Amino acids (AAs) and vitamin imbalances are observed in celiac disease (CD). This study evaluated the plasma profile of vitamin A and AAs and the expression level of IL-2, IL-4, IL-10, IL-12 and TGFβ in CD patients. A total of 60 children and adults with CD and 40 healthy controls (HCs) were included. The plasma profile of Vitamin A and AAs and the mRNA expression levels of target genes were assessed. Active adult patients exhibited a decrease in Vitamin A levels (p = 0.04) and an increase in IL-2 (p = 0.008) and IL-12 (p = 0.007) mRNA expression compared to the HCs. The treated adult patients showed elevated Serine (p = 0.003) and Glycine (p = 0.04) levels, as well as increased IL-12 (p < 0.0001) mRNA expression, and a decrease in Tryptophan (p = 0.04) levels relative to the controls. Additionally, the treated adult patients had higher plasma levels of Threonine compared to both the active (p = 0.04) and control (p = 0.02) subjects, and the increased mRNA expression of IL-4 (p = 0.01) in comparison to the active patients. In active children with CD, the IL-2 mRNA level was found to be higher than in the controls (p < 0.0001) and in the treated children (p = 0.005). The treated children with CD exhibited decreased plasma levels of Tryptophan (p = 0.01) and Isoleucine (p = 0.01) relative to the controls, and the increased mRNA expression of TGFβ (p = 0.04) relative to the active patients. Elevated levels of specific AAs (Serine, Glycine, Threonine) in the treated CD patients suggested their potential to improve intestinal damage and inflammation, while decreased levels of Tryptophan and Isoleucine highlighted the need for dietary intervention.

Asthma is a condition where the airways become tiny and swollen producing extra mucus. This can cause breathing difficulty and wheezing, coughing, and shortness of breath. Self-care education affects the quality of life of children. This study examined the effect of self-care education on quality of life for children between 8 and 11 years with allergic asthma. This study was a randomized controlled trial. Study sample included 70 children between 8 and 11 years with asthma allergy referred to Children’s Hospital Clinic of Khorramabad, Lorestan Province in 2015; they were selected by possible non-consecutive sampling method. Children were divided by random sampling of blocks, and classified into two groups of 35 patients each in the experimental and control groups. Both groups were matched for age and sex of children’s and parents’ educational level and initial quality of life scores were analyzed (using covariance analysis). At the beginning, quality of life was calculated by the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) for each of the group. The intervention was carried out in four sessions of 45 minutes of self-care education for children in the case group. No intervention was done in the control group. Eight weeks later quality of life was measured in each of the group. There was a significant difference between increase values of PAQLQ in the intervention group and control group (p < 0.001). These results show that self-care education enhances the quality of life in asthmatic children.

Key Clinical Message: Crohn's disease is one of the three subtypes of inflammatory bowel disease, with regional, transmural, and granulomatous inflammation. The present study is a case report on an 11‐year‐old boy who was referred to the hospital due to penis swelling and pain since a year ago, the patient sometimes complained of pain when urinating, he was having a severe painful swelling in the penis shaft; however, his scrotum was completely normal. He was diagnosed with crohn's disease, thus was placed on azathioprine therapy which eradicated his pain after 3 months, and thus, his skin lesion became much smaller. Crohn's disease, especially in children, should be considered in patient with unknown skin complications, and, if clinically suspected, biopsy examination should be performed. The diagnosis of crohn's disease may be delayed in extradigestive cases. This disease occurs when associated with skin manifestations, which is uncommon. We reported a case with penile crohn's disease, of which few cases have been reported in children to date.

The amino acids (AAs) and vitamins imbalances are observed in celiac disease (CD). This study evaluated the plasma profile of vitamin A and AAs and the expression level of IL-2, IL-4, IL-10, IL-12 and TGFβ in CD patients. A total of 60 children and adults with CD and 40 healthy controls (HCs) were included. Plasma profile of Vitamin A and AAs and the mRNA expression levels of target genes were assessed. Active adult patients exhibited a decrease in Vitamin A levels (p=0.04) and an increase in IL-2 (p=0.008) and IL-12 (p=0.007) mRNA expression compared to HCs. Treated adult patients showed elevated Serine (p=0.003) and Glycin (p=0.04) levels, as well as increased IL-12 (P<0.0001) mRNA expression, and a decrease in Tryptophan (p=0.04) levels relative to the controls. Additionally, treated adult patients had higher plasma levels of Threonine compared to both active (p=0.04) and control (p=0.02) subjects, and increased mRNA expression of IL-4 (p=0.01) in comparison to active patients. In active children with CD, IL-2 mRNA level was found to be higher than in controls (P<0.0001) and in treated children (p=0.005). Treated children with CD exhibited decreased plasma levels of Tryptophan (p=0.01) and Isoleucine (p=0.01) relative to the controls, and increased mRNA expression of TGFβ (p=0.04) relative to active patients. Managing Retinoic acid levels is crucial to alleviate intestinal inflammation of CD patients. Threonine, tryptophan, and Isoleucine are potential therapeutic options for treating CD, and targeting serine, histidine, tyrosine, and aspartate may hold promise as therapeutic targets for CD patients.