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Background: Children of atopic dermatitis (AD) have difficulties in social adaptation and academic achievements. Health related quality of life (HRQOL) is a multidimensional measure not restricted to physical effects of disease or its treatment. Objective: We sought to assess, through validated questionnaire sets, the impact of AD on the HRQOL of children and their parents or caregivers. Methods: This analytical cross-sectional study was conducted on 85 children with physician diagnosed AD recruited from the Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University from May 2018 to December 2019. HRQOL of the patients was assessed using the Children’s Dermatology Life Quality Index (CDLQI) and that of parents/caregivers was assessed using the Family Dermatology Life Quality Index (FDLQI). Results: Analysing the CDLQI revealed that more than half of the studied sample (55.4%) had an extremely affected quality of life (QOL). The most affected physical aspects were itching and pain. There was statistically significant effect of face eczema on QOL of children. We also found that 65.9% of parents/caregivers had a significantly affected QOL score and the most frequently reported problems were emotional distress and treatment burden. The presence of other allergies in the affected child, other sib affection and adverse effects of treatment were the most significant distressing factors on the QOL of parents/caregivers. Poor QOL of children also impacted their parents’ mental and physical health .Conclusion: AD affects the QOL of both children and their guardians in many aspects. There is necessity to pay more attention to the psychological and social aspects in the children with AD and to respect their parents’ psychosocial impact and financial burden within the integrated management plans of AD.
Background: BclI is the promoter polymorphism observed within human glucocorticoid receptor gene (hGR/NR3C1) which plays an important role in the development of bronchial asthma (BA) and resistance to Glucocorticosteroids (GCs) in the severe BA. Objective: To assess the influence of BclI gene (rs41423247) polymorphisms on phenotypic expression of bronchial asthma in a group of Egyptian asthmatic children. Methods: This case control study included 135 asthmatic children with varying degrees of asthma severity. They were recruited from Allergy and Pulmonology Outpatient Clinic, Cairo University. Ninety healthy age and sex matched children served as the control group. Determination of BclI single nucleotide polymorphism (SNP) was done by polymerase chain reaction restriction fragment length polymorphism (PCR- RFLP). Results: Our results revealed that the variants of BclI polymorphism: CC/CG/GG was found with frequency 73.3%, 26.7%, 0% in control group. While in asthmatic children, their frequency was 42.2%, 51.1%, 6.7%, respectively. This revealed a significant difference in distribution between cases and control, similarly there was a significant difference in frequency of allele G between both groups (P-value <0.001). The frequency of allele G/C showed statistically significance association with increased severity of bronchial asthma (P-value<0.001), with uncontrolled asthma and hospitalization (P value <0.001). Conclusion: The Bcl I polymorphism of hGR/NR3C1 gene is significantly associated with bronchial asthma. The GG phenotype is significantly associated with increased susceptibility to the development of severe asthma and uncontrolled asthma symptoms, with increased risk of hospitalization.
Background: Asthma is an airway inflammatory disorder with functional and structural changes. Regulatory T (T reg) cells are important in controlling immune responses. The study was aimed to investigate the frequency of Treg cells in obese asthmatic children, in comparison to non-obese asthmatics and healthy matched controls .Methods: In addition to anthropometric and body mass index (BMI) assessment, peripheral blood samples from healthy control subjects (n = 30) and asthmatic obese (n=30) and asthmatic non-obese children (n=30) were examined for serum IgE, eosinophils counts, and flowcytometric measurement of CD4+CD25+CD127 low/neg- T cells. Pulmonary function testing was performed for asthmatic children .Results: Obese asthmatics showed significantly higher levels of serum IgE and CD4+CD25+CD127 low/neg- T cells as compared to healthy controls (p < 0.001, 0.001, respectively) while comparable numbers of T reg cells were found among obese and non-obese asthmatic children. Asthmatics receiving inhaled corticosteroids (ICS) showed higher percentages of CD4+CD25+CD127 low/neg- T cells than the non-receivers (median 11.8% vs 8.8%, p <0.001). No significant correlations were found between Treg and age, eosinophil percentage, total serum IgE, pulmonary functions, or BMI and its Z score .Conclusion: Our study demonstrates an increased frequency of Treg cells in asthmatic children compared to controls with possible association with the use of ICS but not with obesity. Small sample size and lack of obese non-asthmatic group are the main points of limitation in our study.
Background: JIA is known to affect the physical and social wellbeing and impact scholastic achievement of children. Health-related quality of life (HRQOL) is an important outcome measure in understanding the impact of chronic illness. Objective: We sought to evaluate the HRQOL of a group of children with juvenile idiopathic arthritis (JIA) to uncover their main problems that might prevent them from leading a normal life . Methods: We consecutively enrolled 119 JIA patients who were classified according to the ILAR criteria into 16 cases with oligoarticular (13.4%), 36 with polyarticular (30.3%) and 67 with systemic JIA (56.3%). They were 62 (52.1%) males and 57 (47.9%) females with a mean age of 7.7 years. Patients were evaluated by the Pediatric Quality of Life Inventory TM Version 4.0 (PedsQLTM) questionnaire. Results: Physical and feeling problem scores were negatively correlated to age, age at onset, diagnostic lag and diseases duration. The learning problem score showed negative correlation with age, age at onset and receival of non-steroidal anti-inflammatory drugs (NSAIDs) pointing to the favorable effect of pain control on the quality of life. Also, learning and social problem scores were positively correlated to the diagnostic lag. Total scores showed negative correlation with age and age at onset. Conclusion: JIA has an important impact on the HRQOL and normal development. Pain control is mandatory for reduction of learning problems via the judicious use of NSAIDs and the delay in diagnosis was associated with unfavorable learning and social outcome.
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