Respiratory symptoms and bronchial reactivity : studies on their prevalence and clinical significance

Because there was no agreed operational definition of asthma, an attempt was made to identify, within the community, individuals with a cluster of features which would include those commonly found in asthmatics. We have therefore looked at the prevalencee of some respiratory symptoms and studied in more detail a subgroup of patients looking in particular at bronchial hyperreactivity and its relation to respiratory symptoms.The study comprised two surveys conducted in one area of Southampton, each survey was designed in two phases. The first survey Phase I: Questionnaires were sent to a systematic sample of 2149 subjeects. A response rate of 74% was obtained. 30% of the respondents had shortness of breath, 11% had morning tightness, 6% had nocturnal dysponoea, 27% had wheezing and 12% had productive cough. Phase II: because the prevalence of shortness of breath and wheeze were high and the interrelation between both symptoms four groups were selected at random. Group I subjects with SOB; Group II subjects with wheeze; Group III subjects with both SOB and wheeze; Group IV subjects with neither SOB nor wheeze. Spirometry and histamine challenge were carried out on 102 subjects who attended the department. Bronchial hyperreactivity (BRR) was defined by relating reactivity to specific symptoms,the symptomatic counterpart to BUR 'bronchial irritability'(BI) was defined. On defining ERR and BI a group of subjects with a cluster of features was identified; these features were: BI and/or nocturnal dyspnoea (ND)and/or morning tightness(MT)for more than one hour and BHR. these features constituted by definition a syndrome which was labelled ~SHABI~.The second survey: designed to shed light on this syndrome. Phase I: A simplified version of the questionnaire sent to a systematic sample of 2000 subjects. The response rate was 80%. There were no significant difference between the prevalence of respiratory symptoms in both surveys. Phase II Four groups were selected; Group I ~SHABI~ all subject with one or more of the following: BI, ND, MT&gt;lhr. Group II all subjects with MT&lt;lhr. Group III: random sample from subjects with SOB+wheez. Group IV random sample from subjects with no respiratory symptoms. Spirometry and/or bronchial challenge were carried out on 105 subjects who attended the department. All subjects with ~SHABI~ had BHR. There was positive correlation between FEV1% predicted and PC20 for ~SHABI~ and Group II. All those diagnosed by General Practioners as having asthma were contained in ~SHABI~. The prevalence of ~SHABI~ was 5.5% in men and 4.8% in women between the age of 19-70 years.</p

Parathyroid hormone in pediatric patients with β-thalassemia major and its relation to bone mineral density; a case control study

Background: Thalassemia syndromes are heterogeneous groups of inherited anemias. Its treatment depends on recurrent blood transfusion with a problem of iron overload, which leads to multiple endocrinopathies including hypoparathyroid. The aim of the study is to estimate the level of serum parathyroid hormone and its relation to bone mineral density in transfusion dependent beta-thalassemia major children. Subjects and methods: We measured serum calcium, phosphorus and parathyroid hormone in a sample of pediatric patients with thalassemia, compared them with age and sex matched healthy control. Measurement of bone mineral density by dual-energy X-ray absorptiometry was done in 2 sites: lumbar spine (L2–L4) in the anteroposterior position and left femur neck using Lunar Densitometry in osteoporosis Unit Ain Shams University Hospital for thalassemia patients. Results: Thalassemic patients had significantly higher alkaline phosphatase and lower bone mineral density. Conclusion: Osteopenia in β-thalassemia major patients is multifactorial and is mainly predisposed by defective function of the parathyroid gland and excessive iron deposition

Vitamin D status in hospitalized male patients in Ain Shams University Hospitals and relation to body composition

Background Vitamin D deficiency is highly prevalent worldwide; its effect on bone is well known and understood, but the effect of this deficiency is still not clear. Objective This study examines vitamin D status in Egyptian hospitalized elderly male patients and its relation to body composition, muscle strength, and performance. Design This was a cross-sectional study. Participants and methods Data collected from a previous cross-sectional study, in which a systematic random sampling technique was used where every third patient (skip interval) was included in the study and vitamin D was measured only to a selected number of patient who meets inclusion criteria, were selected for inclusion in the study on the basis of the exclusion criteria, which may have affected the parameters measured. Complete assessment of history and physical examination were performed. Measurements Body composition was measured using bioelectrical impedance analysis (Geratherm), hand grip was measured using a Jamar handheld dynamometer, performance was measured using the timed get up and go test, and 25-hydroxyvitamin D was measured by enzyme-linked immunosorbent assay. Results Our study included 88 elderly men 60 years of age or older; the mean age of the participants studied was 64.74 ± 4.6 years, and 86.3% were married, 22.7% were physically active, and 15.9% were nonsmokers. The mean BMI was 26.4 ± 7.2 kg/m2 and the mean vitamin D level was 12.15 ng/ml. The prevalence of vitamin D insufficiency was 19.3% and that of vitamin D deficiency was 79.5%. Vitamin D deficiency was not associated with age, occupation, marital status, smoking (type, duration, and quantity), hand grip, timed get up and go test, and parameters of body composition. Conclusion Vitamin D deficiency and insufficiency is highly prevalent among elderly Egyptian men, and its impact on body composition, muscle function, and strength is not significantly noticeable