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