Thymus vulgaris ameliorates cough in children with asthma exacerbation: a randomized, triple-blind, placebo-controlled clinical trial

Background: Asthma is one of the most common chronic respiratory diseases with inflammatory involvement and has a high burden worldwide. This study aimed to determine the effect of Thymus vulgaris (TV) on cough in children between 5 and 12 years old with mild to moderate asthma exacerbation. Methods: In this randomized, triple-blind clinical trial, 60 children between the ages of 5 and 12 with asthma exacerbations were randomly divided into two groups. The intervention group (n = 30) was given TV powder at a dose of 20 mg/kg every 8 hours, prepared as syrup, along with routine medical treatment for a week, and the control group (n = 30) received only routine medical treatment with placebo syrup. At the end of the week, clinical and laboratory symptoms, and spirometry data were re-recorded for both groups. Finally, the recorded factors were compared and statistically analyzed. Results: The results showed that after the intervention, activity-induced cough reduced, and difference was statistically significant between the two groups (p = 0.042), but the reduction in wheezing and breathlessness had no statistically significant difference. Spirometry data showed a significant difference in forced expiratory volume in 1 second (FEV1) between the two groups after intervention (p = 0.048), but this difference was not significant in FEV1/FVC (forced vital capacity), peak expiratory flow (PEF), and forced expiratory flow at 25–75% of the vital capacity (FEF25–75%). Conclusion: The results show that TV syrup may be useful as an adjuvant treatment in children with asthma exacerbations (AU)

Thymus vulgaris ameliorates cough in children with asthma exacerbation: a randomized, triple-blind, placebo-controlled clinical trial.

BACKGROUND: Asthma is one of the most common chronic respiratory diseases with inflammatory involvement and has a high burden worldwide. This study aimed to determine the effect of Thymus vulgaris (TV) on cough in children between 5 and 12 years old with mild to moderate asthma exacerbation. METHODS: In this randomized, triple-blind clinical trial, 60 children between the ages of 5 and 12 with asthma exacerbations were randomly divided into two groups. The intervention group (n = 30) was given TV powder at a dose of 20 mg/kg every 8 hours, prepared as syrup, along with routine medical treatment for a week, and the control group (n = 30) received only routine medical treatment with placebo syrup. At the end of the week, clinical and laboratory symptoms, and spirometry data were re-recorded for both groups. Finally, the recorded factors were compared and statistically analyzed. RESULTS: The results showed that after the intervention, activity-induced cough reduced, and difference was statistically significant between the two groups (p = 0.042), but the reduction in wheezing and breathlessness had no statistically significant difference. Spirometry data showed a significant difference in forced expiratory volume in 1 second (FEV1) between the two groups after intervention (p = 0.048), but this difference was not significant in FEV1/FVC (forced vital capacity), peak expiratory flow (PEF), and forced expiratory flow at 25-75% of the vital capacity (FEF25-75%). CONCLUSION: The results show that TV syrup may be useful as an adjuvant treatment in children with asthma exacerbations.

Autistic feature as a presentation of Inborn Errors of Metabolism.

Autism spectrum disorder (ASD) is a category of neurodevelopmental disorders characterized by social and communication impairment and restricted or repetitive behaviors. The pathogenesis of ASD is not well understood and it's proved that genetic is strongly associated with ASD in 5 to 25% of cases. Inborn errors of metabolism(IEMs), defined by a vast array of disorders that are caused by specific enzyme deficiencies or transport protein defects, is as frequent as in 1 in 800 births. IEMs can manifest several psychiatric or behavioral manifestations such as self-injuriesincreased activity and aggression, personality changes, paranoia, depression, catatonia, and psychosis. IEMs underlie autistic symptoms in less than 5% of cases. The literature on the association between ASD and respiratory chain abnormalities is growing, including complex III/IV deficiency and MELAS (mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes) syndrome, as well as glucose-6-phosphate dehydrogenase deficiency. Google Scholar, Pubmed, and SCOPUS databases were searched using a combination of the following keywords: "autism spectrum disorder", "autism spectrum", "autistic feature" and "inborn error of metabolism", " IEM", "congenital error of metabolism". Initially, 655 articles were found and our expert and methodologist altogether selected 187 articles based on the titles, relevance, and text language. After reading full texts, 37 studies were selected for review. We think it's best to consider IEMs in children with syndromic ASD and/or if there is a strong familial history of autism or parental consanguineous marriage.

Antioxidant Levels in Cord Blood of Term Neonates and Its Association with Birth Weight.

OBJECTIVE: Due to excessive production of free radicals and antioxidants evolved mechanisms against oxidative stress, infants are very vulnerable. As there was a significant relation between antioxidant levels and birth weight, we aimed verify this relationship. MATERIALS & METHODS: In this descriptive analytical study we evaluated the antioxidant status of 40 healthy term newborns (gestation age 38-42 wk) with weight >2500 g (AGA) and 40 healthy term newborns (gestation age 38-42 wk) with LBW babies (weight < 2500 g) (SGA) in Ardabil Buali Hospital, Ardabil, northwest Iran in 2014. About 15 Ml of cord blood was collected after the second stage of labor. The levels of vitamin A, E, and C, catalase, glutathione peroxidase (GPX), bilirubin and serum uric acid were measured by standard methods. Informed consent was obtained from newborn mothers and study protocol was approved by university Ethics Committee. Data were analyzed using SPSS.19. RESULTS: The mean levels of bilirubin, vitamin C, E, catalase and GPX in AGA group were significantly higher than SGA group but the mean of serum uric acid in SGA group was more than AGA. In addition, the mean of vitamin A was similar in two groups. There was a significant relation between antioxidant levels and birth weight in term newborns. CONCLUSION: In line with other studies the amounts of antioxidant levels except serum uric acid in AGA group was significantly more than SGA group.

Study on MRI changes in phenylketonuria in patients referred to mofid hospital/iran.

OBJECTIVE: Phenylketonuria is one of the most common metabolic disorders and the first known cause of mental retardation in pediatrics. As Screening for phenylketonuria (PKU) is not a routine neurometabolic screening test for neonates in Iran, many PKU cases may be diagnosed after developing the clinical symptoms. One of the findings of PKU is myelination disorders, which is seen as hypersignal regions in T2-weighted (T2W) and FLAIR sequences of brain MRI. The aim of our study was to assess MRI changes in PKU patients referred to Mofid Children's Hospital, 2010-2011. MATERIALS & METHODS: We studied all PKU cases referred to our clinic as a referral neurometabolic center in Iran for brain MRI and assessed the phenylalanine level at the time of Imaging. The mean phenylalanine level (in one year), clinical manifestations, and MRI pattern based on Thompson scoring, were evaluated. RESULTS: The mean age of our study group was 155±99 months and the mean diagnosis age was 37±27.85 months. There were 15 patients with positive and 15 with negative family history. The mean phenylalanine level at the time of imaging was 9.75±6.28 and the mean 1 year phenylalanine level was 10.28±4.82. Seventy percent of our patients had MRI involvement, in whom 20% showed atrophic changes, in addition to white matter involvement. Based on modified Thompson scoring, the score for our study group was 4.84. The maximum involvement in MRI was in occipital region, followed by parietal, frontal, and temporal zones. There was not any correlation between MRI score and patients' age. But we found significant relationship between MRI score and the age of regimen cessation. No correlation was seen between phenylalanine level (at the time of Imaging) and MRI score. But there was a relationship between mean 1 year phenylalanine level and MRI score. CONCLUSION: According to the results of this study, brain MRI and white matter involvement can be used for evaluation of long-term control of phenylalanine level in PKU cases.