CRHR1 polymorphism at rs242941, rs242940, and rs72834580: association of symptoms improvement with intranasal corticosteroids in allergic rhinitis Jordanian patients.

OBJECTIVES: Rhinitis is classified into several types with allergic rhinitis (AR) being the most common. AR is among the inflammatory diseases, such as asthma and chronic obstructive pulmonary disease (COPD), in which corticosteroids are administered to overcome the decrease in cortisol production. The treatment options available for AR vary with 1st line treatment being intranasal corticosteroids (INCS). The responsiveness to corticosteroids is due to their binding to corticotropin-releasing hormone receptor-1 (CRHR1). Various studies have studied the responsiveness to corticosteroids treatment in patients with asthma and COPD in association with CRHR1 gene single nucleotide polymorphisms (SNPs). METHODS: In our study, we investigated the association of three SNPs of CRHR1 gene (rs242941, rs242940, and rs72834580) with symptoms improvement post-treatment in AR patients. Blood samples were collected from 103 patients for DNA extraction and gene sequencing. Those patients started to receive INCS for 8 weeks and their symptoms were assessed, through a questionnaire, before treatment and post-treatment to check for symptoms improvement. RESULTS: Our data showed that improvement of eye redness is significantly less following INCS treatment in patients with allele (C) (AOR=0.289, p-value-0.028, 95 % CI=0.096-0.873) and genotype (CC) (AOR=0.048, p-value-0.037, 95 % CI=0.003-0.832) of rs242941 SNP. There was no correlation with other genotypes, alleles, or haplotypes of the investigated SNPs. CONCLUSIONS: Our findings show that there is no correlation between CRHR1 gene polymorphism and symptoms improvement following INCS treatment. Further studies are required to evaluate the association of INCS and symptoms improvement post-treatment with larger sample size.

An intronic single-nucleotide polymorphism (rs13217795) in FOXO3 is associated with asthma and allergic rhinitis: a case-case-control study.

BACKGROUND: Asthma and allergic rhinitis are respiratory diseases with a significant global burden. Forkhead box O3 (FOXO3) is a gene involved in the etiology of a number of respiratory diseases. The objective of this study is to assess the association of rs13217795, an intronic FOXO3 single-nucleotide polymorphism, with asthma and allergic rhinitis. METHODS: In this case-case-control genetic association study, genotyping was conducted using the PCR-RFLP method. Genotype-based associations were investigated under the general, recessive, and dominant models of disease penetrance using binomial logistic regression; and, allele-based associations were tested using Pearson's chi-squared test. RESULTS: The final study population consisted of 94 controls, 124 asthmatics, and 110 allergic rhinitis patients. The general and recessive models of disease penetrance were statistically significant for both case-control comparisons. Under the general model, the odds of the asthma phenotype were 1.46 (0.64 to 3.34) and 3.42 (1.37 to 8.57) times higher in heterozygotes and derived allele homozygotes, respectively, compared to ancestral allele homozygotes. The corresponding odds ratios for the allergic rhinitis phenotype were 1.05 (0.46 to 2.40) and 2.35 (0.96 to 5.73), respectively. The dominant model of disease penetrance was not statistically significant. The minor allele in all study groups was the ancestral allele, with a frequency of 0.49 in controls. There was no deviation from Hardy-Weinberg equilibrium in controls. Both case-control allele-based associations were statistically significant. CONCLUSIONS: Herein we present the first report of the association between rs13217795 and allergic rhinitis, and the first independent verification of the association between rs13217795 and asthma. Marker selection in future genetic association studies of asthma and allergic rhinitis should include functional polymorphisms in linkage disequilibrium with rs13217795.

Antibiotics do not reduce post-tonsillectomy morbidity in children.

The objectives are to assess the efficacy of antibiotics in reducing post-tonsillectomy morbidities in children. This is a clinical trial study that was undertaken at the Jordan University Hospital during the period from June 2008 to July 2009. All patients undergoing tonsillectomy were randomly divided into two matched groups on alternating basis: group A included patients who received antibiotics (amoxicillin with clavulanic acid) for 5 days in the post-tonsillectomy period and group B included patients who received none. The two groups were compared with respect to fever, secondary bleeding, throat pain, and the time to resume to normal diet. Bleeding was more common in group A (5.5 %) than in group B (2 %). The average duration of throat pain was 4.2 days in group A, while it was 3.9 days in group B. The average time to resume normal diet was 5.7 days in group A, whereas it was 5.3 days in group B. Fever was noted in 17 (31 %) patients from group A, while it was observed in 15 (30 %) patients from group B. The use of antibiotics in the post-tonsillectomy period does not reduce post-operative morbidity in children and therefore it is advised to use antibiotics on an individual basis rather than routinely for patients undergoing tonsillectomy.

Extracting coins from the upper end of the esophagus using a Magill forceps technique.

OBJECTIVES: To assess the efficiency of a Magill forceps technique (MFT) in removing coins from the upper end of the esophagus. METHOD: The study population was 75 patients, all of them were children under the age of 12 years. This study was carried out in ENT department at Princess Basma Teaching Hospital during the period October 1996-September 1999. MFT is based on the insertion of a Mc-Intosch laryngoscope into the pharynx to elevate the larynx and to expose the esophageal entrance, then Magill forceps were advanced into the esophagus and opened in order to see and extract the coin from the esophagus. RESULTS: Seventy-one coins were successfully removed without any complications from 75 children admitted with coins in the upper end of the esophagus. In the remaining four cases, the coins had slipped down into the stomach. The average time taken to remove the coin was 30 s. CONCLUSION: MFT is a quick, easy and safe technique for removing coins from the upper end of the esophagus.