Clarifying the relationship and analyzing the influential factors of bronchial asthma in children with attention-deficit hyperactivity disorder

BACKGROUND Bronchial asthma is closely related to the occurrence of attention-deficit hyperactivity disorder(ADHD)in children,which can easily have adverse effects on children’s learning and social interactions.Studies have shown that childhood asthma can increase the risk of ADHD and the core symptoms of ADHD.Compared with children with ADHD alone,children with asthma and ADHD are more likely to show high levels of hyperactivity,hyperactive-impulsive and other externalizing behaviors and anxiety in clinical practice and have more symptoms of somatization and emotional internalization.AIM To explore the relationship between ADHD in children and bronchial asthma and to analyze its influencing factors.METHODS This retrospective cohort study was conducted at Dongying People's Hospital from September 2018 to August 2023.Children diagnosed with ADHD at this hospital were selected as the ADHD group,while healthy children without ADHD who underwent physical examinations during the same period served as the control group.Clinical and parental data were collected for all participating children,and multivariate logistic regression analysis was employed to identify risk factors for comorbid asthma in children with ADHD.RESULTSSignificant differences were detected between the ADHD group and the control group in terms of family history ofasthma and allergic diseases, maternal complications during pregnancy, maternal use of asthma and allergymedications during pregnancy, maternal anxiety and depression during pregnancy, and parental relationshipstatus (P < 0.05). Out of the 183 children in the ADHD group, 25 had comorbid asthma, resulting in a comorbidityrate of 13.66% (25/183), compared to the comorbidity rate of 2.91% (16/549) among the 549 children in the controlgroup. The difference in the asthma comorbidity rate between the two groups was statistically significant (P <0.05). The results of the multivariate logistic regression analysis indicated that family history of asthma and allergicdiseases, maternal complications during pregnancy, maternal use of asthma and allergy medications duringpregnancy, maternal anxiety and depression during pregnancy, and parental relationship status are independentrisk factors increasing the risk of comorbid asthma in children with ADHD (P < 0.05).CONCLUSIONChildren with ADHD were more likely to have comorbid asthma than healthy control children were. A familyhistory of asthma, adverse maternal factors during pregnancy, and parental relationship status were identified asrisk factors influencing the comorbidity of asthma in children with ADHD. Clinically, targeted interventions basedon these factors can be implemented to reduce the risk of comorbid asthma. This information is relevant for resultssections of abstracts in scientific articles.

Research Progress on Pulmonary Rehabilitation in Children with Bronchial Asthma

Bronchial asthma is a chronic respiratory disease that poses a significant threat to the physical and mental health of children globally.Currently,pulmonary rehabilitation is a non-pharmacological intervention that has shown promise in treating chronic respiratory diseases.However,most studies related to pulmonary rehabilitation only focus on chronic conditions such as chronic obstructive pulmonary disease(COPD),lung cancer,and bronchiectasis.Research on bronchial asthma in children is still in the preliminary stages.This article reviews the concept,basic content,and application mode of pulmonary rehabilitation,to provide reference for the clinical research of pulmonary rehabilitation in children with bronchial asthma,and to carry out multimodal pulmonary rehabilitation to improve the disease control level and quality of life of asthma in children.

Research Progress in Integrated Chinese and Western Medicine Health Management for School-Age Children with Asthma

Objective:The purpose of this study is to investigate the application of Chinese and Western medicine in the health management of school-age children with asthma and its research progress,with a view to providing a more comprehensive and effective management strategy for the clinic.Methods:Using the method of literature review,this study systematically searched and analyzed the relevant studies on the combination of Chinese and Western medicine in the health management of school-aged children with asthma in recent years,focusing on Chinese medicine treatment,Western medicine treatment,and the combined health management of Chinese and Western medicine.Results:Chinese medicine treatment,Western medicine treatment,and the health management mode of combining Chinese and Western medicine showed unique advantages in school-age asthmatic children.Through the comprehensive use of Chinese medicine’s diagnosis and treatment,Chinese medicine conditioning,Chinese medicine characteristic therapy,and Western medicine’s modern medical methods,it not only effectively relieved asthma symptoms but also significantly improved the quality of life of the children.At the same time,this management mode also focuses on the psychological guidance and family care of the children,forming an all-round and multi-level health management system.Conclusion:The health management strategy of combining Chinese and Western medicine has a broad application prospect in school-age asthmatic children,and its specific interventions and mechanisms of action should be further studied to provide more scientific and systematic guidance for clinical practice.

COVID-19 frequency and clinical course in children with asthma

BACKGROUND The epidemic of severe acute respiratory syndrome coronavirus 2 infection,known as the coronavirus disease 2019(COVID-19),has caused a global health concern.Since its emergence,numerous studies have focused on various clinical manifestations and outcomes in different populations.However,studies are ongoing as the consequences and impact of COVID-19 in children with chronic diseases such as asthma are controversial.AIM To fill this research gap by retrospectively evaluating the course,laboratory,and clinical findings of COVID-19 among 414 asthmatic children followed up from the pediatric allergy outpatient clinic and known to have had COVID-19.METHODS The data of 5510 patients over the age of 5 diagnosed with asthma in our hospital's data were retrospectively scanned with specific parameters using protocol numbers from the hospital filing system.The data included retrospective evaluation of pulmonary function test results before and after COVID-19,routine hematological and biochemical parameters,sensitization states(total IgE,specific IgE,and skin prick test results),and radiological(computed tomography)findings.To inquire about the course and symptoms of COVID-19,asthma patients or their parents were then called and evaluated with a questionnaire.RESULTS As a result of retrospectively scanning the data of 5510 asthma patients over the age of 5,it was determined that 414(7.5%)patients had COVID-19.The mean age of 414 patients was 17.18±4.08(min:6;max:28)years.Two hundred and three of our 414 patients are male,and 211 are female.When their vaccination status was questioned,21.5% were vaccinated.When the symptoms of our 290 patients were questioned,it was stated that 59.0% had fever symptoms.The rate of using regular prophylactic asthma medications was 19%.The rate of using salbutamol in asthma was found to be 22%.The rate of patients using methylprednisolone was 1%.Emergency service admission was 17.2%,and hospitalization was found to be 4.8%.Leukopenia(<4000)was found in 14.1%of patients,and 8.08% of our patients had neutropenia(<1500).Lymphopenia(<1500)was detected in 44.4% of patients,and lymphocytosis(>4000)was found in 5.05% of patients.In 65% of our patients,the C-reactive protein value was elevated.A high aspartate aminotransferase and alanine aminotransferase value was detected in 3.2% and 5.4% of patients were found,respectively.31%of patients had an elevated lactate dehydrogenase value.Typical radiological findings for COVID-19 were detected in 3/309 of patients.CONCLUSION According to our study,there is a correlation between the severity of COVID-19 and asthma symptoms and the course of the disease.However,it is worth noting that the retrospective nature of the study and the differences in sample size,age,and demographic characteristics between the two groups do not allow for an optimal comparison.Therefore,further investigation is needed to explore the relationship between COVID-19 and asthma,and it can be suggested that COVID-19 may trigger asthma attacks and asthma may impact the course of COVID-19.

Comparison of Allergic Rhinitis and Bronchial Asthma Impacts on Tympanometric Parameters in Children at Kano, Nigeria

Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction that affects sino-nasal mucosa and is characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness and eyes itching. Bronchial asthma (BA) is one of the common childhood diseases that affects the respiratory system characterized by recurrent cough, wheezing, chest tightness and difficulty with breathing. The two conditions are different manifestations of allergic disease of the airway;the composition of the inflammatory substrate in the mucosa of allergic patients is similar to the late-phase allergic response seen elsewhere in the respiratory tract, such as in bronchial asthma. Aim: The aim was to compare the impacts of allergic rhinitis and bronchial asthma on tympanometric parameters in children. Patients & Methods: This is a hospital based comparative cross-sectional study. Two groups of participants aged 4 - 12 years, one group with documented clinical diagnosis of allergic rhinitis and the other group with documented clinical diagnosis of bronchial asthma were consecutively selected from ear, nose and throat (ENT) and pediatrics cardiopulmonary outpatient clinics of Aminu Kano Teaching Hospital Kano respectively. Equal number of children aged 4 - 12 years with no history of ENT diseases or bronchial asthma that were selected from elementary schools within the same community served as a control group. An interviewer-administered questionnaire was filled out for all the participants, complete ENT and chest examinations were carried out and subsequently all the selected participants had tympanometry done, findings were recorded and analyzed. Results: The mean age of participants with bronchial asthma was found to be 7.5 ± 2.6 years while participants with allergic rhinitis had the mean age of 6.8 ± 2.1 years. The mean middle ear pressure (MEP) of participants with bronchial asthma was found to be -15.22 dapa and -40.32 dapa in those with allergic rhinitis. Acoustic reflex was found to be absent in 15.4% of the participants with bronchial asthma and 29.6% of allergic rhinitis participants. Type B tympanogram was found in 2.8% of bronchial asthma participants and 7.3% in participants with allergic rhinitis. Type C tympanogram was found in 4.6% of participants with bronchial asthma and 15.5% of participants with allergic rhinitis. Type A tympanogram was found in 90% of participants with bronchial asthma and 75% of participants with allergic rhinitis. The difference between type A, B and C tympanograms of participants with bronchial asthma and those with allergic rhinitis was found to be statistically significant (Type A χ2 = 14.62, df = 4, p value = 0.01, Type B χ2 = 14.06, df = 4, p value = 0.01, Type C χ2 = 17.01, df = 6, p value = 0.01). Conclusion: Participants with allergic rhinitis were found to have more abnormalities of tympanometric parameters compared to participants with bronchial asthma which signifies allergic rhinitis conferred an increased risk of having middle ear diseases and otitis media with effusion compared to bronchial asthma.

Unveiling childhood asthma:Exploring biomarkers,zinc,and beyond

This editorial discusses a case-control study by Ibrahim et al,published in the recent issue of the World Journal of Clinical Pediatrics.Childhood bronchial asthma is a chronic inflammatory respiratory disease.It was found that an increase in oxidative stress leads to a decrease in antioxidants causing oxidative damage to mitochondrial respiratory chain complexes resulting in the inflammation of the airway,hypersecretion of mucus causing a cascade of clinical manifestations ranging from recurrent episodes of coughing,wheezing,and breathlessness to shortness of breath.Since oxidative stress mediates the inflammatory response in asthma,the supplementation of anti-oxidants can be one strategy to manage this disease.Zinc is one such antioxidant that has attracted much attention about asthma and airway inflammation.Zinc is a crucial trace element for human metabolism that helps to regulate gene expression,enzyme activity,and protein structure.Apart from zinc,free serum ferritin levels are also elevated in case of inflammation.Several previous studies found that ferritin levels may also help determine the pathology of disease and predict prognosis in addition to tracking disease activity.However,this study's results were different from the findings of the previous studies and the zinc levels did not show a significant difference between asthmatic children and non-asthmatic children but ferritin levels were significantly high in asthmatic children as compared to the controls.Hence,the possible role of the biochemical nutritional assessment including zinc and ferritin as biomarkers for asthma severity should be assessed in the future.

Childhood asthma biomarkers including zinc: An exploratory crosssectional study

BACKGROUND Childhood bronchial asthma(BA)is a chronic inflammatory respiratory disease.Nutritional conditions,including zinc deficiency,can affect such allergic disorders.AIM To outline the difference in serum zinc levels between asthmatic children and healthy controls.METHODS A cross-sectional study was carried out at Children’s Hospital,Cairo University,investigating serum zinc levels in children with BA(n=40)and healthy children(n=21).Other markers included serum ferritin,iron,hemoglobin(Hb),and immunoglobulin E(IgE)levels.Independent t-tests and Mann-Whinny tests were used for comparisons.The Kruskal-Wallis test was applied to compare serum ferritin and IgE levels with regard to asthma severity.Spearman's rank correlation was performed to explore the relationship between serum ferritin levels and both iron and Hb levels in asthmatic children.RESULTS Children with BA had higher levels of zinc,yet the difference was not significant(P=0.115).Serum ferritin and IgE levels were significantly higher in asthmatic children(P=0.006 and 0.001,respectively),yet their levels did not differ significantly by severity(P=0.623 and 0.126,respectively).There was a nonsignificant weak correlation between serum ferritin levels and both serum iron and Hb levels.CONCLUSION Serum zinc levels do not seem to differ between asthmatic children and healthy children.Serum ferritin levels may be a marker of asthma control.Serum IgE levels are not markers of asthma severity.

Pattern of Acute Asthma Seen in Children Emergency Department of the River State University Teaching Hospital Portharcourt Nigeria

Acute exacerbations of asthma are one of the leading causes of emergency room visits and hospitalizations in children. Asthma exacerbations also demonstrate a seasonal pattern in which high rates can be seen at a particular season and knowledge of the seasonal pattern of asthma exacerbation in any locality can improve asthma management. Objective: To determine the prevalence, management outcome and seasonal pattern of emergency department visits for acute exacerbation of asthma. Methods: This was a retrospective review of the emergency department register of all asthma admissions in the Rivers State University Teaching Hospital, Portharcourt, Nigeria over a five year period from January 2014 to December 2018. Results: A total of 205 (2.9%) asthma-related visits were recorded out of 7046 emergency room visits. The mean age of the patients was 6.1 (±4.2) yrs, with an M:F ratio of 1.97:1. The median length of hospital stay was 24 hrs. Children older than 11 yrs were more likely to be admitted for >48 hrs (OR 4.18, 95% CI;1.67, 10.39, P;0.003). Emergency department visits for asthma were more in the rainy season April-September 129 (63.9%) with a peak in May. There is a significant variation in the seasonal pattern of emergency room asthma admission with age (P = 0.018). Children >3 yrs have their highest admission rates in May while younger children experience two peaks in February and November. Conclusion: Asthma exacerbation is more in rainy season among children in Portharcourt although there is a variation in seasonal pattern of asthma exacerbation with age.

Analysis of montelukast in combined with extended care applied in children with bronchial asthma

Objective:To explore the application effect of montelukast in combined with extended care in children with bronchial asthma.Methods:A total of 80 children with bronchial asthma who were admitted in our hospital from May, 2014 to May, 2015 were included in the study and randomized into the observation group and the control group with 40 cases in each group. The patients in the two groups were given routine treatments and pidotimod granules. On this basis, the patients in the observation group were given additional montelukast and extended care after discharge. The fasting peripheral venous blood before treatment and 3 months after treatment in the two groups was collected. The immunoturbidimetry was used to detect the serum IgA, IgG, and IgM. The pulmonary function detector was used to detect FEV1, FVC, and PEF. Follow-up visits were paid to record the asthma attack times, readmission rate, re-first aid rate, and first aid times after discharge within 1 year.Results:IgA and IgG after treatment in the two groups were significantly elevated (P<0.05), while IgM had no significant change (P>0.05). The elevated degree of IgA and IgG in the observation group was significantly greater than that in the control group (P<0.05). FEV1 (L), FVC (L), and PEF (L/min) after treatment in the two groups were significantly elevated when compared with before treatment (P<0.05). The elevated degree of FEV1, FVC, and PEF in the observation group was significantly greater than that in the control group (P<0.05). The asthma attack times, readmission rate, re-first aid rate, and first aid times after discharge within 1 year in the observation group were significantly lower than those in the control group (P<0.05).Conclusions:The routine treatment in combined with montelukast can better effectively control the symptoms in children with asthma, and improve the pulmonary function. After discharge, the extended care can be more beneficial to control the asthma attack, and enhance the living quality.

Clinical Analysis of Dispelling Wind,Eliminating Lung and Relieving Cough Combined with Western Medicine in the Treatment of Cough Variant Asthma in Children

Objective:This study mainly explores the clinical effect of dispelling wind,eliminating lung and relieving cough combined with western medicine in the treatment of cough variant asthma.Methods:80 children with cough variant asthma accepted by our hospital from January 2018 to December 2020 were randomly selected for the study and divided into two groups.One group was the reference group(40 cases)treated with procaterol hydrochloride tablets and montelukast sodium,and the other group was the research group(40 cases)・The method of eliminating wind,eliminating lung and relieving cough was combined with procaterol hydrochloride tablets and montelukast sodium to observe and compare the curative effects of the two groups.Results:There was no significant difference in TCM symptom score and eosinophil(EOS)count between the two groups before treatment(P>0.05);After treatment,the TCM symptom scores of coughs,pharyngeal itching,expectoration,nasal congestion and nasal itching in the research group were lower than those in the reference group,and the EOS count was lower than that in the reference group(P<0.05);The effective rate of research group was higher than that of reference group(P<0.05).Conclusions:For children with cough variant asthma,Qufeng Sufei cough relieving method combined with procaterol hydrochloride and montelukast sodium can improve children's symptoms and reduce eosinophil count.

Cross-sectional population based study examining the impact of children with asthma on US rural families

Introduction: Approximately 7.1 million US children have asthma. The burden of asthma is disproportionate with ruralUSpopulations experiencing a higher prevalence of the disease. Rural populations experience additional disparities regarding health care access, job availability, and daily living resources. Hence, the family impact of having a child with asthma may be influenced by geographic locale. This impact could be a result of health insurance tied to employment, out of pocket costs, and health care provider availability. Few studies have assessed the impact a child’s asthma has on a family. This study sought to answer the question: What is the impact of children with asthma on US rural families? Methods: Multivariate techniques were performed to examine a single year of data from two connected population-based datasets, the 2007-2008 National Survey of Children’s Health and the 2009-2010 Children with Special Health Care Needs Survey. Children with current asthma defined the study population for both datasets. A logistic regression model was performed for each database. The dependent variable for the first model was child in family currently has asthma, for the second it was rural children with current asthma. Results: The first logistic regression model confirmed that rural children were more likely to have asthma than non-rural children. The second logistic regression model yielded that rural families with a child diagnosed with asthma had greater odds of: not having health insurance, having a parent who stopped working, avoided a job change, or experienced financial problems because of the child’s health. Conclusions: This study demonstrated that rural families experience a disproportionate financial hardship as a result of their child’s asthma. Pharmacist intervention in asthma care in rural areas has the potential to decrease the financial burden for a family while also improving a child’s health.

Primary study on correlation betweenβ_2-adrenoceptor haplotypes and asthma in children of Han nationality in Chongqing

Objective:To investigatethecorrelationbetweenβ 2 -adrenergicreceptors(β 2 -AR)haplotypesandasthmaof Hannationalitychildrenin Chongqingregion.Methods:PCRandrestrictionfragmentanalysiswereusedto study16,27lociof theβ 2 -ARpolymorphismin76unrelatedasthmaticchildrenandin100healthychildrenandadultsof Hannationali-ty as control.A statisticalanalysisof thecorrelationbetweenglycine(Gly)16allele,Gly16/glutamine(Gln)27haplotype andasthmaticclinicalstatuswas carriedout.Results:Therewas no significantincreaseof thefrequencyof Gly16and Gln27alleleintheasthmaticgroupas comparedwiththecontrolgroup(P>0.05).Therewasa significantincreaseof the frequencyof Gly16alleleandGly16/Gln27haplotypein severeasthmaticcasesthanin themildandmoderateasthmatic ones(P<0.01,0.05).Conclusion:Itis consideredthatasthmais notcausedby GlyandGlnallelesofβ 2 -ARpolymor-phisms.Gly16alleleandGly16/Gln27haplotypearepossiblycorrelatedwiththeseverityof theclinicalmanifestationsin thechildrenof HannationalityinChongqing.

The Association of PM2.5 and Surface Ozone with Asthma Prevalence among School Children in Japan: 2006-2009

Researches on asthma have found that air pollution increased asthma prevalence among sensitive age groups, including school children, and exposed them to the recognized health impacts. The aim of this study is to examine the association between elevated annual mean concentration of PM2.5 (particulate matter with aerodynamic diameter less than 2.5 micrometers) and surface ozone and asthma prevalence among school children in Japan from 2006 to 2009. Annual rates of asthma prevalence among preschool and school children (5 to 11 years) are obtained from the database of the Ministry of Education, Culture, Sports, Science and Technology—Japan (MEXT). Data on the concentrations of PM2.5 and surface ozone were obtained from 1,183 stations of air quality monitoring distributed in 47 prefectures. Annual means of these concentrations were compared to annual variations in asthma prevalence by using Pearson correlation coefficient. We found different associations between the annual mean concentration of PM2.5 and surface ozone and the annual rates of asthma prevalence among preschool and school children from 2006 to 2009. The positive values of the correlation coefficient in prefectures such as, Gumma, Shimane, and Niigata, are consistent with the previous knowledge. However, significant inverse associations were found in many prefectures. Our study suggests that the association between elevated concentrations of PM2.5 and surface ozone and asthma prevalence among school children in Japan is not strong enough to assume concretely a plausible and significant association.

Comparison of treatment guidance based on bronchial responsiveness to mannitol, spirometry or exhaled nitric oxide in stable asthmatic children

Aim: The goal of this study was to compare asthma treatment guidance based on bronchial hyper-responsiveness to mannitol, spirometry or exhaled nitric oxide (FeNO) in stable asthmatic children. Methods: 60 stable allergic asthmatic children aged 7 to 16 years on a low to medium dose treatment with inhaled corticosteroids (ICS) were recruited to a double blind randomised controlled trial. At study entry (visit 1), the following was assessed: FeNO, spirometry, bronchial hyper-responsiveness to mannitol (MDP-?test), quality of life (paediatric asthma quality-of-life questionnaire;PAQLQ) and asthma control (asthma control test;ACT). Subjects were randomly assigned to one of three groups and treatment was modified by a blinded respiratory physician according to the test results of visit 1: ICS dose was doubled when FeNO was >22 ppb (group 1), in case of a positive MDP-test (group 2) or when FEV1 was <80% of a predicted one (group 3), respectively, or remained unchanged for the remaining subjects. After 3 months (visit 2), the subjects were reassessed and all tests were repeated. Results: 48 children successfully completed the study. At the first visit, 8 out of 16 (50%) children in group 1 showed a FeNO > 22 ppb, 8 children out of 16 (50%) in group 2 showed a positive MDP-test and 3 children out of 16 (18.7%) in group 3 had a FEV1 < 80% of that predicted and had their ICS-dose doubled. In group 1, FeNO decreased significantly after the intervention (p = 0.005), whereas the self-administered and the interviewer-administered PAQLQ (p = 0.02 resp. p = 0.033) as well as the ACT (p = 0.031) increased. Neither the number of children with a positive mannitol challenge nor spirometric results changed significantly. In group 2 and group 3, there were no significant changes in none of the assessed parameters. Conclusion: In this small pragmatic double blind randomised controlled study, we showed that ICS dose modification based on FeNO led to increased quality of life and enhanced asthma control, and to a reduction in airway inflammation and was superior to treatment modifications based on bronchial hyper-responsiveness to mannitol or on FEV1.

Asthma in Children at the Pediatric Intensive Care Unit of University Hospital of Brazzaville (Congo)

Objectives: To describe the epidemiological, clinical and therapeutic aspects of asthma in children at the Pediatric Intensive Care Unit of University Hospital of Brazzaville. Patients and methods: We reviewed the records of children hospitalized in the Pediatric Intensive Care Unit of University Hospital of Brazzaville from January 1 to December 31, 2015, and retained those from two months to 17 years hospitalized for asthma. The study variables were: age, sex, influence of seasons, history of atopy;the factors triggering the crisis, the type of follow-up, the degree of severity of asthma exacerbation, the type of treatment instituted and the course of the disease. In total, out of 2012 hospitalized children, 65 children met the inclusion criteria. Results: The hospital prevalence of asthma was 3.5%. Among 65 children of study, 42 (59.2%) were male and 29 (40.8%) female. The mean age was 3.9 ± 2.9 years (range from 2 months to 14 years). Children aged 30 months to 5 years were the most represented (40%). They were known as asthmatics, n = 18 (27.7%). Family atopy was found, n = 11 (16.9%). Acute Otorhinolaryngologic infections were in all cases the factors triggering the crisis. The peak frequency of hospitalizations for asthma occurred during the short rainy season. The crisis was moderate n = 46 (70%) and severe n = 19 (29%). Beta 2 mimetics were administered in all cases, by subcutaneous in 18 cases (27.7%) and inhaled in 47 cases (72.3%). The outcome was favorable in all cases with a mean hospital stay of 1.46 ± 0.92 days. Conclusion: Childhood asthma remains a public health challenge and severe asthma is the paradigm of uncontrolled and costly asthma. This first work suggests that a large-scale study be carried out for a better knowledge of it.

Association between Asthma and Dental Caries amongst 12 - 15 Years Old Children: A School-Based Cross-Sectional Study in Karachi, Pakistan

Objective: The study aimed to determine an association between dental caries and asthma among 12 to 15 years old children. Methods: This is a school-based cross-sectional study conducted from January to February 2016. A random sample of 544 children aged 12 - 15 years were enrolled from five private schools of Karachi. Dental caries was assessed using DMFT Index (Decayed, Missing, Filled teeth). The main exposure variable was asthma and information on it was collected through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Results: The data was analyzed using Cox Proportional Hazard algorithm. Crude and adjusted prevalence ratios with 95% CI were reported. Total 554 children, 306 (56.3%) boys and 43.7% girls participated in the study. Mean age of children was 13.2 ± 0.05 years. Total number of children with DMFT > 0 was 30.5%. The decayed component contributed largely (22.8%) to the DMFT score. Overall prevalence of asthma was 20%. Prevalence of caries in asthmatic children was 28.4% as compared to 31% among non-asthmatic children. Adjusted prevalence ratio of dental caries in asthmatic children was 0.8 (95% CI 0.6 - 1.3) after adjusting for carious food intake, age, oral hygiene index and dentist visit;the association between asthma and dental caries turned out to be in-significant. Conclusions: There was no association observed between asthma and dental caries among the children examined in this study.

Barriers of Asthma Care among Asthmatic Children in Saudi Arabia: Maternal Perspectives

Background Bronchial asthma is one of the most common chronic conditions among children. Despite the improvement in asthma treatment regimens, its prevalence and related morbidity are increasing, especially among underserved, minority children. There are barriers in the management of asthma, which may impact the quality of outcomes. The goal of this study is to explore these barriers. Methods A cross-sectional study was conducted on interview data collected through 2019 from mothers of children (aged 6 - 12 years) with asthma visiting, for convenience, a public shopping mall. The interviewees were randomly selected, because they met the inclusion criteria. Participants were considered if the mother answered “yes” to the following questions: Has your child had physician-diagnosed asthma? Is your child currently taking asthma medications of asthma? Two community nurses conducted the interviews. Data was obtained using administrative questionnaires. Data were analyzed using SPSS version 21.0 (IBM Inc., Chicago, IL, USA). Descriptive statistics of percentage, mean, frequency and standard deviation were applied for categorical and continuous variables. Results Three hundred mothers participated in this study. Their average age was 36.8 years, 55% were housekeepers by profession, and 34% had obtained less than high school education. The majority of children (61%) were males, 45% had moderate asthma, and 42% had mild asthma. The most frequent types of barriers identified by parents were environmental factors (67.7%), followed by health care providers (63%), the health care system (48%), and patient or family characteristics (43%). Mothers were specifically concerned about the use, safety, and long-term complications of medications, the impact of exercise limitation on their child’s quality of life, and their own quality of life. Conclusion This study showed several barriers against asthma care in Saudi Arabia, which mainly related to environmental or personal characteristics. This highlights the need to enhance current policies within the health care system in Saudi Arabia to overcome these barriers.

TCM Treatment of Asthma in Children with Yin Hua Wu Mei Tang——Professor Liu Bichen's Experience in Treating Asthma

Asthma is characterized by paroxysmaldyspnea,rales in the throat,difficulty in breathing,and inability to lie horizontally.It is commonly seenin children with a weak body constitution,and tendsto be intractable,thus being harmful to the

Effect of pediatric massage in the treatment of chronic persistent asthma in children: A systematic review and meta-analysis of randomized controlled trials

Objective:To systematically evaluate the clinical effect of pediatric massage on chronic persistent asthma in children.Methods:We searched relevant literatures through PubMed database,Embase database,Cochrane library,Wanfang database,CNKI and VIP database to screen randomized controlled trials that met the inclusion criteria.According to Cochrane bias risk assessment criteria,the quality of the included literature was evaluated.Finally,Stata 15.1 software was used to analyze the extracted data.Results:A total of 18 studies,1656 participants were included in our Meta analysis.The pooled results showed that pediatric massage therapy could significantly increase clinical efficacy[OR=3.95(2.88,5.41),P<0.001],improve lung function[FEV1:SMD=0.90(0.20,1.61),P=0.012]and[PEF:SMD=0.74(0.58,0.91),P<0.001],reduce asthma attacks[SMD=1.25(-1.63,-0.87),P<0.001]and upper respiratory tract infections[SMD=-1.39(-1.63,-1.15),P<0.001];Conclusion:Pediatric massage therapy has a significant effect in the treatment of chronic persistent asthma in children.It can not only improve the pulmonary function,but also effectively prevent the onset of asthma.

Effects of budesonide inhalation and montelukast on airway function and serum inflammatory factors in children with asthma

Objective: To investigate the effect of budesonide and montelukast on airway function and serum inflammatory factors in children with asthma. Methods: A total of 72 children with bronchial asthma were selected as the subjects, and randomly divided into the observation group (36 cases) and the control group (36 cases). The children in the control group were treated with Budesonide Aerosol, and the observation group was treated with montelukast sodium on the basis of the control group. The airway function and the level of inflammatory factors were detected and compared between the two groups. Results: Before treatment, there was no significant difference in TEF25%, TEF50%, TEF75% and FEV1/FVC between the two groups;After treatment, the TEF25%, TEF50%, TEF75% and FEV1/FVC of the two groups were improved before treatment, and the indexes in the observation group were higher than those in the control group, the difference was statistically significant. Before treatment, the IL-4, IL-6, IL-8, IL-17, TNF- alpha levels in the two groups were not statistically different;After treatment, the levels of IL-4, IL-6, IL-8, IL-17 and TNF- in the two groups were lower than those before the treatment, and the indexes in the observation group were lower than those in the control group, and the differences were statistically significant. Conclusion: Budesonide inhalation combined with montelukast can improve the airway function and inflammatory factors in children with asthma.