Study of serum leptin in asthmatic children

Bronchial asthma is a chronic inflammatory disorder of the airways. Steroids as inhaled and systemic forms are used as a line for controlling moderate and severe forms of bronchial asthma. Leptin is a 16 kd protein produced predominantly in white adipose tissue. Its major role in body weight regulation is to signal satiety to the hypothalamus. Most humans who are obese are not leptin-deficient but rather letpin resislant and, thue, have elevated circulating letpin levels, In the present study, serum leptin level has been studied in 40 patients; 10 patients with bronchial asthma receiving systemic steroids, 10 patients with bronchial asthma receiving inhaled steroids, 10 patients with bronchial asthma not receiving steroids and 10 obese non asthmatic patients to uncover the effects of different types of steroid therapy on leptin level, Increased serum level of leptin was observed in patients with bronchial asthma receiving systemic steroids and obese non asthmatic patients when compared with control group. Whereas no significant increase in serum leptin level as regards patients with bronchial asthma receiving inhaled steroids or those not receiving steroids when compared with control group. Serum leptin level in bronchial asthma patients receiving systemic steroids was significantly increased more than those receiving inhaled steroids and those not receiving steroids. This increased leptin level was positively correlated with body mass index [BMI], fasting blood glucose, serum cholesterol and triglyceride levels and serum cortisol level suggesting the strong relation between leptin and degree of steroid changes and obesity in patients with and without bronchial asthma. This elevated leptin can be explained by the effect of systemic steroids and simple obesity on leptin level and we can conclude that inhaled steroids have no effect on serum leptin level and soon body fat store

Zinc supplementation in acute diarrhea, does it affect copper status?

Intervention trials have shown that zinc is efficacious in treating acute diarrhea in children. In randomized double blind controlled clinical trial we evaluated the adverse effect of zinc supplementation on serum copper when used for treatment of mate infants and children [age 3-36 months] suffering from acute diarrhea. The study was carried out at Diarrheal Disease Research and Dehydration Center [DDRRC] at Bab El-Sha'reya University Hospital for one year. One hundred cases with some dehydration according to WHO classification were admitted to hospital and randomized to received either zinc or placebo for 14 days. The following investigations were performed at admission: serum Na, K, zinc, copper and hemogram. All cases were asked to come for follow up visit at the end of therapy [14 days from admission data]. At follow up visit serum for zinc and copper was investigated. At admission serum zinc and copper were within normal range in both zinc and placebo groups and without statistically significant difference. The mean duration of diarrhea for zinc treated group was shorter than that in placebo group [46.2 +/- 22.2 versus 48.9 +/- 23.9 hours] but the difference between the two groups was not statistically significant. Only 80 cases were followed up. On follow up visit serum copper was lower in zinc group than that in placebo group but the difference was not statistically significant. It is concluded that zinc supplementation for 14 days in management of acute diarrhea has no effect on serum copper

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

Study of hydrogen peroxide in breath as inflammatory marker in asthmatic children

Asthma is a major global public health problem. Airway inflammation is the primary cause of development and progression of asthma. Activation of inflammatory cells induces a respiratory burst resulting in the production of reactive oxygen species, such as H[2]O[2]. We sought to measure the concentration of H[2]O[2] in exhaled breath condensate in asthmatics children and its correlation to asthmatic triggers, pulmonary function tests, treatment modalities and blood absolute white blood cell counts. Fifty asthmatic and 35 healthy children were studied. Their ages ranged from 9-14 years. Exhaled H[2]O[2] was measured using a colorimetric assay. In asthmatic children, there was a significant elevation of the mean H[2]O[2] concentration compared to values in normal subjects [P<0.0001]. Bad housing showed significant correlation to asthma severity and to number of acute asthmatic attacks. Basal spirometric pulmonary function tests, mean values showed no significant correlation to the level of H[2]O[2] nor to treatment with inhaled steroids. Similarly, neither asthma severity nor the intake of inhaled steroids did show any significant correlation with H[2]O[2] level. Exhaled H[2]O[2] was found significantly elevated in asthmatic children. Measurement of exhaled H[2]O[2] may h4 to assess airway inflammation and oxidative stress in asthmatic patients

Study of some cytokines in active and inactive tuberculosis

This study included 10 patients with active pulmonary tuberculosis, 10 patients with inactive disease and 20 healthy individuals as controls. T cell proliferation assay with PPD antigen showed higher stimulation index [SI] in the inactive compared with the active tuberculous patients [9.53 +/- 2.75 vs. 4.61 +/- 1.67, respectively] reflecting the good status of the immune system towards mycobacterial antigen. Gamma interferon [IFN] level [pg/ml] was significantly higher in the inactive than the active tuberculous patients and controls [210.24 +/- 58.57, 79.20 +/- 21.79 and 32.89 +/- 33.58, respectively]. Similar results were shown for IL-2, where its level [pg/ml] in the inactive patients was significantly higher than the active tuberculous patients [234.92 +/- 51.47 vs. 99.26 +/- 19.20, respectively]. On the other hand, IL-10 was significantly higher in the active than the inactive patients [435.23 +/- 78.22 vs. 235.98 +/- 50.74 pg/ml, respectively] indicating a dominant Th2 type response during the course of TB infection. Tumor necrosis factor alpha [TNF- alpha] was significantly higher in the active than the inactive tuberculous patients [402.46 +/- 57.44 vs. 188.64 +/- 59.82 pg/ml, respectively]. The tuberculostatic effects of INF-alpha and TNF-alpha in the active stage of the disease were discussed

Comparative study of hypertonic saline versus normal saline nasal wash in pediatric chronic sinusitis.

The objective of this study was to compare the effect of nasal wash with hypertonic saline [HS] [3.5%] versus normal saline [NS] [0.9%] on CS. Thirty patients with chronic sinusitis [CS] aged 3-16 years were studied. They were randomly divided into two treatment groups matched in age and severity of the disease. Each individual was treated with either HS or NS for four weeks. All patients were evaluated by two clinical scores [cough and nasal secretions/postnasal drip, PND] and by a radiology score at the beginning of the study and after four weeks. The results showed that the HS group was significantly improved in all scores [average +/- SD], e.g. cough score from 3.6 +/- 0.51 to 1.6 +/- 0.74, nasal secretion/PND score from 2.86 +/- 0.35 to 1.6 +/- 0.74 and radiology score from 8.06 +/- 1.28 to 2.66 +/- 1.04. The NS treatment group showed a significant improvement only in the PND score [from 2.66 +/- 0.49 to 1.53 +/- 0.83], but no significant change was reported in both cough score [from 3.53 +/- 0.52 to 3.33 +/- 0.49] and the radiology score [from 8.13 +/- 1.25 to 7.86 +/- 0.91]. It was concluded that HS nasal wash is an efficient treatment of CS