Montelukast versus sodium cromoglycate in children with mild persistent asthma: effect on allergic inflammation and bronchial hyperresponsiveness

The effect of montelukast and cromolyn on allergic inflammation and bronchial hyperresponsiveness was compared in 40 children with mild persistent asthma. Twenty children received oral montelukast [Singulair] while twenty children received inhaled cromolyn [Intal-5 MDI] during the study period of 6 weeks. Asthmatic children were evaluated clinically and with pulmonary function tests [forced expiratory volume in one second [FEV[1]] and peak expiratory flow [PEFR], challenge tests [histamine and exercise] and measurement of inflammatory markers [blood eosinophil count, serum immunoglobulin E [IgE], eosinophil cationic protein [ECP], interleukin 4[IL4] and nitric-oxide products in sputum] both. before and after six weeks therapy with either montelukast or cromolyn. Twenty age and sex matched non atopic children served as controls. Asthmatic children, on admission, had significant decrease in mean FEV[1] and PEFR and increase in mean eosinophil count, serum levels of total serum IgE, ECP, IL4 and sputum nitric-oxide products as compared to controls. Both drugs produced significant and equal improvement in pulmonary functions [FEV[1] and PEFR], decrease in the degree of bronchial hyperresponsiveness to histamine and exercise and a significant decrease in blood eosinophil count, serum IgE, ECP and IL4 and sputum nitric-oxide products. However all these parameters were still significantly different as compared to mean control levels. Better asthma symptoms control was observed with montelukast than with cromolyn sodium and there was a greater significant adherence with montelukast than with cromolyn- sodium with both patients and parents preference for montelukast

Study of some renal function tests in epileptic children on antiepileptic drug monotherapy

In the present study we tried to verify the renal function status in epileptic children at diagnosis and 4 months following AED monotherapy. This study was carried out on 45 children, 27 males and 18 females aged 5-16 years, suffering from different types of freshly diagnosed epilepsy. They were classified into 3 groups: Group 1: Consisted of 15 patients treated by carbamazepine [CBZ] [Tegretol] monotherapy. Group II: Consisted of 15 patients treated by sodium valproate [VPA] [Depakine] monotherapy. Group Ill: Consisted of 15 patients treated by phenytoin [PHE] [Epanutin] monotherapy. In addition 20 healthy children of matched age and sex, products of nonepileptic families, with normal hepatic and renal function tests, served as a control group. All children included in this study were subjected to the following: determination of fasting blood urea, estimation of fasting serum creatinine, estimation of creatinine clearance, determination of urinary albumin/24 hours, urinary N-acetyl-8-D-glucosaminidase [NAG]/24h and urinary alpha-1 microglobulin [alpha-1MG]/24h. Our results revealed the following: Normal renal glomerular and tubular function tests in patients before therapy. Normal renal glomerular function tests [blood urea nitrogen serum creatinine, creatinine clearance, routine urine analysis and 24 hr urinary albumin] in all patients after AED therapy. Significant increase in urinary NAG was observed in all patient groups after therapy and this increase was highest in patients receiving valproate monotherapy. Significant increases in urinary alpha-1MG in patients receiving carbamazepine or phenytoin with no change following VPA therapy were recorded

Effects of treatment with antiepileptic drugs on serum lipid profile in epileptic children

This study aimed to assess the effect of 3 months physical training program on the metabolic state of 20 diabetic children. Ten healthy, age and sex matched children were also studied as controls. The physical fitness of diabetic children was significantly lower than controls while the body mass index [BMI] was comparable in both groups. Pre-training values of total cholesterol, low density lipoproteins [LDL-Ch], lipoprotein[a] and apolipoprotein B [Apo B] were significantly higher, while high density lipoprotein [HDL-Ch] was significantly lower in diabetics than in healthy children. No significant difference was detected regarding triglycerides [TG] and apo-lipoprotein A[1] levels [Apo A[1]]. After training, the fitness of studied patients significantly increased while BMI showed no significant change. The percentage of glycosylated hemoglobin [Hb A[1]C] as well as blood sugar levels significantly decreased. Meanwhile no changes in insulin requirements were detected.The post-training values of total cholesterol, LDL-Ch, lipoprotein[a] and apo B were significantly lower than pre-training levels. No significant changes were noticed regarding HDL-Ch, apoA[1] or TG levels. Thus improvement of physical fitness may lead to better control of glycemic state and serum lipids

impact of antiepileptic drugs on cognitive and behavioral functions in children with idiopathic generalized epilepsy

The effects of antiepileptic drugs [AEDs] on the cognitive functions and behavior were studied in 60 freshly diagnosed epileptic children suffering from idiopathic generalized tonic-clonic [GTC] seizures, compared with 15 healthy children. The mean age at presentation was 11.6 + 2.3 years [range 6-15 years]. Our results demonstrated that children suffering from idiopathic GTC, before initiation of AED therapy, had cognitive and behavioral disturbances as evidenced by lower results of the various tests utilized. The behavioral and cognitive impairment became worse after phenytoin [PHT] and phenobarbital [PB] monotherapy in spite of adequate seizure control, while the behavioral and cognitive functions got better after carbamazepine [CBZ] and Valproate [VPA] monotherapy. PHT was more damaging on cognition while PB was more damaging on behavior. We concluded that AEDs significantly modify cognitive functions and behavior in epileptic children. PHT and PB have deleterious effects while CBZ and VPA have positive effects on cognition and behavior