end of the study]. Comparing growth indicators before and after controlling asthma clarified that no statistical significant differences were detected between asthmatic children and controls [W/H p=0.2, H/A p=0.2]. It was concluded that asthma did not influence the growth, however bone age was delayed

Role of zinc in management of shigellosis

This study aimed to asses the impact of zinc supplementation on the clinical severity and recovery from shigellosis among affected infants and children. A randomized, double-blind controlled clinical trial was conducted in shigellosis infected infants children aged<5 years. Sixty patients were randomly allocated to receive either zinc [n=30] or placebo [n=30]. Participants<6 and>=6 months were given 3.5 ml and 7 ml of zinc sulphate or placebo solution, respectively, once a day for 14 days. Standard rehydration and antimicrobial therapy were given to all patients according to WHO guidelines. At enrollment the following investigations were performed: serum zinc, serum electrolytes [Na, K], hemoglobin, hematocrit, and total and differential leukocyte count. A second blood sample was obtained at a follow-up visit after the completion of 14 days of treatment for estimation of serum zinc level. At discharge, duration of diarrhea [39.2[6.5] vs 57.7[7.2] h, p=0,00], and duration of presence of blood in stool [38.1[5,4] vs 561[6.11 h], p=0.00] were significantly shorter in zinc group in comparison to placebo group. The children in zinc group consumed significantly lesser amount of ORS than placebo group [138.3[9.1] vs182 [11.5] ml/kg, p=0.00]. Zinc supplemented children experienced significantly fewer stool motions than those in placebo [11.2[0.6] vs 18.4 [0.4], p=0.00]. After 14 days of intervention serum zinc was higher among zinc group than placebo group [78.4 [16.2]vs 65. [15.8] micro g/dl] and the difference between two groups was statistically significant [p=0.002]. It was concluded that zinc supplementation for infants and children suffering acute shigellosis hasten the recovery from the illness

Bacterial aetiology of pneumonia and its abstract relation to nutritional status among infants and children

Pneumonia is one of the leading cause of death among children under 5 years. No data are available in Egypt about organisms causing pneumonia among severe protein energy malnutrition [PEM]. The aim of this study was to assess the difference between well nourished and severely malnourished children regarding the bacterial aetiology of pneumonia. The study was an analytical one which carried out for one year among the attendants of Bab El-Sha'reya University Hospital. All study patients had an age 3 months up to 5 years with duration of illness less than 3 days. They were divided into two groups: pneumonia with severe PEM [n=70] and pneumonia with normal nutritional status [n=70]. Pneumonia was diagnosed if there was rapid breathing, chest indrawing or positive X-ray for pneumonia. Severe PEM was considered if any of the following was present: weight for length < 80% of the reference median or pitting oedema. Exclusion criteria were history of wheezing, chronic illness or use of antibiotic for the present illness for more than 2 doses. Severity of pneumonia was classified according to WHO. All enrolled patients were subjected to the following investigations: chest X-ray, complete blood picture, plasma proteins, BCG test and blood culture. Positive blood culture was higher among malnourished than well nourished patients [30% versus 17.1% respectively] but the difference was not statistically significant. Streptococcus pneumoniae was the most common organism in positive culture followed by Haemophilus influenzae in both severe PEM and well nourished patients and there was no statistically significant difference between them regarding the type of bacteria detected. Positive blood culture was higher among patients with severe pneumonia than those with pneumonia in both severe PEM and well nourished patients. Comparison between those with positive culture and those with negative blood culture among malnourished patients did not show any statistically significant difference. We concluded that the yield of positive blood culture with pneumonia was expected low. However relative more positive cases were found among those with severe PEM and or severe pneumonia

Risk factors for severity of childhood bronchial asthma

Bronchial asthma is the most common chronic illness of childhood and despite advances in therapy, asthma prevalence, morbidity and mortality are all increasing in many places. The objective of present study was to assess potential risk factors for severity of bronchial asthma among children 2-10 years of age. The study was a case-control age matched carried out at Bab El-Sha' reya University Hospital for one year. The inclusion criteria included any child 2- 10 years of age with episodes of wheezing in the last 3 months that responded to bronchodilators. The severity of asthma was classified according to National Asthma Education and Prevention Program [NAEPP]. Patients with mild intermittent bronchial asthma were considered as controls [n=100] while patients with moderate or severe asthma were considered as cases [n=100]. Exclusion criteria were congenital heart diseases, chronic chest conditions and history of admission to neonatal intensive care unit. All enrolled patients were interviewed by special questionnaire which included all potential risk factors and were subjected to the following investigations: chest X-ray PA, CBC, total and differential leucocytic count, hemoglobin level and serum immunoglobulin IgE. Residence in urban area, male gender, crowding index >= 4 persons room, low birth weight and passive smoking >10 cigarette/day were risk factors for severity of asthma [Odds ratio 3.3, 2.1, 1.6, 1.5, 1.3 respectively]. After controlling for different confounders, they were still risk factors for severity of asthma. Serum IgE, absolute eosinophil count, percentage of cases with higher serum IgE than normal level and hyper-inflated lung in X-ray were higher among cases than controls but the difference was not statistically significant. We recommended a large scale cohort studies of children to evaluate the relative risk of potential risk factors for severity of bronchial asthma