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OBJECTIVES:We aimed to evaluate the seasonal variations of acute asthma presentation in children and the utility of the pediatric asthma score (PAS) and its components in early admission prediction.METHODS:As part of a randomized controlled trial addressing the clinical efficacy of budesonide nebulization in the treatment of acute asthma in children, the PAS was measured at baseline, 1st, 2nd, 3rd, and 4th h from the start of medications. Decision of admission was taken at or beyond the 2nd h.RESULTS:Out of a total 906 emergency department (ED) visits with moderate-to-severe acute asthma, 157 children were admitted. June to September had the lowest number of visits. The admission-to-discharge ratio varied throughout the year. During the ED stay, between baseline and 3rd h, admission predictability of the total score improved progressively with a small difference between the 2nd and 3rd h. The total score remained the strongest predictor of admission at every time point compared to its individual components. The drop of PAS from baseline to the 2nd h was not a good predictor of admission. Oxygen saturation (OS) and respiratory rate (RR) had relatively higher predictability than other components.CONCLUSIONS:Decision of admission could be made to many children with moderate-to-severe acute asthma at the 2nd h of ED stay based on their total PAS. OS and RR should be part of any scoring system to evaluate acute asthma in children.

Objective: Graphesthesia is the ability to identify a symbol traced on the skin. Agraphesthesia is the impairment in this ability and is encountered in various disorders of the somatosensory pathways. We aimed to describe the demographic and symbolic features that influence correct recognition of Arabic graphesthesia stimuli in healthy Arabic individuals. Methods: Participants were community dwelling healthy Arabian individuals of 18 years of age or older. Demographic information collected included age, gender, years of education, and hand dominance. Assessment was conducted using a list of 15 symbols drawn in a single stroke while the hands were obscured from vision. Symbols were current letters and numbers from Arabic script. Each participant was exposed to 60 attempts in total in a random order and correct responses were counted. Results: A total of 126 male and female participants were included. On average, men scored less than women (p < 0.0001), older subjects scored less than those below 30 years of age (p = 0.03), and higher years of education resulted in higher scores (p = 0.047) while handedness did not significantly associate with performance. More correct responses were seen for numerical symbols than letters (p < 0.0001). Symbols with unique script were more likely to be correctly identified. Conclusions: Number and letter symbols traced on the palm are identified with varying levels of accuracy when conducted according to our method. Female gender, younger age, and higher education are associated with higher scores. Among the many potential symbolic properties that contribute to recognition, a numeric symbol with a unique script is most likely to be correctly identified.