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Acute electrolyte and acid-base imbalance is experienced by many children following kidney transplant. This is partly because doctors give very large volumes of artificial fluids to keep the new kidney working. When severe, fluid imbalance can lead to seizures, cerebral edema and death. In this pragmatic, open-label, randomized controlled trial, we randomly assigned (1:1) pediatric kidney transplant recipients to Plasma-Lyte-148 or standard of care perioperative intravenous fluids (predominantly 0.45% sodium chloride and 0.9% sodium chloride solutions). We then compared clinically significant electrolyte and acid-base abnormalities in the first 72 hours post-transplant. The primary outcome, acute hyponatremia, was experienced by 53% of 68 participants in the Plasma-Lyte-148 group and 58% of 69 participants in the standard fluids group (odds ratio 0·77 (0·34 - 1·75)). Five of 16 secondary outcomes differed with Plasma-Lyte-148: hypernatremia was significantly more frequent (odds ratio 3·5 (1·1 - 10·8)), significantly fewer changes to fluid prescriptions were made (rate ratio 0·52 (0·40-0·67)), and significantly fewer participants experienced hyperchloremia (odds ratio 0·17 (0·07 - 0·40)), acidosis (odds ratio 0·09 (0·04 - 0·22)) and hypomagnesemia (odds ratio 0·21 (0·08 - 0·50)). No other secondary outcomes differed between groups. Serious adverse events were reported in 9% of participants randomized to Plasma-Lyte-148 and 7% of participants randomized to standard fluids. Thus, perioperative Plasma-Lyte-148 did not change the proportion of children who experienced acute hyponatremia compared to standard fluids. However fewer fluid prescription changes were made with Plasma-Lyte-148, while hyperchloremia and acidosis were less common.
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Acidosis , Hiponatremia , Trasplante de Riñón , Desequilibrio Hidroelectrolítico , Humanos , Niño , Cloruro de Sodio/efectos adversos , Hiponatremia/epidemiología , Hiponatremia/etiología , Electrólitos/efectos adversos , Acidosis/etiología , Acidosis/inducido químicamente , Desequilibrio Hidroelectrolítico/etiología , Desequilibrio Hidroelectrolítico/inducido químicamente , Fluidoterapia/efectos adversos , Soluciones Isotónicas/efectos adversos , Gluconatos , Cloruro de Potasio , Cloruro de Magnesio , Acetato de SodioRESUMEN
BACKGROUND: Steroid-resistant nephrotic syndrome (SRNS), commonly caused by focal segmental glomerulosclerosis (FSGS), is associated with progression to stage 5 chronic kidney disease, requirement for kidney replacement therapy and a risk of disease recurrence post-kidney transplantation. Ofatumumab (OFA) is a fully humanised monoclonal antibody to CD20, with similar mechanisms of action to rituximab (RTX). METHODS: We report a case series of seven UK patients (five paediatric, two adult), all of whom developed FSGS recurrence after kidney transplantation and received OFA as part of their therapeutic intervention. All also received concomitant plasmapheresis. The 2-year outcome of these seven patients is reported, describing clinical course, kidney function and proteinuria. RESULTS: Four patients (all paediatric) achieved complete urinary remission with minimal proteinuria 12 months post-treatment. Three of those four also had normal graft function. Two patients showed partial remission-brief improvement to non-nephrotic proteinuria (197 mg/mmol) in one patient, maintained improvement in kidney function (estimated glomerular filtration rate 76 ml/min/1.73 m2) in the other. One patient did not demonstrate any response. CONCLUSIONS: OFA may represent a useful addition to therapeutic options in the management of FSGS recurrence post-transplantation, including where RTX has shown no benefit. Concomitant plasmapheresis in all patients prevents any definitive conclusion that OFA was the beneficial intervention.
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Anticuerpos Monoclonales Humanizados , Glomeruloesclerosis Focal y Segmentaria , Trasplante de Riñón , Adulto , Anticuerpos Monoclonales Humanizados/uso terapéutico , Niño , Glomeruloesclerosis Focal y Segmentaria/epidemiología , Glomeruloesclerosis Focal y Segmentaria/prevención & control , Humanos , Trasplante de Riñón/efectos adversos , Recurrencia , Prevención Secundaria , Reino Unido/epidemiologíaRESUMEN
BACKGROUND: Primary nephrogenic diabetes insipidus (NDI) is a rare disorder and little is known about treatment practices and long-term outcome. METHODS: Paediatric and adult nephrologists contacted through European professional organizations entered data in an online form. RESULTS: Data were collected on 315 patients (22 countries, male 84%, adults 35%). Mutation testing had been performed in 270 (86%); pathogenic variants were identified in 258 (96%). The median (range) age at diagnosis was 0.6 (0.0-60) years and at last follow-up 14.0 (0.1-70) years. In adults, height was normal with a mean (standard deviation) score of -0.39 (±1.0), yet there was increased prevalence of obesity (body mass index >30 kg/m2; 41% versus 16% European average; P < 0.001). There was also increased prevalence of chronic kidney disease (CKD) Stage ≥2 in children (32%) and adults (48%). Evidence of flow uropathy was present in 38%. A higher proportion of children than adults (85% versus 54%; P < 0.001) received medications to reduce urine output. Patients ≥25 years were less likely to have a university degree than the European average (21% versus 35%; P = 0.003) but full-time employment was similar. Mental health problems, predominantly attention-deficit hyperactivity disorder (16%), were reported in 36% of patients. CONCLUSION: This large NDI cohort shows an overall favourable outcome with normal adult height and only mild to moderate CKD in most. Yet, while full-time employment was similar to the European average, educational achievement was lower, and more than half had urological and/or mental health problems.
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BACKGROUND: The aim of this study was to investigate whether dalteparin is a safe and effective anticoagulant for paediatric home haemodialysis (HD) and to assess the determinants of dosing. METHODS: Data were collected for all children (< 18 years) undergoing home HD from 2011 to 2017 at one large paediatric nephrology centre in the UK. All children had anticoagulation with dalteparin sodium according to a standardised protocol. Dalteparin safety was assessed by monitoring for accumulation, adequate clearance of dalteparin and adverse events. Dalteparin efficacy was assessed through monitoring for clot formation in dialysis circuits. Potential determinants of dalteparin dosing were assessed. RESULTS: Eighteen children were included, their median age at start was 12 years, and 50% were male. Eighty-three percent of children had four home HD sessions each week, with a median total dialysis hours of 20 h/week. Thirty-three percent of children had nocturnal home HD. Median dalteparin dose at 12-month follow-up was 40 IU/kg (range 8-142 IU/kg). Factors associated with higher dalteparin dosing requirements included a younger age of the child (p < 0.01), a lower blood flow rate (p < 0.01) and the use of a central venous line for dialysis access (p = 0.038). No children had evidence of bioaccumulation of dalteparin or inadequate clearance. No significant bleeding or adverse events were reported. CONCLUSIONS: Dalteparin is a safe and effective anticoagulant when used for paediatric home HD. In this study, there was no evidence of bioaccumulation or significant adverse events. Further research is required to directly compare dalteparin with unfractionated heparin (UFH) and evaluate anticoagulant choice for paediatric home HD.
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Anticoagulantes/administración & dosificación , Dalteparina/administración & dosificación , Hemodiálisis en el Domicilio/efectos adversos , Fallo Renal Crónico/terapia , Trombosis/prevención & control , Adolescente , Factores de Edad , Coagulación Sanguínea/efectos de los fármacos , Niño , Preescolar , Dalteparina/efectos adversos , Relación Dosis-Respuesta a Droga , Femenino , Estudios de Seguimiento , Hemorragia/inducido químicamente , Hemorragia/epidemiología , Humanos , Masculino , Estudios Retrospectivos , Reino UnidoRESUMEN
The genes involved in menthol biosynthesis are reported earlier in Mentha × piperita. But the information on these genes is not available in Mentha arvensis. To bridge the gap in knowledge on differential biosynthesis of monoterpenes leading to compositional variation in the essential oil of these species, a comparative transcriptome analysis of the glandular trichome (GT) was carried out. In addition to the mevalonic acid (MVA) and methylerythritol phosphate (MEP) pathway genes, about 210 and 196 different terpene synthases (TPSs) transcripts were identified from annotation in M. arvensis and M. × piperita, respectively, and correlated to several monoterpenes present in the essential oil. Six isoforms of (-)-menthol dehydrogenases (MD), the last enzyme of the menthol biosynthetic pathway, were identified, cloned and characterized from the transcriptome data (three from each species). Varied expression levels and differential enzyme kinetics of these isoforms indicated the nature and composition of the product, as these isoforms generate both (-)-menthol and (+)-neomenthol from (-)-menthone and converts (-)-menthol to (-)-menthone in the reverse reaction, and hence together determine the quantity of (-)-menthol in the essential oil in these two species. Several genes for high value minor monoterpenes could also be identified from the transcriptome data.
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Mentha/metabolismo , Mentol/metabolismo , Tricomas/metabolismo , Transferasas Alquil y Aril/genética , Transferasas Alquil y Aril/metabolismo , Regulación de la Expresión Génica de las Plantas , Mentha/enzimología , Mentha/genética , Ácido Mevalónico/metabolismo , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , Tricomas/enzimología , Tricomas/genéticaRESUMEN
BACKGROUND: Conventional thrice weekly haemodialysis (HD) provides adequate dialysis to prevent mortality, but morbidity is prevalent in both the paediatric and adult population. There has been growing interest in the potential of intensive dialysis regimes entering the realm of optimal dialysis, with superior health and quality of life outcomes. CASE DIAGNOSIS/TREATMENT: We present the case of a 13-year-old girl who had bilateral nephrectomies as a result of bilateral Wilms tumors. In the third year of treatment with conventional HD, she presented with symptomatic progressive cardiac failure, presumably secondary to anthracycline-induced cardiomyopathy. Consequently, she was taken off the renal transplant list and became increasingly dependent on frequent in-centre dialysis sessions to manage her symptoms. Five months after switching to a frequent and extended home HD regime, we observed a tremendous improvement in her health and well-being, with complete reversal of her cardiac dysfunction. CONCLUSIONS: Home HD is a practically viable option in children with severe cardiac dysfunction. Gentler, more intensive dialysis will draw out and improve the ureamic component of heart disease. This may translate into improved cardiac function.
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Insuficiencia Cardíaca/terapia , Hemodiálisis en el Domicilio/métodos , Adolescente , Femenino , Humanos , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: Vitamin A accumulates in renal failure, but the prevalence of hypervitaminosis A in children with predialysis chronic kidney disease (CKD) is not known. Hypervitaminosis A has been associated with hypercalcemia. In this study we compared dietary vitamin A intake with serum retinoid levels and their associations with hypercalcemia. METHODS: We studied the relationship between vitamin A intake, serum retinoid levels, and serum calcium in 105 children with CKD stages 2-5 on dialysis and posttransplant. Serum retinoid measures included retinol (ROH), its active retinoic acid (RA) metabolites [all-trans RA (at-RA) and 13-cis RA] and carrier proteins [retinol-binding protein-4 (RBP4) and transthyretin (TTR)]. Dietary vitamin A intake was assessed using a food diary. RESULTS: Twenty-five children were in CKD 2-3, 35 in CKD 4-5, 23 on dialysis and 22 posttransplant; 53 % had vitamin A intake above the Reference Nutrient Intake (RNI) value. Children receiving supplemental feeds compared with diet alone had higher vitamin A intake (p = 0.02) and higher serum ROH (p < 0.001). Notably, increased ROH was seen as early as CKD stage 2. For every 10 ml/min/1.73 m(2) fall in estimated glomerular filtration rate (eGFR), there was a 13 % increase in ROH. RBP4 levels were increased in CKD 3-5 and dialysis patients. The lowest ratios of ROH:RBP4 were seen in dialysis compared with CKD 2-3 (p = 0.03), suggesting a relative increase in circulating RBP4. Serum ROH, RBP4 and at-RA were associated with serum calcium. On multivariable analysis RBP4 levels and alfacalcidol dose were significant predictors of serum calcium (model R (2) 32 %) in dialysis patients. CONCLUSIONS: Hypervitaminosis A is seen in early CKD, with highest levels in children on supplemental feeds compared with diet alone. Serum retinoid levels significantly predict hypercalcemia.
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Hipercalcemia/etiología , Hipervitaminosis A/complicaciones , Insuficiencia Renal Crónica/sangre , Insuficiencia Renal Crónica/complicaciones , Adolescente , Niño , Preescolar , Cromatografía Líquida de Alta Presión , Dieta , Femenino , Humanos , Lactante , MasculinoRESUMEN
Robotic surgery has emerged as a transformative technology in obstetrics and gynecology, offering enhanced precision and minimally invasive techniques for various procedures. This paper explores the evolution of robotic surgery in obstetrics and gynecology, examining its historical development, current applications, and prospects. Through a comprehensive review of the literature and case studies, we highlight the benefits of robotic surgery, including reduced trauma, improved patient outcomes, and increased surgeon capabilities. However, cost, training requirements, and regulatory concerns hinder widespread adoption. Continuing technological innovation is expected to enhance the efficacy and applicability of robotic-assisted procedures. Collaboration between healthcare professionals, researchers, and industry stakeholders is essential to address these challenges and ensure optimal patient care. By embracing the opportunities presented by robotic surgery while addressing associated challenges, practitioners and researchers can contribute to the continued advancement of this transformative technology in obstetrics and gynecology.
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Artificial intelligence (AI) has emerged as a transformative force in healthcare, particularly in pulmonary diagnostics. This comprehensive review explores the impact of AI on revolutionizing lung imaging, focusing on its applications in detecting abnormalities, diagnosing pulmonary conditions, and predicting disease prognosis. We provide an overview of traditional pulmonary diagnostic methods and highlight the importance of accurate and efficient lung imaging for early intervention and improved patient outcomes. Through the lens of AI, we examine machine learning algorithms, deep learning techniques, and natural language processing for analyzing radiology reports. Case studies and examples showcase the successful implementation of AI in pulmonary diagnostics, alongside challenges faced and lessons learned. Finally, we discuss future directions, including integrating AI into clinical workflows, ethical considerations, and the need for further research and collaboration in this rapidly evolving field. This review underscores the transformative potential of AI in enhancing the accuracy, efficiency, and accessibility of pulmonary healthcare.
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This comprehensive review examines the diagnostic potential of bronchoalveolar lavage (BAL) in interstitial lung disease (ILD), emphasizing its accuracy and significance in various ILDs, including idiopathic pulmonary fibrosis (IPF), sarcoidosis, hypersensitivity pneumonitis, and connective tissue disease-associated ILD. The analysis underscores the importance of abnormalities in both cellular and non-cellular components of BAL fluid for precise ILD diagnosis. Recommendations advocate for the integration of BAL into clinical guidelines, a multidisciplinary diagnostic approach, and further standardization of procedures. Looking toward the future, ongoing research highlights technological advancements, biomarker discovery, and the integration of artificial intelligence in BAL interpretation. These developments not only promise to enhance ILD diagnosis but also offer prospects for a more personalized approach to patient management based on insightful patient stratification guided by BAL findings. This abstract encapsulates the key findings, recommendations, and future prospects identified in the review, providing a concise overview of the diagnostic potential of BAL in ILD.
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Bronchoesophageal fistula (BEF) is a rare, yet clinically significant, condition characterized by an abnormal connection between the bronchial tree and the esophagus. We present the case of a 25-year-old female who initially presented with symptoms of aspiration pneumonitis and was subsequently diagnosed with BEF, attributed to poorly differentiated squamous cell carcinoma. Despite initial attempts at palliative intervention through esophageal stent placement, persistent symptoms prompted further investigation, revealing the underlying malignancy. This case underscores the diagnostic challenges associated with BEF, particularly when malignancy is involved, and emphasizes the importance of a multidisciplinary approach in optimizing patient outcomes. Early recognition, thorough evaluation, and comprehensive oncological management are essential in addressing the clinical complexities posed by BEF. Further research is warranted to better understand the pathophysiology and optimal management strategies for this rare but clinically significant condition.
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Pregnancy-associated breast cancer (PABC) presents unique challenges due to its occurrence during or shortly after pregnancy. Pregnancy-associated plasma protein A (PAPP-A) has emerged as a potential biomarker and regulator in PABC. This comprehensive review examines the role of PAPP-A in PABC, highlighting its involvement in tissue remodeling and cancer progression. Molecular mechanisms linking PAPP-A to breast cancer, including signaling pathways and interactions with other molecules, are explored. The review also discusses the diagnostic and therapeutic implications of PAPP-A dysregulation in PABC, emphasizing the need for further research to elucidate underlying mechanisms and develop targeted therapies. Collaborative efforts among researchers, clinicians, and industry stakeholders are essential for translating findings into clinically relevant interventions to improve outcomes for PABC patients.
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Our research addresses the challenge of low concentrations of viridiflorol, a unique and highly valuable sesquiterpene found in various Mentha species. We employed biotechnological strategies to enhance viridiflorol production, which could significantly boost export revenue. Mentha piperita L. sesquiterpene synthase (MpTPS4) was the focus of our study because it is a key enzyme in the biosynthesis of viridiflorol. Through biochemical characterization, we confirmed that MpTPS4 exclusively synthesizes viridiflorol. By overexpressing MpTPS4 in M. ×piperita L. using a glandular trichome-specific promoter, we achieved a notable increase (9-25 %) in viridiflorol content. Additionally, we explored the practical application of viridiflorol as a deterrent against the herbivore Helicoverpa armigera. The RNAi-mediated knockdown of MpTPS4 resulted in a significant reduction in viridiflorol levels in the essential oil. More importantly, these results show how relevant MpTPS4 is for making viridiflorol and how biotechnology could be used to increase biosynthesis. Our research provides valuable insights into enhancing the production of this commercially important sesquiterpene, offering promising opportunities for the mentha industry.
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Transferasas Alquil y Aril , Aceites Volátiles , Sesquiterpenos , Aceites Volátiles/química , Sesquiterpenos/metabolismo , Sesquiterpenos/química , Transferasas Alquil y Aril/genética , Transferasas Alquil y Aril/metabolismo , Mentha piperita/química , Citosol/enzimología , Mentha/química , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , AnimalesRESUMEN
INTRODUCTION: During the COVID-19 pandemic, evidence emerged that immunosuppressed children were less affected by COVID-19 infections compared with immunosuppressed adults. The aim of our study was to investigate how COVID-19 infections affected paediatric kidney transplant recipients (pKTR) in the UK. METHODS: Questionnaires regarding COVID-19 infection data and care of pKTR during the COVID-19 pandemic were sent to all 13 UK paediatric nephrology centres examining asymptomatic and symptomatic pKTR with positive COVID-19 PCR testing from 1 April 2020 to 1 December 2021. RESULTS: 63 pKTR who were 3.1 (range 0.1-15) years post-transplantation had COVID-19 infection with positive SARS-CoV-2 PCR RNA. Classical COVID-19 symptoms were present in half of the patients; with atypical presentations including diarrhoea (13%) and lethargy (13%) also noted, while a third of patients were asymptomatic. Eighteen patients (28%) were hospitalised including five asymptomatic patients admitted for other reasons. No patients needed ventilation or intensive care admission, and one patient received supplemental oxygen. There was evidence of acute kidney injury (AKI) in 71% of patients, but no patients needed kidney replacement therapy with haemofiltration or dialysis. CONCLUSION: We report 10.4% of the UK paediatric renal transplantation population had documented COVID-19 infections with positive SARS-CoV-2 PCR RNA with 28% of those affected requiring hospitalisation. The increased incidence of AKI, particularly after the first wave of the COVID-19 pandemic, was possibly due to increased testing. There was low morbidity and mortality compared with the adult population.
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Lesión Renal Aguda , COVID-19 , Trasplante de Riñón , Niño , Humanos , COVID-19/epidemiología , Estudios Transversales , Trasplante de Riñón/efectos adversos , Pandemias , Estudios Retrospectivos , ARN , SARS-CoV-2RESUMEN
BACKGROUND: Renal biopsies are usually performed in the prone position, often under general anaesthesia. Because it is theoretically and pragmatically safer to anaesthetise children in the lateral rather than the prone position, we compared the efficacy and safety of ultrasound-guided renal biopsy in these two positions. CASE-DIAGNOSIS/TREATMENT: In our department, physician preference dictates positioning during renal biopsy. We retrospectively audited the case notes and biopsy quality of 50 consecutive biopsies performed in each position, reviewing a total of 44 lateral and 47 prone position biopsies. Patient characteristics were similar for age and sex. Endotracheal intubation was carried out in all patients in the prone position and 18 % of patients in the lateral position. All patients were successfully biopsied, and the diagnostic yield and complications were similar in both groups. CONCLUSIONS: Renal biopsy under general anaesthesia is as successful in the lateral position as when it is performed prone. Therefore, the lateral position should be considered as an alternative because it reduces the anaesthetic risk.
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Anestesia General , Biopsia Guiada por Imagen , Enfermedades Renales/patología , Riñón/patología , Posicionamiento del Paciente , Adolescente , Factores de Edad , Anestesia General/efectos adversos , Niño , Femenino , Humanos , Biopsia Guiada por Imagen/efectos adversos , Intubación Intratraqueal , Masculino , Posicionamiento del Paciente/efectos adversos , Valor Predictivo de las Pruebas , Posición Prona , Estudios RetrospectivosRESUMEN
Retained intrauterine fetal bone fragments are emerging as a potential yet often overlooked cause of secondary infertility, posing significant challenges for couples who have previously experienced successful pregnancies. This review article explores the association between retained fetal bone fragments and secondary infertility by delving into their impact on fertility, pregnancy outcomes, and diagnostic challenges. The review highlights the underlying mechanisms of fragment retention, including immune response and inflammation, and their detrimental effects on endometrial receptivity and implantation. The diagnostic difficulties and importance of specialized imaging techniques like hysteroscopy for accurate diagnosis are also discussed. The article also provides insights into available treatment options, such as medical management and surgical interventions, focusing on hysteroscopy as the gold standard for diagnosis and treatment. The implications for clinical practice emphasize early diagnosis and intervention to improve fertility outcomes and reduce the emotional burden of secondary infertility. Furthermore, the review discusses preventive strategies and the potential for future research to refine diagnostic methods and explore novel treatments. By recognizing and addressing the impact of retained fetal bone fragments, this review aims to enhance the understanding and management of this condition, providing valuable support to couples seeking to overcome the challenges of secondary infertility on their journey toward parenthood.
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This comprehensive review delves into the intricate relationship between asthma and pregnancy, specifically focusing on the challenges encountered in the first trimester and the ensuing impact on maternal and fetal health. Examining physiological changes during pregnancy reveals the dynamic interplay influencing respiratory function and immune responses. Key findings underscore the vulnerability to asthma exacerbations in the critical first trimester, emphasizing the potential risks to both maternal and fetal well-being. Maternal and fetal outcomes are discussed, emphasizing the associations between poorly controlled asthma and adverse perinatal outcomes. Implications for clinical practice highlight the importance of preconception care, continuous monitoring, and collaborative efforts between obstetricians and pulmonologists. Patient education emerges as a fundamental aspect to empower pregnant women in managing their condition. The conclusion emphasizes the imperative for comprehensive care, advocating for individualized treatment plans, multidisciplinary collaboration, and public health initiatives. By adopting this holistic approach, healthcare providers can navigate the complexities of asthma during pregnancy, ultimately ensuring the optimal health of both the expectant mother and her developing fetus.
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Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder affecting a significant portion of the female population, characterized by hormonal imbalances, oxidative stress, sleep disturbances, and mood disorders. This review explores the multifaceted role of melatonin, a hormone primarily known for regulating circadian rhythms, in PCOS management. Melatonin's potential impact on hormonal balance, oxidative stress, sleep quality, and mood is comprehensively examined. It has been shown to enhance insulin sensitivity, regulate sex hormones, and influence gonadotropins, offering promise in addressing the intricate hormonal imbalances common in PCOS. As a potent antioxidant and anti-inflammatory agent, melatonin mitigates oxidative stress and its associated complications. Its role in improving sleep quality and mood can significantly enhance the psychological well-being and daily functioning of PCOS patients. We discuss the potential implications of melatonin as a complementary or adjunct therapy, alongside existing PCOS treatments, and its significance in improving the overall quality of life for individuals with this syndrome. While further research is needed, melatonin's multifaceted effects promise a brighter future for PCOS patients.
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OBJECTIVE: To assess the effect of yoga on control of asthma in children with bronchial asthma. METHODS: This hospital-based interventional randomized controlled trial conducted in the Department of Pediatrics at a tertiary care center of North India from November 2017 to October 2018 enrolled 140 newly diagnosed cases of asthma of age 10-16 y who were randomly divided into two groups. Seventy children in the case group practiced yoga under supervision for a period of 3 mo in addition to pharmacological treatment. Seventy controls received only pharmacological treatment. Pulmonary-function tests were done at baseline, 6 wk, and 12 wk along with quality of life (QOL) assessment by Pediatric Asthma Quality of Life Questionnaire (PAQLQ). The outcome measures assessed were forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC and peak expiratory flow rate (PEFR). QOL evaluation was done in 3 domains: activity limitation, symptoms, and emotional function. RESULTS: The asthmatic children practicing yoga have shown significant improvement in FVC, FEV1, FEV1/FVC and PEFR which was better as compared to controls. Improvement was also noted in mean-PAQLQ score in cases which was statistically significantly better as compared to controls. CONCLUSION: Yoga appears to have significant positive effect on control of asthma measured by pulmonary-function test and QOL. Therefore yoga therapy can be recommended as an adjuvant in management of asthma along with standard pharmacological management.