الفهرس 
Wheezy InfantOnly 14 pages are availabe for public view
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Abstract
Infantile wheezing, which includes viral associated wheeze and asthma, are amongst the most common reasons for children to present urgently to a doctor.
A proposed mechanism related changes in dietary antioxidant intake to reduced lung antioxidant defenses, with increased airway susceptibility to oxidant damage resulting in airway inflammation and asthma.
Trace elements play an important role in various physiological processes, and are crucial for proper functioning of the immune system.
The major trace elements such as zinc, selenium, copper, and magnesium have Immune modulatory effects and thus influence susceptibility and the course of a variety of infections.
The dietary Zinc (Zn) plays essential roles in cellular metabolism and gene expression Zinc deficiency results in enhanced oxidative damage in the airways by causing infiltration of inflammatory cells and increased superoxide and nitric oxide production.
Our aim is to test the hypothesis of zinc deficiency in infantile wheezing via measuring the hair and serum zinc levels in a group of Egyptian wheezy infants, comparing it to a control group of healthy infants and correlate zinc levels to disease severity.
We conducted our study on Thirty wheezy infants & thirty apparently healthy age and sex matched subjected to complete history taking,general examination,chest examination,laboratory investigations e.g. CBC with total eosiniphil count, hair and serum zinc level.
Statistical analysis revealed:
• There was no statistically significant difference between cases and control as regards age, gender distribution or residence.
• Wheezers (cases) had more number of sibs with less rooming and less flooring when compared to control. They also had less breast feeding, more atopy, more food allergy, stronger family history of atopy &more exposure to smoking, upper respiratory tract infection.
• There were no statistical significance differences between cases and control in weight & height percentile, HR or RR.
• All the cases had viral induced wheeze. 66.7% of the cases had recurrent wheeze 3 to 6 times/ year. During attack most cases had fever, cough, URTI catarrhal and dyspnea (83.3%, 96.7%, 96.7% and 90% respectively), 60% of the cases treated in hospital. In between attack the cases suffer from wheeze and cough (53.3% & 93.3% respectively). All cases suffer from nocturnal awaking 56.7% of them repeated weekly. All cases suffer from RD. 53.3% of them show wheeze almost all of them expiratory. Inhaled bronchodilator and leukotriene antagonist are the most common used medication.
• Eosinophils count was significantly higher in wheezers than control subjects. Serum zinc level was significantly lower in wheezers than control subjects. Zinc deficiency was significantly commoner among wheezers and healthy control.
• No age, gender or residence relation to serum zinc level among the studied cases.
• There were no statistical significance differences between cases with deficient and adequate Zn level in sibs. No., room no floor, frequency of URTI, type of feeding, atopy, family history and food allergy exposure to smoking or vaccination intake.
• There were no statistical significance differences between deficient and adequate cases in weight & height percentile, RR or HR.
• Infants with zinc deficiency had significantly higher wheeze frequency & severity.
• That there was no statistical significance differences between deficient and adequate cases in weight & height percentile, RR or HR.
• Hair zinc & serum zinc are possibly correlated to each other.
• Serum zinc cut-off level was 53.6, sensitivity was 87.5%, specificity was 86.4% and accuracy 86.7%.
Conclusion
Wheezers (cases) had more number of sibs with less rooming and less flooring when compared to control. They also had less breast feeding,more atopy, more food allergy,stronger family history of atopy &more exposure to smoking, upper respiratory tract infection .
Eosinophils count was significantly higher in wheezers than control subjects. Serum and hair Zinc level was significantly lower in wheezers than control subjects.
Zinc deficiency was significantly commoner among wheezers and healthy control.
Infants with zinc deficiency had significantly higher wheeze frequency & severity.
Hair zinc & serum zinc are possibly correlated to each other.
Serum zinc cut-off level was 53.6, sensitivity was 87.5%, and specificity was 86.4% and accuracy 86.7%.
Recommendations
According to our study we recommend that infants with recurrent wheeze should be tested for their Zinc level either their serum level or their hair level as measuring Zinc level in hair samples is considered non invasive technique and our study revealed that hair Zinc level and serum Zinc level were possibly correlated and hair level is not conditionaly changeable.
Instructions for the discovered Zn deficient wheezy infants to seek medical advice for Zn supplements.
Educational parental courses for the importance of Zn in the body function and the Zn rich food sources.