RESUMEN
Chronic cough is a common problem encountered by pediatrician. It has a wide variety of causes ranging from minor conditions to life-threatening ones. Exhaled nitric oxide [ENO] has been suggested as a marker of airway inflammation. This study aimed to determine the common causes of chronic recurrent cough in children and adolescents and to evaluate the role of ENO in the investigation of chronic cough. The ENO was measured in 44 children and adolescent suffering chronic recurrent cough and in 10 healthy control subjects. The study showed that the most common cause of chronic/recurrent cough was bronchial asthma, diagnosed in 45.5% of patients followed by cough variant asthma, seen in 36.4% of cases. Postnasal drip syndrome constituted the third cause, observed in 13.6% of the total subjects. Foreign body removal was done in one patient and chronic bronchitis was diagnosed in one other patient. ENO concentration was 35ppb for asthmatic children whereas in the cough variant asthma group it was 27.6ppb. In the non-asthma group if was 10.7ppb and in the control group it was 8.6ppb. ENO values were significantly higher in patients with chronic cough attributable to asthma and cough variant asthma as compared with those with chronic cough not due to asthma and to healthy volunteers. These values were numerical and higher in asthma than in children with cough variant asthma
Conclusion: ENO may have a potential role in the evaluation of chronic cough. Patients with chronic cough not due to asthma had a low ENO values as compared with asthmatics and healthy volunteers. Low ENO values suggest little likelihood of asthma
RESUMEN
Recurrent abdominal pain [RAP] is a common pediatric diagnostic problem. An organic etiology can be found in only 10% of cases. Because infection with helicobacter pylori [H. pylori] in adults and children results in gastritis, a causative role for the organism has been postulated. The study was designed to compare the prevalence of H. pylori infection in children with RAP with healthy asymptomatic children and to investigate the related symptoms and some risk factors for acquisition of infection. Cases were 70 children presenting with RAP, controls were 20 healthy children. A standard questionnaire was used to gather social, demographic and full clinical information on each participant. The new non-invasive H. pylori antigen stool test was used to assess the infection status. Twenty seven [38.6%] children tested positive for H. pylori in the RAP group as compared to 30% in the controls [p=0.03] with no significant difference. Sixteen children were found to have other organic cause i.e giardiasis, amebiasis, worm infestation and urinary tract infection. No significant difference was detected comparing H. pylori positive children with the negative ones with respect to abdominal pain characteristics. Only nocturnal awakening was more common in H. pylori positive children. The presence of H. pylori was associated with both parents being born in a country with a high prevalence of infection, living in joint families with more family members and low social class. The study concluded that the prevalence of H. pylori infection in children with RAP is comparable to that of healthy children and it is not associated with RAP. No specific symptomatolgy could be attributed to H. pylori infection in children. Large compound families with overcrowding, bed sharing and low social level are risk factors for H. pylori infection