Effect of inhaled corticosteroids in moderate doses on bone mineral density in childhood asthma

Inhaled corticosteroids [ICSs] are the most effective asthma therapy, and therefore the recommended treatment for persistent asthma at any step of severity. Nowadays, they are prescribed more frequently and in higher doses than previously in the management of children with persistent asthma. Although these drugs have less potential for systemic impact than oral steroids, some recent studies in bone mineral density suggest that they are not devoid of systemic side effects. The aim of this study was to evaluate the effect of Iong-term treatment of asthmatic children with moderate dose inhaled corticosteroid [Fluticasone propionate, FP] on bone mineral density [BMD].The study was a cross-sectional one and was conducted on a total of 60 children [5-11 years old]; 30 with stable moderate persistent asthma on regular FP for 6-48 months, at a dose of 250-500 mg/day via a metereddose inhaler [MDI] plus spacer with mouthpiece and 30 healthy non-asthmatic control children of matched age and sex. All study population were subjected to measurement of BMD of L2-L4 vertebrae and nondominant proximal radius by dual-energy X-ray absorptiometry [DXA]. Analysis of the results showed that: [1]. All BMD measures [gm/cm2, % of age-matched nonnative data, and Z-score] of L2-L4 vertebrae and radius BMD [gm/cm2] were slightly but not significantly lower in asthmatic children than in healthy controls [L2-L4: t=0.33, ' P=0.849, t=1.998; P=0.246 and t=2.933 P=0.094, Radius t=0.644; P=0.622 respectively]. [2]. All asthmatic children but one [966%] had a normal Z-score of L2-L4 [within 2 SD of the mean for age-matched normative data]. [3]. No significant correlation between the BMD of L2-L4 vertebrae or radius and the daily dose of FP [r=0.030 P=0.874 and r=0.315 P=0.090]. [4]. A significant negative correlation between L2-L4 BMD and both the duration and the cumulative dose of FP [r=-0.694; P<0.001, and r=-0.669, ' P<0.001], such correlation was not signifIcant with respect to radius BMD [r=-0.338 P=0.067. r=-0.223 P=0.237]

Conclusions: 6-48 months treatment with a moderate dose of FP has no significant adverse effect on BMD in Prepubertal asthmatic children with moderate persistent asthma

Pre-tragal creases, versus ear lobe crease in coronary artery disease

The aim of the present work is to evaluate the association of pretragal creases and diagonal ear lobe crease and correlating it to obesity, hyperlipidemia and CAD. 50 male patients under the age of 50 years presenting with acute MI and 20 male normal controls has been studied as regard the presence of ear lobe and pretragal creases, as well as BMI [body mass index], waist/hip ratio, electrocardiogram, S. cholesterol, S. Triglycerides, HDL and LDL. Exclusion criteria include, D.M., hypertension, endocrinal diseases, COPD and females. The results showed 90% with pretragal creases and 60% with ear lobe crease. All patients with ear lobe and pretragal creases showed increase of S. cholesterol, S. triglycerides and LDL when compared to control. Patients with combined ear lobe and pretragal creases showed highly significant reduction of height and highly significant increase of waist/hip ratio. There is positive correlation of patients with pretragal creases with waist circumferences, waist/hip ratio and HDL. Specificity was 70% and 90% of ear lobe and pretragal creases while sensitivity was 59.3% and 89%, respectively

Shisha smoking and Reinke's edema

This study was done on 21 females, with age above 35 years, living in Saudi Arabia. All patients were suffering from dysphonia in the form of low pitched deep rough voice. They have only one common habit, i.e. shisha smoking more than 10 years. Indirect laryngoscopy revealed polypoidal swellings of both vocal folds. Microlaryngoscopy was applied for them and proved the nature of the lesions, Reinke's edema. The lesions of both vocal folds were removed in one setting operation following Kleinsasser trend. The treatise coincides with the studies, suggesting smoking as the underlying cause of Reinke's edema, but the pathophysiology is still obscure

Assessment of some treatment of head and neck hemangiomas

Forty three cases of head and neck haemangiomas were treated at otorhinolaryngology and General Surgery Departments in Mansoura University Hospital during the period of 1988 to 1991. They were 23 cases of cutaneous haemangiomas, 14 cases lip haemangiomas and 6 cases oropharyngeal haemangiomas. The adopted modalities of treatment were discussed including surgery, injection sclero therapy using ethanolamine, and intra-lesional steroid injection. Ethanolamine and intra-lesional steroid injection are capable of producing a satisfactory therapeutic effect and should be tried as the first line of treatment in head and neck haemangiomas

Fractures of the olecranon process of the ulna

Thirty six cases of olecranon fractures were the subject of this study. The fracture was common among males particularly in the fourth decade of life. A fall on the outstretched hand was found to be the cause of the fracture in 80% of the cases. 69.2% of the fractures were of the transverse and avulsion types. Open reduction and fixation of the fragments by a figure of 8 silk suture was found enough for union. The procedure was simple, safe with minimal complications. Loss of reduction and non-union were not encountered in this series. The operation gave 83.3% satisfactory results