Health Status and Inconveniences of Asthmatic Children During the First Year of the COVID-19 Pandemic.

The Coronavirus Disease 2019 (COVID-19) pandemic has been the most significant health concern in recent years, with respiratory symptoms being the most prominent. In children, asthma is the most prevalent chronic disease. Due to the similarities between the symptoms of these two conditions, we sought to assess the general health status of pediatric patients with asthma and their COVID-19-related difficulties during the first year of the pandemic in Iran. We collected data for this study by administering a questionnaire to the parents of 200 children with asthma who were registered in the database of the Asthma Clinic at a tertiary medical center in Tehran, Iran. Forty-five (22.5%) of 200 patients were suspected of having COVID-19, 11 (24.4%) underwent polymerase chain reaction (PCR) testing, and 10 (90.9%) assays were positive. During the first year of the pandemic, 41 patients (20.5%) were referred to a medical center at least once, with 31.7% due to an asthma attack. One hundred eighty-nine patients (94.5%) reported an improved disease status than the previous year, and only 31 patients (15.5%) were using asthma-related medications such as Salbutamol. The estimated mean Asthma Control Test (ACT) scores for two age categories, 4-11 years and 12-18 years, were 25.55±2.27 and 23.28±3.31, respectively, indicating satisfactory disease control. In the majority of our study population, asthma control was acceptable. However, the pandemic caused a significant increase in the anxiety levels of patients and their parents.

Pigeon mite: An underdiagnosed cause of papular urticaria.

BACKGROUND: Dermanyssus gallinae, known as bird mite, generally lives on nestlings' featherless skin. Humans are accidentally infected, and itchy dermatitis is induced when the mites are unable to use birds' blood. The diagnosis is difficult due to the very small size and rapid movement of the mites, which make them hard to spot. CASE PRESENTATION: A 14-year-old male and his mother were referred to the allergy clinic complaining of a 2-week generalized itchy cutaneous papular lesion, unresponsive to antihista-mines, with the feeling of an insect moving on the surface of the skin. Due to the history of recently hatched pigeons nesting on their balcony and finding very small bugs, diagnosed as D. gallinae, they were instructed to clean the pigeon's nest as the source of these parasites, which successfully solved the problem. CONCLUSION: Bird mite infestation should be considered in the differential diagnosis of recurrent pruritus and urticaria, refractory to conventional treatments. Physicians should be aware of this mite infestation in approach to any patient with papular urticaria.

Pigeon mite: An underdiagnosed cause of papular urticaria

Background: Dermanyssus gallinae, known as bird mite, generally lives on nestlings’ featherless skin. Humans are accidentally infected, and itchy dermatitis is induced when the mites are unable to use birds’ blood. The diagnosis is difficult due to the very small size and rapid movement of the mites, which make them hard to spot. Case presentation: A 14-year-old male and his mother were referred to the allergy clinic complaining of a 2-week generalized itchy cutaneous papular lesion, unresponsive to antihista-mines, with the feeling of an insect moving on the surface of the skin. Due to the history of recently hatched pigeons nesting on their balcony and finding very small bugs, diagnosed as D. gallinae, they were instructed to clean the pigeon’s nest as the source of these parasites, which successfully solved the problem. Conclusion: Bird mite infestation should be considered in the differential diagnosis of recurrent pruritus and urticaria, refractory to conventional treatments. Physicians should be aware of this mite infestation in approach to any patient with papular urticaria (AU)

Possible Involvement of Nitric Oxide in the Antipruritic Effect of Metformin on Chloroquine-Induced Scratching in Mice.

BACKGROUND: Metformin ameliorates non-histamine-mediated itch. We have recently reported that the nitric oxide (NO) pathway is involved in chloroquine (CQ)-induced scratching behavior. Here we investigated the involvement of the NO pathway in the antipruritic effect of metformin on CQ-induced itch. METHODS: Metformin (5-200 mg/kg, given intraperitoneally [i.p.]) was injected 4 h before CQ (400 µg/site, given intradermally [i.d.]) or compound 48/80 (100 µg/site, i.d.). A nonspecific nitric oxide synthase (NOS) inhibitor, NG-nitro-L-arginine methyl ester (L-NAME; 1 and 10 mg/kg, i.p.), or an NO precursor, L-arginine (10 and 100 mg/kg, i.p.) was administered 30 min before injection of CQ. A neural NOS (nNOS) inhibitor, 7-nitroindazole (7-NI; 1 and 10 nmol/site, i.d.) was concurrently administered with CQ. The scratching behavior was recorded for 30 min following the injection of CQ. We studied the changes in skin and spinal nitrite levels after treatments. RESULTS: Our results showed that metformin (100 and 200 mg/kg) significantly reduced the CQ-induced scratching behavior but not the compound 48/80-induced scratching behavior. L-Arginine inhibited the antipruritic effect of metformin, while L-NAME and 7-NI significantly potentiated the inhibitory effects of a subeffective dose of metformin on the CQ-induced scratching behavior. The skin but not the spinal nitrite level was significantly increased after CQ administration. The elevated cutaneous nitrite level was reversed by effective doses of either metformin or 7-NI, but not by the subeffective doses of metformin + 7-NI. CONCLUSION: Acute injection of metformin significantly inhibits CQ-induced scratching behavior. This effect is mediated through inhibition of the NO pathway, especially by inhibiting the dermal nNOS enzyme.