We are thankful to the reader for raising some issues for discussion regarding the association of allergic rhinitis (AR) and sinusitis with childhood asthma [1].

First, regarding the diagnosis of asthma and use of spirometry, it has already been mentioned in the paper that asthma was diagnosed based on history and clinical examination as per the National Asthma Education and Prevention program II (updated 2002). Spirometry is not a diagnostic modality for asthma, and was not used in this study.

Second, regarding the sampling technique, considering the cross-sectional nature of the study to find out the point prevalence of AR and sinusitis in childhood asthma, asthma cases visiting first time to the clinic were enrolled. As the children visiting to the clinic randomly (without choice/selection of the investigator), it fits into probability sampling. The main objective of the study was to find the association of AR and sinusitis in children with different type of asthma severity. A formal sample size calculation was not made as there was no previous study on sinusitis employing the CT scan criteria for diagnosis in asthmatic children. As described earlier, sample size calculation may be prone to error if choices of parameters for calculation are not proper [2].

Third, it has been already mentioned in the paper, for severity determination, persistent asthma (mild and moderate) was made as one group, as a result binomial logistic regression was applied.

Fourth, regarding the diagnosis of sinusitis, it was already mentioned in the paper that all the five children with clinical suspicion of sinusitis were having sinusitis confirmed on CT scan. We did not perform CT scan in children having no clinical suspicion of sinusitis.

1. Chinnakkannan SK, Singh M, Das RR, Mathew JL, Saxena KA. Association of allergic rhinitis and sinusitis with childhood asthma. Indian Pediatr. 2016:54:21-4.