Sleep and neurocognitive functioning in children with eczema

Sleep disruption in childhood is associated with clearly defined deficits in neurocognition and behaviour. Childhood eczema is also a potent cause of sleep disruption though it is unknown whether it too results in neurocognitive deficits. To test this hypothesis, neurocognitive (WISC-IV), parental-reported sleep quality (Sleep Disturbance Scale of Children (SDSC)) and overnight polysomnographic (PSG) data were collected in 21 children with eczema and 20 healthy controls (age range 6-16 years). Children with eczema had worse sleep quality on both PSG (notably increased nocturnal wakefulness, a higher number of stage shifts and a longer latency to REM onset) and parental report. In addition, they demonstrated significant neurocognitive deficits (especially verbal comprehension, perceptual reasoning and to a lesser extent working memory) with a composite Full Scale IQ 16 points lower than controls. Parental reported sleep problems but not PSG parameters were correlated with reduced neurocognitive performance. However, hierarchical regression analyses revealed that eczema status was predictive while sleep fragmentation (parental or PSG) was not predictive of neurocognitive performance. As this is the first study to systematically examine neurocognitive functioning in children with eczema and given the finding of significant deficits it merits replication especially given the prevalence of the condition. The unanswered question is whether these cognitive deficits normalise with effective eczema treatment and if this is mediated by improvements in sleep architecture.

Asthma prevalence in Iranian guidance school children, a descriptive meta-analysis

BACKGROUND

The morbidity and mortality of asthma have risen among children, especially those under 18, during the past 3 to 4 decades. There are various single studies in different target populations of Iran, which have reported different estimations. The present study designed in order to estimate a pooled prevalence among Iranian guidance school children.

MATERIALS AND METHODS

After searching for relevant articles in international and local databases from 1997 to 2009, we found 16 relevant articles and studies having the inclusion criteria. The outcome measure was the prevalence of asthma, and forest plot was used for presenting the findings of the meta-analysis. Heterogeneity between the studies was evaluated by the Cochran test. Moreover, the random effects model was used for estimation of pooled measures in Stata software (version 10).

RESULTS

From all the entered studies, 10 articles were published in English and the rest in Persian language. The pooled estimates for females, males and both genders were calculated as 3.9% (95% CI: 3.2% - 4.6%), 5% (95% CI: 4.2% - 5.8%), and 4.4% (95% CI: 3.7% - 5.1%), respectively.

CONCLUSION

The prevalence of asthma among Iranian children varied from 1.26% to 11.6%, which is possibly due to the difference in sex, ethnicity race, and socio-economic level of Iranian population. Also, the prevalence of asthma among Iranian guidance school children was lower in comparison to the other neighborhood countries.