Study of bone mineral density in asthmatic children

Bronchial asthma is the most common chronic disease of children; some of asthmatic children experience growth retardation and delayed puberty. Inhaled corticosteroids are recommended as first line anti-inflammatory therapy in asthma, they are the most effective controller therapy. Information on bone turnover in asthmatic children still controversial, some studies showed that bone mineral density in asthmatic children within normal value, on the other hand, other studies demonstrated reduction in bone mineral density. The aim of this work is to assess the effect of asthma and its therapy on bone mineral density in children. Thirty asthmatic children and adolescent, their ages ranged from 7-15 years and 15 apparently healthy age and sex matched children were enrolled in the study. All asthmatic patients were on inhaled corticosteroid therapy for at least 6 months duration. Patients and controls were subjected to full history taking, meticulous clinical examination and laboratory investigations; including serum calcium, phosphorus and alkaline phosphatase. Determination of bone minerals density of the lumbar spine by dual energy X-ray absorpiometry method at L2-L4 levels of lumbar vertebrae. showed that height was higher among controls [143.5 +/- 12] compared to patients [133.6 +/- 11] with statistical significant difference, also the bone age was much delayed among studied cases [9 +/- 2.4] compared to control [10.4 +/- 1.9] with statically significant difference P<0.05. The study revealed that patients had lower bone mineral density [0.61 +/- 0.11] and lower z-score [-2.08 +/- 0.5] when compared to control [0.69 +/- 0.13] and [-1.4 +/- 1.8] respectively with statistically significant difference P<0.05. Bone mineral density was reduced in asthmatic children

Adrenocortical function relation to inflammatory markers in early untreated rheumatoid arthritis

To study adrenocortical function alterations in patients with early rheumatoid arthritis [RA]. 25 untreated patients with new onset RA were studied and compared with 25 age and sex-matched healthy subjects [controls]. All subjects were studied for plasma ACTH, cortisol, dehyroepiandrosterone sulfate [DHEAS], free and total testosterone, erythrocyte sedimentation rate, C-reactive protein and rheumatoid factor. No significant differences in the basal levels of ACTH, Cortisol, DHEAS, and total testosterone when comparing RA patients with controls were found, while there were statistically significant elevations in the inflammatory indices [ESR and CRP] and lower basal morning levels of free testosterone [Lower in males age >/= 45 years] in RA patients when compared with controls. From this study we concluded that adrenocortical function seem to be unaltered in early untreated RA patients

Relationship of disease severity to some biochemical markers of generalized osteoarthritis

To find out whether serum level of MMP-3, plasma level of TIMP-1 and urinary pyridinoline are specifically increased in generalized osteoarthritis [OA] or not. Also whether there is a relationship between those markers and the disease severity as detected clinically and radiologically. Thirty females suffering of generalized OA and 15 apparently healthy matched females as controls were studied. Serum MMP-3, plasma TIMP-1 and urinary pyridinoline were measured. The knee and hand joints were graded clinically [Steinbrocker] and radiologically [Kellgren and Lawrence]. Serum level of MMP-3, plasma level of TIM-1 and urinary pyridinoline were significantly higher in generalized OA patients than normal controls. The joint space width decreased with increasing Kellgren - Lawrence grade. All biochemical markers had negative correlations with the joint space width, but only urinary pyridinoline had a significant correlation. All biochemical markers had positive correlations with Steinbrocker grading. Some biochemical markers of OA may be of diagnostic value and a predictor for the severity of the disease in progressive generalized OA. The inhibition of their production and activity may decrease or delay the joint damage

Fecal lactoferrin, fecal leukocytes and occult blood in the diagnostic approach to childhood invasive diarrhea

This study was carried out on 60 children with acute diarrhea, from pediatric department faculty of medicine, A-Azhar University, from November 2002 to Jne 2003, their mean age was [3+1.5] years. To evaluate the value of fecal lactoferrin, [F.LF] fecal leukocytes [F.L] and fecal occult blood [O.B] in the diagnostic approach to childhood invasive diarrhea. Our results showed that 20% had campylobacter, 16.5% with shigellosis 9.2% had E. Coli, 6.6 with Salmonellosis, 9.2% had entamebia, 5% with giardia, 3.3% with cryptosporidium and 31.6% with no pathogen. Also our results revealed the sensitivity of individual tests was 97.12%, 78.7% and 68.95% in FL.F, O.B and F.L. respectively. On the other hand the negative predictive values in combined tests was 100% in both FLF+FL and FLF + OB while it was 87.9% in FL+OB. So FLF showed a greater over all sensitivity than FL or OB for detecting invasive pathogen and the combination of FLF or FL and of FL.F or OB or both yielded sensitivities and negative predictive value close to 100%. Conclusion FLF was the most accurate index test, it may be viewed as the screening test of choice to avoid expensive stool culture in the diagnostic approach to invasive diarrhea