The prevalence of bronchial asthma and allergic rhinitis has been on the rise in India. Cannabis is reported to be one of the allergenically important airborne pollen identified by the clinico-immunologic evaluation in the spring season in India. We report a case of 38-year-old male patient with typical clinical manifestations of bronchial asthma and allergic rhinitis that classically exacerbates during the pollination period of Cannabis. On evaluation, the patient was found to be significantly sensitized to Cannabis sativa. Subsequent subcutaneous immunotherapy leads to marked improvement in control of asthma as well as improved quality-of-life.

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Background: Indoor combustion source, like incenses, are commonly used for aesthetic and religious purposes in various indoor as well as outdoor environments. The combustion leads to the production of a large amount of smoke, which can pose a health risk due to inhalation exposure of particulate matter (PM). Objective: Monitoring of PM (PM ₁₀ , PM _2.5 , and PM ₁ ) during the preburning, burning and postburning phases of incenses (agarbatti and dhoop) and mosquito coil in the indoor environment. Materials and Methods: The monitoring of PM was carried out using the Grimm Portable Laser Aerosol Spectrometer and dust monitor model 1.108/1.109. The substances used were mosquito coil, incense (sandal), incense (floral sticks) and dhoop. The data were analyzed using the SPSS statistical package version 14.0 for windows (SPSS, Chicago, IL, USA), using one-way analysis of variance to compare the PM ₁₀ , PM _2.5 and PM _1.0 concentration levels. Results: The mean concentrations of PM ₁₀ (1879.7 μ/m ³ ), PM _2.5 (1775.4 μ/m ³ ) and PM ₁ (1300.1 μ/m ³ ) during burning phase were highest for dhoop. The mean concentrations of PM ₁₀ , PM _2.5 and PM ₁ during burning of mosquito coil were 259.2 μ/m ³ , 232.4 μ/m ³ and 214.0 μ/m ³ respectively. The burning of incense (flora) had PM ₁₀ (854.1 μ/m ³ ), PM _2.5 (779.8 μ/m ³ ) and PM ₁ (699.8 μ/m ³ ), which were higher, in comparison to burning of incense (sandal). The particulate emission during the burning of dhoop (PM _10, PM _2.5, PM ₁ ) was significantly higher (P < 0.05) than incense (sandal and flora) and mosquito coil. The concentrations of PM ₁₀ , PM _2.5 and PM ₁ even during postburning phase were significantly higher for dhoop in comparison to other three products, resulting in prolonged exposure even after the cessation of burning phase. Conclusion: The study suggests burning of dhoop, incense sticks and mosquito coil in the indoor environment emit quiet higher respirable PM, which may accumulate on prolonged exposure and lead to respiratory illnesses.

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Nine hundred and eighteen patients with bronchial asthma and/or allergic rhinitis including 548 (59.69%) males and 370 (40.31%) females with a mean age of 30.10 years were studied for skin sensitivity to various aeroallergens by skin prick test. The maximum numbers of patients (261; 28.43%) were between age group of 20 to 29 years. Patients diagnosed with bronchial asthma were 191 (20.81%), allergic rhinitis were 305 (33.22%), and both bronchial asthma and allergic rhinitis were 422 (45.97%). Significant skin positive reactions (2+ and above) were found in 657 (71.57%) subjects, which included 130 (14.16%) of bronchial asthma patients, 208 (22.66%) of allergic rhinitis patients, and 319 (34.75%) of both. The younger adults aged 20-29 years were the most commonly affected group with 197 (21.46%) significant skin positive patients. Insects (43.90%) followed by various types of weed pollens (21.79%), tree pollens (15.14%), dust (14.49%), house dust mite (12.42%), fungal spores (11.98%), grass pollens (7.73%), kapok cotton (2.18%), silk (1.31%), and wool (0.76%) were the offending allergens. Among individual allergens, most common aeroallergen was moth (33%), and least common was ehretia (0.54%). Among grass pollens, Cynodon (3.05%) was most common, and least common grass pollen aeroallergen was Pennisetum (1.74%). Among weed pollens, Ageratum (5.45%) was most common, and least common was Chenopodium album (1.53%). Among tree pollens, Holoptelia (5.01%), was most common, and least common was Ehretia (0.54%). Among dust, the wheat dust (8.28%) was the most common, followed by house dust (7.08%), and least common was paper dust (1.53%). Among the fungal spores, Aspergillus fumigatus (4.25%) were the most common, and least common was Candida (1.09%). Among insects, moth (33%) followed by mosquito (31.92%) were the most common, and least common was rice weevil (12.75%). When compared with the pattern of our study, there was significantly increased in sensitization to various allergens.

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Background: Exposures to various aeroallergens play a crucial role in the pathogenesis of bronchial asthma (BA) and allergic rhinitis (AR). On the basis of climate change, the prevalence of aeroallergens may vary in different regions. AIMS: The aim of the study was to determine the prevalence of the sensitivity to aeroallergens among patients with BA and/or AR based on skin prick test (SPT) reactivity in India. Settings And Design: This study was conducted at National Centre of Respiratory Allergy, Asthma and Immunology and Department of Respiratory Allergy and Applied Immunology, (Department of Respiratory Medicine), Vallabhbhai Patel Chest Institute, University of Delhi, Delhi-110007 (India). Subjects And Methods: A total of 4835 patients were screened from the Outpatient Department of institute during the period of August 2008 to July 2016. Out of 4835 patients, 4263 patients were performed SPT consisting of 2361 (55.38%) males and 1902 (44.62%) females, with a mean age of 30.06 years were included in the study. Diagnosis of BA and AR was made according to the GINA and ARIA guidelines, respectively. SPT was done with 58 different types of aeroallergens, which included grass pollens, weed pollens, tree pollens, dust, fungi, insects, kapok cotton, wool, and silk antigens. Statistical Analysis Used: Data analysis was done using Excel 2007. Results: Significant skin positive reaction (2 + and above) against aeroallergens were found in 1993 (46.77%) participants including 422 (9.9%) BA patients, 570 (13.37%) AR patients, and 1001 (23.48%) of both BA/AR. The younger adults aged 20–29 years were the foremost commonly affected group with 626 (14.68%) significant skin-positive patients. Among individual allergens, most common aeroallergen was mosquito (30.89%) and least common was Ehretia (0.37%). Conclusions: In different states of India, the mosquito was found the most common sensitizing allergen in BA and/or AR patients. Sensitization was the most common in the younger age group (20–29 years) patients.

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Background: The prevalence of asthma is increasing in the developing world. Asthma, management guidelines have been instituted to provide recommendations for the optimal control of asthma. This study evaluated the current level of asthma control as reported by the patients, which may be a reflection of adherence to guidelines. Materials and Methods: Asthma patients referred to a respiratory diseases clinic were recruited for the study. The asthma control test (ACT) was administered on the patients and data were also obtained for medication use and disease monitoring. A total ACT score of <20 signified poor control. Results: Out of 78 patients, 70 completed the survey (89.7%). The average age of patients was 46 ± 18 years (mean ± standard deviation). The average ACT score was 14.4 ± 4.8 82.9% of patients had poor control. 57.1% of patients who perceived their asthma to be well or totally controlled were objectively assessed to be poorly controlled. More than half of the patients used short acting β2 agonist alone and only 20% used inhaled corticosteroids for maintenance therapy. Thirty eight patients made unscheduled emergency room visits in the past 12 months and 68.8% could not use their inhaler devises well. Emergency room visits (odds ratio [OR] 9.5) and poor inhaler technique (OR 18.9) was independent predictors of poor asthma control. Conclusion: The current level of asthma control among patients in Uyo is below guideline recommendations. Management of patients did not appear to follow guideline recommendations and patients tend to over-estimate their disease control.

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Background: Allergic rhinitis (AR) is the most common type of chronic rhinitis, affecting 10-20% of the population. Severe AR has been associated with significant impairments in quality of life, sleep, and work performance. A role for vitamin D in the regulation of immune function was first proposed after the identification of vitamin D receptors in lymphocytes. It has since been recognized that the active form of vitamin D, 1α, 25(OH) 2D3, has direct affects on naïve and activated helper T-cells, regulatory T-cells, activated B-cells and dendritic cells. There is a growing researches linking vitamin D (serum 25(OH) D, oral intake and surrogate indicators such as latitude) to various immune-related conditions, including allergy, although the pattern of this relationship is still yet to establish. Such effects of vitamin D can significantly affect the outcome of allergic responses like in AR. Aims and Objectives: To evaluate nasal symptom scores in patients of AR, pre- and post-treatment with and without supplementation of vitamin D. Materials and Methods: Vitamin D levels were assessed in 21 patients with AR diagnosed clinically and evaluated prospectively during the period of 1 year. Pre- and post-treatment vitamin D3 serum levels measured and documented. They received oral vitamin D (chole-calciferol; 1000 IU) for a given period. The results were compared with the patients having AR - treated conventionally without supplementation of vitamin D. Results: Improvement in the levels of serum vitamin D levels were significant in post-treatment patients (P = 0.0104). As well as clinical improvement in terms of reduction in the total nasal symptom score was also significant in the post-treatment patients (P < 0.05). Conclusion: Supplementation of vitamin D in such patients alters natural course of AR toward significant clinical improvement.

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The practice of Allergy and Immunotherapy is not streamlined in our country and there were no guidelines till we published in 2009 in IJAAI. The guidelines are updated now incorporating the additional information after 2009. The purpose of bringing out these guidelines was to maintain the uniformity in the methods of diagnosis and management i.e. Immunotherapy in the country. Because of different soil conditions, temperature, different allergens, different seasonal variations etc, it was the felt the need to have separate guidelines for India, although such guidelines are available from other organisations. These guidelines are based on available guidelines with modifications/alterations at appropriate places keeping in mind the situation in our country.

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Background: Aeroallergens as one of the most common cause of allergic disease derived from pollens, dust mites, fungi, and animals. The prevalence of aeroallergens is different in various areas. Objectives: This study was designed to identify the frequency of sensitization to aeroallergens in patients with allergy in Shiraz, Southwestern Iran. Materials and Methods: This descriptive study included 656 patients with allergy from Southwestern Iran from July to December 2014. Sensitization to aeroallergens was assessed by skin prick test using a panel of common 15 aeroallergens in studied patients. Results: A positive skin test to at least one of the applied allergens was seen in 74.5% of our patients. The female to male ratio and mean age of the patients were 1.27 and 27.6 ± 14.7 years, respectively. Pollens were the most common type of aeroallergens (64.6%), followed by dust mites (34.6%), cockroach (30.6%), and molds and cat hair (16% for each). Among pollens, the frequency of sensitization to weeds, grasses, and trees was in turn. Conclusion: The results of the present study revealed that pollens play as a main sensitizing allergen in asthma, allergic rhinitis, and eczema. This pattern was compatible with the results from studies carried out in this area.

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Objective: Identification of common allergens by skin prick test in patients of united airway disease. Materials and Methods: Skin prick test was performed in 60 patients of United Airway Disease to identify the common allergens. A total of 62 allergens consisting of 36 types of pollen, 5 fungi, 4 insects, 8 type of dusts, 4 dander, 3 fabrics, Dust mite and Parthenium leaves were tested. Result: Most common allergens were Dust mite (60%) followed by Parthenium leaves (45%), insects (18.75%), pollen (14.81%), dust allergens (8.51%), fabrics (8.33%), fungi (5.66%), dander (5%). Most common insect allergens were cockroach (female) (30%), cockroach (male) (23.33%). Common pollens were Ricinus communis (28.33%), Amaranthus spinosus (28.33%), Parthenium hysterophorus (26.66%), Eucalyptus tereticornis (26.66%) and Cynodon dactylon (25%). Common dust allergens were house dust (21.66%), paper dust (11.66%) and cotton mill dust (10%). Among fabrics kapok cotton (13.33%) showed maximum positivity. Among fungi Aspergillus fumigatus (10%) followed by A. niger (6.66%) were most common. In animal dander group common ones were cat dander followed by dog dander. Conclusion: In conclusion it can be said that the knowledge drawn by above study will help to treat patients by immunotherapy or avoidance strategy.

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Airway epithelial cells were first considered as a barrier to the inhaled environmental bioparticles, but recent evidences show that they have a more vital role to play in the pathophysiology of Airway diseases. Many of the factors present in the inhaled air interact with the receptors expressed on the epithelial cells leading to their activation. Activated epithelial cells then secrete a range of mediators that help in mediating the inflammation. These mediators contain the chemokines that act as chemoattractants and recruit inflammatory cells like neutrophils, macrophages, mast cells, eosinophils, and Th-2 cells that further exacerbate the intensity of inflammation. Some of the inhaled substances like protease enzymes can also disrupt the barrier of epithelium and gain an entry to the immune cells of the body leading to their activation. Bronchial asthma, chronic obstructive pulmonary disease, and acute respiratory distress syndrome represent a broad range of conditions involving pulmonary inflammation. This review takes into account the role of epithelial cells in initiating allergic reactions at mucosal surfaces.

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Objectives: The objective of the following study is to assess the quality-of-life (QOL) in children with asthma using the mini pediatric asthma quality-of-life questionnaire (mini PAQLQ) with treatment and from the caregiver's point of view using the pediatric asthma caregivers quality-of-life questionnaire (PACQLQ). Materials and Methods: Of the 75 children with asthma in the age group from 7 to 17 years of age, 69 were included in the study. The QOL was assessed using the mini PAQLQ and PACQLQ. An asthma clinical severity score was also used to assess the clinical condition simultaneously. Results: On treatment, there was a significant change in the activity and symptom category of the mini PAQLQ (P < 0.001), but there was no significant change in the emotional domain of the mini PAQLQ even after medical intervention (P = 0.563). This indicates that although the activity level of children improved with significant symptomatic improvement, these children did not recover emotionally from the impact of the disease with medical intervention. There was a significant change noted in both the activity and emotional domain of the PACQLQ with treatment. Conclusions: Although the children improved clinically with treatment there was no significant change in the emotional domain of mini PAQLQ. Inspite of there being a positive change in the groups after intervention, no statistically significant change was noted in the PAQLQ scores. Management of a child with asthma should not only include medical intervention but also psychological support and counseling.

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Introduction: Allergic rhinitis is one of the most common chronic conditions with a significant impact on the quality of life. The association between eosinophils and allergic disease has been known for many years. Nasal smear eosinophilia (NSE) (normal septal motion [NSM]) is a valuable test for the diagnosis of allergic rhinitis. Objective: The objective was to compare NSM and blood absolute eosinophil count (AEC) with the severity of the clinical score and to see the levels in patients with different symptoms and different group of patients with allergic rhinitis. Materials and Methods: In this prospective study, all patients aged more than 12 years presented to our institute; with a clinical diagnosis of allergic rhinitis were enrolled after taking written consent. Then, all patients were subjected for blood AEC and nasal smear for eosinophils. Results: There was a good correlation of NSE with severity of clinical score. There was no correlation of blood AEC with severity of clinical score and majority (94.29%) of the patients had no eosinophilia. The mean values of blood AEC, NSE, and clinical severity score were much higher in group of patients having nasal and respiratory system involvements as compared to only nasal and nasal with ocular system involvement. Conclusions: Nasal smear cytology is a simple, economical, and semi-invasive procedure having good correlation with severity of clinical score should be used routinely. There is a need to revise the normal standard value and grading of blood AEC.

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Atmospheric allergens play an important role in the pathogenesis of naso-bronchial allergy. It is important to know the prevalence of allergens in one's area.for proper diagnosis and effective management The data of positive reaction to fungi on 1500 patients of nasobronchial allergy has been included in this study. Allergy test (skin testing with intradermal injection of antigen) was conducted on patients and the results were interpreted by comparing the wheal produced by the test substance in relation to the control. While analyzing the results 60 patients were excluded because of (±) or one plus (+) cutaneous reaction to fungal antigens. Topping the list, cladosporium was positive in 158 patients (11%) followed by Alternaria tenuis in 144 (10%), Curvularia lunata in 108 (75%), Helminthosporium sp. in 115 (8%). Moderate positives were Rhizopus nigricans in 92 (6.4%) patients, Candida albicans in 86 (6%), Aspergillus fumigatus in 86 (6%), Mucor mucedo in 83 (5.8%), Aspergillus niger in 81 (5.6%), Phoma batae 79 patients (5.5%), Aspergillus tamarii 72 (5.5%), Trichoderma 72 (5%). The low positives were Penicillium in 50 patients(3.5%), Aspergillus flavus 43 (3%), Nigerospora 41 (2.5%), Neurospora sitophila 41 (2.5%), Epicoccum purpurascens 31 (22%), Aspergillus versicolor 30 (2%) and Fusarium solani 28 (2%) patients. Information about fungal antigen positivity is being provided in the present article, which would serve as a reference to the physicians dealing with allergy patients as well as those studying environmental sciences.

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Context: Asthma is a global problem, its prevalence varies among different countries and cities and age groups. In children, asthma is one of the most common chronic diseases and one of the leading causes of morbidity and mortality. Aims: This study was conducted to estimate the prevalence of asthma among children in Jazan Region (JR), Saudi Arabia. Settings And Design: This is study conducted in Jazan region, saudi arabia among school age children. It is a cross-sectional study used a modified international study os asthma and allergy in children questionnaire. Subjects And Methods: The target study population were school age, witth sample size of 1200 distributed to all geographical areas. Statistical Analysis Used: The data had been entered and analyzed using Statistical Package for Social Sciences software version 22.0. Descriptive statistics (e.g., number, percentage) and analytic statistics using Chi-square tests (χ²) to test for the association and/or the difference between two categorical variables will be applied. A P < 0.05 was considered statistically significant. Results: The total study population was 1400, most of them were Saudi (1273, 90.9%). Male students were 840 (60.0%), and female students were 560 (40.0%). According to the residency, 811 (57.9%) students were lived in rural, 64.7% of them were male, and 589 (42.1%) of participants lived in urban area. Most of the students lived in plain area (840, 60.0%), and only 16.4% of them lived in mountain area in which 63.5% of them were male. Elementary school students account 54.1% of total students; about 63% of them were male. The prevalence of life-long wheezes was 17.7%. The prevalence of exercise-induced wheeze and wheeze during the last 12 months was 206 (14.7%) and 159 (11.4%), respectively. Students with the past medical history of bronchial asthma were 212 (15.1%), with no clear statistical significant difference in frequency between male and female (P = 0.161). Asthma was confirmed by doctor in 10% of participants. Conclusions: The prevalence of asthma among children in JR is slightly higher than those reported from local and regional reports.

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Aims: To quantify and identify the pollen grains in the atmosphere of Delhi. Settings and Design: The study was conducted at the National Centre of Respiratory Allergy, Asthma and Immunology, Vallabhbhai Patel Chest Institute (VPCI), University of Delhi, Delhi, India. Subjects and Methods: The study was conducted for 2 months at VPCI, University of Delhi (North Campus), Delhi. Pollen grains were collected on a daily basis using 24-h Burkard (UK) volumetric air sampler. Trapped pollen film was stained with a fuchsin stain that is protected with a cover slip and examined under a light microscope. Identification was done with the help of manuals for pollen identification. Statistical Analysis Used: Data analysis was done by Microsoft Excel 2007. Results: In this study period (April and May 2017), a total of 10,858/m³ pollens were counted; of these, 7758/m³ pollens of 34 species of trees, weeds, and grasses were identified. Overall, Juniper sp. (1385/m³) pollen of tree was found to be the most dominant pollen, followed by Cannabis sativa (726/m³), Pooideae grasses (e.g. Poa sp., Lolium perenne, Dactylis glomerata) (654/m³), Cynodon dactylon (509/m³), Amaranthus sp. (506/m³), Artemisia sp. (460/m³), Cassia sp. (447/m³), Chenopodium album (412/m³), Helenium autumnale (381/m³), and Parthenium (301/m³). Juniper sp. (1310/m³) pollens in April 2017 and C. sativa (421/m³) pollens in May 2017 have shown their dominance. Conclusions: In our study, various pollens of different plant species were counted and identified in this short study period. The common pollens found were Juniper sp., C. sativa, Pooideae grasses (e.g. Poa sp., Lolium perenne, Dactylis glomerata), C. dactylon, Amaranthus sp., C. album, H. autumnale, Parthenium, and Artemisia sp. in 2 months. This short study may be helpful for the respiratory allergic patients to protect themselves by pollens.

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Background: Bronchial asthma (BA) and allergic rhinitis (AR) are among the most common allergic disorders. Identification of specific causative allergens is of paramount importance for further management. Aims: This study aims (1) to find out the prevalence of various allergens leading to AR and/or BA through skin prick test (SPT), (2) to identify the trigger factors in these patients, (3) to study correlations of allergens and seasonal variations in patients suffering from AR and/or BA. Materials and Methods: A total of 134 patients were collected from outpatient department and inpatient department of Respiratory Medicine Department of Geetanjali Medical College and Hospital, Udaipur, from January 2016 to December 2017. The diagnosis of BA and AR was made according to the GINA and ARIA guidelines, respectively. SPT was done with 78 different types of aeroallergens, which included 23 types of pollens, 6 types of fungi, 10 types of insects, 6 types of dusts, 6 types of dander, 3 fabrics, 2 feathers, and 22 food allergens. Patients who had taken short-acting oral antihistaminics, beta-blockers, steroids, tricyclic antidepressants or any other drug that could affect the test within one week prior to testing were excluded. Also, patients on long-acting oral antihistaminics within four weeks of testing and pregnant women were excluded. Results: A total of 134 patients consisting of 73 (54.48%) males and 61 (45.52%) females, in the age group of 5–65 years, were included in the study. The maximum numbers of patients (50; 37.31%) were between the age group of 20 and 35 years. The maximum number of patients (94; 70.15%) had a duration of suffering from >1 years. AR was found in 60 (44.78%), BA associated with AR was found in 39 (29.1%), while BA alone was found in 35 (26.12%). In 54% of patients, triggers were found for exacerbation of their symptoms, the most common being air pollution (48%) followed by cold exposure (20%), physical activity (12%), irritants (9%), smoke (7%), and fumes and odors (4%). A total of 10,452 SPTs were done, out of which 265 (%) showed positive reactions. The positivity for pollens was seen in 116 (43.77%) patients followed by insects [79 (29.81%)], fungi [22 (8.3%)], house dust mite [15 (5.66%)], dusts [11 (4.15%)], fabrics [10 (3.77%)], danders [9 (3.4%)], and feathers [3 (1.13%)], respectively. Food allergens showed no significant reactions to SPT. Conclusions: Our study showed that insects were the most common allergen in BA patients, while pollens were the most common allergen in patients of AR with or without BA. Intermittent symptoms were common with pollen allergy.

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Allergic bronchopulmonary aspergillosis (ABPA) is known to complicate asthma and cystic fibrosis, but an association of ABPA with chronic obstructive pulmonary disease (COPD) has also been found lately. The mechanism through which ABPA operates is still an enigma. With the discovery of ABPA in COPD, interest in the theory that asthma and COPD could share a common etiology has been rekindled. Herein, we present the case of a 60-year-old male, diagnosed case of COPD, who reported exacerbations during the monsoons, which mandated frequent courses of systemic steroids. He was diagnosed to have co-existing ABPA based on positive skin tests to Aspergillus niger, A. flavus, A. fumigatus, and A. tamarii and raised serum total IgE and specific IgE against Aspergillus spp. His CT scan showed centrilobular and panacinar emphysema along with central bronchiectasis. The spirometry showed a significant response to bronchodilators. The patient fulfilled all the minimal essential requirements for the diagnosis of ABPA, except asthma. The patient responded well to systemic steroids. This report makes an important observation that species of Aspergillus other than A. fumigatus could be instrumental in causing ABPA in patients with COPD, unlike that seen in asthma. The possible etiologic mechanisms underlying the development of ABPA in COPD and also the evolution of ABPA from its serological to bronchiectasis variant are discussed in this report.

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Aim: To determine the association between anemia and asthma among children as case-control and also investigate the effect of hemoglobin (Hb) on asthma and atopy markers. Settings: The case-control study was performed during a period between March 2012 and October 2013, on asthmatics and controls (<14 years) at Pediatric Allergy-Immunology Clinics and Primary Health Care Clinics, Qatar. Subjects and Methods: A total of 520 cases and 520 controls matched by age, gender, and ethnicity. Sociodemographic and clinical data were collected through physician diagnosis and questionnaire. Their health status was assessed by past or present clinical manifestations, family history, physical examination, body mass index (BMI), anemia, Hb level, calcium, and phosphorus. Results: About 56.3% of asthmatic and 51.9% of controls were males and 43.7% of asthmatic and 48.1% of controls were females. The mean age (± standard deviation, in years) for asthmatic versus controls was 9.3 ± 3.28 versus 10.2 ± 3.38. Anemia was more prevalent in asthmatics than controls. Lower Hb levels were associated with more allergic disease and elevated serum IgE. The study revealed that Hb level, iron and ferritin deficiencies were considerably higher in asthmatic children compared to healthy children. There was a significant difference found in the mean values of Hb levels between asthmatic (10.58 ± 3.05 g/dL) and control children (11.75 ± 3.10) (P = 0.006). Besides, mean IgE was statistically significantly higher in asthmatic compared to control children (P < 0.001). There was a significant correlation between Hb level and total IgE in asthmatic compared to controls (r = 0.295 vs. r = 0.268, P = 0.001). The analysis revealed that the predictors for development of asthma in children were serum iron deficiency (P < 0.001), phosphorus (P < 0.001), parental consanguinity (P = 0.046), breastfeeding < 6 months (P < 0.001), BMI (P = 0.005), less physical activity (P < 0.001), family history of asthma (P = 0.028), and ferritin (P < 0.001). White blood cell count (P < 0.001), serum IgE level (P < 0.001), and serum calcium level (P < 0.001) were considered as the main risk factors after adjusting for age, gender, and other variables. Conclusion: The study findings showed a high prevalence of iron deficiency among children with asthma and allergic diseases. Serum Hb levels were lower in asthma, allergic rhinitis, and atopic dermatitis children. Hb level and anemia were strong contributors for asthma and allergic diseases.

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Bronchial asthma is a clinical syndrome with variable causes. It characterizes by episodes of broncho-constriction which leads to shortness of breath. In traditional medicine, some medicinal plants have been used to cure the asthmatic symptoms. We evaluate the bronchorelaxant effect of Boswellia carterii (Olibanum) and Glycyrrhiza glabra (Licorice) then to choose the better. 54 patients with chronic bronchial asthma were participated. After clinical assessment, estimation of pulmonary function tests and serum electrolytes: calcium, magnesium, potassium and selenium were done before and after the study. Boswellia carterii was given to 18 patients and glycyrrhiza glabra to another 18 patients while prednisolone was given to another 18 patients as control for 21 days. The results showed that the tested plants had significant elevation in the values of forced expiratory volume in first second (FEV1%) as (72.45±5.83 vs 61.33±6.04 and 81.10±11.07 vs 62.30±7.22) for olibanum and licorice respectively. Also, elevation in the values of forced volume capacity (FVC) with marked reduction in asthmatic attacks as (2.63±0.82 vs 0.72±0.16, 3.60±0.02 vs 1.08±0.08, and 2.25±0.16 vs 1.05± 0.15) for olibanum licorice and prednisolone respectively, but showed better symptomatic improvement with licorice as compared to olibanum. The results prove the superiority of glycyrrhiza glabra over boswellia carterii for chronic bronchial asthma.

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Purpose: Allergic patients have a specific psychological profile and experience a specific mental and emotional context. This study examines the psychological traits of allergic patients in comparison with those of control group. Materials and Methods: This was a case-control study in which 102 men and women allergic patients who referred to Sari Tooba clinic were selected. One hundred and two people from the normal population were selected as the control group and were matched with allergic samples. Minnesota Multiphasic Personality Inventory (MMPI2) questionnaire was used for data collection. The data were analyzed by variance analysis, t?test, and correlation tests. -test, and correlation tests. Results: The average scores of patients in MMPI2 test for hypochondriasis, hysteria, depression, psychasthenia, and social introversion were significantly higher than for paranoia (P < 0.05). Also, allergic women obtained higher scores in hypochondriasis, psychasthenia, masculinity-femininity, hysteria, and depression scales than allergic men (P < 0.05). These results also showed that hypomania has a higher frequency among asthmatic patients than in patients with allergic rhinitis (P < 0.05). Conclusion: This study showed that psychopathological traits such as hypochondriasis, hysteria, depression, psychasthenia, and social introversion have a higher frequency among allergic patients than in the general population. These results emphasize on considering psychological interventions along with medical treatments.

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Introduction: The loss of body mass leading to cachexia is known to exist in chronic obstructive pulmonary disease (COPD). However, the role of body composition in asthmatics has not been widely explored. Materials and Methods: Body weight (BW), body mass index (BMI), percentage of ideal BW (PIBW), fat mass (FM), fat free mass index (FFMI), and midthigh cross-sectional were evaluated in COPD (n = 40) and asthma (n = 40) and compared with 20 healthy controls. Socioeconomic status served as a marker of dietary adequacy. Results: Weight (P < 0.001), BMI (P < 0.01), FMI (P < 0.05), and FFMI (P < 0.001) differed significantly among socioeconomic classes. Significant intergroup differences of weight and FFMI in the upper (P < 0.05) and BMI and PIBW in the upper-middle class (P < 0.05) were seen. BW in COPD was lower than bronchial asthma (BA) (P < 0.001) and controls (P < 0.001). BMI in COPD was lower than BA (P < 0.000) as were PIBW (P < 0.000) and FM (P < 0.001), whereas neither study group differed from controls. FFMI in COPD was lower than BA (P < 0.004) and controls (P < 0.01). No parameter differed between BA and control groups. Comparing by severity of airflow obstruction, all parameters were reduced in COPD, but statistical significance (P < 0.05) was noted for BMI and FFMI in mild/moderate cases and weight, BMI, PIBW, and FM in severe/very severe cases. No significant differences were noted when assessed with respect to severity of either disease. Correlations were noted between FFMI and post bronchodilator forced expiratory volume in the 1 ^st second (FEV) ₁ (r = 0.342) and weight and post bronchodilator FEV ₁ (r = 0.322) in COPD. Conclusion: COPD produces malnutrition with regards to both fat and fat free components, irrespective of the severity of the disease, whereas asthma bears no such association.

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Background and Objective : Food intolerance is an adverse reaction to food in which there is no involvement of defense (immune) system. There is some evidence for the use of food-specific immunoglobulin G (IgG) levels as a guide to identify food intolerance. The current study was thus planned to study the prevalence of IgG-based food intolerance in bronchial asthma (BA) patients and healthy controls in Indian population. Materials and Methods: A total of 65 subjects were recruited for the study comprising 50 cases of BA and 15 healthy controls. These were assessed for food intolerance using specific IgG against selected food items. The results were graded as specific IgG against the selected food item: >30 U/mL - elevated and <30 -normal as per manufacturer`s recommendation. Results: The BA group had highest food intolerance against the vegetables, whereas in control subjects the food intolerance was highest for nuts. The prevalence of food intolerance was higher in male asthmatic patients, but in the control group females showed higher intolerance. The common food items to which food intolerance test was positive in descending order were cow milk (56%), casein (48%), tiger nut (48%), almond (46%), amaranth (46%), peanut (46%), soybean (44%), alga wakame (44%), scallop (44%), mulberry (42%) in asthmatic patients and almond (80%), cowmilk (73%), casein (66.6%), peanut (60%), cashew nut (60%), tiger nut (53.3%), carrot (53.3%), flax seed (53.3%), quino (53.3%), clan (53.3%), sunflower seed (53.3%) in control subjects. Conclusion: The specific IgG is a test to evaluate food intolerance. The common food items to which food intolerance test was positive in descending order were cow milk (56%), casein (48%), tiger nut (48%), almond (46%), amaranth (46%), peanut (46%), soybean (44%), alga wakame (44%), scallop (44%), mulberry (42%) in asthmatic patients.

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Upright sitting is preferred position for spirometry. The spirometric values in seventy five adult patients with obstructive lung function in sitting versus standing position were compared. The forced vital capacity (FVC) in standing position were marginally more, but no change in forced expiratory volume (FEV ₁ ) was observed. The agreement in diagnosing reversibility of obstruction in either position was high.

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