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Background: Asthma is a prevalent chronic pulmonary disease presented in 20% of population. Steroids have been shown to be effective in asthma treatment however, controversies are arisen in the route of administration. The present study was conducted in a private clinic in Kashan to determine the effects of different routes of corticosteroid administration (Oral, injection and inhalation) on asthma attack.

Materials and Methods: 120 patients had entered this clinical trial. Patients were distributed in three groups oral, injection and inhalation group. All subjects received salbutamol. Spirometry was performed before and after the therapy and then results were analyzed.

Results: The study population included 63 males (52%) and 57 females (48%) with the mean age of 39.9 years. Comparison of FEF25-75, FEV1 and FVC results showed non-significant differences between the oral and injection groups, however, they were more effective than inhalation corticosteroids.

Conclusion: Administration of corticosteroids either orally or by injection can be easily used to control asthma attack. Inhalation therapy is less effective and is not recommended.

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Background : Using plants for therapeutic application was developed many years ago. Iranian and Chinese traditional medicine are apparent examples dealing with this category of medicine, however, these have no scientific background. During the present study, Artemisia was evaluated as a bronchodilator agent for the treatment of asthma. We have assessed the spirometric changes following the Artemisia inhalation.

Materials and methods : For this double blind clinical trial, samples were randomly assigned in the case and control groups. Prior to the intervention spirometery was achieved and FEV1, and FEV!/FVC were recorded. Then, groups had inhaled Artemisia and placebo for 15 minutes, then, spirometery was again performed.

Results : Patients aged 17-50 years. There was no significant difference between groups regarding their age, sex and clinical manifestations. The mean duration of disease was 8.3 years. A 10% increment in FEV1 was noted in 45% and 15% of the experiment and placebo groups, respectively (p<0.1), however, this increment was found in FVC/FEV1 index of 50% patients of each group (NS).

Conclusion : Indices have shown better improvement in the experiment group. Similar studies with greater sample size are recommended.

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Background: The spirometric indices are important values in asthmatic patients. There are some reports indicating that IgE and serum eosinophilia could help to interpret spirometric status. The aim of this study was to determine spirometric indices, IgE and serum eosinophilia of asthmatic patients in Kashan.

Materials and methods: 154 patients were enrolled in this descriptive study. They were referred to a private clinic and Shaheed Beheshti hospital in Kashan. These patients were examined for spirometry , total serum IgE and eosinophilic count. Patients were assigned according to <5% eosinophilia, >5% eosinophilia and also IgE <150U/ml and IgE >150U/ml. Groups were compared with t-test.

Results : The study population included 76 male and 78 females with the mean age of 34.8 ± 16.8 years. Spirometric indices and serum IgE did not show a significant association (NS). FEV1 was 73.8 ± 21.6 in patients with <5% eosinophilia and was 62.9 ± 19.4 in patients with >5% eosinophilia (p<0.01). Other spirometric indices did not show a significant association with eosinophilia status. FEF_25-75% did not differ significantly between groups (NS).

Conclusion : In middle-ages asthmatic patients spirometric indices do not correlate with patient's IgE status. There is a reverse relation between IgE and spirometric indices except for FEF. Further studies are strongly recommended.

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Background: Asthma is the most common chronic disease in childhood. Several factors have been considered as the disease risk factors. The neonatal phototherapy has recently been recognized as the main childhood risk factor. The aim of this study was to evaluate the relationship between the neonatal phototherapy and childhood asthma.

Materials and Methods: This analytical case-control study was conducted on the asthmatic children with a history of neonatal icterus as the case group and those with no history of neonatal icterus as the control group with similar characteristics (age, gender, type of delivery and birth weight). Twenty-eight out of 200 subjects in the case and 34 in the control group had the inclusion criteria. Phototherapy and its duration were compared in the case and control groups. Data were analyzed using chi-square and t-test.

Results: Twenty-six (92.8%) subjects in the case group and 20 (58.8%) subjects in the control group had a past history of phototherapy (P=0.002). The mean number of days for neonatal phototherapy in the case and control groups was 4.9 and 3.2, respectively (P=0.001).

Conclusion: This study shows that neonatal phototherapy, as well as its duration, is an effective factor affecting childhood asthma. So, the phototherapy must be avoided except in rare situations with the least duration.

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Background: It has been hypothesized that obesity and disturbance in glucose metabolism can play an important role in the development of asthma. There is accumulating evidence in the literature that obesity can increase both the incidence and severity of asthma. Therefore, this study was conducted to determine the relationship between adiponectin, an anti-inflammatory cytokine, and blood glucose levels in overweight and obese adult patients with asthma.

Materials and Methods: Forty-fine obese or overweight men (age 38-50 years) with mild-to-moderate asthma referred to Saveh health centers participated in this study. Fasting blood glucose, insulin, and adiponectin levels were measured. The homeostasis model assessment (HOMA) was applied to evaluate beta-cell function using fasting glucose and insulin levels. Data were analyzed using Pearson correlation coefficient.

Results: The results of this study showed that there was a significant relationship between the serum adiponectin and FEV1/FVC, FEV1 and FVC in asthma patients. In addition, serum adiponectin level was positively correlated with insulin and beta-cell function, but negatively with fasting glucose level.

Conclusion: According to the results, there is a negative correlation between serum adiponectin levels and blood glucose concentration in adult asthmatic patients. Furthermore, our findings showed that the reduction of systemic adiponectin level influences blood glucose concentration via insulin level and beta-cell function.

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Background: Considering the effectiveness of nebulized furosemide in asthma crisis that were non-responsive to the inhalational β-agonists , this study aimed to examine the effect of concomitant administration of furosemide (10 mg) and nebulized salbutamol (2.5 mg) on spirometry parameters in persistent asthma.

Materials and Methods: In this clinical trial, 53 patients (age, 18-75 years) with a 6-months history of persistent asthma were randomly allocated to two groups, the salbutamol (n=27) and salbutamol + furosemide (n=26) groups. Participants in each group were classified into the mild, moderate and severe persistent asthma on the basis of FEV1 . Participants were administered salbutamol or salbutamol + furosemide, and then the spirometry parameters were recorded 15 minutes after the completion of nebulization treatment . Before and after the treatment, mean and standard deviation of the spirometry parameters and their changes were calculated .

Results: Results showed no significant difference regarding the mean percentage change for FEV1 in the salbutamol (27.5%) and salbutamol + furosemide groups (25.83%) after the treatment (P=0.72). Moreover, no significant difference was seen between the two groups regarding the mean percentage changes in other parameters after the treatment (FVC, FEV1, PEF, MMEF, FEV1/FVC, P>0.25).

Conclusion: Concomitant administration of furosemide and salbutamol has no advantage over salbutamol in normalizing the spirometry parameters of persistent asthma.

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Background: Previous studies on the relationship between birth weight and childhood asthma have shown controversial results some studies refer to high birth weight and some to low birth weight as a risk factor for asthma. This study aimed to evaluate the prevalence of abnormal birth weight among the asthmatic children.

Materials and Methods: In this cross-sectional study, 400 asthmatic patients (age range, 5-15 years) referred to Kashan asthma and allergy clinic during 2007-2008 were allocated in to four groups based on birth weight.

Results: Sixty-two percent of asthmatic children had an optimal birth weight, 32.5% high weight, 1% very low weight and 4% low weight. In gender-based study of these children, 0.4% of boys had very low weight, 2.3% low weight, 63.7% optimal weight and 33.6% high weight among girls 1.7% very low weight, 6.2% low weight, 61% optimal weight and 31.1% high weight.

Conclusion: According to the results of the study, high birth weight is associated with asthma and among the children with abnormal birth weight, high birth weight has greater prevalence with similar results for both genders.

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Background: IL-4 is an important mediator of inflammatory cytokine derived from T helper cells and mast cells which triggers IgE synthesis. IL-4 plays an important role in allergic immune response for its ability to prevent apoptosis of T lymphocytes. IL-4 also plays a role in lymphocytes cell differentiation, cytokines and IgE production. This study aimed to evaluate the relation between the serum levels of IL-4 and IgE with disease severity in patients with allergic asthma.

Materials and Methods: In this case-control study, 110 asthmatic patients referred to Asthma and Allergy Clinic in Kashan and 70 healthy controls were randomly selected. Blood sample (5 ml) was taken from all the patients and healthy subjects and the serum levels of IL-4 and IgE were measured using the standard laboratory kits and ELISA method, respectively.

Results: The IL-4 and IgE mean levels were not significantly associated with age and sex. The mean IgE level increased from moderate to severe with increasing asthma severity (P=0.847). Moreover, the IL-4 level in patients with severe asthma was higher than the other patients (P=0.002).

Conclusion: IL-4 level was increased with increasing asthma severity, but this was not the case for IgE.

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Background: Asthma is the most common childhood chronic disease. The increased prevalence of the disease has been contributed in conducting the various studies on the mechanism of asthma. One of the main factors that are assumed to be more effective in asthma is serum vitamin D level. Therefore, this study was carried out to evaluate the serum vitamin D level among the asthmatic children (5-15 years) in Isfahan during 2012-2013.
Materials and Methods: This study was conducted on children referred to the pediatric clinics in Isfahan during 2012-2013. Children with and without asthma were divided into the case and control groups, respectively. Then, the serum level of 25-hydroxy vitamin D was measured.
Results: This study included 196 asthmatic and 200 non-asthmatic children. The vitamin D levels were 25.79±17.42 and 30.33±16.37 for the case and control groups, respectively this difference was statistically significant (P<0.008). Moreover, 59.7% of the patients with asthma and 46% in the control group were vitamin D deficient. Vitamin D levels in severe and non-severe (mild and moderate) asthma were 24.75±15.90 and 26.26 ± 18.10, respectively. No significant correlation was found between the asthma severity and vitamin D level (P= 0.3).
Conclusion: Due to the low levels of vitamin D among the asthmatic patients, the regular control of serum vitamin D is recommended to treat the patients in case of deficiencies. Also, life style and food diet should be modified and directed towards eliminating the nutritional deficiencies in the society.

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Background: Previous studies on the relation between birth weight and childhood asthma have had conflicting results. The aim of this study was to examine the effect of birth weight on asthma during the first three years of life.

Materials and Methods: This cohort study was performed on 240 neonates in Kashan city between 2009 and 2013(during a period of four years). Subjects were allocated into two groups of low and normal birth weight and were then observed for having asthma over the next three years. Child’s asthma was evaluated by physical examination and, if possible, by using a peak flow meter.

Results: A total of 80 underweight and 134 normal weight children participated in this study. Twenty-one percent of children with low birth weight and 10.4% of children with normal birth weight were affected by asthma (P=0.03). The mean age of developing asthma was 21.53±7.66 months in the low birth weight group and 27.43±6.54 months in the normal weight group (P=0.03). After adjusting for the effect of confounding variables, a significant relationship was found between birth weight and developing asthma (P=0.04).

Conclusion: The results of the present study reveal that low birth weight can be an independent risk factor for developing asthma during the first three years of life.

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Background: Asthma is among the most common chronic childhood disease. The recent studies suggest that some school and behavioral problems manifesting the hyperactivity   symptoms are caused by asthma and its related treatment. While other studies show no association between these factors. Therefore, this study was carried out to determine the comorbidity of attention deficiency and hyperactivity among the asthmatic children in Kashan during 2013.

Materials and Methods:  In this case-control study, the asthmatic children (n=89) referring to the Asthma and Allergy Clinic in Kashan were selected based on purposive sampling method as the Case group  and  age/sex-matched healthy children (n=117) were randomly selected as Control group. The spirometry and pick flowmetry tests were used for the diagnosis of asthma. The DSM-IV criteria were also used for the diagnosis of attention deficiency associated with hyperactivity.  

Results: The comorbidity of attention deficiency and hyperactivity among the asthmatic children was 5 times more than the Control (P=0.001) (OR: 5.67, CI: 2.66-12.08). In this study no significant relation was seen between the attention deficiency associated with hyperactivity and the severity of asthma and also the sex (P=0.624 and P=0.06, respectively).

Conclusion: Asthma probably increase the risk of attention deficiency associated with hyperactivity. Therefore the diagnosis and treatment of behavioral disorders in asthmatic children is considered important.

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Background: Alexithymia is a personality trait characterized by the inability to identify and describe emotions. Only few researches have studied the correlation between alexithymia and health factors in psychosomatic disorders. This study aimed to determine the correlation between alexithymia and anxiety, depression in asthmatic patients.

Materials and Methods: This cross-sectional study was conducted on all asthmatic patients referred to Khorram Abad medical centers. Among them 100 cases were chosen using the convenience sampling. The tools were Alexithymia Scale )TAS-20( along with Hospital Anxiety and Depression Scale )HADS(. The data were analyzed using Pearson correlation and Multivariate Regression.

Results: A significant positive relationship was seen between aalexithymia, its factors and anxiety/depression. In addition, multiple multivariate regression analysis showed that difficulty in identifying feelings and describing feelings can predict the anxiety and depression.

Conclusion: Findings showed that difficulty in identifying and describing emotions as two factors of Alexithymia in asthmatic patients can predict the depression and anxiety. So, considering the emotional aspects of asthma, effective approaches should be taken into account in the treatment of these patients' mental health problems.

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