Pub Date : 2022-01-01DOI: 10.4103/ijaai.ijaai_32_22
L. Silvia, J. Podhini, S. Palanisamy
BACKGROUND: Asthma is one of the common chronic illnesses in children affecting about 10-15% worldwide. Proper management of asthma depends on the knowledge, attitude, and practices of the parents towards asthma which in turn will enable early intervention and prompt management. OBJECTIVE: To determine the parental knowledge, attitude towards asthma and its correlation with the compliance of asthma management in children. METHODOLOGY: It is a cross-sectional observational study carried out in a tertiary care hospital between January 2020 to December 2020. RESULTS: The study included 112 participants. Mothers were the predominant caregivers (72.3%). Family history of asthma was noticed in 42.8%. 88.4% knew that their child was suffering from asthma, 18% felt that asthma is contagious. Change in the climate (91.1%), dust (60.7%), respiratory infection (49.1%), and smoke (44.6%) were the common triggers. 15% tried an alternate system of medication. Majority (87%) had moderate knowledge, 92 (82%) showed good practices. 56 (50%) exhibited negative attitude. Nearly 60% of the participants preferred inhaler therapy. The causes for non-adherence to inhaler therapy were fear of addiction (46.7%), child refusing inhaler (40%), cost of therapy (40%) and child being symptom free in between episodes (37.8%). CONCLUSIONS: This study revealed a moderate level of knowledge and good practices towards childhood asthma among the parents of asthmatic children. Better knowledge and good practices among the parents strongly correlated with mother being the participant of the study, educational status, positive family history of asthma and persistent asthma symptoms. Better knowledge and positive attitude towards asthma was associated with adherence to inhaler therapy.
{"title":"Parental knowledge, attitude toward asthma, and its correlation with compliance of asthma management in children","authors":"L. Silvia, J. Podhini, S. Palanisamy","doi":"10.4103/ijaai.ijaai_32_22","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_32_22","url":null,"abstract":"BACKGROUND: Asthma is one of the common chronic illnesses in children affecting about 10-15% worldwide. Proper management of asthma depends on the knowledge, attitude, and practices of the parents towards asthma which in turn will enable early intervention and prompt management. OBJECTIVE: To determine the parental knowledge, attitude towards asthma and its correlation with the compliance of asthma management in children. METHODOLOGY: It is a cross-sectional observational study carried out in a tertiary care hospital between January 2020 to December 2020. RESULTS: The study included 112 participants. Mothers were the predominant caregivers (72.3%). Family history of asthma was noticed in 42.8%. 88.4% knew that their child was suffering from asthma, 18% felt that asthma is contagious. Change in the climate (91.1%), dust (60.7%), respiratory infection (49.1%), and smoke (44.6%) were the common triggers. 15% tried an alternate system of medication. Majority (87%) had moderate knowledge, 92 (82%) showed good practices. 56 (50%) exhibited negative attitude. Nearly 60% of the participants preferred inhaler therapy. The causes for non-adherence to inhaler therapy were fear of addiction (46.7%), child refusing inhaler (40%), cost of therapy (40%) and child being symptom free in between episodes (37.8%). CONCLUSIONS: This study revealed a moderate level of knowledge and good practices towards childhood asthma among the parents of asthmatic children. Better knowledge and good practices among the parents strongly correlated with mother being the participant of the study, educational status, positive family history of asthma and persistent asthma symptoms. Better knowledge and positive attitude towards asthma was associated with adherence to inhaler therapy.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"33 1","pages":"40 - 46"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73417146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/ijaai.ijaai_34_22
P. Kathuria, M. Rai
The new classification of drug hypersensitivity reactions (DHRs) is based on phenotypes, endotypes, and biomarkers. Immediate and delayed reactions are the clinical phenotypic presentation while endotypes are based on cellular, biological mediators, and biomarkers. Complement activation, cyclooxygenase-1 inhibition, Mas-Related G Protein-Coupled Receptor-X2 (MRGPRX2), Cytokine release syndrome (CRS) is also included in DHRs due to mast cell activation e.g., radio contrast media, nonsteroidal anti-inflammatory drugs, monoclonal antibodies, oxaliplatin and taxanes, etc. Genetic predisposition of specific human leukocyte antigen alleles has been associated with the development of T cell-mediated symptoms of severe cutaneous adverse reactions (SCAR), which includes acute generalized exanthematous pustulosis, drug rash with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, and toxic epidermal necroplasia, due to antibiotics, retrovirus and anti-convulsant drugs, etc., drug desensitization (Ds), is a personalized treatment approach for immunoglobulin E (IgE), and Non-IgE mediated DHRs, for example, antibiotics, biologicals, chemotherapy, etc. This review will update on the mechanism of DHRs, the clinical approach of alternative drugs, and Ds in a high-risk patient.
{"title":"Management of drug allergy-clinical update","authors":"P. Kathuria, M. Rai","doi":"10.4103/ijaai.ijaai_34_22","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_34_22","url":null,"abstract":"The new classification of drug hypersensitivity reactions (DHRs) is based on phenotypes, endotypes, and biomarkers. Immediate and delayed reactions are the clinical phenotypic presentation while endotypes are based on cellular, biological mediators, and biomarkers. Complement activation, cyclooxygenase-1 inhibition, Mas-Related G Protein-Coupled Receptor-X2 (MRGPRX2), Cytokine release syndrome (CRS) is also included in DHRs due to mast cell activation e.g., radio contrast media, nonsteroidal anti-inflammatory drugs, monoclonal antibodies, oxaliplatin and taxanes, etc. Genetic predisposition of specific human leukocyte antigen alleles has been associated with the development of T cell-mediated symptoms of severe cutaneous adverse reactions (SCAR), which includes acute generalized exanthematous pustulosis, drug rash with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, and toxic epidermal necroplasia, due to antibiotics, retrovirus and anti-convulsant drugs, etc., drug desensitization (Ds), is a personalized treatment approach for immunoglobulin E (IgE), and Non-IgE mediated DHRs, for example, antibiotics, biologicals, chemotherapy, etc. This review will update on the mechanism of DHRs, the clinical approach of alternative drugs, and Ds in a high-risk patient.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"55 1","pages":"4 - 17"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76611204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/ijaai.ijaai_24_22
Kaushal Kumar, A. Mahajan, D. Haldwani, D. Bhadoria, B. Goswami
BACKGROUND: Asthma is a serious global health problem affecting all age groups. It is being recognized for its health impact on the working status of adults, and uncontrolled asthma is associated with significant morbidity, mortality, and socioeconomic problems. The knowledge of comorbidities of asthma, including thyroid disorders, is important for its management. METHODOLOGY: A case–control study was conducted in 60 diagnosed patients of bronchial asthma in the age group of 20–40 years attending medicine outpatient departments and Chest Clinic of Lok Nayak Hospital, New Delhi. Thirty controls were taken from the normal population. Pulmonary function tests using "Schiller SP1 portable top spirometer" were done, and forced vital capacity (FVC), forced expiratory volume in 1st s (FEV1), FEV1/FVC ratio, and peak expiratory flow rate (PEFR) were analyzed. The thyroid function was assessed by estimating levels of serum thyroid-stimulating hormone (TSH), free T3, and free T4 using the Cobas e411 autoanalyzer. RESULTS: Based on TSH analysis of asthmatic patients, 25% were hypothyroid, 16.7% were hyperthyroid, and 58.3% were euthyroid. There were significant reductions in FEV1, FEV1/FVC ratio, and PEFR in asthmatics compared to controls, but no significant differences were found in these parameters among the asthmatics with different thyroid status. CONCLUSION: The thyroid functions varied in asthmatics. However, the variation in the thyroid function did not affect the pulmonary function in asthmatic patients.
{"title":"Influence of thyroid status on pulmonary functions in bronchial asthma patients","authors":"Kaushal Kumar, A. Mahajan, D. Haldwani, D. Bhadoria, B. Goswami","doi":"10.4103/ijaai.ijaai_24_22","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_24_22","url":null,"abstract":"BACKGROUND: Asthma is a serious global health problem affecting all age groups. It is being recognized for its health impact on the working status of adults, and uncontrolled asthma is associated with significant morbidity, mortality, and socioeconomic problems. The knowledge of comorbidities of asthma, including thyroid disorders, is important for its management. METHODOLOGY: A case–control study was conducted in 60 diagnosed patients of bronchial asthma in the age group of 20–40 years attending medicine outpatient departments and Chest Clinic of Lok Nayak Hospital, New Delhi. Thirty controls were taken from the normal population. Pulmonary function tests using \"Schiller SP1 portable top spirometer\" were done, and forced vital capacity (FVC), forced expiratory volume in 1st s (FEV1), FEV1/FVC ratio, and peak expiratory flow rate (PEFR) were analyzed. The thyroid function was assessed by estimating levels of serum thyroid-stimulating hormone (TSH), free T3, and free T4 using the Cobas e411 autoanalyzer. RESULTS: Based on TSH analysis of asthmatic patients, 25% were hypothyroid, 16.7% were hyperthyroid, and 58.3% were euthyroid. There were significant reductions in FEV1, FEV1/FVC ratio, and PEFR in asthmatics compared to controls, but no significant differences were found in these parameters among the asthmatics with different thyroid status. CONCLUSION: The thyroid functions varied in asthmatics. However, the variation in the thyroid function did not affect the pulmonary function in asthmatic patients.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"95 1","pages":"28 - 33"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88409018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/ijaai.ijaai_1_22
R. Hiremath, Sandhya Ghodke
{"title":"People living with HIV/AIDS (PLHAs) Knowledge regarding progression of HIV infection: A cross-sectional study","authors":"R. Hiremath, Sandhya Ghodke","doi":"10.4103/ijaai.ijaai_1_22","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_1_22","url":null,"abstract":"","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"36 1","pages":"60 - 61"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78598617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/ijaai.ijaai_37_20
K. Ravibabu, V. Adepu, Jamalpur Prakash, Raju Nagaraju, J. Surendar
BACKGROUND: The vegetable markets are a rich source of organic dust and bioaerosol exposure. The effect of duration of exposure on health complaints, systemic inflammatory responses (SIR), immunological markers, and pulmonary function tests (PFT) among loading and unloading workers at the vegetable market was not explored. OBJECTIVE: The current study was undertaken to assess the effect of duration of exposure on health complaints, SIR, immunological markers, and PFT among workers working at the vegetable market. MATERIALS AND METHODS: The study design is descriptive, 45 male participants with no smoking habit and having more than 3 years of experience were enrolled in the study. The study participants were categorized into low (n = 23) and high (n = 22) exposure groups based on the median duration of exposure, which is the multiplication of years of exposure and working hours per day. The demographic details, health complaints, SIR, immunological, and PFT parameters were investigated and compared between low and high exposure groups. RESULTS: Workers with a prolonged duration of exposure have reported a considerable increase in musculoskeletal disorders, eye irritation, and skin allergies. SIR such as serum albumin, high sensitivity C-reactive protein, lymphocytes, white blood cell count, and immunological markers (immunoglobulin E and immunoglobulin A) were considerably increased, and PFT were significantly decreased in the high exposure group as compared to the low-exposure group. CONCLUSIONS: Contemporary study revealed that high duration of exposure contributes to augmented health complaints, SIR, immunological markers, and reduced competence of PFT among loading and unloading workers at vegetable markets. Therefore, this study suggests workplace hygiene practices with the use of personal protective equipment might lower the health effects and inflammation markers.
{"title":"Effect of duration of exposure on health complaints, systemic inflammatory responses, immunological markers, and pulmonary function tests among workers working at the vegetable market","authors":"K. Ravibabu, V. Adepu, Jamalpur Prakash, Raju Nagaraju, J. Surendar","doi":"10.4103/ijaai.ijaai_37_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_37_20","url":null,"abstract":"BACKGROUND: The vegetable markets are a rich source of organic dust and bioaerosol exposure. The effect of duration of exposure on health complaints, systemic inflammatory responses (SIR), immunological markers, and pulmonary function tests (PFT) among loading and unloading workers at the vegetable market was not explored. OBJECTIVE: The current study was undertaken to assess the effect of duration of exposure on health complaints, SIR, immunological markers, and PFT among workers working at the vegetable market. MATERIALS AND METHODS: The study design is descriptive, 45 male participants with no smoking habit and having more than 3 years of experience were enrolled in the study. The study participants were categorized into low (n = 23) and high (n = 22) exposure groups based on the median duration of exposure, which is the multiplication of years of exposure and working hours per day. The demographic details, health complaints, SIR, immunological, and PFT parameters were investigated and compared between low and high exposure groups. RESULTS: Workers with a prolonged duration of exposure have reported a considerable increase in musculoskeletal disorders, eye irritation, and skin allergies. SIR such as serum albumin, high sensitivity C-reactive protein, lymphocytes, white blood cell count, and immunological markers (immunoglobulin E and immunoglobulin A) were considerably increased, and PFT were significantly decreased in the high exposure group as compared to the low-exposure group. CONCLUSIONS: Contemporary study revealed that high duration of exposure contributes to augmented health complaints, SIR, immunological markers, and reduced competence of PFT among loading and unloading workers at vegetable markets. Therefore, this study suggests workplace hygiene practices with the use of personal protective equipment might lower the health effects and inflammation markers.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"140 1","pages":"47 - 53"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78199864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/ijaai.ijaai_5_21
Ankita Gupta, Amit Kumar
COVID-19 pandemic has been caused by severe acute respiratory syndrome coronavirus 2 which has caused worldwide health concerns. A 48-year-old female suffering from COVID-19 was started on favipiravir (FPV) along with other drugs. Within 12 h of initiation of FPV, the patient developed urticaria all over the body. She was given stat dose of injection dexamethasone and injection avil. Symptoms resolved within 3 days. Urticaria is a rare side effect of FPV but requires vigilant monitoring in the treatment of COVID-19 patients.
{"title":"A case report of urticaria as a rare side effect of favipiravir in a patient with COVID-19","authors":"Ankita Gupta, Amit Kumar","doi":"10.4103/ijaai.ijaai_5_21","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_5_21","url":null,"abstract":"COVID-19 pandemic has been caused by severe acute respiratory syndrome coronavirus 2 which has caused worldwide health concerns. A 48-year-old female suffering from COVID-19 was started on favipiravir (FPV) along with other drugs. Within 12 h of initiation of FPV, the patient developed urticaria all over the body. She was given stat dose of injection dexamethasone and injection avil. Symptoms resolved within 3 days. Urticaria is a rare side effect of FPV but requires vigilant monitoring in the treatment of COVID-19 patients.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"39 1","pages":"103 - 105"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78103329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/ijaai.ijaai_14_21
Krishnan Sabhapathy, S. Krishnan
OBJECTIVE: Retrospective study looking at the profile of patients undergoing drug sensitivity tests (DST) and its utility in preventing hypersensitivity in the perioperative period. MATERIALS AND METHODS: Adult patients who had a previous history of drug allergy and or other forms of allergies were enrolled in the study. These were patients referred to our center before procedures requiring anesthesia. DST was done by the Skin prick method and supplemented by intradermal in few patients. Drugs chosen for testing was based on patient's allergic history and referring doctors request, usually anesthetics, antibiotics, and analgesics. RESULTS: Of 110 patients included in study, 84 were female. Eighty-eight had a history of drug allergy, either documented or presumed. Twenty-one had other forms of allergy, of whom 11 had food allergy, eight had allergic rhinitis with or without asthma, and three had allergic dermatitis or urticaria. The DST was positive in 65 patients, negative in 45. Drugs that showed positive reactions were ciprofloxacin in 21 patients, diclofenac in 20, atracurim, and ondansetron in 11, paracetamol, amoxicillin clavulanate, pentazocine in five each. CONCLUSION: DST in preanesthetic evaluation would prevent potential hypersensitivity reaction in the perioperative period. Sixty percent of patients showed sensitivity; ten percent of them had food allergy, allergic rhinitis, skin allergy without a history of drug allergy. Antibiotics and analgesics showed more sensitivity than anesthetics. All patients underwent their anesthetic procedures without any drug hypersensitivity reaction.
{"title":"Clinical profile of drug sensitivity test in patients with a previous history of allergy as part of preanesthetic evaluation","authors":"Krishnan Sabhapathy, S. Krishnan","doi":"10.4103/ijaai.ijaai_14_21","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_14_21","url":null,"abstract":"OBJECTIVE: Retrospective study looking at the profile of patients undergoing drug sensitivity tests (DST) and its utility in preventing hypersensitivity in the perioperative period. MATERIALS AND METHODS: Adult patients who had a previous history of drug allergy and or other forms of allergies were enrolled in the study. These were patients referred to our center before procedures requiring anesthesia. DST was done by the Skin prick method and supplemented by intradermal in few patients. Drugs chosen for testing was based on patient's allergic history and referring doctors request, usually anesthetics, antibiotics, and analgesics. RESULTS: Of 110 patients included in study, 84 were female. Eighty-eight had a history of drug allergy, either documented or presumed. Twenty-one had other forms of allergy, of whom 11 had food allergy, eight had allergic rhinitis with or without asthma, and three had allergic dermatitis or urticaria. The DST was positive in 65 patients, negative in 45. Drugs that showed positive reactions were ciprofloxacin in 21 patients, diclofenac in 20, atracurim, and ondansetron in 11, paracetamol, amoxicillin clavulanate, pentazocine in five each. CONCLUSION: DST in preanesthetic evaluation would prevent potential hypersensitivity reaction in the perioperative period. Sixty percent of patients showed sensitivity; ten percent of them had food allergy, allergic rhinitis, skin allergy without a history of drug allergy. Antibiotics and analgesics showed more sensitivity than anesthetics. All patients underwent their anesthetic procedures without any drug hypersensitivity reaction.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"80 1","pages":"67 - 71"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74593716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/ijaai.ijaai_11_21
Ann Nisha, Navakumar Manickam, Kannan Gopalan, S. Vellaisamy
BACKGROUND: Lower legs and feet eczema may be due to exogenous causes such as allergic contact dermatitis (ACD) or endogenous cause such as atopy. Currently, patch testing is the only scientific proof of contact allergy. AIMS: The aim was to study the clinicodemographic profile and to evaluate the role of patch testing in lower leg and feet eczema. MATERIALS AND METHODS: This was a cross-sectional study conducted among 60 patients with lower leg and feet eczema. They were subjected to patch testing with Indian standard series and readings were interpreted according to the International Contact Dermatitis Research Group scoring system. RESULTS: Our study included 32 (53.3%) males and 28 (46.7%) females (M: F = 1.1:1). The mean age was 42.61 ± 13.40 years corresponding to occupationally active age group. Construction workers (10 [31.25%]) were the most common occupational group affected among males (P = 0.007). Among females, most commonly affected were housewives (10 [35.71%]) (P = 0.0002). The most common pattern of eczema seen was ACD (22 [36.7%]). Positive patch test response was recorded in 17 (28.3%) patients and the most common allergen found to be positive was potassium dichromate (6 [35.3%]). Correlating the morphology with patch test results, ACD (13 [59.1%]) was significantly positive when compared to other eczemas (4 [10.53%]) (P = 0.000). CONCLUSION: Patch testing is a valuable diagnostic aid in lower leg and feet eczema. It plays a pivotal role in identifying causative allergens associated with ACD from which allergen avoidance can be advised for a better clinical outcome and quality of life.
背景:小腿和足部湿疹可能是由于外源性原因，如过敏性接触性皮炎(ACD)或内源性原因，如特应性。目前，斑贴试验是接触性过敏的唯一科学证据。目的:目的是研究临床人口学概况，并评估贴片试验在下肢和足部湿疹中的作用。材料和方法:这是一项横断面研究，在60例下肢和足部湿疹患者中进行。他们接受了印度标准系列的斑贴测试，读数根据国际接触性皮炎研究小组评分系统进行解释。结果:纳入男性32例(53.3%)，女性28例(46.7%)(M: F = 1.1:1)。职业活跃年龄组平均年龄为42.61±13.40岁。男性中最常见的职业是建筑工人(10名[31.25%])(P = 0.007)。女性中最常见的是家庭主妇(10例[35.71%])(P = 0.0002)。最常见的湿疹类型为ACD(22例[36.7%])。17例(28.3%)患者出现斑贴试验阳性反应，最常见的过敏原为重铬酸钾(6例[35.3%])。将形态学与斑贴试验结果相比较，ACD(13例[59.1%])与其他湿疹(4例[10.53%])相比显著阳性(P = 0.000)。结论:斑贴试验是诊断下肢及足部湿疹的有效方法。它在识别与ACD相关的致病性过敏原方面起着关键作用，可以建议避免过敏原，以获得更好的临床结果和生活质量。
{"title":"Clinicodemographic and patch testing profile of patients with lower leg and feet eczema at a tertiary care center in South India","authors":"Ann Nisha, Navakumar Manickam, Kannan Gopalan, S. Vellaisamy","doi":"10.4103/ijaai.ijaai_11_21","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_11_21","url":null,"abstract":"BACKGROUND: Lower legs and feet eczema may be due to exogenous causes such as allergic contact dermatitis (ACD) or endogenous cause such as atopy. Currently, patch testing is the only scientific proof of contact allergy. AIMS: The aim was to study the clinicodemographic profile and to evaluate the role of patch testing in lower leg and feet eczema. MATERIALS AND METHODS: This was a cross-sectional study conducted among 60 patients with lower leg and feet eczema. They were subjected to patch testing with Indian standard series and readings were interpreted according to the International Contact Dermatitis Research Group scoring system. RESULTS: Our study included 32 (53.3%) males and 28 (46.7%) females (M: F = 1.1:1). The mean age was 42.61 ± 13.40 years corresponding to occupationally active age group. Construction workers (10 [31.25%]) were the most common occupational group affected among males (P = 0.007). Among females, most commonly affected were housewives (10 [35.71%]) (P = 0.0002). The most common pattern of eczema seen was ACD (22 [36.7%]). Positive patch test response was recorded in 17 (28.3%) patients and the most common allergen found to be positive was potassium dichromate (6 [35.3%]). Correlating the morphology with patch test results, ACD (13 [59.1%]) was significantly positive when compared to other eczemas (4 [10.53%]) (P = 0.000). CONCLUSION: Patch testing is a valuable diagnostic aid in lower leg and feet eczema. It plays a pivotal role in identifying causative allergens associated with ACD from which allergen avoidance can be advised for a better clinical outcome and quality of life.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"116 1","pages":"61 - 66"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87746512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.4103/ijaai.ijaai_12_21
P. Kathuria, M. Rai
The role of an allergist in recognizing the pollen-food allergy syndrome (PFAS) and lipid transfer protein syndrome (LTPS) is essential. LTPS differs from PFAS by having a different family of panallergens and clinical characteristics. Both are complex syndromes posing diagnostic and therapeutic challenges. Many cross-reactive allergen components are involved, such as plant panallergens profilins, PR-10 proteins (Bet v 1 homologous), and lipid transfer proteins (LTP). PFAS results from cross-reactivity between pollen-specific immunoglobulin E (IgE) and homologous proteins found in fruits and vegetables. In most cases, grass pollen is responsible for profilin hypersensitivity. But, tree and weed pollen may also act as primary sensitizers, depending on geographical differences. Nonspecific LTP (nsLTP) is ubiquitous in terrestrial plants and can induce systemic allergic severe reactions. Peach (Pru P 3) is the primary sensitizer for LTP-driven allergy, and its clinical relevance is considered the prototypic marker for LTPS. nsLTPs have been identified as a major allergen in tree and weed plants. A second critical point is the diagnosis of LTPS associated with cofactors such as exercise, alcohol, antacids, and NSAIDS, that can promote severe reactions. Skin Prick Test (SPT) with Peach extracts that have been highly enriched for Pru p 3 with very low content of other allergens for LTPS, is suggestive of LTPS. For PFAS, positive SPT with profilin-enriched date palm pollen and watermelon extract shows sensitivity and specificity that is very close to that of the recombinant grass pollen profilin. The present review address differences between the PFAS from LTP syndrome with particular attention to the clinical impact on cross-reactivity or cross-sensitization to pollens.
{"title":"Pollen-food allergy syndrome and lipid transfer protein syndrome: Clinical relevance","authors":"P. Kathuria, M. Rai","doi":"10.4103/ijaai.ijaai_12_21","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_12_21","url":null,"abstract":"The role of an allergist in recognizing the pollen-food allergy syndrome (PFAS) and lipid transfer protein syndrome (LTPS) is essential. LTPS differs from PFAS by having a different family of panallergens and clinical characteristics. Both are complex syndromes posing diagnostic and therapeutic challenges. Many cross-reactive allergen components are involved, such as plant panallergens profilins, PR-10 proteins (Bet v 1 homologous), and lipid transfer proteins (LTP). PFAS results from cross-reactivity between pollen-specific immunoglobulin E (IgE) and homologous proteins found in fruits and vegetables. In most cases, grass pollen is responsible for profilin hypersensitivity. But, tree and weed pollen may also act as primary sensitizers, depending on geographical differences. Nonspecific LTP (nsLTP) is ubiquitous in terrestrial plants and can induce systemic allergic severe reactions. Peach (Pru P 3) is the primary sensitizer for LTP-driven allergy, and its clinical relevance is considered the prototypic marker for LTPS. nsLTPs have been identified as a major allergen in tree and weed plants. A second critical point is the diagnosis of LTPS associated with cofactors such as exercise, alcohol, antacids, and NSAIDS, that can promote severe reactions. Skin Prick Test (SPT) with Peach extracts that have been highly enriched for Pru p 3 with very low content of other allergens for LTPS, is suggestive of LTPS. For PFAS, positive SPT with profilin-enriched date palm pollen and watermelon extract shows sensitivity and specificity that is very close to that of the recombinant grass pollen profilin. The present review address differences between the PFAS from LTP syndrome with particular attention to the clinical impact on cross-reactivity or cross-sensitization to pollens.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"11 1","pages":"37 - 42"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73690679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Self-reported food allergy is very common in asthmatics and hence these food items are frequently avoided by the patients. Food allergy is defined as an adverse immunological response to a dietary protein. Skin prick test (SPT) is a sensitive tool for identifying the presence of specific immunoglobulin E antibodies that can be associated with acute allergic reactions. However, sensitization often exists without clinical consequences, and at the same time, self-reported food allergens are frequently negative on SPT. The purpose of our study was to assess the clinical relevance of self-reported food allergy and the role of SPT in identifying food allergies in patients with bronchial asthma. METHODOLOGY: One hundred bronchial asthma patients were screened for this study, and skin prick testing for 22 food allergens frequently consumed in India, particularly Northern India was performed. RESULTS: A total of 36 subjects reported perceiving precipitation or an increase in severity of the asthmatic symptoms by one or more food items, and the most common food items mentioned in history were curd in 24%, rice in 19%, citrus fruits such as lemon in 14%, orange in 14%, banana in 8%, cold drinks in 16%, and ice creams in 16%. There were 68 patients negative for food allergens by SPT (food allergen negative [FAN] group) and 32 patients were positive (Food allergen Positive [FAP] group). Out of 36 asthmatics with self-reported food allergy, none was found to be SPT positive to the reported food allergens. However, 50% of patients with self-reported and only 21.9% with no history of food allergy were positive to one or more food allergens. Further, FAP group patients were tolerating these foods without any trouble or exacerbation of symptoms. Among the FAP group, 96.9% of patients had positive SPT for one or more other allergens also such as insects, pollens, fungi, or other aeroallergens. Only one patient had isolated food allergy by SPT. It implies that isolated food allergy is very rare in asthmatic patients. Common food allergens found positive by SPT were black gram in 12%, followed by red gram 9% and bengal gram, rice, and Baker's yeast 7% each. CONCLUSION: We concluded that the prevalence of food allergy in India among asthmatic adults though high, has a very poor correlation between patient's history of food allergens that is perceived as a precipitating or exaggerating factor for symptoms and actual sensitization as elicited by SPT. At the same time, there is high nonspecific food sensitization in self-reported patients as compared to those with no history of any perceived food allergy.
{"title":"Self-reported food allergy and its clinical significance in adult bronchial asthma patients:– A prospective study","authors":"Priya Sharma, Bharath Janapati, Rachna Rohatgi, Anil Jain","doi":"10.4103/ijaai.ijaai_73_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_73_20","url":null,"abstract":"BACKGROUND: Self-reported food allergy is very common in asthmatics and hence these food items are frequently avoided by the patients. Food allergy is defined as an adverse immunological response to a dietary protein. Skin prick test (SPT) is a sensitive tool for identifying the presence of specific immunoglobulin E antibodies that can be associated with acute allergic reactions. However, sensitization often exists without clinical consequences, and at the same time, self-reported food allergens are frequently negative on SPT. The purpose of our study was to assess the clinical relevance of self-reported food allergy and the role of SPT in identifying food allergies in patients with bronchial asthma. METHODOLOGY: One hundred bronchial asthma patients were screened for this study, and skin prick testing for 22 food allergens frequently consumed in India, particularly Northern India was performed. RESULTS: A total of 36 subjects reported perceiving precipitation or an increase in severity of the asthmatic symptoms by one or more food items, and the most common food items mentioned in history were curd in 24%, rice in 19%, citrus fruits such as lemon in 14%, orange in 14%, banana in 8%, cold drinks in 16%, and ice creams in 16%. There were 68 patients negative for food allergens by SPT (food allergen negative [FAN] group) and 32 patients were positive (Food allergen Positive [FAP] group). Out of 36 asthmatics with self-reported food allergy, none was found to be SPT positive to the reported food allergens. However, 50% of patients with self-reported and only 21.9% with no history of food allergy were positive to one or more food allergens. Further, FAP group patients were tolerating these foods without any trouble or exacerbation of symptoms. Among the FAP group, 96.9% of patients had positive SPT for one or more other allergens also such as insects, pollens, fungi, or other aeroallergens. Only one patient had isolated food allergy by SPT. It implies that isolated food allergy is very rare in asthmatic patients. Common food allergens found positive by SPT were black gram in 12%, followed by red gram 9% and bengal gram, rice, and Baker's yeast 7% each. CONCLUSION: We concluded that the prevalence of food allergy in India among asthmatic adults though high, has a very poor correlation between patient's history of food allergens that is perceived as a precipitating or exaggerating factor for symptoms and actual sensitization as elicited by SPT. At the same time, there is high nonspecific food sensitization in self-reported patients as compared to those with no history of any perceived food allergy.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"33 1","pages":"82 - 87"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91158301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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