Background: Acute otitis media is considered as one of the most frequent childhood inflammatory disorders. Aim of The Work:This study aimed to investigate the possible link between iron deficiency anemia and acute episodes on top of chronic otitis media. Patients and Methods:This prospective study is included pediatric patients who attend the ENT outpatient clinic in Mallawi Hospital, El Minia; El Azhar University _Assuit, from July 2019 to June 2020. A total of 100 patients of age Group up to 18 years old and both sexes suffering from recurrent otitis media divided into Group A: Included 34 children treated with iron supplementation three months, Group B: Included 33 children treated with iron supplementation and medical treatment three months.Group C: Included 33 children treated with medical treatment for three months. Results:In group A the change of hemoglobin level from [10.15 ± 0.33] to [11.41 ± 0.43] decreasing occurrence rate of CSOM from 3.47± 0.51 to 1.41± 0.49 with statistically significant difference [p<0.001].In group B, the change of Hb level from [10. ± 0.32] to [11.48 ± 0.29] decreasing occurrence rate of Chronic Suppurative Otitis Media from 33.42 ± 0.92 to 1.39± 0.56 with statistically significant difference [p<0.001].In group C, the change of Hb level from [10.03 ± 0.43] to [10.09± 0.31] decreasing occurrence rate of CSOM from 3.39±0.66 to 2.33± 0.48 with statistically significant difference [p<0.001]. Conclusions:The combination of iron and medical treatment in anemic patients can improve hemoglobin level and significantly decrease otitis media's occurrence rate.

Background:The optimal tracheostomy time is considered a debatable issue for patients with severe Head injury in intensive care units [ICUs], which require mechanical ventilation [MV] for long period. The aim of the work:The current study aimed to investigate the effect of tracheostomy operation in early few days of admission on the length of mechanical ventilation [MV]. In addition, to determine outcomes and associated mortality rate. Patients and Methods: a prospective randomized Comparative clinical study included 200 patients admitted to ICU units of Al-Azhar university hospitals and El Haram hospital who had the following criteria: severe head injury, Cerebral trauma on and Glasgow Coma Scale [GCS] score 8 or less on the fourth day viewed by brain CT scan done without given any sedation. Divided into 2 groups on the fourth day of admission each group includes 100 patients, one group submitted to early Tracheostomy [ET] [group A] and the other group submitted to extended endotracheal intubation [EEI] [Group B].Results: There was shorter in the main period of the mechanical ventilatory support for group A than group B with statistically significant relationship p value=0.02.Their no remarkable difference in the occurrence of Nosocomial pneumonia between group A and group B. p value of Nosocomial pneumonia = 0.62. Conclusion:In severe head injury, ET significantly decreases the mechanical ventilation time.