ABSTRACT
Patients with interstitial lung disease [ILD] appear to be at an increased risk of vitamin D deficiency for reasons that are not clear. This study was designed to determine the serum vitamin D level and to evaluate the relationship between the serum level of vitamin D and the underlying etiology, the clinical severity, and pulmonary functions among children with ILD. This cross-sectional case-control study was conducted on 40 patients aged 4-16 years with ILD from those regularly attending the Pediatric Chest Clinic and Pediatric Allergy and Immunology Clinic, Children's Hospital, Ain Shams University. They were divided into two subgroups: 20 patients with nonconnective tissue disease-associated ILD constituted group I and 20 patients with connective tissue disease-associated ILD constituted group II. Twenty apparently healthy children of matched age and sex were recruited as the control group. The mean serum vitamin D [25-hydroxyvitamin D] level was significantly lower among patients with ILDs compared with controls [21.15 +/- 4.6 vs. 48 +/- 40.76 ng/ml, respectively, P < 0.05], and there was no significant difference between patients' subgroups. The mean alkaline phosphatase level was significantly higher in patients with ILDs compared with controls [P < 0.05]. Our patients had a highly significant increase in the total leukocytic count, erythrocyte sedimentation rate, and C-reactive protein in connective tissue disease-associated ILD as compared with nonconnective tissue disease-associated ILD. Serum vitamin D levels showed a significant positive correlation with forced vital capacity and significant negative correlations with the age and the duration of steroid therapy. By linear regression analysis, patients' age and the duration of steroid therapy were significant predictors of low serum vitamin D levels [at P = 0.045 and 0.01, respectively]. Children with ILD appear to be at an increased risk of vitamin D deficiency and insufficiency, particularly those with reduced lung function. All patients with ILD receiving long-term corticosteroid therapy should be considered at increased risk for bone fracture. Preventive measures and routine estimation of vitamin D [25-hydroxyvitamin D] should be recommended and vitamin D supplementation is advised on an individual basis
ABSTRACT
Children with epilepsy are at an increased risk of poor health-related quality of life even in the absence of active seizures. The study was undertaken to assess the health-related quality of life and its predictors in children with epilepsy, comparing the relationship between different types of seizures and health-related quality of life in Egypt. This cross sectional case control study included 50 epileptic children aged 8-12 years, with a mean age of 9.35 +/- 1.59 years and a male to female ratio of 1.8: 1. They were divided into two subgroups according to the types of seizures: 26 patients with generalized seizures in subgroup I and 24 patients with partial seizures in subgroup II, and 50 apparently healthy children of matched age, sex, and social class were included as the control group. The Arabic version of the 23-item Pediatric quality of life Generic Core Scale [Parents' scale] was applied to evaluate the health-related quality of life of both patients and healthy controls. Diminished health-related quality of life is a common feature of epilepsy. Highly significant lower overall quality of life scores of all functioning domains of health-related quality of life were present between patients' subgroups [P < 0.001], and between total patients versus control groups [P < 0.001]. Univariate analysis was performed to identify significant predictors of poorer quality of life in children with epilepsy. On analyzing the risk factors using odds ratio, epilepsy-related risk factors such as age at onset of seizures, types of seizures, duration of the illness, number and duration of antiepileptic drugs as well as children's clinical variables such as learning problems, developmental delay in milestones, limitation in child hobbies, urine incontinence, and prolonged sleep, and some family-related variables such as marital disharmony and parental anxiety were found to be significantly strong predictors of poorer health-related quality of life in children with epilepsy, with prediction of 95%. Epileptic patients were found to be at a higher risk of developing impaired quality of life with lower mean scores of all domains of quality of life, especially patients with generalized, frequent fits, those on polytherapy, and patients with a younger age of seizure onset and a longer duration of illness. The scope of management of epilepsy should include optimal seizure control and improvement of the health-related quality of life of the affected children