This study aimed to identify the clinical and laboratory manifestations that affect outcome of scorpion envenomation in children. It included 154 children admitted with scorpion sting envenomation over a period of 2 years. The epidemiological, clinical, and laboratory findings of patients were recorded, and grading of severity was performed based on local and systemic involvement. Organ failure was determined according to diagnostic criterion of multiple organ dysfunction syndrome, and severity of illness was assessed by the Pediatric Risk of Mortality (PRISM III) score. Of studied children, 58.4% were males and 41.6% were females. Children aged > 5 years suffered more scorpion stings (79.9%) than others did. The place of residence was rural more than urban, outdoor stings more than indoors, nocturnal more than diurnal, and most stings were on the exposed areas of the limbs. Based on clinical evaluation, 37.7% of patients were classified as class I severity followed by class II (48.7%) and class III (13.6%). Among studied cases, 21 deaths (13.6%) were registered; all of them belonged to class III severity. Mortality was significantly higher in children with agitation, coma, convulsions, arrhythmia, heart failure, pulmonary edema, and priapism. There were significantly higher values of leukocytes, platelets, creatinine, liver enzymes, glucose, and creatine phosphokinase in non-survivors than in survivors. The presence of organ failure was associated with mortality. In addition, the need for mechanical ventilation and inotropic support were at increased risk of mortality. Moreover, a significant association was found between PRISM score and the number of failed organs with fatal outcome.

The present study showed that the prevalence of gastrointestinal parasites in overall studied ruminants (cattle, sheep and goats) where highest with Trichsrtongylus Axei 26.9% (n=343), Lungworm (Dictyocaulus spp.) 9.8%, (n= 125), Eimeria (Coccidia) 7.2% (n=92), Ascaris (Neoscaris vitulorum) 3.6% (n=14), and Homonchus contortus 2.3% (n=30) respectively. For cattle, the overall prevalence was 30.9% (n=120) with highest by Trichsrtongylus Axei 22.9% (n=89), Ascaris 3.6% (n=14), Lungworm 2.3% (n=9) and Homonchus 2.1% (n=8) respectively. For sheep, the overall prevalence was 60.7% (n= 282) with highest by Trichsrtongylus Axei 30.5% (n=142), Lungworm 17.8% (n=83), Eimeria 9.3% (n=43), and Homonchus 2.6% (n=14) respectively. For goats, the overall prevalence was 47.8% (n=202) with highest by Trichsrtongylus Axei 26.5% (n=112), Eimeria 11.6% (n=49), Lungworm 7.8% (n=33) and

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Nontraumatic coma (NTC) is a considerable cause of morbidity and mortality in children. This prospective observational study aimed to determine the clinico-etiological profile of NTC in children and delineate clinical signs predicting mortality in Upper Egypt from June 2019 to May 2020. All children from 1 month of age to 16 years who were admitted with NTC were included in the study. All patients received full histories and physical examinations, including Glasgow Coma Scale (GCS). Routine laboratory investigations including complete blood count, electrolytes, blood sugar, serum creatinine, and liver function tests were performed for all patients. Specific investigations such as metabolic studies, lumbar punctures, brain computed tomography scans, and magnetic resonance imaging were done when indicated. The precise etiology was determined and clinical presentations for survivors and nonsurvivors were compared. Among the 137 cases of NTC identified, central nervous system (CNS) infections were the most common cause leading to 38 cases, followed by toxic causes in 37 cases, status epilepticus in 22 cases, and metabolic causes in 21 cases. Hypothermia, hypotension, abnormal respiratory patterns, muscle hypotonia, absent corneal reflex, presence of shock, and need for mechanical ventilation were significantly correlating with mortality. The estimated mortality rate was 18.2% and all cases with GCS < 5 died. Toxic causes were the most commonly identified etiology in patients who died. In conclusion, the authors identified several etiologies for NTC in Upper Egypt and their corresponding clinical signs at presentation. This information can be used to improve the clinical care provided to children with NTC.