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Hindi translation and validation of the Childhood Asthma Control Test (C-ACT).Children aged 5-11 years with newly diagnosed asthma were enrolled and followed every 4-weeks for 12 weeks. Asthma control was assessed with C-ACT and Global Initiative for Asthma (GINA) criteria.60 children (34 boys, 56%) were enrolled. C-ACT showed a statistically significant correlation with GINA criteria at all visits. Cronbach's alpha to assess the internal consistency was 0.74, and the intraclass correlation coefficient to measure test-retest reliability was 0.83. The maximum area under the curve (AUC) for C-ACT was 0.95 (95% CI: 0.89-1.0; P0.001). At a cutoff score of ≥20, the sensitivity, specificity, positive predictive value, and negative predictive value of C-ACT were 97.9%, 25%, 88.7%, and 87.5%, respectively.Hindi version of the C-ACT score is valid, reliable, and correlates well with the GINA criteria for asthma control in children. It has a high sensitivity at a cutoff score of ≥20, but the specificity was poor in differentiating asthma control.

BackgroundThere is conflicting evidence for vitamin D supplementation in childhood asthma. We aimed to systematically synthesise the evidence on the efficacy and safety of vitamin D supplementation in childhood asthma.MethodsWe searched electronic databases (Medline, Embase and Web of Science) and a register (CENTRAL) for randomised controlled trials (RCTs) published until 30 September 2021. RCTs enrolling asthmatic children (1–18 years old) and comparing vitamin D against placebo/routine care were included if they met at least one of the endpoints of interest (asthma attacks, emergency visits or hospitalisation). We used the Risk of Bias 2 tool for risk of bias assessment. Random-effects meta-analysis with RevMan 5.3 software was performed. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the level of certainty of the evidence.Results18 RCTs (1579 participants) were included. The pooled meta-analysis did not find a significant effect of vitamin D supplementation on asthma attacks requiring rescue systemic corticosteroids (six studies with 445 participants; risk ratio (RR) 1.13, 95% CI 0.86–1.48; I2=0%) (moderate-certainty evidence). In addition, there was no significant difference in the proportion of children with asthma attacks of any severity (11 trials with 1132 participants; RR 0.84, 95% CI 0.65–1.09; I2=58%) (very low-certainty evidence). Vitamin D does not reduce the need for emergency visits (three studies with 361 participants; RR 0.97, 95% CI 0.89–1.07; I2=0%) and hospitalisation (RR: 1.38, 95% CI 0.52–3.66; I2=0%) (low-certainty evidence).ConclusionVery low- to moderate-certainty evidence suggests that vitamin D supplementation might not have any protective effect in childhood asthma.

Objectives Insulin resistance may be associated with impaired lung function. The objective of this study was to examine the relationship between insulin resistance and lung function in asthmatic children. Methods We performed a cross-sectional study on asthmatic children aged 6–18 years at Tertiary Care Center, India. Fasting serum glucose and insulin levels were analyzed to calculate the homeostatic model assessment of insulin resistance (HOMA-IR) in 90 children. Lung function tests were performed. Spearman correlation was used to assess the relationship between insulin resistance and lung function. Linear regression was done to adjust the potential confounders. Results Insulin resistance was present in 15.5% of patients. We found a statistically significant inverse relationship between HOMA-IR and spirometric parameters such as forced expiratory volume in 1 s/forced vital capacity ratio and forced expiratory flow between 25 and 75% on Spearman correlation. However, adjusted regression for age, gender, and body mass index showed no significant association of lung function parameters with HOMA-IR. Conclusions Insulin resistance may be considered for the decline in lung function in asthmatic children.

This systematic review focuses on the efficacy of auditory verbal therapy (AVT) in children with cochlear implants based on their auditory performance. The results presented are based on research findings from 2010 to 2021. The systematic review was designed based on the Popular Reporting Systems for the Systematic Review and Analysis of Meta-Analysts (PRISMA), the 2020 revised version, and the Critical Evidence for Clinical Evidence (CATE) checklist. Specific keywords were chosen based on the formulated research question and searched on the following search engines: Google Scholar, Microsoft Academic, PubMed, Semantic Scholar, Cochrane, Science Direct, and BASE. All the searched articles were analysed based on specific exclusion criteria. The results revealed an important progression based on the auditory performance among children with cochlear implantation who received habilitation. The studies highlight that younger the age at implantation better the auditory performance and this may be necessary to allow at least relatively normal organization of auditory pathways in pre-lingual children with hearing impairment. Therefore, regular revitalization of aural-verbal rehabilitation and speech and language therapy is essential for younger children with hearing impairment to achieve the highest level of hearing function. This systematic review highlights importance of assessment of the auditory performance to be considered in the test battery while evaluating children with CI before and after habilitation along with AVT.

Purpose: The aim of this study was to analyze the subcortical and cortical auditory evoked potentials for speech stimuli in children with speech-in-noise (SIN) deficits associated with auditory processing disorder (APD) without any reading or language deficits. Method: The study included 20 children in the age range of 9–13 years. Ten children were recruited to the APD group; they had below-normal scores on the speech-perception-in-noise test and were diagnosed as having APD. The remaining 10 were typically developing (TD) children and were recruited to the TD group. Speech-evoked subcortical (brainstem) and cortical (auditory late latency) responses were recorded and compared across both groups. Results: The results showed a statistically significant reduction in the amplitudes of the subcortical potentials (both for stimulus in quiet and in noise) and the magnitudes of the spectral components (fundamental frequency and the second formant) in children with SIN deficits in the APD group compared to the TD group. In addition, the APD group displayed enhanced amplitudes of the cortical potentials compared to the TD group. Conclusion: Children with SIN deficits associated with APD exhibited impaired coding/processing of the auditory information at the level of the brainstem and the auditory cortex. Supplemental Material: https://doi.org/10.23641/asha.21357735

Background To achieve balance, persons with blindness (PWB) use proprioceptive and vestibular cues rather than the visual system; however, PWB are equally susceptible to acquire vestibular disorders. Reliable assessments of the vestibular system in PWB are essential to determine the presence or absence of vestibular disorders. Purpose The saccular and the utricular functioning can be assessed using cervical vestibular-evoked myogenic potential and ocular vestibular-evoked myogenic potential, respectively. Evaluation of the functional integrity of the semicircular canals requires an assessment of the vestibular ocular reflex; however, this can be challenging in PWB. Video head impulse test (vHIT) assesses the vestibular ocular reflex (VOR) elicited against the natural high-frequency head movement in the planes of all six semicircular canals. This study aimed to explore the feasibility and outcomes of administering vHIT in PWB. Research Design Standard (static) groups comparison. Study Sample Nineteen young PWB and 23 age-matched adults with “normal” vision (control group) were included in the study. Data Collection and Analyses PWB underwent vHIT once, while the control group was tested in three conditions; condition 1 was used to simulate blindness for the control group, where vHIT was done in a pitch-dark room without prior instructions; condition 2 included vHIT testing in daylight, without a fixed visual target and any instructions; and condition 3 involved vHIT in daylight in the presence of a set visual target and with standard instructions to maintain visual focus on the visual target. Results The VOR gain was abnormal in the PWB group for all the canals. Among the PWB, the lateral canals (mean = 0.63) had the best VOR gain, followed by the anterior canals (mean = 0.53) and the posterior canals (mean = 0.31). In the control group, the VOR gain was significantly reduced in condition 1. There was no significant difference between the VOR gain in the PWB group and the control group in condition 1 for the lateral and the anterior canals. A higher proportion of participants in the PWB group had the presence of refixation saccades. Conclusion VOR is significantly reduced in PWB but not completely absent. There may be a need to develop normative data for blind individuals to decide whether or not a person with blindness has a vestibular dysfunction, specifically a VOR deficit.

AimTo determine the clinicopathological characteristics and outcomes of children diagnosed with lupus nephritis in a tertiary hospital in western Rajasthan and compare it with the data available from other parts of India.Material and methods:A retrospective review of children presenting to a tertiary care center in western Rajasthan, India, with a diagnosis of pediatric Systemic Lupus Erythematosus (p SLE), between July 2017 and July 2020 was done. Comparisons of pediatric lupus in western India to other parts of country were done.Results19 children with SLE with Renal involvement were enrolled and followed up. The median age at presentation was 15 years (IQR-16–9.5) (73% females). 8/19 (42%) children presented with AKI, of which 62% children presented as rapidly progressive renal failure. Six (37.5%) patients required dialysis at presentation. 84.21% of children were evaluated with renal biopsy, 16 biopsies were done in 19 children, among which class II, III, and IV lupus nephritis were reported in 21%,42%, and 35% respectively(4 crescentic). Antiphospholipid antibodies were positive in 8/15(53%), children which is much higher than a reported incidence of 30% in other Indian studies. Ten patients (52%) had neurological involvement, with seizures being the most common form of presentation (60%). Seven patients (36%) developed hepatitis. We noted many uncommon presentations in the small group like Autoimmune Pancreatitis, Mononeuritis multiplex, and peripheral digital gangrene. Cyclophosphamide was used in 10 out of 19 patients for inducing remission with class 3 and 4 nephritis and MMF in 8 children. 55% patients attained remission (after completing induction), of which 4 relapsed during the follow up. Four patients were lost to follow-up. A total of 27% patients died and 10% patients developed end stage renal failure. It was seen that those who died had more cardiac and neurological involvement at presentation, higher grade of proteinuria, lower GFR, and need for dialysis at admission.Conclusion:We found a more severe form of clinical manifestation in pediatric SLE patients at the time of the first presentation in the form of severe renal and extrarenal manifestation compared to other parts of the country.

A cochlear implant is an electronic sensory system that converts mechanical energy into coded electrical signals that directly activate the auditory nerve fibers. Present review article investigates the findings of previous research papers which have assessed speech and language outcome in children who underwent early cochlear implantation. Several databases, including PubMed, Google, Google Scholar, and Medline, were investigated for research papers on the speech and language outcomes of children who had early-life implants. According to previous research, early detection and intervention of hearing loss are critical for the growth of speech and language skills. The effect of early detection of hearing loss and early cochlear implantation on a child's overall speech-language and auditory growth is highlighted in this article.

Purpose Auditory training is known to improve the speech-perception-in-noise (SPIN) skills in children with auditory processing disorders (APDs); however, conventional non–computer-based trainings are dreary and nonmotivating. This study intended to develop a computer-based noise desensitization training module in Indian English and test the efficacy of the same in children with APD having SPIN deficits. There are no such modules available at present to be used in Indian children. Method The module incorporated words-in-noise training, with monosyllables and trisyllables as target words in the presence of speech-shaped noise as well as multitalker babble at different signal-to-noise ratios ranging from +20 to −4 dB SNR. The study included 20 children with SPIN deficits diagnosed with APD and who were recruited randomly to the experimental group who received the training ( n = 10; M age = 11.1 years) and to the control group who did not receive any training ( n = 10; M age = 11.4 years). The outcome measures included behavioral measures and electrophysiological measures (auditory long latency responses for speech in quiet and noise). Results Compared to children in the control group, children in the experimental group exhibited improvements in the SPIN scores as well as temporal processing measures after training. Dichotic consonant–vowel tests and auditory memory and sequencing tests did not yield significant improvement post training. Also, auditory long latency responses in quiet and noise revealed significant reduction in the amplitudes after training. No significant difference was noted in the latencies of auditory long latency responses post training. Control group participants did not show any significant difference in any of the measures between the initial and follow-up evaluations. Conclusions The developed training module was successful in fetching improvements in behavioral and electrophysiological measures. It would be a great addition to the evidence-based rehabilitation support inventory for children with SPIN deficits in India. Supplemental Material https://doi.org/10.23641/asha.14551041

Cochlear implantation (CI) is a safe technique to give hearing sensation to a person with hearing impairment. The present study aimed to compare the two surgical approaches of CI, mastoidectomy and veria, for their effects on saccular function assessed using cervical vestibular-evoked myogenic potential (cVEMP).Multiple group time series design.The study included 63 children (3-8 years old) who underwent CI using veria technique (The post-implant results revealed the absence of cVEMP in nearly 40% of the participants. The amplitudes were significantly lower at the time of the switch-on and at the 4-months follow-up period (The saccular responses are better preserved with the mastoidectomy technique than the veria technique for CI surgery.

Acoustic change complex (ACC) is an important tool to investigate the encoding of the acoustic property of speech signals in various populations. However, there is a limited number of research papers that have explored the usefulness of ACC as a tool to study the neural encoding of consonant–vowel (CV) transition in children with central auditory processing disorder (CAPD). Thus, the present study aims to investigate the utility of ACC as an objective tool to study the neural representation of consonant–vowel (CV) transition in children with CAPD. Twenty children diagnosed having CAPD and 20 normal counterparts in the age range of 8–14 years were the participants. The ACC was acquired using naturally produced CV syllable /sa/ with a duration of 380 ms. Latency of N1′ and P2′ was found to be prolonged in children with CAPD compared to normal counterparts, whereas the amplitude of N1′ and P2′ did not show any significant difference. Scalp topography showed significantly different activation patterns for children with and without CAPD. Prolonged latencies of ACC indicated poor encoding of CV transition in children with CAPD. The difference in scalp topography might be because of the involvement of additional brain areas for the neural discrimination task in children with CAPD.

PurposeThis study aimed to investigate usefulness of acoustic change complex (ACC) as an objective measure of difference limen for intensity (DLI) in auditory neuropathy spectrum disorders (ANSD) and cochlear hearing loss (CHL).MethodThe study used a multiple static group comparison research design. Twenty normal-hearing individuals (NH), 19 individuals with ANSD, and 23 individuals with CHL underwent DLI measurement using behavioral (psychoacoustic) techniques and ACC. For eliciting ACC, a 500-ms, 1,000-Hz pure tone was presented at 80 dB SPL. Additionally, six variants of this stimulus with intensity increments of 1, 3, 4, 5, 10, and 20 dB starting 250 ms after stimulus onset were used to elicit the ACC.ResultsThe lowest intensity change that produced replicable and clearly identifiable ACC was referred as objective DLI. In comparison to NH and CHL, the behavioral as well as the objective DLI were significantly larger (poorer) in ANSD (p< .05). Significantly strong positive correlation existed between DLI obtained using behavioral and objective measures (p< .05).ConclusionsACC could be a useful objective tool to measure DLI in the clinical population, provided the individuals of the clinical population fulfill the prerequisite of the presence of Auditory Long Latency Responses.Supplemental Materialhttps://doi.org/10.23641/asha.12560132

BackgroundPrevious studies have used the acoustic change complex (ACC) as a tool to investigate the perception of acoustic changes in an ongoing signal in various populations. However, there is no study that has explored the usefulness of ACC to objectively study the neural representation of CV transition in children with CAPD. The present study aims to investigate the utility of ACC as an objective tool to study neural representation of a CV transition in children with CAPD.Material and methodsThere were 40 children aged 8 to 14 years in this study. They were divided into 2 groups of 20 children each based on the outcomes of audiological tests: a clinical group (CAPD) and a comparison group. A diagnosis of CAPD was made for 20 children after completion of a two-stage evaluation process (screening and diagnosis). The ACC was acquired using Neuro Scan Syn (v. 4.4) for the naturally produced CV stimulus /sa/ which had a total duration of 380 ms.ResultsA Mann–Whitney U-test revealed significantly delayed latency of N1′ and P2′ in children with CAPD compared to healthy children. However, there was no significant difference in peak-to-peak amplitude of N1′–P2′ between children with CAPD and normal children.ConclusionsThe prolonged latencies of ACC indicated poor encoding of the CV transition in children with CAPD. It is suggested that poor temporal processing of CV transitions in these children might be the reason for poor speech perception in the CAPD population.

Acoustic change complex (ACC) is an evoked potential recorded in response to subtle change(s) in the continuing stimuli. It is assumed that poor speech perception can be due to poor encoding of consonant–vowel (CV) transition in cochlear hearing loss (CHL) and auditory neuropathy spectrum disorder (ANSD). The present study aims to investigate the use of ACC as an objective tool to study neural representation of CV transition in individuals with ANSD, CHL, and normal hearing (NH). The study consisted of three groups of population (NH, ANSD, and CHL) in the age range of 18–40 years. ACC was recorded for naturally produced CV stimulus /sa/ of 380 ms in duration, which consists consonant (150 ms) and vowel (230 ms) using Biologic Navigator pro 7.2.1. The result showed significantly prolonged latencies of ACC in individuals with ANSD compared to NH. The current study also showed significantly prolonged latency and significantly lower peak-to-peak amplitude in individuals with ANSD compared to CHL. The interesting finding of the present study was significantly better peak-to-peak amplitude for CHL compared to NH. Whereas, there was no significant difference between NH and CHL for latencies measures. Poor neural synchronization in individuals with ANSD could be the reason of poor neural representation of CV transition in present study. The outcome of the present study showed poor neural representation of CV transition in individuals with ANSD compared to CHL and NH. Current study also showed better encoding of CV transition in individuals with CHL compared to ANSD.

To determine the association between blood eosinophil and neutrophil counts with asthma control.This retrospective study, conducted in tertiary care hospital of western India, evaluated the hospital electronic medical record (HEMR) of children aged 5 to 18 y who were diagnosed with asthma as per the Global Initiative for Asthma (GINA) guidelines in the pediatric chest clinic (PCC). Eosinophil and neutrophil counts were recorded from HEMR and asthma control was determined as per the GINA guidelines on follow-up.A total of 742 children attended the PCC in the last 2 y from March 2017 to February 2019; out of which, blood eosinophil and neutrophil counts were done in 116 children with asthma. The median eosinophil and neutrophil count were 0.46 (0.13, 0.78) × 10High lung function is associated with good asthma control. Although not independently associated, the high absolute eosinophil counts (AEC) is associated with better asthma control, while high absolute neutrophil counts (ANC) is associated with poor asthma control.

Background: West Nile virus (WNV) is a positive-sense single-stranded RNA virus of the family Flaviviridae and genus Flavivirus. The virus is transmitted primarily by the bite of Culex species mosquito and is of global concern. The infection is associated with a wide spectrum of signs and symptoms and is more fatal in the elderly, infants, and immunocompromised individuals. Case presentation: We report a case of WNV meningoencephalitis in an immunocompetent female who presented with features of acute meningitis with a 5-days history. After the radiological suspicion of viral meningoencephalitis, viral serology was performed and was reactive for IgM antibody against WNV, delaying the diagnosis for at least 5 days. Conclusion: The purpose of this case report is to prime the treating physicians on the usefulness of viral serology in such a scenario. Viral serology is a simple and relatively rapid technique to diagnose or rule out the suspected viral cause of meningoencephalitis and minimize the time gap between diagnosis and start of supporting treatment wherever appropriate antivirals are not available for clinical use.

The neurological manifestation following a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is varied, and till now, only a few studies have reported the same.We used retrospective data from May to July 2021 and prospective study data from August to September 2021, including that from children aged between one month and 18 years who presented to a tertiary care referral center with the neurological manifestation and had a history of coronavirus disease 2019 (COVID-19) infection or exposure and positive SARS-CoV-2 serology. The neuroradiological manifestations were further categorized as in a predesigned proforma.Case records of the 18 children who fulfilled the criteria were included in the study; among them, seven (38.8%) were male and 11 (61.1%) were female. Predominant presentation in our study group was status epilepticus (six of 18) and Guillain-Barré syndrome (five of 18). Other manifestations included stroke (two of 18), demyelinating syndromes (three of 18), and autoimmune encephalitis (two of 18). Most of the children had favorable outcomes except for one mortality in our cohort.Delayed complications following SARS-CoV-2 infection are seen in children. A temporal correlation was noted between the COVID-19 infection and the increasing number of neurological cases after the second wave. Steroids could be beneficial while treating such patients, especially in the presence of high inflammatory markers. Testing for SARS-CoV-2 serology during the pandemic can give a clue to the underlying etiology. Further multicentric studies are required to understand the varied neurological manifestations following SARS-CoV-2 infection in children.

To identify the risk factors for pneumonia and severe pneumonia in children.Prospective cohort study.Five tertiary-care teaching hospitals in India.Children 2 to 59 months of age suffering from acute respiratory infection (ARI).Risk factors for the development of WHO defined pneumonia and severe pneumonia.A total of 18159 children screened, and 7026 (39%) children with ARI were enrolled. According to the WHO criteria, 938 (13.4%) and 6088 (86.6%) of the enrolled children had pneumonia and no pneumonia, respectively. Out of 938 children with pneumonia, 347 (36.9%) had severe pneumonia. On univariate analysis, younger age, male gender and low weight for height, were significant risk factors for pneumonia. On multivariate analysis, one-unit increase in age in months (OR = 0.97; 95% CI: 0.97-0.98) and weight for height z-score (OR = 0.76; 95% CI: 0.72-0.79) had a protective effect.Young age and undernutrition (low weight for height/length) in children are significant independent risk factors for pneumonia.

Background The role of serum Procalcitonin (PCT) in adults in diagnosis of Community acquired pneumonia (CAP) is well established, however, role in pediatric CAP remains controversial. Objectives The objective of this study was to investigate the utility of serum procalcitonin in differentiating bacterial community-acquired lower respiratory tract infection from non-bacterial respiratory infection in children; radiologically confirmed pneumonia was used as the reference. In addition, we assessed the utility of adding the PCT assay to the clinical criteria for diagnosis of pneumonia. Study design Subanalysis of a larger prospective,multicentriccohort study. Participants Children, 2 months to 59 months of age, attending paediatric OPD of 5 urban tertiary care hospitals, suffering from acute respiratory infection (ARI). Intervention Detailed clinical history and examination findings of enrolled children were recorded on predesigned case record form. Samples for PCT were obtained at admission and were measured centrally at the end of the study except for one site using VIDAS® B.R.A.H.M.S PCT kit (Biomerieux SA, France). Outcomes Sensitivity and specificity of procalcitonin for diagnosis of radiologically confirmed pneumonia. Results Serum Procalcitonin was measured in 370 patients; median (IQR) age of these children being 12 (7, 22) months, 235 (63.5%) were boys. The median (IQR) serum procalcitonin concentration was 0.1(0.05, 0.4) ng/mL.Sensitivity and specificity of raised PCT (> 0.5 ng/mL) for pneumonia as per any CXR abnormalities were 29.7% and87.5%,(P P P . Adding PCT to the existing clinical criteria of WHO did not improve the sensitivity for diagnosis of pneumonia. PCT was significantly higher in children with severe pneumonia. Conclusion Positive PCT (> 0.5 ng/mL) is significantly associated with radiographic pneumonia but not with pneumonia based on WHO criteria.However, it can act as a surrogate marker for severe pneumonia.

To evaluate association between total IgE levels and wheezing in preschool children from India. Data were collected in a prospective birth cohort study related to wheezing till three years of age. Total IgE was measured at enrolment, at one year and two years of age and correlated with wheezing episodes. A total of 310 (167 boys) children were enrolled. Total IgE levels increased with age (P

To develop a normal reference range of Infant pulmonary function test (IPFT) indices for Indian children. Prospective birth cohort study. Division of Pediatric Pulmonology of a tertiary-care institute in India from August 2012 to March 2017. All neonates born at the institute during the study period were screened for eligibility. IPFT at baseline and every 6-month until 36-months of age. Tidal breathing flow-volume loop (TBFVL), Rapid thoracoabdominal compression (RTC), and Raised volume RTC (RVRTC) indices at baseline and follow-up. 310 newborns were enrolled in the cohort; 281 of them (169 male) had completed 36-months of follow-up at the end of the study period. There was no influence of gender on the baseline IPFT indices. Tidal volume per unit body weight (VT/kg) significantly increased from baseline to 36 months of age (P

Background: Cow urine has been widely used as therapeutic or additive agents in different parts of Nepal, mainly to treat infections, cuts, burns, etc. Cow urine has been considered as sacred and holy water and used in many rituals and worshipping purposes. Apart from therapeutic and rituals ceremony cow urines are also used in purification and disinfecting the houses. Objective: The aim of the study was to investigate the in-vitro antioxidant and antibacterial activity of cow urine from different altitudes across Nepal. Materials and Methods: Antioxidant activity of cow urines was carried out by using 2,2-Diphenyl-1-picrylhydrazyl (DPPH) as free radicals. The antibacterial activity of cow urines was tested by the agar disc diffusion method against Escherichia coli (gram-negative) and Staphylococcus aureus (gram-positive). Results: The urine sample from Muktinath (Subalpine region) showed the highest 44.8±0.21% inhibition against DPPH free radicals. The urine samples from Jajarkot and Marpha (Temperate zone) showed 39.70±0.43% and 37.30±0.15% inhibition against DPPH free radicals respectively. The urine samples from Palpa and Shyangja (Subtropical region) showed 30.00±0.24 and 34.4±0.01 percent inhibition of DPPH radicals. The samples from Butwal and Dhangadhi (Tropical region) showed the least percentage inhibition of 23.9±0.08 and 21.12±0.1 respectively. Amongst the entire sample, the subalpine region of cow urine (Muktinath 3710m) made known the highest inhibition zone such as 10.56±0.05mm against S. aureus and 7.46±0.15 against E.coli. Conclusion: Our study has concluded that cow urines have the antibacterial and antioxidant activities and vary in potency according to altitudinal and climatic differences. Hence cow urine from the subalpine zone has better antibacterial and antioxidant activity than that of lower altitudinal climatic zones.

OBJECTIVE To determine the role of vitamin D supplementation as an adjunct to standard treatment in childhood asthma. STUDY DESIGN In this placebo-controlled, blinded, randomized controlled trial, we enrolled 60 children aged 6 to 11 years with moderate persistent asthma and randomly assigned them into intervention (2000 IU per day of vitamin D) and placebo groups (n = 30 each). The primary outcome was asthma control as assessed by the childhood asthma control test (C-ACT) scores at 12 weeks post-randomization. The secondary outcomes were improvement in the forced expiration in 1 s (FEV1 ), fractional exhaled nitric oxide (FeNO), asthma exacerbations, use of systemic steroids, number of emergency visits, post-intervention vitamin D levels, and adverse outcomes. We analyzed by intention to treat. RESULTS There was no significant difference between the C-ACT score in the two groups (median [first-third quartile] scores were 25 [24-26] in both groups, p = 0.7). Also, there was no significant difference between the two groups in terms of the FEV1 , FeNO, number of exacerbations, emergency visits, hospital admissions, and adverse outcomes. However, the post-intervention vitamin D levels (ng/ml) were significantly higher in the intervention group (35.5 vs. 18.8; p

To explore the association of symptoms of sleep-related breathing disorders (SRBD) with asthma control in Indian children. This study was carried out in the pediatric chest clinic of a tertiary care center in western India. Children from 6 to 18 y of age with a physician-diagnosed case of asthma were included in the study. A validated pediatric sleep questionnaire, SRBD scale, was used to screen the symptoms of SRBD. At the same time, Asthma Control Questionnaire (ACQ) was administered to assess asthma control. A total of 207 (73% boys) children with asthma were enrolled; the median age was 10 (7, 13) y. Asthma symptoms were well controlled (ACQ ≤ 0.75) in 102 (49.3%) and partly or poorly controlled (ACQ > 0.75) in 105 (50.7%) children. Inattention and/or hyperactivity was the most common SRBD symptom observed in 125 (60.4%) children; daytime sleepiness, mouth breathing, snoring, and night-time breathing problems were observed in 92 (44.5%), 91 (44%), 77 (37.2%), and 68 (32.8%) children, respectively. SRBD score showed a near-linear correlation with ACQ score (r = 0.28, p

In this birth cohort, coronavirus acute respiratory infection was detected in 6.5% of the episodes; the commonest strain was OC43, followed by NL63, HKU1, and 229E. Children with coronavirus acute respiratory infection during infancy had significantly decreased forced expiratory volume in 0.5 seconds, forced expiratory flow between 25% and 75% of forced vital capacity, and peak expiratory flow at 3 years of age.