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BACKGROUND: Allergic rhinitis (AR) represents one of the most common global health problems with seriously increasing incidence over the last decades. The goal of the treatment of rhinitis is to prevent or reduce the symptoms caused by the inflammation of affected tissues. Intranasal steroids and oral antihistamines are recommended as first lines of treatment. Acupuncture had reported a significant improvement in daily symptoms and an increase of symptom-free days in many studies enrolling adults' patients. AIM: This study aimed to evaluate the laser acupuncture effect on the treatment of children AR in comparison to the effect of the medication and to assess the anti-inflammatory effect of laser acupuncture through measurement of serum inflammatory marker (hs-CRP). METHODS: Sixty patients with allergic rhinitis their age group ranged from 4 to 18 years were divided randomly into two groups. Group 1 enrolled 30 patient that received AR in the form of intranasal steroids, antihistaminic, leukotriene antagonists while group2 thirty patients received 12 laser acupuncture sessions (2 sessions a \ week) on specific traditional Chinese acupuncture points. RESULTS: There was a significant improvement in the severity score symptoms in both groups through and by the end of the study. High Significant improvement in the levels of the inflammatory marker in both groups, especially in the group which receive laser acupuncture sessions. CONCLUSION: Laser acupuncture is a reliable, painless and non-invasive successful technique, which may be used as a complementary treatment for pediatric allergic rhinitis.

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OBJECTIVES: This work aimed to highlight a challenging asymptomatic problem which is early detection of hearing impairment in toddlers with protein energy malnutrition (PEM) as a neuro-cognitive effect of PEM on developing brain in relation to hemoglobin level. METHODS: 100 toddlers, aged 6-24 months, fifty with moderate/severe PEM and fifty healthy children, were included in study. Both TEOAEs and ABR testing were used to assess auditory function. RESULTS: Study reported an association between malnutrition and hearing impairment, 26% of cases had conductive deafness secondary to otitis media with effusion using tympanometry; 84.6% showed type B and 15.4% type C which may suggest developing or resolving otitis media. Their ABR showed 46% mild and 53% moderate impairment. 32% of PEM cases had sensory neural hearing loss and with type (A) tympanometry. Those were assessed using ABR; 58% had mild, 34% moderate and 8% profound impairment. 10% of PEM cases had mixed hearing loss with 50% type B and 50% type C tympanometry and their ABR showed moderate to profound impairment. TEOAEs latencies at different frequencies correlate negatively with hemoglobin level. CONCLUSIONS: Toddlers with moderate/severe PEM had hearing impairments of different types and degrees. Neuro-physiological methods could be early and safe detectors of auditory disorders especially in high-risk toddlers. Anemia increases risk for auditory dysfunction.

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Chronic lung disease (CLD) in children represents a heterogeneous group of many clinico-pathological entities with risk of adverse impact of chronic or intermittent hypoxia. So far, few researchers have investigated the cognitive function in these children, and the role of auditory P300 in the assessment of their cognitive function has not been investigated yet. This study was designed to assess the cognitive functions among schoolchildren with different chronic pulmonary diseases using both auditory P300 and Stanford-Binet test. This cross-sectional study included 40 school-aged children who were suffering from chronic chest troubles other than asthma and 30 healthy children of similar age, gender and socioeconomic state as a control group. All subjects were evaluated through clinical examination, radiological evaluation and spirometry. Audiological evaluation included (basic otological examination, pure-tone, speech audiometry and immittancemetry). Cognitive function was assessed by auditory P300 and psychological evaluation using Stanford-Binet test (4th edition). Children with chronic lung diseases had significantly lower anthropometric measures compared to healthy controls. They had statistically significant lower IQ scores and delayed P300 latencies denoting lower cognitive abilities. Cognitive dysfunction correlated to severity of disease. P300 latencies were prolonged among hypoxic patients. Cognitive deficits in children with different chronic lung diseases were best detected using both Stanford-Binet test and auditory P300. P300 is an easy objective tool. P300 is affected early with hypoxia and could alarm subtle cognitive dysfunction.

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Polymorphisms in the promoter region of CD14 gene have been associated with asthma and atopy although the findings between cohorts have not been uniform. We aimed at investigating the association between CD14 gene (-1145G/A) polymorphism and bronchial asthma in Egyptian children. Genotyping of CD14 gene (-1145G/A) polymorphism was done by real-time PCR in 192 asthmatic children (atopic, n = 100 and non-atopic, n = 92) and 181 age- and gender-matched healthy children. Serum levels of total IgE were measured by ELISA. Skin prick test was performed on all patients. We found that the frequency of AA genotype was significantly higher in asthmatic children compared to healthy controls. Asthmatic children carrying GG genotype had a significantly lower prevalence of atopic asthma. Meanwhile, the "A" allele was significantly higher in atopic asthmatic children compared to healthy and non-atopic children. Moreover, atopic children carrying the "G" allele showed better asthma control. In conclusion, our findings represent an evidence for the role of CD14 gene (-1145G/A) polymorphism in childhood asthma and asthma control.

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UNLABELLED: In settings of limited health resources, using leukocyte-filtered blood is limited to patients with leukocyte-mediated complications. The aim of this study was to determine the patterns of lung dysfunction among patients with ß-thalassemia major (BTM) after the application of the leukostop filter during transfusion for a period of 6 months. The study included 30 patients with transfusion-dependent BTM divided into two groups according to the use of leukocyte filter. Group I included 15 patients with BTM allocated to use the leukocyte filter before each blood transfusion for 6 months and group II included 15 patients with BTM using nonleukocyte-filtered blood. Patients with history of airway disease and smokers were excluded. Chest X-ray and pulmonary function tests (PFT) using spirometry were done for each patient at baseline and after the use of the leukocyte filter for 6 months. No significant difference was found at baseline PFTs in both groups, the distribution of obstructive pulmonary disease significantly improved in group I in the postfilter evaluation, P < 0.05, however no change in pulmonary disease distribution in group II. A statistical significance improvement in forced vital capacity (FVC), forced expiratory volume in 1st second (FEV1) and FEV1/FVC in postfilter evaluation, while in group II a decline in FEV1, FVC, and no significant change in FEV1/FVC ratio. There was no correlation between serum ferritin and PFT results. CONCLUSION: Pulmonary function abnormalities, although subclinical is not an infrequent finding in patients with BTM; leukofiltred blood may improve PFT.

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