IQ scores of children with moderate asthma: a comparison with healthy children

Intelligence quotient is an indicator of one's efficacy and many factors including chronic diseases may impact upon it. This study aims to compare the IQ of children diagnosed with moderate asthma to the IQ of healthy children. This comparative study was conducted between June 2011 and January 2012 in an Academic Referral Clinic. In this study, 114 patients aged 6 to 13 years who were diagnosed with moderate asthma were compared with 90 age and sex matched healthy patients from their families. Wechsler intelligence scale for children was used by split half method to calculate the overall IQ, verbal IQ and practical IQ. The t-test and Chi square test were used to analyze quantitative variables and qualitative variables, respectively. In this study, 204 children, 114 [56%] in the case group and 90 children [44%] in the control group participated in comparing their IQs. One hundred and fifteen [56%] were males and 89 [44%] were females. The overall IQs of asthmatic patients and healthy patients were 109 and 108, respectively; the difference was not significant [p=0.905]. Furthermore, there was no significant difference in the IQ scores between males and females. Although asthma is a chronic disease and causes many respiratory problems, it has no negative impact on IQ

Chronic urticaria: the necessity of laboratory examination

Urticaria is a common dermatologic disease. About 20 per cent of the population experiences it in a life-time period. The aim of this study was to compare the various laboratory examinations of chronic urticaria patients and healthy individuals and to determine the necessity of laboratory tests in such patients. In this study 78 patients suffering from chronic urticaria and 67 healthy individuals [2-50 year-old] with analogous demographic features underwent ALT, AST, S/E, ESR, CBC, TSH, T4, C4, C3, CH50, ANA, anti-thyroglobulin, anti-peroxidase, and anti H. pylori antibodies testing. Forty-one per cent of patients had increased IgE in comparison to 14.92% in normal subjects. Anti-thyroid antibodies were positive in 17.94% of cases while only 9% of normal individuals were positive [p<0.05]. Anti H. pylori antibodies were positive in 69.23% of patients [all above 18-year-old] and 61.19 per cent of normal population [p>0.05]. No significant difference found in other variables. Urticaria is often diagnosed based on clinical grounds and no routine laboratory examination is required

Serum level of trace elements [zinc, lead, and copper], albumin and immunoglobulins in asthmatic children

Bronchial asthma [BA] is a chronic inflammatory disease and it is a major health problem. Trace elements such as copper and zinc are essential components of anti-oxidant enzymes and optimal function of the immune response. Changes in the levels of these elements may lead to increase the risk of asthma. The study group consisted of 175 asthmatic children and 165 control group of healthy general population who attend the outpatient allergic clinic [Bou Ali Hospital] in Sari, Mazandaran, Iran between August 2010 and March 2011. Complete blood count, eosinophil count and serum total IgE level and Serum trace element levels [Zinc, lead and copper] were measured in both groups. There was a significant difference in serum levels of copper, lead, IgE [increased], and decreased IgA, between two groups [p=0.001]. There was no significant difference in blood zinc levels and eosinophilia between two groups [p=0.732 and 0.068, respectively] Increased serum levels of copper and lead may be associated with asthma

MICB gene expression on peripheral blood mononuclear cells and susceptibility to multiple sclerosis in north of Iran

Multiple sclerosis [MS] is an autoimmune multifactorial degenerative disease with detrimental affliction on central nervous system. MHC class I chain- related geneA,B [MICA and MICB] are nonclassical human leukocyte antigens that can affect on some diseases and also on transplantation. The purpose of this study was to evaluate the MICA and MICB MRNA expression in multiple sclerosis patients. In this study, we evaluated MICA and MICB MRNA expression in the peripheral blood mononuclear cells by reverse transcryptase-polymerase chain reaction [RT-PCR] in MS patients and normal controls. The results of this study showed that 32.6% of patients with progressive clinical outcome over expressed MICB genes in comparison with controls [p=0.002]. It is concluded that the high expression of MICB gene in MS patients is an important criterion of MS disease that it may be due to the interaction between MICB and its receptor on CD8+T or NK cells

[Skin prick test in asthmatic, allergic rhinitis and urticaria patients]

Asthma, allergic rhinitis and urticaria are common diseases in the world. The aim of this study was to investigate the aeroallergen by skin prick test in patients, in Mazandaran province, Sari [Iran]. This was a prospective study of skin prick test of aeroallergens in patients with asthma, allergic rhinitis or both and urticaria based on clinical and Para clinical criteria. Eight hundred and nine cases were referred to Tooba and Boo-Ali allergic centers in Mazandaran University of Medical Sciences between December 2006 and July 2010. The aeroallergens were included; House dust mites [DF, DP], Coach Roach, Feather, Aspergillus, Alternaria, Pigweed, Nettle, Oak, Maple and others. Negative [normal saline] and positive controls [histamine] were applied for all patients. A total of three hundred and fifty out of 809 cases were males [43%] and 459 cases were Females [57%]. The age range was between 5 and 50 years old, 42.5 percent [n=340] of patients had ages between 10 and 20 years old. In asthma, allergic rhinitis or both and urticaria, the prick test DF 32%, DP 33%, Cockroach 22% and feather 9 were positive. Other allergens were positive between 0 and 10 percent, except candida which was 28% positive. Total IgE levels and Eosinophil count was increased in 54 and 35 percent of cases, respectively. Due to warm and humid weather in north of Iran [Sari], house dust mites are more common

FOXP3 and TGF-beta gene polymorphisms in allergic rhinitis

Regulatory CD4[+]T [Treg] cells are effective in maintaining immune tolerance. To investigate single nucleotide polymorphisms [SNPs] of Transforming Growth Factor beta-1 [TGF-P 1] and Forkhead Box Protein 3 [FOXP3] genes in Iranian patients with allergic rhinitis [AR]. Variations at codons 10 and 25 of TGF-p 1 and FOXP3 at positions -3279 A>C and -924 A>G were evaluated in AR patients and compared with controls. In a case-control study, 155 AR patients and 163 allergy-free controls were genotyped using polymerase chain reaction sequence-specific primer [PCR-SSP] technique. The analysis of the frequency of these SNPs showed that the haplotype formed by FOXP3 -3279 A allele occurred significantly more frequently in patients than controls [odds ratio=1.44, 95% CI=1.312-2.66; p=0.001]. Our results suggest that polymorphism in FOXP3 gene is associated with susceptibility to AR

Hypersensitivity to house dust mite and cockroach is the most common allergy in North of Iran

Asthma and allergic rhinitis are among the most common diseases in the world. The aim of this study was to detect, by skin prick test, aeroallergens in allergic patients in Sari, Mazandaran in north of Iran. This is a prospective study of skin prick test of aeroallergens in asthma, allergic rhinitis and their combination with clinical diagnosis. Three hundred and seventy five cases aged between 5 to 50 years, were referred to Tooba and Boo-Ali allergic centers of Mazandaran University of Medical Sciences between December 2006 and July 2009. The aeroallergens studied included house dust mites [Dermatophagoides farinae, Dermatophagoides pteronyssinus], cockroaches, feather, aspergillus, Alternaria, pigweed, nettle, oak and maple. Of the studied individuals, 175 cases were males [46.7%] and 200 were females [53.3%], of which 156 [n=41.5%] reacted to allergen extracts. In asthma, allergic rhinitis and their combination, the respective positive percentages were 26.6%, 22.9%, and 32.6% for Dermatophagoides farinae; 26.6%, 25.3%, and 23.3% for Dermatophagoides pteronyssinus; 12.7%, 17.4%, and 11.6% for cockroaches and 16.5%, 4.7%, and 7.0% for the feather. Other allergens were positive up to 5 percent. Total IgE levels were elevated in 56.4%, 53% and 60.5% of asthmatic, allergic rhinitis and the combination group, respectively. Eosinophils count was elevated in 40.5%, 33.2% and 37.2% of the same groups, respectively. The hypersensitivity to house dust mites is very common in north of Iran which may be attributed to the warm and humid weather of this area

[Primary Immuno-deficiencies [PID]]

Primary immune-deficiencies [PID] are associated with a wide range of clinical disorders along with variable symptoms. The aim of this study was to evaluate and improve our knowledge regarding PID from patients that were referred to Booali Sina Hospital. We evaluated all of PID's that were referred to Booali Sina Hospital from their data records. Demography, clinical and laboratory data were recorded and then analyzed. In the duration of 3 years, we had 10 patients with PID [7 males and 3 females]. Of these cases, 5 had hum oral [50%], 1case had phagocytic [10%], 3 cases had cellular [30%] and 1 case had hyper IgE syndrome [10%]. Many of them had respiratory and otitis media infections, while a few patients had adenitis, gastroenteritis, liver abscesses, bleedings and malignancy. PID is a diverse disorder that involves different immune systems. Knowledge from patient's clinical symptoms and consideration in their differential diagnosis can be helpful in early diagnosis and an effective treatment

Nitroblue tetrazolium test in patients with beta-thalassemia major

To assess the neutrophil function in thalassemia major [TM] patients and compare it with the control group, and to recognize its relevant factors. This was a retrospective cohort study, which was carried out from October 2007 to February 2008 in the Thalassemia Research Center in Boo Ali Sina Hospital in Sari, Mazandaran, north of Iran. The study population consisted of TM patients in Boo Ali Sina Teaching Hospital. The method of sampling in the case group was systematic, and it was target based in the control group. The sample size determined was based on previous studies. Thalassemia major was diagnosed based on hemoglobin electrophoresis [case group]. The control group was their brothers and sisters, who had +/- 5 years of age difference, and were of the same gender as the patients. Data collection was based on interview, investigating demographic characteristics, and also obtaining medical information from the medical records of the patients. The neutrophil function was assessed by performing nitroblue tetrazolium [NBT] reduction test. The test was carried out on both groups, and the data were analyzed by software using SPSS version13.0. In this study, 39 patients and 39 healthy controls were compared. The average age of the patients was 21.6 +/- 5.3 years, and it was 22.4 +/- 5.1 years in healthy controls [p=0.7]. There was a significant correlation between the tests' results, and the patients' age [p=0.008]. The rate of impaired NBT results in the patients was 36%, while it was 10% in controls, which were significantly different. The neutrophil activity based on NBT test was 89.9 +/- 11.6% in the case group, and 93.7 +/- 2.51% in the control group, [p=0.025]. This study indicates that neutrophil activity in thalassemic patients was significantly lower, compared to the normal control group, especially in young patients. Based on the results, evaluation of neutrophil function, and pyogenic infections in TM patients seems necessary

Study of alpha1-antitrypsin phenotypes frequencies in patients with primary antibody deficiency

Primary antibody deficiencies are the most frequent primary immunodeficiency disorders. Bronchiectasis as a feature of these disorders may be developed due to some factors such alpha-1-antitrypsin deficiency. In order to determine the prevalence of two common alpha-1-antitrypsin deficiency alleles [PI*Z and PI*S] in Iranian patients with antibody deficiency, this study was performed. The prevalence of PI*M, PI*S, and PI*Z allele combinations was determined in 40 patients with primary antibody deficiency [with and without bronchiectasis] and compared with 60 healthy control subjects. Phenotyping was performed by isoelectric focusing. The phenotype frequencies among patients were as follow: M in 92.5%, S in 2.5% and Z in 5%. There was not any significant difference in distribution of alleles or phenotypes between patients and control subjects. Moreover, no significant difference was found between patients with and without bronchiectasis. We did not find evidence to support an association between alpha-1-antitrypsin phenotypes and primary antibody deficiencies in a small, controlled study. Larger studies will be required to clarify the relationship between alpha-1-antitrypsin genotype and susceptibility to bronchiectasis in patients with antibody deficiency

Association between the polymorphism of TGF- beta 1 gene promoter [-509C>T] and idiopathic chronic Urticaria

Idiopathic Chronic Urticaria [ICU], the most common form [70-80%] of chronic urticaria is supposed to have immune basis causes. It is speculated that the promoter polymorphism of TGF- beta 1 gene may be involved in ICU. This condition is thought to affect at least 0.1% of the population and often can be severe and difficult to treat. A total of 40 patients with ICU and 41 normal subjects were studied. DNA was extracted from whole blood and TGF- beta 1 promoter -509C>T polymorphism was determined by PCR-RFLP method. Out of the 40 patients with ICU, 11 [27.5%] had CC, 26 [65%] had CT and 3 [7.5%] had TT genotypes. A higher proportion of case subjects with the C allele [CT type or CC type] was found compared with the T allele. These results do suggest an influence of genetic variability at the promoter of TGF- beta 1 gene [-509C>T] on the occurrence of ICU. This polymorphism has been shown as a useful genetic change in our study. Further work is required to confirm this result

DNA banking of primary immunodeficiency disorders in Iran

Primary immunodeficiency disorders are a heterogeneous group of genetic disorders, with different modes of inheritance, consisting of more than 100 different types. We constructed the DNA banking of primary immunodeficiency disorders for the first time in Iran. The DNA of 31 immunodeficient patients and their families [total of 92 samples] were collected, as the first step for construction of DNA banking. DNA was isolated from whole blood by salting out method. Among our patients, Common variable immunodeficiency was the most common disorder, followed by X-linked agammaglobulinemia, Ataxia-telangiectasia, Chronic granulomatous disease, Severe combined immunodeficiency, Hyper IgM syndromes, and Leukocyte adhesion defects. DNA banking is a useful method for further detection of mutation in immunodeficient patients and prenatal diagnosis for presence or absence of the disorder in the fetus which can be confirmed by molecular genetics testing

Evaluation of six years allergen immunotherapy in allergic rhinitis and allergic asthma

Allergen immunotherapy involves the administration of gradually increasing quantities of specific allergens to patients with IgE-mediated conditions until a dose is reached that is effective in reducing disease severity from natural exposure. In the present study we evaluated a period of six years immunotherapy allergic rhinitis and allergic asthma patients with positive skin prick test of common aeroallergen. The immunotherapy was performed on 156 patients. One hundred twenty of the cases were allergic rhinitis [80%], 29 cases had allergic asthma and 7 cases were mixed [4.5%]. 70% in allergic rhinitis group, 75% in allergic asthma group and 42.8% in mixed group completely improved. Immunotherapy, an older therapeutic method, has now been updated, and with appropriate indications, precautions and methods, has been clearly shown to be effective in the treatment of allergic rhinitis and in some cases of asthma and insect hypersensitivity

Evaluation of fluticasone [flixonase] nasal spray versus beclomethasone [beconase] nasal spray in the treatment of allergic rhinitis

Although response to intranasal steroid therapy has been reported in patients with allergic rhinitis, efficacy of some nasal steroids is noteworthy. This study was undertaken to evaluate the efficacy of a two-week course of Fluticasone [Flixonase] nasal spray vs. Beclomethasone [Beconase] nasal spray in patients with symptoms of allergic rhinitis referred to our clinic. This study reviewed sixty randomized studies with symptoms of allergic rhinitis which supported common aeroallergens with skin prick test. Patients received a total daily dose of nasal spray of Fluticasone [Flixonase] 100 mcg bid [N=30] compared with patients with allergic rhinitis who received a total daily dose of Beclomethasone [Beconase] 50mcg 2 puffs bid [N=30] patients were visited before and after therapy, and efficacy of flixonase and beconase was evaluated by the change in nasal symptoms including: nasal discharge, nasal obstruction, nasal itching, and sneezing. After two weeks of treatment nasal symptoms of blockage, discharge, sneezing and itching were significantly better in the group treated with fluticasone nasal spray 65%, 82%, 67%, 79% respectively [p<0.001] but after treatment with beconase nasal spray lower benefits in the nasal symptoms includes: 50%, 71%, 51%, 57% respectively. After two weeks of treatment no deleterious changes consequent to therapy were observed in nasal symptoms. 100 mcg bid flixonase [Fluticasone] intranasal spray is more effective than 50 mcg 2 puffs bid beconase [Beclomethasone] intranasal spray. Like asthma, allergic rhinitis is an inflammatory disease and should be managed with anti-inflammatory medication