scholarly journals Risk Factors for Fracture in Diabetes: The Canadian Multicentre Osteoporosis Study

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Lisa-Ann Fraser ◽  
Alexandra Papaioannou ◽  
Jonathan D. Adachi ◽  
Jinhui Ma ◽  
Lehana Thabane
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Family History ◽  
Female Gender ◽  
Diabetic Patients ◽  
Mineral Density ◽  
Cross Sectional ◽  
Increased Risk ◽  
Traumatic Fracture ◽  
History Of

Objective. Individuals with diabetes have been found to be at increased risk of nontraumatic fracture. However, within the diabetic population, how to distinguish who is at the highest risk and warranting therapy has remained elusive. Design. Cross-sectional analysis of a national population-based cohort study. Patients. Men and women over the age of 50 with diabetes from across Canada. Measurements. Logistic regression analysis to identify diabetes specific factors associated with a history of one or more non-traumatic fractures. Results. Six hundred and six individuals with diabetes with a mean age of 69 years were examined. Thirty percent had a history of non-traumatic fracture. Macrovascular diseases in the form of stroke or TIA, as well as hypertension, were found to be independently associated with fragility fracture. Other, more traditional, clinical risk factors were also associated with fracture, including increased age, female gender, rheumatoid arthritis, family history of osteoporosis, and decreased bone mineral density. Conclusions. In this cohort of Canadians with diabetes, those with rheumatoid arthritis, a family history of osteoporosis, female gender, increased age, decreased BMD, cerebrovascular disease, or hypertension were more likely to have had a non-traumatic fracture. These risk factors may be important to clinicians when identifying which of their diabetic patients are at highest risk of fracture and in need of preventative therapies.

scholarly journals P129 Predictors of low bone mineral density in rheumatoid arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Malika A Swar ◽  
Marwan Bukhari
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Bone Mineral Density ◽  
Family History ◽  
Bone Loss ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Fragility Fracture ◽  
Mineral Density ◽  
History Of

Abstract Background/Aims  Osteoporosis (OP) is an extra-articular manifestation of rheumatoid arthritis (RA) that leads to increased fracture susceptibility due to a variety of reasons including immobility and cytokine driven bone loss. Bone loss in other populations has well documented risk factors. It is unknown whether bone loss in RA predominantly affects the femoral neck or the spine. This study aimed to identify independent predictors of low bone mineral density (BMD) in patients RA at the lumbar spine and the femoral neck. Methods  This was a retrospective observational cohort study using patients with Rheumatoid arthritis attending for a regional dual X-ray absorptiometry (DEXA) scan at the Royal Lancaster Infirmary between 2004 and 2014. BMD in L1-L4 in the spine and in the femoral neck were recorded. The risk factors investigated were steroid use, family history of osteoporosis, smoking, alcohol abuse, BMI, gender, previous fragility fracture, number of FRAX(tm) risk factors and age. Univariate and Multivariate regression analysis models were fitted to explore bone loss at these sites using BMD in g/cm2 as a dependant variable. . Results  1,527 patients were included in the analysis, 1,207 (79%) were female. Mean age was 64.34 years (SD11.6). mean BMI was 27.32kg/cm2 (SD 5.570) 858 (56.2%) had some steroid exposure . 169(11.1%) had family history of osteoporosis. fragility fracture history found in 406 (26.6%). 621 (40.7%) were current or ex smokers . There was a median of 3 OP risk factors (IQR 1,3) The performance of the models is shown in table one below. Different risk factors appeared to influence the BMD at different sites and the cumulative risk factors influenced BMD in the spine. None of the traditional risk factors predicted poor bone loss well in this cohort. P129 Table 1:result of the regression modelsCharacteristicB femoral neck95% CIpB spine95%CIpAge at scan-0.004-0.005,-0.003<0.01-0.0005-0.002,0.00050.292Sex-0.094-0.113,-0.075<0.01-0.101-0.129,-0.072<0.01BMI (mg/m2)0.0080.008,0.0101<0.010.01130.019,0.013<0.01Fragility fracture-0.024-0.055,0.0060.12-0.0138-0.060,0.0320.559Smoking0.007-0.022,0.0350.650.0286-0.015,0.0720.20Alcohol0.011-0.033,0.0 5560.620.0544-0.013,0.1120.11Family history of OP0.012-0.021,0.0450.470.0158-0.034,0.0650.53Number of risk factors-0.015-0.039,0.0080.21-0.039-0.075,-0.0030.03steroids0.004-0.023,0.0320.030.027-0.015,0.0690.21 Conclusion  This study has shown that predictors of low BMD in the spine and hip are different and less influential than expected in this cohort with RA . As the FRAX(tm) tool only uses the femoral neck, this might underestimate the fracture risk in this population. Further work looking at individual areas is ongoing. Disclosure  M.A. Swar: None. M. Bukhari: None.

scholarly journals Sweet Taste Threshold among Medical Students with Family History of Diabetes Mellitus

2020 ◽  
Vol 7 (4) ◽  
Author(s):  
Nasya Aisah Latif ◽  
Yulia Sofiatin ◽  
Maya Kusumawati ◽  
Rully Marsis Amirullah Roesli
Keyword(s):  
Diabetes Mellitus ◽  
Medical Students ◽  
Family History ◽  
Sweet Taste ◽  
Diabetic Patients ◽  
Taste Threshold ◽  
Cross Sectional ◽  
Family History Of Diabetes ◽  
Increased Risk ◽  
History Of

Background: Diabetic patients have low sensitivity towards sweet taste, thus consuming more sugar. A young adult with family history of diabetes mellitus (FHD) who lives with diabetic parents may have an increased risk of overconsumption of sugar due to a similar dietary pattern, leading to diabetes. This study aimed to explore the difference in the sweet taste threshold (STT) between students with and without a family history of diabetes mellitus. Methods: This cross-sectional study was conducted in October –November 2018 on Class 2018 medical students living in a student dormitory who were divided into those with family history of diabetes (FHD) and those without it (non-FHD). Family history of diabetes and other known diseases were self-reported. The three-Ascending Forced Choice method was used to determine the sweet recognition threshold. Mann-Whitney analysis was used to compare the sweet taste thresholds between the two groups. Result: A total of 183 subjects participated in this study. The non-FHD group had a higher rank of sweet taste threshold than subjects in the FHD group (94.21 vs 81.16), albeit insignificant (p=0.192). Interestingly, the modes of best estimation threshold (BET) for non-FHD group was than the FHD group (0.067 M vs 0.043 M). Conclusion: The BET for students without family history of diabetes is higher than those with family history of diabetes. It is imperative that low sugar consumption campaign should also aim young people without FHD.

scholarly journals Thyroid Dysfunction and Associated Risk Factors among Nepalese Diabetes Mellitus Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Saroj Khatiwada ◽  
Rajendra KC ◽  
Santosh Kumar Sah ◽  
Seraj Ahmed Khan ◽  
Rajendra Kumar Chaudhari ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Relative Risk ◽  
Family History ◽  
Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Female Gender ◽  
Diabetic Patients ◽  
History Of ◽  
Associated Risk Factors

Objectives. To assess thyroid function and associated risk factors in Nepalese diabetes mellitus patients.Methods. A cross-sectional study was carried out among 419 diabetes mellitus patients at B. P. Koirala Institute of Health Sciences, Dharan, Nepal. Information on demographic and anthropometric variables and risk factors for thyroid dysfunction was collected. Blood samples were analysed to measure thyroid hormones, blood sugar, and lipid profile.Results. Prevalence rate of thyroid dysfunction was 36.03%, with subclinical hypothyroidism (26.5%) as the most common thyroid dysfunction. Thyroid dysfunction was much common in females (42.85%) compared to males (30.04%)p=0.008and in type 1 diabetes (50%) compared to type 2 diabetes mellitus (35.41%)p=0.218. Diabetic patients with thyroid dysfunction had higher total cholesterol, HDL cholesterol, and LDL cholesterol in comparison to patients without thyroid dysfunction. Significant risk factors for thyroid dysfunction, specifically hypothyroidism (overt and subclinical), were smoking (relative risk of 2.56 with 95% CI (1.99–3.29,p<0.001)), family history of thyroid disease (relative risk of 2.57 with 95% CI (2.0–3.31,p<0.001)), and female gender (relative risk of 1.44 with 95% CI (1.09–1.91,p=0.01)).Conclusions. Thyroid dysfunction is common among Nepalese diabetic patients. Smoking, family history of thyroid disease, and female gender are significantly associated with thyroid dysfunction.

scholarly journals Assessment of plasma blood sugar level in first degree relatives of known type 2 diabetes patients: a descriptive study from Maharashtra, India

2020 ◽  
Vol 7 (3) ◽  
pp. 482
Author(s):  
J. K. Deshmukh ◽  
P. Y. Mulay ◽  
Amit G. Naghate ◽  
Anant A. Takalkar
Keyword(s):  
Family History ◽  
Health Check ◽  
Steady Increase ◽  
Diabetic Patients ◽  
Maternal History ◽  
Family History Of Diabetes ◽  
First Degree Relatives ◽  
Increased Risk ◽  
History Of

Background: There is steady increase in the prevalence of diabetes mellitus from 0.73% to current 2.4% in rural and 4.0% to 11.6% in urban areas. Familial clustering of diabetes may support a genetic predisposition to diabetes. With increase in the prevalence of diabetes there is increase in number of first degree relative as well, thus an increased risk of developing diabetes, will also increase. To study the plasma glucose levels in First-degree relatives of family member of type 2 diabetic patients was the objective of the present study.Methods: It is a descriptive observational study with 1020 individuals serially coming to our outpatient Department for Pre-employment Medical Health Check Up Annual Health Check Up were selected. These individuals have been enrolled for the study and their family history of diabetes was noted, their sugar levels and their lipid levels were estimated and their body mass index was calculated. The data thus collected and analyzed with excel.Results: 184 (18%) individuals were FDRs, were as 836 (82%) individuals were Non-FDRs. There were 754 (74%) males [131(17%) FDR and 623(83%) Non-FDR], were as 213 (26%) females [53(20%) FDR and 213(80%) Non-FDR], 61(6%) individuals were having Diabetic Mother, 91(9%) individuals had Diabetic Father and 32(3%) were those in whom both the Parents were Diabetic. It was found that maternal history has strong association for getting abnormal BSL levels as compared to a diabetic father as the RR of 9.82 (95% 4.84 to 19.95) in individuals with mother being diabetic, and RR of 1.54(95% 0.68 to 3.87) of father being diabetic.Conclusions: Family history of diabetes, maternal history of diabetes and history of both the parents having diabetes are risk factors for diabetes in FDRs.

scholarly journals Study on Associated Risk Factors of Hypertension at Sipaghat of Sindhupalchowk District, Nepal

2017 ◽  
Vol 1 ◽  
pp. 73-82
Author(s):  
Naresh Manandhar
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Alcohol Consumption ◽  
Lifestyle Modification ◽  
Percent Level ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Family History Of Hypertension ◽  
Associated Risk Factors

Background: Hypertension is a progressive cardiovascular syndrome arising from complex and interrelated etiologies. Males have slightly higher prevalence than female in most of countries of Southeast-Asian region.Objective: The objective of study is to find out prevalence and the risk factors of hypertension at Sipaghat, Sindhulchowk, Nepal.Materials and Methods: A cross-sectional study was conducted at Sipaghat of Sindhupalchowk district in May 2016 and 260 persons were selected randomly. Results: The prevalence of hypertension was higher in male (25.4%) than female (17.4%). Mean age of study population was 42.08 years with standard deviation, 15.95 years. Variables namely age group, smoking, alcohol consumption and family history of hypertension were found to be significant at 5 percent level of significance. Alcohol consumption and smokers have more than two times higher chance of getting hypertension compared to alcohol non-consumer and nonsmoker with 95% confidence intervals were 1.08-4.80 and 1.21-6.10, respectively. Persons with family history of hypertension have 3.8 times more chance of getting hypertension compared to no family history of hypertension with 1.89-7.61 of 95% confidence interval.Conclusion: Lifestyle modification reduces blood pressure which prevents or delays the incidence of hypertension. Hypertension can be controlled and prevented by modifying the lifestyle. People should be advised to avoid modifiable risk factors of hypertension like smoking, consumption of alcohol and physical inactivity through health education programs.Nepalese Journal of Statistics, 2017, Vol. 1, 73-82

scholarly journals Prevalence of major cardiovascular disease risk factors among a group of sub-Saharan African young adults: a population-based cross-sectional study in Yaoundé, Cameroon

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e029858 ◽  
Author(s):  
Jobert Richie Nansseu ◽  
Bibiane Siaheu Kameni ◽  
Felix Kembe Assah ◽  
Jean Joel Bigna ◽  
Saint-Just Petnga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Cross Sectional Study ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Prevalence Estimates ◽  
Hazardous Alcohol ◽  
History Of ◽  
Hazardous Alcohol Consumption

ObjectiveTo determine the prevalence estimates of some major risk factors for cardiovascular disease (CVD) in a young adult-aged population living in Yaoundé, Cameroon.DesignA cross-sectional study held from May to July 2017.SettingParticipantsStudents aged 18–35 years, with no known history of CVD, found at the campus during recruitment and who voluntarily agreed to be included in the study.Primary and secondary outcome measuresData were collected on personal and family history as well as lifestyle and nutritional habits; anthropometric parameters and blood pressure were also measured. Prevalence rates were calculated with their respective 95% CI.ResultsOverall, 931 participants (53.8% males) were included, with a median age of 23 years (IQR 21–25). The prevalence estimates for some major CVD risk factors were: 3.1% (95% CI 2.0 to 4.2) for family history of heart attack, 6.3% (95% CI 4.7 to 7.9) for family history of stroke, 26.7% (95% CI 23.9 to 29.5) for hazardous alcohol consumption, 0.9% (95% 0.3 to 1.5) for current tobacco smoking, 27.6% (95% CI 24.7 to 30.5) for secondhand smoking, 88.9% (95% CI 86.9 to 90.9) for physical inactivity, 99.0% (95% CI 98.4 to 99.6) for inadequate fruits and/or vegetables consumption, 39.8% (95% CI 36.7 to 42.9) for self-reported anxiety, 49.2% (95% CI 46.0 to 52.4) for self-reported depression, 22.1% (95% CI 19.4 to 24.8) for overweight, 3.9% (95% CI 2.7 to 5.1) for obesity, 14.4% (95% CI 12.1 to 16.7) for abdominal obesity, 14.5% (95% CI 12.2 to 16.8) for excess body fat mass, 30.0% (95% CI 27.1 to 32.9) for suspected prehypertension and 2.8% (95% CI 1.7 to 3.9) for suspected hypertension.ConclusionThe prevalence of some major CVD risk factors is high among young adults living in Yaoundé, Cameroon. Therefore, specific actions should be undertaken in this population to mitigate the upcoming burden of CVD. Accordingly, younger-aged adult populations should be encouraged and accompanied to practice physical activity, eat healthily, and stop or avoid smoking and/or hazardous alcohol consumption.

scholarly journals Cardiovascular Risk Factors in Patients with Acute MI in a Secondary Hospital in Bangladesh

2020 ◽  
Vol 12 (2) ◽  
pp. 96-101
Author(s):  
Mohammad Ullah ◽  
Suman Kumar Saha ◽  
Md Toufiqur Rahman ◽  
Md Abdul Karim ◽  
Rashid Ahmed
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Family History ◽  
Cardiovascular Diseases ◽  
General Population ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Secondary Hospital

Background: Incidence of noncommunicable disease, specially cardiovascular diseases, is increasing in Bangladesh. Prevalence of risk factors in ischaemic heart disease (IHD) has been studied in different tertiary hospitals and institutes. This study was done in a secondary hospital with a patient population mainly of low socioeconomic condition and was compared with other patient groups of the country and Indian subcontinent. Methods: this cross sectional study was conducted in Manikganj Sadar Hospital from July 2019 to December 2019. All the patients admitted with the diagnosis of myocardial infarction (MI) were included. Cardiovascular risk factors, like smoking, diabetes mellitus (DM), hypertension (HTN), family history of premature cardiovascular diseases, dyslipidaemia and obesity, were evaluated among the patients. Results: This cross-sectional study showed most of the patients were in the age group of 50-59 years. 66% of the male patients and 2% of the female patients were smoker. 66% of the patients were hypertensive, 44% patients were diabetic, 28.5% patients were overweight, 60.4% patients had total cholesterol > 200mg/dl, 73.6% patients had LDL>130 mg/dl, 110 76.3% patients had HDL < 40 mg/ dl, 72.2% had triglyceride >150 mg/dl and 39% patients had family history of premature cardiovascular disease. Ninety (62.5%) patients had anterior MI, 50 (34.7%) patients had inferior MI and 4 (2.7%) patients had NSTEMI. 65 patients had no major risk factor and 57 % had three or more risk factors. Conclusion: The study population was more aged in comparison to other studies conducted in different parts of Bangladesh. Prevalence of smoking habit was lower but the prevalence of HTN, DM and dyslipidaemia were higher than the general population and other cohorts of MI patients. The prevalence of major risk factors was much higher than the general population of Bangladesh. Cardiovasc. j. 2020; 12(2): 96-101

scholarly journals Risk Factors for Postpartum Thyroid Dysfunction in Euthyroid Women Prior to Pregnancy

Folia Medica ◽  
2017 ◽  
Vol 59 (2) ◽  
pp. 190-196
Author(s):  
Boyan I. Nonchev ◽  
Antoaneta V. Argatska ◽  
Blagovest K. Pehlivanov ◽  
Maria M. Orbetzova
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Early Pregnancy ◽  
Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Multivariate Logistic Regression Analysis ◽  
Postpartum Women ◽  
Increased Risk ◽  
History Of ◽  
Postpartum Thyroid Dysfunction

AbstractBackground:Thyroid dysfunction is common during the postpartum and the predisposing factors for its development are considered specific for the population studied. The aim of this study was to evaluate the risk factors for the occurrence of postpartum thyroid dysfunction (PPTD) in euthyroid women prior to pregnancy.Materials and methods:Forty-five women with PPTD and 55 age-matched euthyroid postpartum women from Plovdiv, Bulgaria were included in the study. TSH, FT4, FT3, TPOAb, TgAb, TRAb were measured and ultrasound evaluation of the thyroid was performed in the first trimester of pregnancy and during the postpartum.Results:The study found higher risk of developing PPTD in women with family history of thyroid disease (OR 4.42; 95% CI 1.87,10.43), smokers (OR 4.01; 95% CI 1.72,9.35), personal history of autoimmune thyroid disease (OR 5.37; 95% CI 1.15,28.53), positive TPOAb (OR 18.12; 95% CI 4.93,66.65) and thyroid US hypoechogenicity during early pregnancy (OR 6.39; 95% CI 2.53,16.12) and those who needed levothyroxine during pregnancy (OR 3.69; 95% CI 1.28,10.61). BMI before pregnancy was significantly lower in women with PPTD than in euthyroid postpartum women (22.80±0.55 vs 26.25±0.97, p=0.013). The multivariate logistic regression analysis identified as most important independent risk factors for PPTD occurrence the TPOAb positivity during early pregnancy, family history of thyroid disease, smoking and lower BMI before pregnancy.Conclusion:Our data suggest that in the population studied several factors are associated with an increased risk of PPTD and screening for thyroid disorders among those women can be beneficial.

scholarly journals Psychiatric Co-Morbidities of Suicide Attempters: A Cross Sectional Observation in a Tertiary Care Hospital of North India

2021 ◽  
Vol 6 (2) ◽  
pp. 40-46
Author(s):  
Shaveta Bhagat ◽  
Mohammad Maqbool Dar ◽  
Ibrar Ahmed
Keyword(s):  
Family History ◽  
General Hospital ◽  
Psychiatric Illness ◽  
Care Hospital ◽  
Cross Sectional ◽  
Suicide Attempters ◽  
Increased Risk ◽  
Co Morbidity ◽  
History Of ◽  
Suicide Attempted

Background: Psychiatric disorders are at increased risk for suicide. Attempted suicide is a common clinical problem in a general hospital. It has a serious clinical and socio-economical impact too. Aims: This study was carried out to assess the prevalence of psychiatric co-morbidities of suicide attempters attending the emergency. Material and methods: This study was a cross sectional, observational study which was conducted at the Community General Hospital Unit, Institute of Mental Health and Neurosciences-Kashmir an associated hospital of Government Medical College Srinagar among the suicide patients attending the outpatient service and inpatient services of the hospital fulfilling inclusion and exclusion criteria over a period of one and a half year, from November 2017 to May 2019. Written informed consent was obtained in a simple and easily understandable unambiguous language. For the diagnosis of psychiatric comorbidity, we used MINI International Neuropsychiatric Interview Schedule Plus (MINI PLUS). A p-value of <0.05 was taken as statistically significant. Results: A total of 221 cases who had been admitted following unsuccessful suicide attempts to the emergency and psychiatry department were taken up for the study. They were evaluated in detail with regards to past attempt of suicide, family history of psychiatric illness or suicide and the presence of psychiatric co-morbidity and the results have been presented below in tabulated and graphical forms. 77.4% of the attempters had no history of psychiatric illness in their family while 22.6% of patients did have family history of a psychiatric illness. 98.2% of attempters had no family history of suicide while 1.8% of the patients gave a family history of suicide. 21.26% males and 54.75% females had associated psychiatric co-morbidities and 23.9% had no associated psychiatric co-morbidities. Conclusion: The most common psychiatric morbidity associated with suicide was found to be major depressive disorder. Most importantly, the suicide attempters should be looked with sympathy rather than with a grimace on face. Such people should not be stigmatized and we should not let their shoulders drop. Keywords: Depression, Bipolar Disorder, Morbidity, Suicide.

scholarly journals Isolated night cough in children: how does it differ from wheeze?

2020 ◽  
Vol 6 (4) ◽  
pp. 00217-2020
Author(s):  
Maja Jurca ◽  
Myrofora Goutaki ◽  
Philipp Latzin ◽  
Erol A. Gaillard ◽  
Ben D. Spycher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Variant Form ◽  
Older Children ◽  
Cough Variant Asthma ◽  
Asymptomatic Children ◽  
Increased Risk ◽  
History Of ◽  
Male Sex ◽  
Similar Risk

It has been postulated that some children with recurrent cough but no wheeze have a mild form of asthma (cough variant asthma), with similar risk factors and an increased risk of future wheeze.This longitudinal study compared risk factors for isolated night cough and for wheeze in the Leicester Respiratory Cohort in children aged 1, 4, 6 and 9 years and compared prognosis of children with isolated night cough, children with wheeze and asymptomatic children.We included 4101 children aged 1 year, 2854 aged 4 years, 2369 aged 6 years and 1688 aged 9 years. The prevalence of isolated night cough was 10% at age 1 year and 18% in older children. Prevalence of wheeze decreased from 35% at 1 year to 13% at 9 years. Although several risk factors were similar for cough and wheeze, day care, reflux and family history of bronchitis were more strongly associated with cough, and male sex and family history of asthma with wheeze. Over one-third of preschool children with cough continued to cough at school age, but their risk of developing wheeze was similar to that of children who were asymptomatic at earlier surveys. Wheeze tracked more strongly throughout childhood than cough.In conclusion, our study showed that only some risk factors for cough and wheeze were shared but many were not, and there was little evidence for an increased risk of future wheeze in children with isolated night cough. This provides little support for the hypothesis that recurrent cough without wheeze may indicate a variant form of asthma.

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