Inhaled corticosteroids and leukotriene modifiers as mono-therapy for mild persistent asthma

Several guidelines have endorsed inhaled corticosteroids [ICs] as superior for mild per-Mild persistent asthma; sistent asthma. The use of Leukotriene modifiers has been showing an effective potential based on Leukotriene modifiers; reports in past years. In this study the efficacy of a single daily dose of 200 microg of inhaled fluticasone Inhaled corticosteroids propionate was compared with that of the recommended dose of 10 mg of oral montelukast. Comparative data were based on the measurement of specific biomarkers including IgE, eosinophil count, interleukin 4 [IL-4] and fractional exhaled nitric oxide [FENO] as airway inflammation predictors and routine investigations were determined including the pulmonary function tests and X-ray imaging. After week 16, the levels of FENO, IgE, Forced expiratory volume in one second [FEVj] and eosinophilia count percentage were recognized to be of lower significance in asthmatic patients treated with ICS in comparison to those under treatment of leukotriene modifiers. Also, the results revealed a significant positive correlation between FENO level and eosinophil count [r = 0.272, p = 0.047]. The clinical effectiveness of a low dose of fluticasone propionate was superior clinically as a first-line of choice in patients with persistent asthma to that of mentulokast

[ evaluation of the effect of maternal blood lead concentration on the incidence of delivery of low birth weight neonates]

Low birth weight of the neonates is one of the most common problems in neonatology and its incidence is 7.6% of all live births. Several risk factors including lead exposure during pregnancy have been considered as predisposing factors. Thus, we decided to study the relationship between maternal blood lead level and the incidence of delivery of the low birth weight neonates. In this case-control study, 40 mothers with low birth weight newborns [<2500gr] and 40 mothers with normal weight newborns [>2500gr] were considered as case and control groups respectively and admitted in Emam Reza Hospital, Mashad Medical University, in 2005. Blood lead level was measured by use of atomic absorption spectrophotometry. There were no significant differences in the mean values of age, BMI and place of residence between the 2 groups [P values were 0.17 for age, 0.9 for place of residence]. Mean neonatal weight in case and control groups were 2001 +/- 437gm and 3156 +/- 422.7gm respectively. Mean maternal blood lead level was 144.6 +/- 28.5 micro g/lit. Mean maternal blood lead level in control and case groups were 124.6 +/- 17.5 micri g/lit and 104.9 +/- 26.4 micri g/lit respectively which showed a significant difference [P=0.02]. In addition, blood lead level in 68.8% of mothers was higher than 100. Blood lead levels in the mothers of our study were significantly higher than those of other studies in other countries. Although elevated blood lead level during pregnancy did not lead to low birth weight deliveries, it may give rise to nervous system disorders in the future

Prevalence of hepatitis B and hepatitis C in blood donors of Karachi

Hepatitis B virus [HBV] and Hepatitis C virus [HCV] are two major public health problems in the country. The purpose of this study was to compare the prevalence of hepatitis B and hepatitis C in voluntary non-remunerated and replacement donors in Baqai Medical University Hospital and PNS Shifa Karachi from April, 2005 to June, 2007. A total of 11459 donors were bled. Anti-HCV was found positive in 237 [2.068%] HBs Ag was positive in 196 [1.71%] and both were positive in 11 [0.095%] individuals. This study shows a higher prevalence of HCV than HBV infection in blood donors. The prevalence of HCV and HBV can be minimized by the screening of all donors for anti-HCV and HBs Ag and discouraging the use of unsterilized syringes

Evaluation of airway inflammation and chronic hypoxaemia in smokers and nonsmokers with chronic obstructive pulmonary disease

Objective: Chronic obstructive pulmonary disease [COPD] is characterized by progressive development of airways limitation, air hunger and associated with some degree of hypoxemia, The study was undertaken to assess both airway inflammation and chronic hypoxemia in smokers [Sm] and nonsmokers [NSm] with COPD during exacerbation compared with those with stable COPD, healthy smokers and nonsmokers

Patients and Methods: Unrelated male patients [Sm and NSm] with stable COPD and another with unstable COPD were included during exacerbation, in addition to healthy, male subjects [Sm and NSm] were also participated in the study as control group. All participants underwent lung function tests and completed a history and symptoms questionnaire at the end of the last year follow up Period. Sputum and blood samples were collected for evaluation of airway inflammatory indices; interleukin-6 [IL-6], tumor necrosis factor-alpha[TNF-alpha], nitric oxide [NO] and endothelin-l [ET-1], as well as markers of chronic hypoxemia; serum angiotensin converting enzyme [sACE] an Plasma lactate [La]

Results : Smokers showed significantly higher levels of sputum airway inflammatory mediators than those of nonsmokers. In addition, these markers were significantly inversely correlated with the FEV1% [Forced expiratory volume in one second] of patients with COPD [Sm and NSm]. Individuals who experienced an acute COPD exacerbation had elevated inflammatory cytokines and airways limitation, relative to their clinically stable COPD patients. Plasma lactate was significantly elevated in all exacerbators compared to their matched stable patients and healthy subjects. Sputum NO was elevated in all patients with COPD compared to their matched healthy subjects and was negatively correlated with their FEV1%

Conclusion: Smokers with COPD have more objective airway dysfunction, airway inflammation and hypoxemia than NSm with COPD. NO, TNF-alpha, lL-6, and ET-l may be of value to monitor the course of COPD and possibly to predict COPD exacerbations