Background Cases of foreign body aspiration in children may be encountered in emergency departments. A suggestive history is important in diagnosing aspirated foreign body owing to the difficulty in making a diagnosis on the basis of an abnormal physical examination or chest radiography alone. The aim of this study was to examine the sensitivity and specificity of the presenting symptoms, physical examination, and radiologic findings as predictors of foreign body aspiration in children. In addition, a feasible simple algorithm with a scoring system was generated to indicate bronchoscopic investigation. Methods In a retrospective cohort, medical records of patients aged less than 16 years with suspected foreign body aspiration who underwent flexible or rigid bronchoscopy were included. Data including age, sex, symptoms, physical examination findings, radiological features, nature and location of the foreign body, and outcome of the bronchoscopy were collected, and multivariable binary logistic regression analysis was employed for prediction of foreign body aspiration. Results A total of 203 children were included, and the model showed excellent discrimination power for positive foreign body aspiration (area under the curve = 0.911) with an accuracy, sensitivity, and specificity of 86.2, 90.6, and 76.6%, respectively. The total weighted risk score at a cut-off > 2 showed a significant good power of discrimination (area under the curve = 0.879), with a sensitivity of 79.9% and specificity of 84.4%. Accordingly, a clinical algorithm was recommended. Conclusions The proposed scoring system and clinical algorithm might help in decision making with regard to the need and type of bronchoscopy in children presenting with potential foreign body aspiration. However, further prospective multicenter studies should be conducted to validate this scoring system.

Sudden infant death syndrome (SIDS) is a common cause of infant mortality below one year, and its causes remain unknown. However, simple protective practices in infant sleep and sleep environment can dramatically reduce its incidence. Aim: Assess the mothers' knowledge and practices for the prevention of SIDS. Method:Descriptive research was conducted in postnatal department at general hospital in Kafrelsheikh city, Egypt, on 180 newly delivered mothers, free from eclampsia, chronic diseases and a delivered baby didn't have health problem as neonatal jaundice or respiratory distress syndrome. Interview questionnaire sheet was used to collect data about characteristics of mothers and their infant; mothers' knowledge and practices about SIDS. Results:More than three-quarters of mothers (85.00%) had poor knowledge level comared to only 10.6% and 4.4% of them had average and good knowledge level about SIDS. Besides, about half of the studied mothers (44.4%) were unsatisfactory about SIDS. Conclusion: More than three-quarters of the mothers didn't hear about SIDS and had poor knowledge level about SIDS. In addition, about half of the mothers demonstrated an unsatisfactory practice level about SIDS prevention. Furthermore, there was a significant positive correlation between the studied mothers' total score of knowledge and reported practicesRecommendation: A regular health education program should be done by a pediatric nurse in the neonatal care unit and on every health visit for the infant in his first year for improving the newly delivered mothers' knowledge and practices regarding SIDS prevention and safe sleep recommendations.

Purpose: Foreign body aspiration (FBA) is a frequent cause of childhood morbidity and mortality. Diagnosis of FBA is challenging in the absence of a witnessed aspiration event. The aim of this study was to determine the accuracy of presenting symptoms as well as physical and radiologic findings as predictors of FBA in children. Thus, indications for bronchoscopy could be determined in such cases. Methods: This retrospective cohort study was conducted in the ENT department, Kafrelsheikh University Hospital. The medical records of patients younger than 16 years old who underwent rigid bronchoscopy for suspected FBA were included. Data including age, gender, symptoms, physical examination findings, radiological features, nature and location of foreign body, and outcome of the bronchoscopy were collected. Results: This study included 130 patients, 105 (80.8%) patients were positive for the presence of a foreign body in their airways. Foreign bodies were most frequently (43.8%) lodged in the right main bronchus, and nuts (66.7%), were the most commonly retrieved. Multivariate regression analysis identified the presence of suggestive signs or symptoms as independent predictors of FBA on rigid bronchoscopy. Conclusion:Objective finding of clinical signs eg unilateral wheezes on chest examination in the presence of symptoms such as a sudden cough, dyspnea, and hoarseness could predict FBA and help physicians in deciding bronchoscopy.

Objective: To assess the effect of asthma in children on systolic and diastolic functions of the heart, and to explore the relationship between the two.Methods: The case-control study was conducted at Kafrelsheikh University Hospital, Egypt, from September 2019 to May 2022, and comprised asthmatic children of either gender aged 5-15 years and healthy controls matched for age and gender. The participants were subjected to detailed history, complete examination, spirometry evaluation and conventional and tissue Doppler echocardiography. Myocardial performance index was calculated and compared. Data was analysed using SPSS 22.Results: Of the 120 subjects, 60(50%) were cases; 33(55%) boys and 27(45%) girls with mean age 9.4±2.9 years (range: 5-15 years). The remaining 60(50%) subjects were controls; 34(56.6%) boys and 26(43.3%) girls with mean age 9.7±2.9 years (range: 5-15 years). Left ventricular dimensions, estimated pulmonary artery pressure, and right ventricular dimensions showed no significant inter-group differences (p>0.05), but right ventricular end diastolic diameter was significantly higher in the cases than the controls (p=0.046). Tissue Doppler showed that lateral annular peak Ê, Â, isovolumetric relaxation time and myocardial performance index values were significantly different between thegroups (p<0.05).Conclusion: Tissue Doppler echocardiography could detect subtle right ventricular diastolic dysfunction in asthmaticchildren even with no clinical symptoms and normal findings on conventional echocardiography.Keywords: Pulmonary artery, Echocardiography, Doppler, Asthma, Spirometry

Sudden infant death syndrome (SIDS) is a prevalent cause of infant mortality under a year, and its reasons remain unclear. However, basic preventive strategies in infant sleeping and sleep surroundings can limit its incidence. Purpose: Evaluating the effectiveness of an educational program on mothers' knowledge and practices for the prevention of SIDS. Design and Method: On 180 recently delivered women, a quasi-experimental study was conducted in the postnatal unit. Data on the mothers and their neonates' characteristics, as well as mothers' knowledge and reported experience with SIDS, were gathered using an interview questionnaire sheet. Results: Before the program, more than 71% of the mothers had little to no understanding of SIDS. Additionally, prior to the educational program, almost half of the mothers showed an unsatisfactory level of practices on SIDS prevention. After applying for the program, the majority of them had adequate knowledge and acceptable practices levels. Conclusion: The training program had a beneficial impact on the mothers' understanding of SIDS and preventative measures. Therefore, enhancing mothers' knowledge and practices on SIDS prevention requires a regular health education program from all health teams during the post-natal period.