Background This study demonstrates the experience of the neonatal intensive care unit (NICU) of a tertiary referral center in Egypt in management of prematures with neonatal sepsis. This retrospective study included preterm neonates admitted to NICU with clinical and/or laboratory diagnosis of sepsis. Blood culture was done followed by antimicrobial susceptibility testing for positive cases. Neonates with sepsis were classified into early onset sepsis (EOS) and late onset sepsis (LOS). Hematological scoring system (HSS) for detection of sepsis was calculated. Results The study included 153 cases of neonatal sepsis; 63 (41.2%) EOS and 90 (58.8%) LOS. The majority of the neonates had very low or moderately low birth weight (90.9%). All neonates received first-line antibiotics in the form of ampicillin-sulbactam, and gentamicin. Second-line antibiotics were administered to 133 neonates (86.9%) as vancomycin and imipenem-cilastatin. Mortalities were more common among EOS group (p < 0.017). Positive blood cultures were detected in 61 neonates (39.8%) with a total number of 66 cultures. The most commonly encountered organisms were Klebsiella MDR and CoNS (31.8% each). Klebsiella MDR was the most predominant organism in EOS (28.9%), while CoNS was the most predominant in LOS (39.2%) The detected organisms were divided into 3 families; Enterobacteriaceae, non-fermenters, and Gram-positive family. There 3 families were 100% resistant to ampicillin. The highest sensitivity in Enterobacteriaceae and Non-fermenters was for colistin and polymyxin-B. An HSS of 3–8 had a sensitivity and specificity of 62.3% and 57.6%, respectively for diagnosis of culture-proven sepsis. Conclusion Neonatal sepsis was encountered in 21.5% of admitted preterm neonates; LOS was more common (58.8%). Mortality was 51.6%. Klebsiella MDR and CoNS were the most commonly encountered organisms in both EOS and LOS. The isolated families were 100% resistant to ampicillin. The hematological scoring system (HSS) showed limited sensitivity for detection of sepsis.

Background Short stature is one of the main causes of children referral to pediatric endocrinologists. Common etiologies include idiopathic growth hormone deficiency (IGHD), small for gestational age (SGA), and idiopathic short stature (ISS). Objectives The aim of this study was to assess and compare the response of children with IGHD, ISS, and SGA to growth hormone (GH) therapy. Methods This was a mixed cohort study that included 40 children with short stature (classified into IGHD, ISS, and SGA) following up at Diabetes, Endocrine, and Metabolism Pediatric Unit (DEMPU), Cairo University Children’s Hospital. Ages ranged between 3 and 18 years. Recruited cases were evaluated for their 1-year response to GH therapy. In addition to history taking, physical examination, and anthropometric measurements, serum levels of IGF-1 were assayed at recruitment. Results Among the 3 groups, height gain (cm/year) was significantly higher in the IGHD group (6.59 cm/year), followed by the ISS (4.63 cm/year) and SGA groups (4.46 cm/year) (p = 0.039). Using the Bang criterion for first-year responsiveness to GH therapy, most cases (30/40, 75%) were considered poor responders. Conclusion There is a male predominance in children seeking medical advice for short stature. Starting GH therapy at an older age was associated with poor response. Children with IGHD respond better to GH therapy than those with ISS and SGA.

Background: Intraventricular hemorrhage (IVH) is a severe complication in preterm babies admitted to Neonatal Intensive Care Units (NICU). Advanced stages of IVH predispose to neurological deficits such as cerebral palsy and hydrocephalus. There are numerous strategies and policies implemented in NICUs around the world to decrease the incidence of IVH in preterm babies and prevent its ensuing neurodevelopmental complications. Aim of the Work:To study the effect of implementing a bundle of care on incidence and severity of IVH among preterm neonates. Materials and Methods: Retrospective analysis of patient records for incidence and severity of IVH between May and August 2018 was done. This was followed by an educational interim period where NICU staff received training of pre-natal, natal, and postnatal care bundle guidelines to reduce IVH. The guidelines were then implemented on all preterm babies (28-34 weeks gestational age (GA)) born and admitted to Kasr Al Ainy Teaching Hospital NICU, Cairo University between October 2018 and January 2019 (n=58). Cranial ultrasonography was performed at week 1 and week 2-3 of life. Frequency and severity of IVH were compared among studied groups. Risk factors for IVH were analyzed and recorded. Results: The frequency of IVH was significantly lower in the post-bundle group (44-46% prebundle, and 27% post-bundle) especially evidenced by the ultrasonography in week two of life. Severity of IVH also improved post bundle since there were no grade III IVH patients in that group. Exposure to hypocapnia, blood pressure fluctuations, IV fluid boluses and administration of sodium bicarbonate were significantly correlated with development of IVH in preterm babies (p = 0.001). Conclusion: Implementation of an IVH care bundle that includes perinatal measures can positively affect the neurological outcome by decreasing incidence and severity of IVH in preterm babies.