Among honey's benefits are its anti-inflammatory and antimicrobial effects. Because gastroenteritis is an acute inflammation of the gastrointestinal tract that may be caused by a variety of microbes, the aim of the present study was to verify whether the addition of honey in oral rehydration solution (ORS) could affect the duration of symptoms of acute gastroenteritis in infants and children. One hundred infants and children with acute gastroenteritis were randomly assigned to one of two treatment groups, each consisting of 50 patients: Group I received ORS for rehydration (control), and Group II received ORS with honey. The mean ages of patients of Groups I and II were 1.5 +/- 1.2 and 1.1 +/- 0.8 years, respectively. In the honey-treated group the frequencies of vomiting and diarrhea were significantly reduced compared to the control group (P < .001 and P < .05, respectively). Also, the recovery time, defined as the number of hours from initiation of treatment to when normal soft stools are passed, with the patient showing normal hydration and satisfactory weight gain, was significantly shortened after honey ingestion (P < .001). In conclusion, honey added to ORS promoted rehydration of the body and sped recovery from vomiting and diarrhea.

We aimed to assess serum levels of polyunsaturated fatty acids (PUFAs) and therapeutic response to omega 3 PUFAs supplementation in children with idiopathic intractable epilepsy. The study was done between November 2007 and December 2008 in the pediatric neurology clinic of Ain Shams University hospitals, Cairo. It comprised 20 children with idiopathic intractable epilepsy on antiepileptic drug polytherapy and twenty healthy age and sex matched controls. Serum levels of alpha-linolenic acid (ALA) (omega-3), eicosapentaenoic acid (EPA) (omega-3), docosapentaenoic acid (DPA) (omega-3), decosahexaenoic acid (DHA) (omega-3), linoleic acid (LA) (omega-6) and arachidonic acid (omega-6) were assessed by gas liquid chromatography. Prior to oral PUFAs supplementations, patients with intractable epilepsy had lower levels of DHA, DPA and higher levels of ALA, EPA and LA compared to controls. After 6 months of oral PUFAs supplementation, compared with healthy controls, levels of DHA was increased while, ALA, LA, EPA, DPA and arachidonic acid were decreased; while comparing to levels before supplement; furthermore, there were an increase in levels of DHA, DPA as well as DHA: EPA and LA: ALA ratios and a decrease in ALA, LA and EPA levels in patients following supplementation compared to their levels prior to oral supplementation. Both the changes in serum levels of PUFAs and their ratios were accompanied by decrease in seizure frequency, duration and severity. There was a significant negative correlation between serum DHA level and seizure duration as well as seizure severity. Altered serum levels of omega three and six PUFAs were associated with uncontrolled seizures, and oral supplementation with DHA and EPA lead to better seizure control.

We aimed to assess serum level of tissue plasminogen activator (tPA) in children with idiopathic epilepsy aiming to find a pathogenic relationship and correlate it with disease intractability, severity, effect of antiepileptic drug therapy and epilepsy control. The study comprised of 24 children with idiopathic epilepsy either on monotherapy or polytherapy. Sixteen children with controlled idiopathic focal and generalized epilepsy while eight were intractable to antiepileptic drugs treatment. Serum tissue plasminogen activator was assessed in the patient group and compared to non-epileptic healthy controls; furthermore, the level of tPA was correlated to the epilepsy severity. Level of tPA was significantly increased in epileptic patients compared to controls (6.11 ? 6.11 ng/dL, and 2.61 ? 1.69 ng/dL, respectively) (P < 0.001). Among the epileptic patient group, serum level of tPA was significantly increased in the intractable group compared to the controlled focal group and controlled generalized group. Also, serum tPA was significantly increased in patients on antiepileptic drugs polytherapy compared to patients on monotherapy. Increased serum tPA level was positively correlated with the epilepsy severity (r = 0.612; P < 0.001). Hence, tPA could be one of the pathogenic endogenously produced chemical substances linked to childhood epilepsy and potential marker of epilepsy intractability.

Opsoclonus-myoclonus syndrome (OMS) is a neuroinflammatory disorder with pervasive morbidity that warrants better treatments. Twelve children with moderate/severe OMS (total score 23 ± 6) who did not remit to multiple immunotherapies were evaluated for neuroinflammation in a case-control study using cerebrospinal fluid (CSF) lymphocyte subset analysis by flow cytometry, chemokine/cytokine analysis by enzyme-linked immunoadsorption assay (ELISA), and oligoclonal bands by immunofixation with isoelectric focusing. Observations made on empirical treatment with rituximab, IVIg, and tetracosactide combination immunotherapy (coined "RITE-CI") were analyzed. All of the patients tested for multiple inflammatory markers were positive; 75% had ≥3 CSF markers. Fifty percent had CSF oligoclonal bands; 58%, B cell expansion; and 50 to 100%, elevated concentrations of multiple chemokines and neuronal/axonal marker neurofilament light chain. After RITE-CI, total score dropped significantly in the group (-85%, < 0.0001) from moderate to trace, and by 2 to 4 severity categories in each patient. The 24-week schedule was well tolerated and clinically effective for moderate or severe OMS, as were other schedules. RITE-CI is feasible and effective as rescue therapy and presents an initial option for children with moderate/severe OMS. Though preliminary, the schedule can be adjusted to patient severity, propensity for relapse, and other factors.

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identified from the electronic patient record/coding (EPR/C) system using triage data, free text and diagnostic codes. Data variables were extracted from the clinical notes and EPR/C system. The hospital wide patient administration system was also searched for any subsequent hospital attendances within 3 months to identify late presenting or missed diagnoses. Analysis was undertaken using R Studio. Results We identified 662 cases, 21 were excluded as already under investigation for limp/very complex cases, leaving 641 cases. 64% Male, median age 4.8 years. Ninety-seven percent (n=624) had a benign self-limiting pathology (474 were IH). 17 significant diagnoses (2 Septic Arthritis, 2 Osteomyelitis, 1 Discitis, 6 Perthes, 6 SUFE) were found.12.9% (n=83) had FBC, ESR and CRP; 1 child had FBC/ CRP only (table 1). Of these patients, 72 (85%) were done at acute presentation and 13 (15%) at PED follow-up clinic.265 cases had a radiological investigation (17 ultrasounds in total)229 cases were reviewed in clinic. 7 cases had the diagnosis changed in clinic/reattendance. No significant cases were missed.The diagnostic accuracy of the algorithm was 97.19% with a negative predictive value of 99.7%. Conclusions The study showed that over 2 years the conservative limping child algorithm successfully identified 17 significant pathologies amongst the 641 cases of unexplained limp, whilst safely reducing the number of blood tests and radiological investigations. Clinicians still tended to over investigate (particularly x-rays in under 8yrs) and the analysis shows that these unnecessary tests did not add value. Inflammatory markers were not useful to either rule in or rule out significant pathology. The focus of an ED algorithm should be on thorough clinical history and examination to select the few cases that need further investigation and assessment.