الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 151 |  |  |
| | | from | 151 | | |
Abstract
Asthma,one of the most common respiratory diseases, is a disorder with a strong hereditary component but complex inheritance. The characteristic features of asthma arise in part through the activity of eosinophil -derived proinflammatory mediators (GINA, 2010)Asthma is a chronic disorder that can place considerable restrictions on the physical, emotional, and social aspects of the lives of patients and may have an impact on their careers. There may be considerable absence from school or work (Kumar et al., 2010 ). The current guidelines emphasize 4 important components of asthma care: (1) assessment and monitoring, (2) control of environmental factors and comorbid conditions, (3) medications and.(4) Education(Gina, 2010) Every asthma consultation is an opportunity to review, reinforce and extend both knowledge and skills. This is true whether the patient is seen in primary care, the accident and emergency department or the outpatient clinic. It is important to recognise that education is a process and not a single event. A hospital admission represents a window of opportunity to review self management skills. No patient should leave hospital without a written personalised action plan and the benefit may be greatest at first admission. The aim of our work:
Is to study the effect of parasitic infestation in children with bronchial asthma , whether protect or exaggerate asthma? 110 Patients and methods : This cross-sectional study was conducted on 80 Egyptian children selected from Menoufia University Pediatric Hospital, Outpatient pulmonology Clinic. They were diagnosed as bronchial asthma. They were 51 male and 29 female .Their ages ranged from 4 years to 14 years. They were divided into 2 groups :- group A( patients with bronchial asthma and parastic infection ) , group B (patients with bronchial asthma without parastic infection) All patients group were subjected to : 1. History taking 2. General examination and thorough clinical examination 3. Laboratory Investigations : complete blood count and it is differential , stool analysis, total serum IgE level .4. Radiology : Chest X-Ray 5- Pulmonary function tests : By Zan 100 performed only for patients above 6 yeares of life. The results: of present study showed: As regard the demographic data of the studied groups, it was found that males represent 63.33% of patients in group (A) and 65% in group (B)(In the present study we found that patients in group A ( age < 6 years 66.67% and more than 6 years 33.33%), and in group B (age < 6 years 90% and more than 6 years 10 % ) which had highly statistically significant differences. It was found in our study that consanguinity, we found that 33.33% of patients in group (A) and 35%in group (B) had positive consanguinity which had no statistically significant differences. As regard family history of asthma, we found that 63.33% of patients in group (A) and 60 %in group (B) had positive family history of asthma which had no statistically significant differences. In the present study to asthma, no significant difference was detected between rural and urban prevalence of all grades of asthma where it was 61.67%and 38.33%for rural and urban in group A respectively .They were 55 %and 45 % for rural and urban in group B respectively, P-values for all of them were > 0.05. In our study assessment of the nutritional status of the children was done using anthropometric measures (weight and height) there was significant lower anthropometric measures between infected and non infected children in weight while there was no significant difference in height. It was found in our study that (75%) of infected children their weight for age were below the 5th percentile, while (35 %) only of non infected children were below fifth percentile with significant difference(P value < 0.05 ).While 16 % of children their height for age were below the 5th percentile, and 25%of non infected children were below fifth percentile with no significant difference (P value >0.05) The laboratory data of the studied patient groups we found that patients in group (A) had higher mean in hemoglobin (9.33 ± .79) than group B (10.96 ±.74) with highly increased significant difference between them. The laboratory data of the studied patient groups we found patients with different parasitic infestation we found that esinophilia was highly increased significant difference with A.lumbricoides and E.vermicularis infection than other types of parasitic 112 As regard the laboratory data of the studied patients groups we found that patients in group (A) they had higher mean in IgE (458.82 267.94) than group B ( 211.65 ± 128.18) which was highly increased significant difference between our studied groups. Pulmonary function tests in patients infected with different parasitic infestation there was significant difference in the FVC% and FEV1% in patients with A.lumbricoides infestation, and no significant difference with other parasitic infestation ( T. trichiura, E.vermicularis, E.histolotica, H.nana). As regard linear stepwise regression of studied variables in relation to each parasite we found that among asthmatic patients with parasitic infestation only A.lumbricoides has significant effect on FEV1,FVC, IgE and Esinophilic count changes. And asthmatic patients with parasitic infestation H.nana has significant effect on FVC, IgE and haemoglobin changes. Among asthmatic patients with parasitic infestation E.vermicularis and Trichuris.Trichura and E.histolotica have no significant effect on all parameters changes .