Bronchial asthma and hypovitaminosis D in Saudi children

BACKGROUND: Asthma, a common lung disease in children, is caused by excessive immune responses to environmental antigens. OBJECTIVE: Given the immuno-modulatory properties of vitamin D, the aim of the current study was to investigate the relationship between vitamin D levels and markers of asthma severity. METHODS: This was investigated in a 70 Saudi children with and without asthma and were recruited from the King Abdul Aziz University Hospital, Jeddah, Saudi Arabia, over the period of 11 months (May 2011-April 2012). Childhood asthma control test instrument was employed to assess the level of asthma control among asthmatic patients. Anthropometric measurements were taken and interviewer-administrated questionnaire was completed for all study participants. Pulmonary function test was performed by recording changes in the peak expiratory flow. Venous blood samples were withdrawn for measurements of vitamin D, bone profile, cytokines profile (interleukin-10, tumor necrosis factor-alpha, platelets derived growth factor), and atopy markers (IgE and eosinophil count). RESULTS: Hypovitaminosis D is highly prevalent among asthmatic children with highly significant increase in several markers of allergy and asthma severity as compared with healthy control children. Significant correlations between several inflammatory and immunological markers and vitamin D levels were also found. Finally, lower 25-hydroxyvitamin D levels were associated with a higher asthma prevalence in multivariable analysis. CONCLUSION: Our study showed that hypovitaminosis D is highly prevalent in the whole population in addition to a highly significant increase in several markers of allergy and asthma severity among asthmatic children as compared with healthy control children.

Value of chest radiography screening in neonatal sepsis

Neonatal sepsis has nonspecific clinical presentation including temperature variation, respiratory complaints, jaundice, poor feeding and central nervous system [CNS] abnormalities. Chest X-ray [CXR] is performed frequently in the initial work-up even if there are no respiratory symptoms or signs. The value of inclusion of chest radiography as part of routine initial investigation in suspected neonatal sepsis cases This was a retrospective study which included review of medical records of 69 neonates with suspected neonatal sepsis. These neonates were assessed clinically, had undergone diagnostic work-up and screening tests which included clinical laboratory, microbiology, immunology and radiological investigations. Out of the 69 neonates, 38 [55.1%] were males and 31 [44.9%] females. On clinical assessment, 24 [34.7%] had respiratory symptoms, whereas only 9 [13%] had significant respiratory signs. Only 52 [75.3%] neonates out of 69 had chest X-ray performed as part of the initial screening. Only 7 [35] neonates presented with respiratory symptoms and an abnormal chest X-ray findings, while 1 [3.1%] neonate without respiratory symptoms had an abnormal X-ray findings [P = 0.003]. Additionally, 6 [66.7%] neonates who had respiratory signs showed abnormal X-ray findings and 2 [4.7%] neonates who did not have respiratory signs had abnormal chest X-ray [P <0.001]. Chest x-ray should be carried out in the initial screening for neonatal sepsis only if there is/are significant respiratory manifestation[s] especially, if respiratory sign[s] is/are present, or highly indicated to exclude other differential diagnosis

impact of some demographic factors on the severity of asthma in children

To investigate the association between some demographic factors and the levels of severity among asthmatic children. Method: One hundred and twenty five asthmatic children aged between 6 months and 15 years were studied in pediatric and asthma clinics at King Abdul Aziz University Hospital [KAUH]. The assessment of clinical severity has based on the global strategy guidelines for asthma assessment and management. Subjects were grouped by age: infants [

Automated eosinophilia: a marker for asthma severity. Is it a gauge for anti-inflammatory therapy?

Current therapy of asthma is based on its clinical severity, which mainly depends on symptoms and peak flow rate, and not on any laboratory criterion. The objective of this study is to investigate the value of total peripheral eosinophil count in asthma assessment through its correlation with the clinical severity. One hundred and seventy eight asthmatics referred to asthma and pediatric clinics were reviewed for complete history and examination. Clinical severity was assessed using symptoms criteria based on the global strategy for asthma management and prevention. Total peripheral eosinophil count by Cell-Dyne 3500 automated counter[registered] and asthma severities were analyzed for any significant association. Asthmatics were aged between 6 months and 70 years [mean = 17.5 years] and males formed 52%. Severity groups are intermittent 22 [12%], mild-persistent 87 [49%], moderate-persistent 56 [31.5%] and severe-persistent 13 [7%]. Total peripheral eosinophil count ranged between 10 and 2470 cells/mm[3] [mean=546 +/- SD]. Eosinophilia [>450 cells/mm] was found in 53% of cases, more in the persistent type [60%]. In each clinical group, total peripheral eosinophil count and their means showed a very significant positive correlation with increased asthma severity [P<0.001] with a high linear trend [P<0.001]. Additionally, total peripheral eosinophil count correlates significantly with a history of other allergic illnesses [P<0.001]. This data supports the use of total peripheral eosinophil count as an accumulative objective marker for asthma severity. In asthmatics, eosinophilia suggests higher severity and/or other allergic illnesses. Optimally, in those, anti-inflammatory drugs would be required to control asthma