Hijab Shaheen, Shagufta Sohail, Noshina Riaz.
Dexamethasone versus Prednisolone in Relapse of Symptoms in Children with Acute Exacerbations of Asthma.
J Islamic Int Med Coll Jan ;15(1):33-6.

Objective: To determine effectiveness of single dose of oral dexamethasone with multiple doses of oral prednisolone in relapse of symptoms in children with acute exacerbations of asthma. Study Design: This was a randomized controlled trial. Place and Duration of Study: The study was conducted from 1st January to 31st December 2016 at the emergency department of Children`s Hospital, Pakistan Institute of Medical Sciences (PIMS), Islamabad. Materials and Methods: Total 302 patients were included in the study with 151 children in each group receiving either dexamethasone or prednisolone. Sampling technique was consecutive and non-probable. Children of age 2 to12 years with previous history of asthma diagnosed by a physician presenting with acute exacerbations in emergency were included after consent. After assessment of Pediatric respiratory assessment measure (PRAM) score by the study physician, the patient was either given a single dose of dexamethasone 0.3mg/kg with maximum dose of 12mg or 1mg/kg of oral prednisolone with maximum dose of 40mg followed by two doses for next 2 days after discharge. Patients were reassessed for PRAM score at day 4. The patients were then called at day 14 for the assessment of relapse of symptoms of asthma like cough, wheeze and breathing difficulty. Data was documented by the study physician on a proforma. SPSS version 20 was used for entry and analysis of data. Data was presented as mean with standard deviations. Percentage was calculated from descriptive variables. Chi-square test was used for nonparametric data. P value was significant if less than 0.05. Results: There was no significant difference in relapse of symptoms of asthma on day 14 between dexamethasone and prednisolone.10 patients i.e. 6.6% in Prednisolone and 12 i.e. 7.9% in Dexamethasone group had relapse of symptoms of asthma on Day 14 with a `p` value of 0.65 which was not significant. Conclusion: Single dose dexamethasone is as effective as multiple doses of prednisolone as measured by relapse of symptoms in children with acute exacerbation of asthma.

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