alireza mahdaviani

 Anxiety and depression in patients with asthma have been linked to frequent exacerbations, increased use of healthcare resources, and poor asthma control.

 In the current study, we examined the correlations between asthma and symptoms of depression/anxiety in adolescents with asthma referred to Masih Daneshvari and Mofid hospitals during 2020 - 2021.

 The current observational, cross-sectional study was conducted by administering the Spence Children Anxiety Scale and a demographic information checklist among 105 subjects. Asthma severity was measured using forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity (FVC), the number of short-acting β-2 agonists used per week or month, the number of night awakenings per week or month, having asthma symptoms in daily activities, the number of asthma attacks needing oral corticosteroids per year, and the number of disease exacerbations per week or month. Data were analyzed, and the correlation between the variables was investigated through linear regression and ordinal logistic regression.

 Patients with a mean age of 11.3 ± 2.5 years showed a mean overall anxiety score of 14 ± 9 out of 114. There was a significant negative correlation between the overall score of anxiety disorders and FEV1 and FEV1/FVC (P < 0.001). There was also a direct correlation between the overall score of anxiety disorders and the frequency of using β-2 agonists, the number of night awakenings, interference with normal functions, and exacerbation frequency (P < 0.001).

 Our findings indicated a significant association between anxiety disorders and asthma in children. Considering the high prevalence of asthma in Iran than the global average, studying the underlying mechanisms of anxiety and psychological and environmental variables in children with asthma can aid in developing effective psychological therapies.

It is known that inflammatory responses occur in the airways of patients with non-cystic fibrosis bronchiectasis during respiratory exacerbations but the role of these cytokines is not clear in this condition. Herein we evaluated the levels of interleukin-1b (IL-1b), IL-8 and tumor necrosis factor a (TNF-a) in the serum and bronchoalveolar lavage among children with non-cystic fibrosis bronchiectasis.
This cross-sectional study was performed on all children with non-cystic fibrosis bronchiectasis who were admitted with respiratory exacerbation in the pediatric pulmonology ward of Masih Daneshvari Hospital, Tehran-Iran. All patients underwent fiberoptic bronchoscopy and spirometry before and after the bronchoscopy. IL-1b, IL-8, and TNF-a levels were measured in the serum and bronchoalveolar lavage.
Patients included 10 (59%) female and 7 (41%) male subjects with mean age of 13.8 years (range, 5-18). Mean values for forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were below the normal range before and after bronchoscopy. Mean value for FVC (from 55% to 63%, P= 0.01) and FEV1 (from 60% to 64%, P= 0.26) increased after bronchoscopy compared to before that. IL-1b and IL-8 levels were increased and TNF-a level was decreased in the serum and bronchoalveolar lavage but no significant correlation was found between spirometry and these cytokines levels.
Changes in inflammatory cytokines levels in serum and bronchoalveolar lavage during respiratory exacerbation in patients with non-cystic fibrosis bronchiectasis have no significant correlation with spirometry and cannot be used in clinical practice.

Chronic Granulomatous Disease (CGD) is a rare inherited primary immune deficiency disorder with defective respiratory burst activity in phagocytes, resulting in recurrent pyogenic infections. In this study, we described two CGD patients who had done bone marrow transplantation (BMT). As Bone marrow transplantation (BMT) is the definitive treatment of the disease, we evaluated the function of their lungs before and after BMT. In both patients, the BMT was from their siblings. In case 1, the patient’s pulmonary function (PFT) before BMT was: FEV1: 34, FVC: 40, FEV1 / FVC: 72%, and after BMT was: FEV1: 66, FVC: 40 by 49, FEV1 / FVC: 64%. In case 2, the patient’s PFT before BMT was: FEV1: 22, FVC: 36, FEV1 / FVC: 41%, and after BMT was: FEV1: 47, FVC: 33, FEV1/FVC: 43%. BMT significantly improved their Pulmonary Problems and Preclinical (PFT). In addition, after BMT, both patients’ well-tolerated clinical signs and the infection rate, and the number of hospitalizations in both patients decreased.

This study aimed to investigate the prediction of asthma control on the basis of perceived stress، locus of control، and self-efficacy in adult patients with asthma. This was a descriptive-correlative and cross-sectional study. The solecty of this study is all asthmatic patients in Tehran. our sample consisted of 100 participants who were selected by purposeful sampling method. A total of 100 patients with asthma were selected among outpatients of Masih Daneshvari Hospital. Participants included 52 women and 48 men. Their mean (±SD) age was 36. 12 (±9. 82) years. Sociodemographic data were collected and Perceived Stress Scale (PSS)، Multidimensional Health Locus of Control (MHLC)، Asthma Self-efficacy Scale (ASES)، and Asthma Control Test (ACT) were applied. Data were analyzed by Pearson correlation and multiple regression analysis. Statistical analysis was performed using the SPSS ver. 16. 0. The results indicated that there were negative significant relationships between perceived stress، dimension of external control (chance) and asthma control، but positive significant relationships between self-efficacy and asthma control. In regression analysis، the perceived stress was the predictor of asthma control. In this study، our findings suggest that perceived stress has an important role in the development and maintenance of asthma symptoms. In addition، self-efficacy and a tendency to externally attribute the locus of control (chance) are significantly associated with asthma control.

The prevalence of allergic diseases has risen in the last decades. The objective of this study was to determine the common allergens in children via the skin prick test. This cross-sectional study recruited 313 allergic children (4 months to 18 years old) referred to the Asthma and Allergy Clinic of Children’s Medical Center in Tehran. A questionnaire containing demographic data and patient history was completed. The Skin Prick Test (SPT) was selected according to the patients’ history of food and/or aeroallergen sensitivity. Patients (62.4% male, 37.6% female) with symptoms of asthma (n=141, 57.1%), allergic rhinitis (n=50, 20.4%), atopic dermatitis (n=29, 11.7%), and urticaria (n=20, 8.1%) were studied. Positive skin prick test to at least one allergen was 58.1%. The most prevalent allergens were tree mix (26%), Alternaria alternata (26%), weed mix (23.6%), Dermatophagoides farinae (22.9%), Dermatophagoides pteronyssinus (22.9%), milk (21.7%), eggs (20%), and wheat flour (18.3%). Also, common allergens in the patients with different symptoms of allergic disorders were as follows: asthma (tree mix, weed mix, and Dermatophagoides farinae); allergic rhinitis (Dermatophagoides farinae, tree mix, and Dermatophagoides pteronyssinus); and atopic dermatitis (Alternaria alternata, Dermatophagoides pteronyssinus, and cockroaches). Identifying allergens in each area is necessary and has an important role in the diagnosis and management of allergic disorders and possibility of performing immunotherapy. In this study, the most common aeroallergens were tree mix, Alternaria alternata, and weed mix and also the most common food allergens were milk, eggs, and wheat. Considering these data, appropriate preventive strategies can decrease the cost and morbidity of therapeutic actions.

Severe congenital neutropenia (SCN) is a rare primary immunodeficiency disease. Different genes are found to be associated with SCN, including ELA2, HAX1, WAS, GFI1, G-CSFR and G6PC3. The aim of this study was to find different gene mutations responsible for SCN in Iranian patients. Twenty-seven patients with SCN referred to Immunology, Asthma and Allergy Research Institute during a five year priod 5 years (May 2007 and May 2012), were included in this study. Neutropenia related exons and flanking regions of ELA2, HAX1, WAS, GFI1, G-CSFR and G6PC3 were amplified by PCR and the sequences were analyzed. The results showed different mutations including 4 ELANE mutations, 11 HAX1 mutations and 2 G6PC3 mutations. None of the patients had GFI1 mutation and also one mutation was found in G-CSFR in a patient with ELANE mutation. Ten patients had unknown genetic diagnosis which was compatible with other studies. According to these results, most of the patients showed HAX1 mutations and this finding which significantly differed from other reports, might be related to differences in Iranian ethnicity and also in high rate of consanguineous marriages in Iran.

This study aimed at evaluating HRCT pulmonary manifestationsin children with Common Variable Immunodeficiency (CVID) hospitalized inthe Pediatric Ward of Masih Daneshvari Hospital during a 10-year period. This study aimed at evaluating HRCT pulmonary manifestations in children with Common Variable Immunodeficiency (CVID) hospitalized in the Pediatric Ward of Masih Daneshvari Hospital during a 10-year period. This retrospective study evaluated 25 children hospitalized with the diagnosis of CVID in the Pediatric Ward of Masih Daneshvari Hospital from 2001 to 2011 and their pulmonary HRCT scans were evaluated. The most common pulmonary HRCT findings were lymphadenopathy (66.7%), bronchiectasis (50%), air trapping (33.3%) and peribronchial wall thickening (33.3%). The highest percentage of CT-scan findings was detected in patients aged 13-17 yrs. Most of the pulmonary changes due to CVID are preventable or treatable. Also, it is possible to prevent irreversible complications of disease if it is diagnosed early. Therefore, HRCT is strongly recommended as an accurate and effective method for monitoring and fast recognition of pulmonary manifestations of the disease especially bronchiectasis which is a very common finding indicative of poor prognosis

Common variable immunodeficiency (CVID) is a heterogeneous group of disorders، characterized by hypogammaglobulinemia، defective specific antibody responses to pathogens and increased susceptibility to recurrent bacterial infections. Delay in diagnosis and inadequate treatment can lead to irreversible complications and mortality. In order to determine infectious complications among undiagnosed CVID patients، 47 patients diagnosed in the Children''s Medical Center Hospital during a period of 25 years (1984-2009) were enrolled in this study. Patients were divided into two groups including Group 1 (G1) with long diagnostic delay of more than 6 years (24 patients) and Group 2 (G2) with early diagnosis (23 patients). The clinical manifestations were recorded in a period prior to diagnosis in G1 and duration follow up in G2. The number of infections، non infectious complications، hospitalizations، and mortality rate was compared between the two groups. The patients in G1 group had 500 episodes of infections before diagnosis in 256 patient-years (0. 08 per patient per year) and 203 times of hospitalization (0. 03 per patient per year)، which were significantly higher than in G2 patients، who had 75 episodes of infections (0. 015 per patient per year) and 88 hospital admissions (0. 018 per patient per year) during 207 patient follow-up years. Frequency of enteropathies and liver diseases in G1 were also significantly higher than in G2. Lack of awareness about nature of disease، especially among rural and suburban physicians، single organ involvement as a site of clinical presenting، and predomination of non infectious presentation in G1 were the major factors of delayed diagnosis. Diagnostic delay is a major concern in CVID patients، which could result in irreversible complications and mortality، while early diagnosis and proper initial treatment leads to better outcomes and quality of life.