The frequency of vitamin D deficiency among asthmatic Egyptian children

Background: Vitamin D plays a role in the pathogenesis of asthma as it has a potent immunomodulatory effect acting on the cells of the innate immunity. It also reduces the risk of respiratory viral infections which are important initiators of asthma exacerbations. Besides, it potentiates the antiinflammatory action of corticosteroids which are considered the mosteffective controllers of asthma. Objective: To detect the frequency of vitamin D insufficiency and deficiency among Egyptian asthmatic children and to correlate vitamin D levels to the severity of asthma. Methods: This case control study was conducted on 60 asthmatic children and 40 healthy controls. All were subjected to clinical history taking including history of sun exposure and asthma medications and full clinical examination. Laboratory investigations included measurement of serum calcium, serum alkaline phosphatase and serum 25-OH-D levels and lung functions (spirometery). Results: There was a significant correlation between vitamin D deficiency and severity of asthma, yet there was no significant relation between sun exposure and 25-OH-D level. Moreover, there was a significant relation between decreased serum 25-OH-D levels and the intensity of corticosteroid use. Vitamin D was also significantly lower in asthmatic patients with coexistent allergic rhinitis. Conclusion: Vitamin D deficiency is prevalent in Egyptian children with asthma .Lower levels of serum vitamin D are associated with high asthma severity, reduced asthma control and increased corticosteroid use.Keywords: Vitamin D, Bronchial asthma, Egyptian, Childre

ICAR: endoscopic skull‐base surgery

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Management of Traumatic Dacryocystitis and Failed Dacryocystorhinostomy Using Silicone Lacrimal Intubation Set

The aim of this work is to study the management and success rate of traumatic dacryocystitis and failed dacryocystorhinostomy (DCR) using Silicone lacrimal intubation set. A prospective study was conducted at a tertiary eye care hospital, India from February 2006 to January 2008. This study material comprised 50 patients of traumatic dacryocystitis and failed dacryocystorhinostomy. Anterior single flap external dacryocystorhinostomy with Silicon intubation was performed in all the patients. The patients were followed up at weekly intervals for 1 month and thereafter every 2 months for 1 year post operatively. Criteria determining success were based on resolution of epiphora and patency on syringing. In traumatic dacryocystitis, 21(91.3%) cases fulfilled these criteria while 23(85.2%) cases of failed DCR were successful. The overall success rate (88%) was determined with an average follow-up of 1 year. Globally, the technique was effective in 85% of cases. The results were comparable with other similar studies. This study concludes that performing a DCR in traumatic dacryocystitis and failed DCR taking into consideration the complications and chances of failure is a challenge for the surgeon. We opine that External dacryocystorhinostomy with Silicon Intubation is one of the most effective modality in dealing with such cases