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Background: While recognizing the etiology of community-acquired pneumonia is necessary for formulating local antimicrobial guidelines, limited data is published about this etiology in Egyptian pediatric patients. The aim of this study is to elucidate the common bacterial pathogens causing CAP among immunocomptent infants and preschool children admitted to Zagazig university Pediatric hospital. Methods: 48 infant and preschool children admitted to pediatric hospital of Zagazig university and presented with signs of pneumonia according to WHO. Etiological agents were identified using conventional bacteriological identification methods and Ig M antibodies detection against common a typical bacteria and respiratory viruses. Results: Staph. Aureus 35.4% is the most common pathogen detected in sputum regardless the age group .In blood culture results negative results in most cases of pneumonia 62.5%. Staph. Aureus is the most common pathogen detected in blood culture in positive cases regardless the age group 18.7% , E Coli 6.25%, Klebsiella 2.08.In Serology results significant difference according to age in viral pneumonia occurrence and non significant difference in bacterial pneumonia based on serological findings with higher diagnosis of Legionella pneumophila 33.33% as a causative organism. Conclusion: This study provides preliminary data regarding the spectrum and frequency of microorganisms causing CAP in infants and preschool children.

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BackgroundNonalcoholic fatty liver disease (NAFLD) is one of the major causes of chronic liver disease. Unfortunately, accurate noninvasive modalities for diagnosing NAFLD and monitoring its progression are unavailable and liver biopsy is still the mainstay of diagnosis. We aim to highlight the importance of radiologic modalities in detecting hepatic steatosis in overweight and obese children. Patients and MethodsOne hundred and twenty (age range 2-18 years) children were assigned to two groups. Group 1 (53 girls and 47 boys) consisted of apparently normal children with simple obesity, that is, body mass index (BMI) higher than or equal to 85th centile for age. Group 2 (nine girls and 11 boys) consisted of apparently normal children with normal BMI corresponding for age. All children were thoroughly examined and underwent laboratory tests, ultrasound, computed tomography (CT), and anthropometric measurements. ResultsIncreased BMI was associated with hepatomegaly, especially in older children above or equal to 11 years, and the aspartate aminotransferase/alanine aminotransferase ratio correlates well with the severity of histopathological abnormalities of the liver. Ultrasound echogenicity showed correlation to BMI only in older obese children above or equal to 11 years; ultrasound also correlates well to CT attenuation and liver biopsy steatosis. CT scan attenuation showed correlation to BMI only in older obese children above or equal to 11 years, but it correlates well to ultrasound echogenicity and liver biopsy findings. ConclusionUltrasound examination when positive is highly accurate in diagnosing NAFLD. A combination of serum biomarkers and radiologic modalities provides a valuable diagnostic approach for patients with nonalcoholic steatosis.

Background: One of the heterogeneous chronic diseases affecting the kidneys is chronic kidney disease (CKD). Patients with chronic kidney disease, which is associated with high morbidity and mortality, are more likely to experience nervous system problems. Objective: This work was performed to estimate the prevalence and predictors of peripheral neuropathy in children with End Stage Renal Disease (ESRD) on hemodialysis. Patient and methods: A total of 80 children from Egypt were recruited and divided into 2 separate groups. As a first step, a case group of 40 children (5-18 years old) with ESRD who were receiving regular hemodialysis was established. Besides the control group of 40 healthy children matched by age and gender to the case group. We subjected all the participants to detailed history taking stressing on duration of dialysis, family history of renal diseases, consanguinity and history of neuromuscular symptoms such as distal paresthesia, or muscle weakness. General examination for weight, height, blood pressure, vital signs, systemic examination including: Heart examination, chest, abdominal and neurological examination. Routine laboratory investigations and nerve conduction studies were done. Results: We found a statistically significant difference in weight and height between the two studied groups. 40% of patients had polyneuropathy. Multivariate analysis showed that longer disease duration (7 years), high parathyroid hormone level and high ferritin were independent predictors of polyneuropathy. Conclusion:Peripheral neuropathy is a common complication among children with end stage renal disease. Longer dialysis duration, high ferritin and parathormone levels were considered strong predictors of polyneuropathy among CKD patients.

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