Background: Incidence data indicate that recurrent pneumonia occurs in 7.7-9% of all children with community acquired pneumonia. We aim by this study to assess the prevalence of recurrent pneumonia among the admissions with diagnosis of pneumonia in Assiut university children hospital for one year and to try to define the possible related risk factors. Patients and methods: This is a prospective hospital based study in Assiut University Children's Hospital. Children younger than 16 years admitted with a hospital diagnosis of pneumonia to Assiut University Children's Hospital for one year from 1Results: Approximately 1 in 12 children with pneumonia in our locality have recurrent pneumonia with percentage of 12.61%. Cardiac diseases especially congenital heart diseases was the cause among 25.45% of the cases, immunodeficiency diseases represented 20.9% of the cases ,while bronchial asthma was the cause of recurrent pneumonia among 16.36% of the cases. As regard to risk factors in studied group, prematurity was detected among 7.27 % of the cases while more than 50% were formula fed and more than 60% exposed to pollution. Father smoking was detected among 36.36% of cases. Patients aged > 6 years showed significantly higher frequency in risk factors as obesity, indoor and outdoor pollution and use of steroids in comparison to other age groups. However, patients aged 0-3 years exhibited significantly higher % frequency of having heart disease, oro-motor in coordination /swallowing dysfunction, gastro esophageal reflux and under nutrition as risk factors for recurrent pneumonia in comparison to other age groups. Conclusions:The most frequent underlying cause for recurrent pneumonia in Assiut University Children's Hospital which presents the largest referral pediatric hospital in Upper Egypt for one year according to our study was cardiac diseases; the second most frequent cause was immunodeficiency diseases, followed by bronchial asthma. Risk factors for recurrent pneumonia include socio-economic status of studied cases, prematurity, exposure to passive smoking and in or outdoor pollution, obesity, under nutrition, lack of breast feeding, gastro esophageal reflux and steroids usage.

Ischemic CVS in children is multifactorial. Thrombophilia testing should be performed in any child with CVS. Early use of aspirin improves the prognosis and has less effect on cognitive function.

Background Meningitis is one of the most dangerous infection affecting children. The need for rapid and accurate diagnosis is mandatory for improving the outcome. Aim of the work To evaluate the role of multiplex polymerase chain reaction (PCR) in diagnosis of meningitis either bacterial or viral and to detect its accuracy. Patients and methods A cross-sectional study was carried out in University Children Hospital, Faculty of Medicine, between November 2019 and September 2020. The study was approved by the Ethics Review Board of Faculty of Medicine, Assiut University, and informed written consent was obtained. The committee’s reference number is 17200161. Clinicaltrails.gov ID: NCT03387969. Forty-eight children aged 2 to 18 years with meningitis were included. Detailed history and examination, blood glucose level at time of admission prior to lumbar puncture, and multiplex PCR in cerebrospinal fluid (CSF) were evaluated. Results The mean age of children was 3.27 ± 1.27 years. Thirty-five (72.9%) cases were bacterial meningitis while 13 (27.1%) cases were viral meningitis. Multiplex PCR had 94% sensitivity and 100% specificity for diagnosis of bacterial meningitis. Conclusion Multiplex PCR may help in diagnosis and differentiation of bacterial and viral meningitis with accurate and rapid results. What is Known:• Rapid and accurate diagnosis is mandatory for successful treatment of meningitis.• Differentiation between bacterial and viral meningitis is important to avoid unnecessary treatment.. What is New:• Multiplex PCR is an important marker for rapid detection of meningitis.• Multiplex PCR may be used to differentiate between bacterial and non-bacterial cause of meningitis.

Background: Neurologically Impaired (NI) children are at increased risk of malnutrition due to several nutritional and non-nutritional factors. Among nutritional factors, insufficient dietary intake as a consequence of feeding difficulties is one of the main issues. Feeding problems are frequently secondary to oropharyngeal dysphasia, which usually correlates with the severity of motor impairment and presents in around 90% of preschool children with Cerebral Palsy (CP) during the first year of life. Other nutritional factors are represented by excessive nutrient losses, often subsequent to gastro esophageal reflux and altered energy metabolism. Among the nonnutritional factors, the type and severity of neurological impairment, ambulatory status, the degree of cognitive impairment, and use of antiepileptic medication altogether concur to determination of nutritional status. Aim: To assess the degree of adherence of medical staff at neurology unit to new guidelines for nutritional assessment and intervention of children with cerebral palsy. Patients and Methods: The study included all cerebral palsy children admitted at Neurology Unit Assiut University Children Hospital from 1 st of January to 30th of June 2017. An observational checklist based on new guidelines developed by the investigators in order to assess the degree of adherence of medical staff at Neurology Unit at Assiut University Children Hospital to protocol for nutritional assessment and intervention in children with cerebral palsy according to this new guidelines. Results: The study included 101 cerebral palsy children, their age ranged from 1 month to 15 years, 65 cases were males and 36 were females. • Children who need no intervention were 7.9% of cases. • Children who need to increase caloric intake were 19.8% of cases. • Children who need to micronutrient supplementation were 19.8% of cases.

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