International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 14(18), September, 2022

Pages: 17-20

Date of Publication: 24-Sep-2022


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Role of Allergic Rhinitis in Cognitive Functions and Psychological Condition of Children Aged 8-16 years

Author: Ipsa Kujur, Mamata Panda, Suryakanta Swain, Bishwajit Mishra, Smruti Dash Mohapatro, Manisha Patro

Category: Healthcare

Abstract:Introduction: Allergic rhinitis (AR) is defined as a symptomatic disorder of the nose induced after coming in contact to allergens by an immunoglobulin E(IgE) mediated inflammation. Allergic rhinitis is one of the commonest chronic allergic diseases in school age group. AR is clinically diagnosed and its symptoms are watery nose, nasal obstruction, itching and sneezing.AR is divided into intermittent or persistent disease according to the duration of active symptoms. The severity of AR can be classified as mild, moderate or severe according to the level of disturbance of the daily activities. Around 20-30% of the population suffers from AR and the majority of them show symptoms from 6-7 years of age. Objectives/Aim: To evaluate the role of symptomatic allergic rhinitis in cognitive functioning of a child and the effect of allergic rhinitis on the psychological condition of affected children. Methodology: A prospective observational study was carried out in the OPD/IPD of HI-TECH Medical college and hospital from 1st September 2019-31st October 2021.150 children were evaluated in this period special questionnaire regarding the quality of life in rhinitis patients for psychological well-being and their cognitive ability like verbal memory, memory retrieval, working memory, information processing, color word interference and cognitive flexibility was evaluated with the help of computerized Visual verbal learning test(VVLT) and Stroop colour word test(SCWT). Results: In the study we found out that there was a significant association with age in years with working memory/memory retrieval/colour word interference/cognitive flexibility, with p less than 0.05. The psychological status of children was assessed by the questionaries and was found to be affected due to regular medications leading to inattentive behavior, absence from school, stress on parents due to high burden of disease, shame because of the persistent nature of the disease and feeling drowsy throughout on medications. Conclusion: Allergic rhinitis affects the psychological well-being of a child and decreases cognitive ability but there is no cognitive impairment drastically.

Keywords: Allergic rhinitis, cognitive function, psychological condition, visual verbal learning test, Stroop colour word test, questionaries on allergic rhinitis

Full Text:

INTRODUCTION:

Allergic rhinitis (AR) is a common chronic disease.1. ISAAC phase 1 revealed that in India 12.5% of children in the age group of 6-7 years and18.6%in the age group of 13-14 years had nasal symptoms related to allergic rhinitis.ISAAC phase 3 revealed an elevation in nasal symptoms to 12.9% and 23.6 % in 6-7- and 13-14-year age groups respectively.4ARis often underestimated. Not only physical manifestations but mental problems, reduce the quality of life (QOL).6,9Allergic rhinitis can have a negative impact on scholastic performance and work performance which contributes to the experience of stress and agony in children.3 Children with allergic rhinitis report increased sleep disturbances secondary to allergic symptoms and increased daytime fatigue which affects school performance.5Michael S Blaiss wrote an article on behalf of the allergic rhinitis in school children consensus group in 2004.2The group concluded that allergic rhinitis symptoms can have considerable harmful effects on absenteeism, presenteeism(inattention, distraction, lack of concentration), cognitive impairment(difficulty in the use of speech, visual perception and construction, calculation ability, information processing and execution etc), poor school performance, behaviour and psychosocial problems in school children.10 Symptomatic allergic patients are significantly slower in processing particular data than non-symptomatic patients. 8 Remembering things and making decisions along with basic functions such as speed directly influences most aspects of daily activities. Consequently, slow thinking and motor action may impose difficulty on the child in an attempt to maintain a certain performance. This causes fatigue and increased susceptibility to distraction. This increases stress in a family system like parent-child conflict, parental sleep disruption, increased parenting stress etc. Therefore, it affects both the child and the parents. Now the question arises if cognition and psychosocial well-being is compromised then to what extent

MATERIALS AND METHODS

This study will be done at Hi-Tech Medical college and hospital Bhubaneswar. The study will cover children aged from 8-16 years. Patient particulars like age, sex, and address will be noted. Detailed history including the age of onset of illness, duration of illness (seasonal or perineal), family history of atopy, previous anti-allergy treatment and history of scholastic performance will be recorded. Four aspects of cognitive development will be measured. To assess VERBAL MEMORY, Visual Verbal Learning Test (VVLT) will be carried out.15 words will be shown and the child will be asked to remember the words shown to him/her. This procedure will be repeated 5 times. A number of words recalled immediately shows WORKING MEMORY. Then after 20 minutes, words remembered show long-term memory(MEMORY RETRIEVAL). To test the information processing of the child, the Stroop-Colour-Word Test (SCWT) will be carried out. The test will involve three cards showing colour names(SCWT1), coloured figures (SCWT2) and names of the colour written in different coloured ink from the name of the colour it is suggesting (SCWT 3). On the first and second cards, the colour names and figures showing the same colour, no incongruity have to be read aloud as quickly as possible, which shows the speed of INFORMATION PROCESSING. On the third card, the amount of time required to discard irrelevant but important information (reading of colour name)will be recorded. The difference between SCWT3 and the mean of SCWT1 and SCWT2 will reflect “COLOUR WORD INTERFERENCE”, which shows COGNITIVE FLEXIBILITY. The results from the above test will be represented using appropriate tables, graphs and diagrams. The psychological condition of the patient will be evaluated using a customised questionnaire.

RESULTS:

The below graphs and tables give us the interpretation that allergic rhinitis patients have a slower working memory, memory retrieval is poor and cognitive flexibility is affected in comparison with normal kids. The significant p-value is set as 0.05. But there isn’t a major change seen in the children in comparison to non-allergic kids. The effect in the psychological domain is far more than in the cognitive domain due to various reasons.

DISCUSSION:

Cognitive impairment (also known as intellectual disability) is a term used when an individual has some kind of shortcomings in mental function and in domains such as communication, self-help and social interaction. These shortcomings will cause a hindrance in the learning and development of a child. The affected child will be slower than a typical child. It is diagnosed with the help of standardized tests of intelligence and adaptive behaviour. Children going through cognitive problems such as low attention, poor memory or lack of inhibition may later suffer mental health issues as teenagers and young adults.7 Allergic rhinitis is one of the major reasons because of why children miss school in childhood days. Due to rhinorrhoea, headache, sleepless nights, difficulty in concentrating, sleeping pattern problems and lethargy, short-term memory problems are seen in children. The consequences of symptomatic allergic rhinitis can extend to adult life affecting the quality of life in all its aspects. Allergic rhinitis causes emotional problems in children causing them to be depressed and ashamed of themselves, hence decreasing their performance in school.

CONCLUSION

Symptomatic allergic rhinitis disturbs day-to-day life due to signs and symptoms experienced and due to grave impact on mental health. Some investigations and tests have been run to gauge the effect on cognitive functions objectively. But still remains uncertain if it leads to an objective reduction in cognitive functions of the affected child. The psychological condition of the affected patients was significantly impaired.

ACKNOWLEDGEMENT-DR PANDA MAMATA, ASSOCIATE PROFESSOR, DEPT.OF PAEDIATRICS

DR MISHRA BISHWAJIT, ASSOCIATE PROFESSOR, DEPT.OF PAEDIATRICS

DR SWAIN SURYAKANTA, PROFESSOR AND HOD, DEPT.OF PAEDIATRICS

DR DASH MOHAPATRA SMRUTI, MBBS,3rd YEAR POSTGRADUATE, DEPT.OF PAEDIATRICS

DR PATRO MANISHA, MBBS,3rd YEAR POSTGRADUATE, DEPT.OF PAEDIATRICS

SOURCE OF FUNDING-NONE

CONFLICT OF INTEREST-NONE

AUTHORS CONTRIBUTIONS- DR IPSA KUJUR: Integrity of the data and accuracy of the data analysis; study of concept and design; critical revision of the manuscript for important intellectual content; study supervision.

DR. MAMATAPANDA: Study concept and design; acquisition, analysis or interpretation of the data; study supervision

DR BISHWAJIT MISHRA AND DR SURYAKANTA SWAIN: Acquisition, analysis or interpretation of the data; study supervision

DR SMRUTI DASH MOHAPATRA: critical revision of the manuscript for important intellectual content

DR MANISHA PATRO: Drafting of the first manuscript

ETHICAL CLEARANCE: INSTITUTIONAL ETHICS COMMITTEE,HI TECH MEDICAL COLLEGE AND HOSPITAL; No.HMCH/IEC/2021/124, dated 6 10 2021

References:

1. Kremer B, den Hartog HM, Jolles J. Relationship between allergic rhinitis, disturbed cognitive function and psychological well-being, clinical exp allergy 2002;32:1310-1315

2. Blaiss MS. Cognitive, social and economic costs of allergic rhinitis, allergy asthma proc 2000;21:7-13

3. Elias M, Chandramani P, Alok S, Impact of allergic rhinitis in school going children, Asia Pac Allergy 2012;2-93-100

4. Lindsay CR. A comprehensive study of the effects of allergic rhinitis on the performance and conduct behavior of school-aged children, 2008

5. Treatment of allergic rhinitis is associated with improved attention performance in children: The allergic rhinitis cohort study for kids. www.plosone.org, October 2014, volume 9, issue 10

6. Allergic rhinitis and school performance, J Investig Allergol Clin Immunol 2009; Vol19, Suppl.1:32-39

7. Change of cognitive function and learning ability in allergic rhinitis. The Korean academy of asthma, allergy and clinical immunology symposium 2.

8. Allergic rhinitis, De shazo RD, Kemp SF.Clinical manifestations and epidemiology of allergic rhinitis(rhinosinusitis). uptodate. com.2008

9. ISAAC Steering committee. Worldwide variation in the prevalence of symptoms of asthma, allergic rhinitis and atopic eczema: ISAAC. Lancet1998; 351:1225-1232

10. Simons FE. Learning impairment and allergic rhinitis. Allergy Asthma Proc. Jul-Aug 1996; 17:185-9. doi: 10.2500/108854196778996895.

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Dr. Pramod Kumar Manjhi joined Editor-in-Chief since July 2021 onwards

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SCOPUS indexing: 2014, 2019 to 2021


Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

Emerging Researcher Award:

‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

A study by Dorothy Ebere Adimora et al. entitled \"Remediation for Effects of Domestic Violence on Psychological well-being, Depression and Suicide among Women During COVID-19 Pandemic: A Cross-cultural Study of Nigeria and Spain\" is awarded Best Article of Vol 14 issue 23
A study by Muhas C. et al. entitled \"Study on Knowledge & Awareness About Pharmacovigilance Among Pharmacists in South India\" is awarded Best article for Vol 14 issue 22
A study by Saurabh Suvidha entitled \"A Case of Mucoid Degeneration of Uterine Fibroid with Hydrosalphinx and Ovarian Cyst\" is awarded Best article of Vol 14 issue 21
A study by Alice Alice entitled \"Strengthening of Human Milk Banking across South Asian Countries: A Next Step Forward\" is awarded Best article of Vol 14 issue 20
A study by Sathyanarayanan AR et al. entitled \"The on-task Attention of Individuals with Autism Spectrum Disorder-An Eye Tracker Study Using Auticare\" is awarded Best article of Vol 14 issue 19
A study by Gupta P. et al. entitled \"A Short Review on \"A Novel Approach in Fast Dissolving Film & their Evaluation Studies\" is awarded Best Article of Vol 14 issue 18.
A study by Shafaque M. et al. entitled \"A Case-Control Study Performed in Karachi on Inflammatory Markers by Ciprofloxacin and CoAmoxicillin in Patients with Chronic Suppurative Otitis Media\" is awarded Best Article of Vol 14 issue 17
A study by Ali Nawaz et al. entitled \"A Comparative Study of Tubeless versus Standard Percutaneous Nephrolithotomy (PCNL) \? A Randomized Controlled Study\" is awarded Best Article for Vol 14 issue 16.
A study by Singh R. et al. entitled \"A Prospective Study to Find the Association of Astigmatism in Patients of Vernal Keratoconjunctivitis (VKC) in a Tertiary Health Care Centre in India (Vindhya Region MP)\" is awarded Best Article for Vol 14 issue 15
A Study by Humaira Tahir et al. entitled "Comparison of First Analgesic Demand after Major Surgeries of Obstetrics and Gynecology between Pre-Emptive Versus Intra-Operative Groups by Using Intravenous Paracetamol: A Cross-Sectional Study" is awarded Best Article for Vol 14 issue 14
A Study by Monica K. entitled "Risk Predictors for Lymphoma Development in Sjogren Syndrome - A Systematic Review" is awarded Best Article for Vol 14 issue 13
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A Study by Vinita S & Ayushi S entitled "Role of Colour Doppler and Transvaginal Sonography for diagnosis of endometrial pathology in women presenting with Abnormal Uterine Bleeding" is awarded Best Article for Vol 14 issue 08
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A Study by Manoj KP et al. entitled "A Randomized Comparative Clinical Trial to Know the Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block Against Multimodal Analgesia for Postoperative Analgesia Following Caesarean Section" is awarded Best Article Award of Vol 13 issue 23
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A Study by Bhat Asifa et al. entitled "Efficacy of Modified Carbapenem Inactivation Method for Carbapenemase Detection and Comparative Evaluation with Polymerase Chain Reaction for the Identification of Carbapenemase Producing Klebsiella pneumonia Isolates" is awarded Best Article for Vol 13 issue 17
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A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09
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A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07
A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
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A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
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A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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