effect of serum levels of vitamin C on asthmatic children: a systematic review

Introduction: Asthma is a chronic inflammatory airway disorder that is distinguished by coughing, wheezing, and dyspnea. It is the most common chronic disease among children. Epidemiological trials have suggested that there may be a correlation between vitamin C intake and the incidence of asthma. Specifically, according to these studies, a rapid increase in the occurrence of asthma may be caused by a decreased intake of dietary antioxidants and various vitamins such as vitamin C. A systematic review was performed to determine the role that vitamin C, in terms of both dietary intake and serum levels, had on asthma in children

Methods: PubMed and Scopus databases were searched for studies that provide information on the effects of vitamin C on asthma in children aged between 1 and 17 years. The inclusion criteria specified that the studies involved needed to be cohort and case series involving at least ten patients. Exclusion criteria were non-English articles, case reports, and articles involving children who were aged below or above the age 1 and 17 respectively

Result: A total of 13 studies involving 6503 patients met the inclusion criteria. Dietary vitamin C intake was lower in people with asthma than in those without asthma. Lower quantity dietary intakes and serum levels of vitamin C were also associated with increased incidents of asthma

Conclusion: According to the extracted data, a relatively low dietary intake of vitamin C is associated with an increased risk of asthma and wheezing. Moreover, asthmatic patients who consumed vitamin C exhibited an improvement in their diseases

Vitamin D and respiratory disorder

The active form of vitamin D is synthesized in some body organs following sun exposure and dietary intake. Vitamin D exhibits its major and critical effects not only through regulation of calcium and phosphate metabolism but also by influencing on respiratory and immune system. Serum concentrations of 25-hydroxyvitamin D below the optimum limit lead to vitamin D insufficiency or maybe deficiency. These inappropriate concentrations of vitamin D lead to different types of pulmonary diseases such as viral and bacterial respiratory infection, asthma, chronic obstructive pulmonary disease, and cancer. In this review we described the association between vitamin D deficiency and severe therapy resistant asthma. We also reviewed the underlying molecular mechanism of vitamin D deficiency in children with severetherapy resistant asthma. Based on current information, future clinical trial are needed to study the role of vitamin D supplementation on different groups of patients with severe asthma including infants, children of school age, and ethnic minorities

Moyamoya disease mimicking encephalitis

Moyamoya disease is a rare vaso-occlusive illness with an unknown etiology characterized by stenosis of the internal carotid arteries with spontaneous development of a collateral vascular network. A 15-month-old girl was referred to the emergency ward of Imam Reza Hospital due to decreased level of consciousness, focal seizures and fever during the previous 24 hours with an impression of encephalitis. Physical examination revealed left side hemiparesis; however brain CT-Scan did not show any significant lesions. Initial therapy with vancomycin, ceftriaxone and acyclovir was administered. CSF analysis did not show any abnormality and the blood as well as CSF cultures results were negative. Brain MRI showed hyperintensity at right frontal and parietal regions, suggesting vascular lesion. Magnetic resonance angiography [MRA] showed bilaterally multiple torsions in vessels at the basal ganglia consistent with moyamoya vessels. In all children exhibiting encephalitis, vascular events such as moyamoya disease should be considered. Brain MRI is a critical tool for this purpose. Common causes of encephalitis such as herpes simplex should also be ruled out

Clinical aspects of patients with febrile convulsion: a survey in Mashhad

Febrile seizures [FS] happen in 2-5% of children aged 6 months to 5 years. Several studies have confirmed that between 2 to 7% of children with FS, develop epilepsy later in life. This study was performed to evaluate the clinical aspects of patients with febrile seizure in our region. This is a retrospective descriptive cross- sectional study that was performed in the pediatric ward of Ghaem hospital in Mashhad, Iran from Sep. 2004 to March 2005. 68 patients aged 6 months to 5 years were evaluated. Most patients were male and aged between 1 to 3 years. 25% had a past history of febrile seizures. Upper respiratory tract infections and gastroenteritis were among the most common causes of febrile seizures, respectively. Simple febrile seizures were seen in 64.7% of the cases. Most of such patients had body temperature above 38.5[degree]c at the time of seizure occurrence. Febrile seizures were more frequently seen in boys aged 1 to 3 years. It most commonly occurred following an upper respiratory tract infection and due to rise in body temperature above 38.5[degree]c

Medical treatment for hepatopulmonary syndrome:a systematic review

Introduction: Hepatopulmonary syndrome [HPS] is known as a chronicliver disease associated with severe pulmonary deoxygenation due tointrapulmonary vascular vasodilation. Although liver transplantationis accepted as a main treatment of HPS, identifying effective drugs forrecovery of HPS can be effective in postponing the transplantation anddecreasing the mortality rate of patients before the transplantation. In thisstudy we briefly reviewed the pathogenesis of HPS and also systematicallyreviewed the current pharmacological treatment of HPS

Method: Pubmed, Scopus, and Google scholar were searched for therelevant English language clinical and experimental articles about themedications used in the treatment of HPS

Results: A total of 38 articles were included in this study which mostlyresulted in decreasing NOS expression, NO production, endothelin-1activation, intrapulmonary angiogenesis and increasing oxygenation

Conclusion: Various drugs have been proposed in treatment of HPS butmore large controlled trial studies, is necessary to determine the exactefficacy of each drugs for HPS recovery

Utility of modeling end-stage liver disease in children with chronic liver disease

Chronic liver diseases consist of wide spectrum disorders that may be complicated by cirrhosis and therefore need to transplantation. The pediatric end-stage liver disease [PELD] score and model of endstage liver disease [MELD] score has been used as predictors of mortality chronic liver diseases listed for liver transplantation. The aim of this study is evaluation of relation between PELD MELD score and evidence of cirrhosis in children with choronic liver disease. This cross-sectional study conducted on 106 patients of chronic liver disease referred to Ghaem haspital, Mashhad university of medical science, Iran during 24 months period [2010-2013]. PELD and MELD score were calculated for all patients. Clincal and patholoogical findings of cirrhosis were recorded. Mean age of patients was 68/3 +/- 41.8 months. Mean PELD MELD score was -1/59 +/- 9/64. There was significant correlation between PELD MELD score and clinical icter, spelenomegaly, evidence of hepatopulminary syndrome, esophageal varices, evidence of cirrhosis in tissue specimences. PELD MELD score appear to be benefit for detection of cirrhotic children among paients with choronic liver disease