Abstract The aim of this study is to detect the risk factors associated with otitis media with effusion (OME) among children with age ranged from 6 months to 2 years. Materials and Methods: it is a crosssectional study 500 children were selected from Assiut University Hospital clinics through multistaged randomized sampling. Parents of these children were interviewed with a structured questionnaire. Clinical examination, including otoscopic examination and tympanometry was performed for each child. Results: There was no statistical significant relationship between OME and gender, age, mother job. There is statistical significant relationship between OME and breast feeding, using pacifier, mother education, sibling of children and exposure to passive smoking. Conclusion: There are multiple risk factors associated with OME in children between 6 months to 2 years of age.

Abstract: Neonatal period is the most hazardous period of life because of various problems/ diseases which a neonate faces. There is great over lap between the risks associated with morbidity and mortality in the perinatal and neonatal periods. The present study aimed to identify the profile and risk factors for neonatal mortality among neonates admitted to neonatal intensive care unit (NICU) in pediatric Assiut University Hospital (AUH). A prospective study was conducted in NICU of pediatric AUH. Study population included all neonates admitted to NICU over a period of one year. The data collected included detailed antenatal and natal histories, details of clinical examination, primary diagnosis, progress during the hospital stay and outcome. The outcome measure was inhospital death. Survival was defined as the discharge of a live infant from the NICU. Differences between deceased and survived neonates were estimated by the chi-square test and t-test. The association between risk factors and neonatal mortality were estimated by relative risk. The significance level used was p-value of less than 0.05. A total of 990 neonates were included in the study, of which 582 neonates (58.8%) died during their hospital stay. The mortality rate decreased with the increase in birth weight, as well as gestational age. Respiratory distress was the commonest primary diagnosis (94.5%) among all admitted neonates, followed by very low birth weight (VLBW) (36.7%), congenital malformations (8.2%), and infections (4.4%). Significant risk factors (P0.05) associated with neonatal mortality were: vaginal delivery, multiple births, low Apgar score at 5 minutes, neonatal respiratory distress, prematurity, and low birth weight (LBW). It is concluded that majority of the causes of neonatal mortality are preventable. Surveillance programs for neonatal death should include preventive actions and interventions for the perinatal period. Focused initiatives for quality improvement may also be necessary. [Eman M. Mohamed, Asmaa M. A. Soliman, Osama M. El-Asheer. Predictors of mortality among neonates admitted to neonatal intensive care unit in pediatric Assiut University Hospital, Egypt.

Abstract: Neonatal period is the most hazardous period of life because of various problems/ diseases which a neonate faces. There is great over lap between the risks associated with morbidity and mortality in the perinatal and neonatal periods. The present study aimed to identify the profile and risk factors for neonatal mortality among neonates admitted to neonatal intensive care unit (NICU) in pediatric Assiut University Hospital (AUH). A prospective study was conducted in NICU of pediatric AUH. Study population included all neonates admitted to NICU over a period of one year. The data collected included detailed antenatal and natal histories, details of clinical examination, primary diagnosis, progress during the hospital stay and outcome. The outcome measure was inhospital death. Survival was defined as the discharge of a live infant from the NICU. Differences between deceased and survived neonates were estimated by the chi-square test and t-test. The association between risk factors and neonatal mortality were estimated by relative risk. The significance level used was p-value of less than 0.05. A total of 990 neonates were included in the study, of which 582 neonates (58.8%) died during their hospital stay. The mortality rate decreased with the increase in birth weight, as well as gestational age. Respiratory distress was the commonest primary diagnosis (94.5%) among all admitted neonates, followed by very low birth weight (VLBW) (36.7%), congenital malformations (8.2%), and infections (4.4%). Significant risk factors (P0.05) associated with neonatal mortality were: vaginal delivery, multiple births, low Apgar score at 5 minutes, neonatal respiratory distress, prematurity, and low birth weight (LBW). It is concluded that majority of the causes of neonatal mortality are preventable. Surveillance programs for neonatal death should include preventive actions and interventions for the perinatal period. Focused initiatives for quality improvement may also be necessary. [Eman M. Mohamed, Asmaa M. A. Soliman, Osama M. El-Asheer. Predictors of mortality among neonates admitted to neonatal intensive care unit in pediatric Assiut University Hospital, Egypt.

Abstract: Neonatal period is the most hazardous period of life because of various problems/ diseases which a neonate faces. There is great over lap between the risks associated with morbidity and mortality in the perinatal and neonatal periods. The present study aimed to identify the profile and risk factors for neonatal mortality among neonates admitted to neonatal intensive care unit (NICU) in pediatric Assiut University Hospital (AUH). A prospective study was conducted in NICU of pediatric AUH. Study population included all neonates admitted to NICU over a period of one year. The data collected included detailed antenatal and natal histories, details of clinical examination, primary diagnosis, progress during the hospital stay and outcome. The outcome measure was inhospital death. Survival was defined as the discharge of a live infant from the NICU. Differences between deceased and survived neonates were estimated by the chi-square test and t-test. The association between risk factors and neonatal mortality were estimated by relative risk. The significance level used was p-value of less than 0.05. A total of 990 neonates were included in the study, of which 582 neonates (58.8%) died during their hospital stay. The mortality rate decreased with the increase in birth weight, as well as gestational age. Respiratory distress was the commonest primary diagnosis (94.5%) among all admitted neonates, followed by very low birth weight (VLBW) (36.7%), congenital malformations (8.2%), and infections (4.4%). Significant risk factors (P0.05) associated with neonatal mortality were: vaginal delivery, multiple births, low Apgar score at 5 minutes, neonatal respiratory distress, prematurity, and low birth weight (LBW). It is concluded that majority of the causes of neonatal mortality are preventable. Surveillance programs for neonatal death should include preventive actions and interventions for the perinatal period. Focused initiatives for quality improvement may also be necessary. [Eman M. Mohamed, Asmaa M. A. Soliman, Osama M. El-Asheer. Predictors of mortality among neonates admitted to neonatal intensive care unit in pediatric Assiut University Hospital, Egypt.

Background: Epistaxis is a common medical problem in pediatric population. Although in most cases it is mild and self-limiting, a proportion of childhood epistaxis is massive, recurrent, or resistant to conventional management. Objective: To compare effectiveness of propranolol as a treatment option for childhood epistaxis versus conventional silver nitrate cautery. Study design and methodology: This is a prospective interventional comparative study that was carried out during a period of 1 year (January 1, 2013 to December 31, 2013) at Qena University Hospital and Assiut University Children Hospital. One hundred children aged 6–12 years who presented with epistaxis to Qena University Hospital and Assiut University Children Hospital during the study period and fulfilling the inclusion criteria were included in the study. They were randomly assigned into one of two interventional groups, where 50 children were treated with oral propranolol (propranolol treatment group) and another 50 children were treated with conventional silver nitrate cautery (cauterization treatment group) for their epistaxis. Propranolol was given at a dose of 1.5–2 mg/kg/day (divided into three doses). Patients were followed for 6 months after their discharge for recurrence of epistaxis. Results: Both groups of patients showed minimal recurrent epistaxis with rates of 14% for propranolol treated group and 12% for cauterization group, with no statistically significant difference between both groups. Local pain was found to be more in patients treated with silver nitrate cauterization. Conclusion: Treatment of primary epistaxis with propranolol or silver nitrate cautery showed equal rates of recurrence, and local nasal pain was slightly more among silver nitrate cauterization treated group. Propranolol could be a favorable treatment option for patients with primary epistaxis. Further studies that include multiple centers and larger number of patients are recommended for more clarification of the effectiveness of such treatment option.

NULLAbstract Background: Egypt is considered a region of the intermediate prevalence of hepatitis B virus (HBV) infection (4.5%). Seroprotection is assured when hepatitis B surface antibody (HBsAb) levels are ≥ 10 mIU/ mL. Our study aimed to evaluate and compare the long-term immunogenicity and efficacy of the recombinant hepatitis B (HB) vaccine. Methods: A cross-sectional study was done for children aged from 9 months to 15 years, receiving health care at Assiut University Children’s Hospital, Assiut, Egypt in 3 months. HBsAb was quantitatively determined by enzyme-linked immune sorbent assay (ELISA). Results: Seroprotection in infants less than 1 year was 89.7% with 55.2% having titer > 100 mIU/mL and this percent dropped to 64.4% after the first year of age with only 29% having titer > 100 mIU/ mL. The overall protection percentage was 32.5% (> 100 mIU/mL), 34.7% of children showed levels between 10 and 100 mIU/mL, while 32.8% were less than 10 mIU/mL. Patients with diabetes mellitus were found to have the lowest seroprotective levels (83.3% were not protected). Non-protective levels were also detected in patients with malnutrition (55.6%), congenital heart diseases (43.2%) and chronic liver diseases (57.1%). Conclusion: Our study shows failure to achieve satisfactory seroprotective levels for hepatitis B vaccine in both healthy and diseased children who adopted vaccination schedule in Upper Egypt. Booster dose in the second year of life is recommended for all children, particularly for those with diabetes millets, congenital heart disease and malnutrition. Keywords: Immunogenicity; Hepatitis B vaccine; Children

NULLAbstract Background: Egypt is considered a region of the intermediate prevalence of hepatitis B virus (HBV) infection (4.5%). Seroprotection is assured when hepatitis B surface antibody (HBsAb) levels are ≥ 10 mIU/ mL. Our study aimed to evaluate and compare the long-term immunogenicity and efficacy of the recombinant hepatitis B (HB) vaccine. Methods: A cross-sectional study was done for children aged from 9 months to 15 years, receiving health care at Assiut University Children’s Hospital, Assiut, Egypt in 3 months. HBsAb was quantitatively determined by enzyme-linked immune sorbent assay (ELISA). Results: Seroprotection in infants less than 1 year was 89.7% with 55.2% having titer > 100 mIU/mL and this percent dropped to 64.4% after the first year of age with only 29% having titer > 100 mIU/ mL. The overall protection percentage was 32.5% (> 100 mIU/mL), 34.7% of children showed levels between 10 and 100 mIU/mL, while 32.8% were less than 10 mIU/mL. Patients with diabetes mellitus were found to have the lowest seroprotective levels (83.3% were not protected). Non-protective levels were also detected in patients with malnutrition (55.6%), congenital heart diseases (43.2%) and chronic liver diseases (57.1%). Conclusion: Our study shows failure to achieve satisfactory seroprotective levels for hepatitis B vaccine in both healthy and diseased children who adopted vaccination schedule in Upper Egypt. Booster dose in the second year of life is recommended for all children, particularly for those with diabetes millets, congenital heart disease and malnutrition. Keywords: Immunogenicity; Hepatitis B vaccine; Children

NULLAbstract Background: Egypt is considered a region of the intermediate prevalence of hepatitis B virus (HBV) infection (4.5%). Seroprotection is assured when hepatitis B surface antibody (HBsAb) levels are ≥ 10 mIU/ mL. Our study aimed to evaluate and compare the long-term immunogenicity and efficacy of the recombinant hepatitis B (HB) vaccine. Methods: A cross-sectional study was done for children aged from 9 months to 15 years, receiving health care at Assiut University Children’s Hospital, Assiut, Egypt in 3 months. HBsAb was quantitatively determined by enzyme-linked immune sorbent assay (ELISA). Results: Seroprotection in infants less than 1 year was 89.7% with 55.2% having titer > 100 mIU/mL and this percent dropped to 64.4% after the first year of age with only 29% having titer > 100 mIU/ mL. The overall protection percentage was 32.5% (> 100 mIU/mL), 34.7% of children showed levels between 10 and 100 mIU/mL, while 32.8% were less than 10 mIU/mL. Patients with diabetes mellitus were found to have the lowest seroprotective levels (83.3% were not protected). Non-protective levels were also detected in patients with malnutrition (55.6%), congenital heart diseases (43.2%) and chronic liver diseases (57.1%). Conclusion: Our study shows failure to achieve satisfactory seroprotective levels for hepatitis B vaccine in both healthy and diseased children who adopted vaccination schedule in Upper Egypt. Booster dose in the second year of life is recommended for all children, particularly for those with diabetes millets, congenital heart disease and malnutrition. Keywords: Immunogenicity; Hepatitis B vaccine; Children

NULLAbstract Background: Egypt is considered a region of the intermediate prevalence of hepatitis B virus (HBV) infection (4.5%). Seroprotection is assured when hepatitis B surface antibody (HBsAb) levels are ≥ 10 mIU/ mL. Our study aimed to evaluate and compare the long-term immunogenicity and efficacy of the recombinant hepatitis B (HB) vaccine. Methods: A cross-sectional study was done for children aged from 9 months to 15 years, receiving health care at Assiut University Children’s Hospital, Assiut, Egypt in 3 months. HBsAb was quantitatively determined by enzyme-linked immune sorbent assay (ELISA). Results: Seroprotection in infants less than 1 year was 89.7% with 55.2% having titer > 100 mIU/mL and this percent dropped to 64.4% after the first year of age with only 29% having titer > 100 mIU/ mL. The overall protection percentage was 32.5% (> 100 mIU/mL), 34.7% of children showed levels between 10 and 100 mIU/mL, while 32.8% were less than 10 mIU/mL. Patients with diabetes mellitus were found to have the lowest seroprotective levels (83.3% were not protected). Non-protective levels were also detected in patients with malnutrition (55.6%), congenital heart diseases (43.2%) and chronic liver diseases (57.1%). Conclusion: Our study shows failure to achieve satisfactory seroprotective levels for hepatitis B vaccine in both healthy and diseased children who adopted vaccination schedule in Upper Egypt. Booster dose in the second year of life is recommended for all children, particularly for those with diabetes millets, congenital heart disease and malnutrition. Keywords: Immunogenicity; Hepatitis B vaccine; Children

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