Background. There is no gold standard test for diagnosis of gastroesophageal reflux disease (GERD) associated infantile wheezing. Objectives. To evaluate the value of bronchoalveolar lavage (BAL) pepsin assay in diagnosis of GERD in wheezy infants. Methods. Fifty-two wheezy infants were evaluated for GERD using esophageal combined impedance-pH (MII-pH) monitoring, esophagogastroduodenoscopy with esophageal biopsies, and BAL pepsin. Tracheobronchial aspirates from 10 healthy infants planned for surgery without history of respiratory problems were examined for pepsin. Results. Wheezy infants with silent reflux and wheezy infants with typical GERD symptoms but normal MII-pH had significantly higher BAL pepsin compared to healthy control (45.3 ± 8.6 and 42.8 ± 8 versus 29 ± 2.6, P < 0.0001 and P = 0.011, resp.). BAL pepsin had sensitivity (61.7%, 72 %, and 70%) and specificity (55.5%, 52.9%, and 53%) to diagnose GERD associated infantile wheeze compared to abnormal MII-pH, reflux esophagitis, and lipid laden macrophage index, respectively. Conclusion. A stepwise approach for assessment of GERD in wheezy infants is advised. In those with silent reflux, a trial of antireflux therapy is warranted with no need for further pepsin assay. But when combined MII-pH is negative despite the presence of typical GERD symptoms, pepsin assay will be needed to rule out GERD related aspiration.

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Inflammatory pseudotumors of the lung are a group of non-neoplastic tumors, which are mainly of parenchymal origin and rarely endobronchial. We report a case of a 9-year-old girl who presented with left-sided tension pneumothorax and subcutaneous emphysema. After emergency management, chest computed tomography revealed an ill-defined left lung mass. Rigid bronchoscopy revealed a mass occluding the left main bronchus at the origin of the left upper lobe bronchus. Initially, the mass was thought to be a foreign body granuloma. Few weeks later, the child presented with recurrence of the same clinical, radiologic, and bronchoscopic outcomes. Histologic examination after the repeat bronchoscopic excision revealed the lesion to be consistent with inflammatory pseudotumor. Left upper lobectomy was performed with a complete resolution of symptoms and no recurrence was observed during the 2 years of follow-up. To the best of our knowledge, this is the first reported case of inflammatory pseudotumor presenting with tension pneumothorax.

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Aim:The aim of this study was to evaluate the effect of asthma on dentoalveolar morphology in the developing child. Methods: This study was conducted on 50 asthmatic Egyptian children and 50 non-asthmatic Egyptian children. Each child's dental casts of the maxilla and mandible were analyzed. The upper and lower intercanine width, the upper and lower intermolar width (UIMW-LIMW), the upper and lower arch length, and the palatal depth were determined. Results: Children with asthma demonstrated higher mean values in more than one of the parameters measured when compared with the mean values of non-asthmatic children for both genders. In general, the UIMW of asthmatic children had lower mean values when compared with the mean value of non-asthmatic children, except when compared regarding gender. A Student t-test noted a significant difference in UIMW and LIMW in male children. Conclusion: Asthma has an effect on upper and lower dental arch dimensions in both genders. Key words:Asthma, dentoalveolar morphology, children Dr. Salwa Mohamad Awad is Professor and Chairman of Pediatric Dentistry, Faculty of Dentistry, Mansoura University, Egypt. She got her BS, MS and PhD from Faculty of Dentistry, Mansoura University, Egypt. She participated in many scientific researches supervision, in the committees of arbitration and discussion of researches, and also in workshops and international scientific conferences. She conducted many local and international scientific researches and got many courses of development faculty administration. Besides, she acts as director of quality unit at college, and internal auditor and evaluator of quality assurance and accreditation.Dr. Fathi Abdulraqep Qasem is Master of Pediatric Dentistry, Faculty of Dentistry, Dhamar University, Yemen. He got his BS from Faculty of Dentistry, Dhamar University, Yemen, and MS from Faculty of Dentistry, Mansoura University, Egypt. He is manager of dental clinic of the training hospital of the Faculty of Dentistry, Dhamar University, Yemen. He participates in many workshops and international scientific conferences.