Effect of the SARS-CoV-2 pandemic on the control and severity of pediatric asthma

Background: The novel disease caused by the new coronavirus SARS-CoV-2 has caused an unprecedented global pandemic. Care providers of asthmatic children are increasingly con-cerned; as viral infections are one of the primary triggers of asthma flare-up. However, the effect of SARS-CoV-2 as well as the generated worldwide lockdown on asthmatic children is unknown.Objective: The aim of this study was to analyze the effects of pandemic SARS-CoV-2 in pediat-ric asthma control.Material and Methods: A retrospective, open, transversal study was performed at five tertiary hospitals. Recruited patients were aged <18 years and had physician-diagnosed asthma. Information regarding the 2019 and 2020 seasons were provided.Results: Data were collected from 107 children (age range: 3–18 years, mean age: 12 years). Well-controlled asthma was observed in 58 (54.2%) patients in 2020 versus 30 (28%) in 2019, and 15 (14%) patients had poorly controlled asthma in 2020 versus 28 (26.2%) in 2019. In 2020, a decrease in exacerbations caused by allergies to pollen, dust mites, molds, and through other causes not related to SARS-CoV-2 infection was observed. An increase in exacerbations was observed due to animal dander, stress, physical exercise, and SARS-CoV-2 infection. Children had a reduced need for asthma-controlling medication, made fewer visits to healthcare pro-viders and had lesser need of treatment with oral corticosteroids if compared with the same season of 2019.Conclusion: Pediatric asthma control improved, the need for controller medication declined, and fewer visits to healthcare providers were made during the pandemic if compared with the 2019 season.

INVOLVEMENT OF SOME ALLERGENS OF PLANT AND ANIMAL ORIGIN IN ALLERGIC REACTIONS RELATED TO RESPIRATORY SYSTEM

In India, the prevalence of allergic responses and bronchial asthma is on the rise, which is a major public health concern. Increased exposure to an allergen, a substance that causes a reaction, can cause allergy sensitization in genetically vulnerable people. Continued exposure to allergens can raise the risk of allergic diseases which can further progress into life threating respiratory diseases. Allergic reactions to a variety of indoor and outdoor allergens play a key role in severe breathing disorders such as asthma and chronic obstructive pulmonary disease (COPD). There are distinctive kinds of allergens like animal proteins and animal dander, pollen, food, fungi, mould, Insects, Bird droppings and many others. The common allergens that cause respiratory difficulties have been identified after an honest effort. A modest retrospective analysis of 160 patients was done. Their medical history was gathered in order to determine whether or not they had been exposed to allergies in the past. All of the study participants were given a Skin prick test (SPT) with a variety of allergens, and their allergy status was evaluated based on the results. Most allergens, such as dust mites, pollen grains, and pigeon droppings, have been discovered to cause severe respiratory allergies, which can lead to life-threatening respiratory complications.

Prospective study on prevalence of aeroallergens in allergic rhinitis in a teaching hospital, Telangana

Allergic rhinitis is an IgE antibody mediated, inflammatory disease.The most commonly encountered risk factors for allergic rhinitis are presence of atopy, asthma, eczema, and other allergic illnesses. Identification of aeroallergens helps in patient counseling to modify life style and prevent exposure to triggering factors.To determine the prevalence of aeroallergens in allergic rhinitis. This was a prospective study done in cases of allergic rhinitis over a duration of one year from January 2019 to December 2019. Complete history taking was followed by ENT examination including Rhinoscopy and endoscopy, peripheral smear examination for eosinophils, absolute eosinophil count testing and Skin prick testing with known allergens and serum IgE level testing. A total of 145 cases of allergic rhinitis were studied. The patient age ranged from 11 years to 50 years. The male to female ratio was 0.5:1. Most common allergen causing allergic rhinitis was dust mite which constituted about 44.1% cases. The next common allergen was Mold which accounted for 20.6% cases. We conclude that there are numerous aeroallergens that can cause allergic rhinitis and the most common ones are dust mites, molds, house dust, animal dander, pollen and others. Correct identification of the aeroallergen helps in the proper counseling of the patients so as to prevent exposure to those aeroallergens thereby reducing the episodes and severity of allergic rhinitis.

Fungi Sensitization in Spain: Importance of the Alternaria alternata Species and Its Major Allergen Alt a 1 in the Allergenicity

Prevalence of allergy to fungi is around 3–10%. The most prevalent species involved in sensitizations are Alternaria alternata, Aspergillus fumigatus, Cladosporium herbarum, and Penicillium notatum. Our main objective was to estimate the prevalence of fungal sensitization and its variation across Spain. Following the ICH-GCP, we recruited 1156 patients from 15 allergy departments in Spain. Hospitals were selected by bioclimatic areas. Patients underwent a skin prick test (SPT) with fungi, pollens, house dust mites, and animal dander. Specific IgE to Alternaria alternata and Alt a 1 was assessed in patients with positive SPT to fungi. Of the 233 patients (20.2%) sensitized to at least one of the five fungi tested, 162 (69.5%) were sensitized to Alternaria alternata and Alt a 1, of whom 113 (69.8%) were children; 181 (77.7%) were also polysensitized to other allergens. Alternaria alternata and Alt a 1 sensitization was present in 25.4% of patients in the Continental area, 12.0% in the Mediterranean area, 7.0% in the Semidesertic area, and 2.3% in the Oceanic area. Prevalence of sensitization to the other tested sources was 63.8% to pollens, 60.5% to house dust mite, and 38.1% to animal dander. We concluded that the prevalence of fungal allergy is increasing. Fungi are still the fourth source of allergen sensitization. Alternaria alternata sensitization is the most prevalent in allergic patients to fungi. Alt a 1 is present in almost 90% of the patients sensitized to Alternaria alternata.

Comparative Clinical Study of Nasya and Jala Neti in Allergic Rhinitis

Allergic rhinitis is a type of inflammation associated with a group of symptoms affecting the nose. When a person with allergic rhinitis breathes in an allergen such as pollen, animal dander, mold, or dust, the body releases chemicals that cause allergy symptoms. Now-a-days, it is a common inflammation in the population. Nasya is very commonly performed in Ayurveda for the same. In the present study another procedure “Jalaneti '' is also selected, which is a classical procedure of Yoga Therapy. The present study has been done to compare the effect of nasya and jalaneti in allegic rhinitis. The study was conducted at Panchkarma Department of Shree Saptashrungi Ayurved Mahavidyala and Hospital, panchvati, Nashik, Maharashtra. Total number of 20 patients of age 10-70 years having allegic rhinitis or Jirnapratishyay as mentioned in Ayurvedic classics were selected. Out of which Nasya with Vacha Tail was given to 10 patients and Jalaneti with Saindhav Jala was given to another 10 patients. Comparison was done by subjective assessment. It was observed that Nasya done as per the textual methods is highly effective in Allergic Rhinitis and showing a way out to the individual suffering from chronic disease. The study confirmed the effect of Nasya in Allergic Rhinitis in improving the quality of life of patients without any untoward effects.

Serum allergen-specific IGE to common aeroallergens among allergic rhinitis patients in Egypt

Background Allergic rhinitis is the most prevalent allergic disease, and the prevalence and sensitization patterns differ among countries. Identifying the most common inhalant allergen in each region plays a key role in the diagnosis and management of allergic rhinitis. There are no data available about the most prevalent aeroallergen among allergic rhinitis patients in Egypt. The aim of this study is to evaluate the prevalence of positive serum allergen-specific IGE to common inhalant allergens among allergic rhinitis patients in Egypt. A cross-sectional study was conducted on 354 allergic rhinitis patients, serum allergen-specific IGE was measured by using the Immuno CAP system to 16 common regional aeroallergens including (pollens, mite, molds, animal dander, and cockroach). Results The overall rate of sensitization to any allergen was 74.6%. Dermatophagoides pteronyssinus, birch pollens, and Dermatophagoides farina were the most prevalent allergens (29.7%, 23.7%, and 18.6%), respectively. Cladosporuim molds were the least prevalent individual allergens (1.7%). Conclusion Our data suggest that Dermatophagoides pteronyssinus and birch pollens were the predominant allergen sources among allergic rhinitis patient in Egypt.

A CONCEPTUAL REVIEW OF KAPHAJA ABHISHYANDA / VERNALKERATO CONJUNCTIVITIS

Kaphaja Netra Abhishyanda is defined in Ayurveda as the disease affecting all parts of the eye characterized by Guruta (heaviness of lids), Kandu (itching), Muhurmuhursrava (repeated lacrimation), photophobia and burning sensation in eyes etc. On reviewing the clinical presentation from modern texts, it is found that Vernalkerato conjunctivitis resembles with Kaphaja Netra Abhishyanda (conjunctivitis). Vernal keratoconjunctivitis is a type of allergic conjunctivitis which is a disease of early age group and becoming more important cause of corneal visual impairment and blindness. Vernalkerato conjunctivitis is the inflammation of conjunctiva caused by a wide range of allergens like pollens, dust and smoke, animal dander, mites or other allergy causing substance and is characterized by itching, hyperaemia and mild papillary reaction. This is also known as Spring Catarrh. ‘Spring catarrh’ nomenclature is indicative of season Vasant Ritu (spring season) which is the Kapha Prakopa period of the year as per the Ayurvedic principles and also the Kapha Prakopaka period of childhood age group. Keywords: Abhishyanda, Guruta, Kandu, photophobia, Muhurmuhursrava.

CONCEPT OF DUSHI VISHA (CUMULATIVE TOXICITY) IN MODERN ERA: A CRITICAL REVIEW

In present era, thousands of harmful toxins are accumulated in environment are taken by human beings in different forms. These harmful toxins cause cumulative toxicity in human being which results in symptoms that can be seen slowly after their long- term use. These harmful toxins may be of Sthavara Visha/plant origin (e.g. Fruits and vegetables contaminated with pesticides, ripening agents, infections, heavy metal toxicity in plants, Maida, Pollen grains, dust, Latex from plants) Jangama Visha/ animal origin (e.g. Animal dander, adulteration in milk and milk products, Sea food containing heavy metals such as Hg, PCBs) Kritrim Visha (e.g. Toxic ingredients in cosmetics, Food preservatives, Food Flavouring agents, Synthetic Colour Additives, Environmental Pollution, Agricultural poisons, Medications like aspirin etc.). This Cumulative toxicity is similar to Dushi Visha as described in Ayurveda. A poison, which is having fewer properties, which means less than ten classical properties that a poison should contain, or either the poison which is having lesser potency of all the ten properties, attains a latent stage in the body is called as Dushi Visha (latent poison). The aim and objectives of this study is to study the concept of Dushi Visha in modern era and its toxic effects on human body.

ASSESSMENT OF AIRBORNE FUNGAL ALLERGENS: BIOCHEMICAL AND IMMUNOPROTEOMIC APPROACH : A REVIEW

Atmospheric air contains a wide variety of components like inorganic gaseous, particulate pollutants and biological particles such as fungal spores, pollen grains, dust mites and animal dander that can affect human health. Among biological particles, airborne fungal spores are an essential source of aeroallergens. In India, allergy prevalence has become a major health concern with symptoms ranging from mild rhinitis to severe asthma and even life threatening anaphylaxis. Aerobiological studies provide qualitative and quantitative information about fungal spores of a given region. The proper identification, purification and molecular characterization of fungal allergens are essential for proper diagnosis and to design immunotherapeutic vaccines. Only a few fungal allergens have been characterized by recombinant technology and structural biology. Detailed analysis of fungal biochemistry can be done by using multiple techonologies including Skin Prick Test (SPT), ELISA, immunonoblot, MALDI TOF, genome and transcriptome sequencing, recombinant technology and bioinformatics. The purpose of this review is to describe the different strategies that have been used to identify, purify and characterize the fungal allergens, which may enrich the database of allergy research and help in the implementation of immunotherapy in future.

Association of Vitamin D Levels and Other Risk Factors with Asthma Exacerbations in Children

Background: The risk factors for asthma exacerbations are well understood. However, the effect of vitamin D levels on number of asthma exacerbations per year is not clearly studied. The objective of the study was to find out the association of serum vitamin D levels and asthma risk factors on asthma exacerbations. Methods: In this study, ninety-nine subjects from 5 to 15 years of age were recruited at an episode of acute exacerbation. It was a cross sectional study and carried out from 2012 to 2015. Pulmonary function test was done by spirometry. Asthma exacerbation was labeled when forced expiratory volume/ forced vital capacity (FEV1/FVC) ratio was less than 80% (American Thoracic Society). Global Initiative for Asthma (GINA) guidelines were used to classify asthma into mild, moderate and severe persistent asthma. Serum vitamin D levels were measured by chemiluminescence method. Pearson Chi-square test was applied and p value (p<0.05) was considered as statistically significant. Results: Children who had exposure to animal dander had significantly lower asthma exacerbations per year (p-value <0.046). There was no significant association between vitamin D levels and number of exacerbations per years (p-value <0.099). Asthma was prevalent in girls of low socioeconomic status (SES) compared to males. However, there was no significant association between smoke, exercise, home environment, food allergies, weather, pollen and dust with asthma exacerbations. Conclusion: Low levels of vitamin D were not associated with increased number of asthma exacerbations per year. However, children exposed to animal dander had lesser number of exacerbations per year (p-value <0.046). Keywords: Asthma; Vitamin D; Children; Exacerbations, Risk factors.