Background: Limited number of studies evaluated cardiac diastolic function in infants of diabetic mothers using tissue Doppler imaging. The aim of this study was to evaluate diastolic parameters in full-term infants of diabetic mothers compared to healthy full-term neonates using both conventional echocardiography and tissue Doppler imaging. This study is a comparative study. Fifty consecutive infants of diabetic mothers (cases) in the first 3 days of life: 25 neonates with poor maternal glycemic control (Hemoglobin A1c > 7.5 g/dl) and 25 neonates with good maternal glycemic control (Hemoglobin A1c ≤ 7.5 g/dl). Thirty healthy full-term infants of non-diabetic mothers with age and sex matching were included as controls. The studied groups were assessed by conventional pulsed wave Doppler and tissue Doppler imaging. Results: Among pulsed wave Doppler parameters, cases had lower values than controls as regards mitral E velocity, mitral E/A ratio, tricuspid E velocity, and tricuspid E/A ratio, while neonates with poor maternal glycemic control had lower values than those with good maternal glycemic control as regards mitral E/A ratio, tricuspid E velocity, and tricuspid E/A ratio as well as higher mitral A velocity (denoting more diastolic dysfunction). Similarly, among tissue Doppler parameters, cases had lower values than controls as regards septal E' velocity, E'/A' ratio, left ventricular E' velocity, E'/A' ratio, and right ventricular E' velocity as well as higher septal A' velocity, left ventricular A' velocity, and right ventricular A' velocity, while neonates with poor maternal glycemic control had lower values than those with good maternal glycemic control as regards septal E' velocity, E'/A' ratio, left ventricular E' velocity, E'/A' ratio, and right ventricular E' velocity, as well as higher left ventricular A' velocity (denoting more diastolic dysfunction). Tissue Doppler was able to detect higher number of neonates with left ventricular diastolic dysfunction than conventional pulsed wave Doppler. Conclusions: Tissue Doppler imaging was found to be able to detect diastolic dysfunction early in infants of diabetic mothers specifically as regards the left ventricle. Tissue Doppler imaging should be considered an integral part of cardiac function assessment in infants of diabetic mothers.

Background: Neonatal sepsis a major health challenge associated with major morbidity and mortality. Neonatal care improved recently. However, different challenges regarding management still exist. Vitamin D deficiencies was proposed as a predictor of neonatal sepsis. Objective: To highlight the impact of vitamin D levels on early onset sepsis in full term neonates. Methodology: This is a case control which carried out at the neonatal intensive care unit of Al-Azhar university hospital (Damietta), from March to April 2019. It included 50 full-term neonates with probable sepsis and 50 healthy controls of matched age and sex with no signs of sepsis. Results: vitamin D level showed significant negative correlation with sepsis, Creactive protein (CRP), positive blood cultures; and significant positive correlations with Apgar score, hemoglobin concentration and platelets count. Regression analysis revealed that, higher CRP and lower vitamin D were associated risks of neonatal sepsis in univariate analysis. Multivariable regression analysis revealed that only lower vitamin D level is the predictor for early neonatal sepsis. Conclusions: Vitamin D levels were significantly lower in septic neonates with high sensitivity and specificity. Vitamin D supplementation to mothers during pregnancy could prevent early onset neonatal sepsis.

Background: Febrile seizures are non-epileptic types of seizure that occur frequently during early childhood. Multiple factors are implicated in the pathogenesis of these types of seizures. Iron deficiency might play as an etiological or, at least, augmenting factor in the development of febrile seizures.Objective: To study iron status among children with simple febrile seizures, and to estimate the prevalence of iron deficiency between them. Patients and methods: A case-control study included 100 febrile children aged 6 months to 60 months, and were ascribed to 2 groups; 50 children with simple febrile seizures [case group], and 50 children who had febrile disease without occurrence of seizures [control group]. Venous samples were obtained for the analysis of complete blood count, and iron indices [serum ferritin, serum iron and total iron binding capacity]. Results: The peak temperature was significantly elevated among the case group [P=0.03]. Regarding iron profile, compared to controls, the case group had significantly lower iron [54.24±16.04 vs. 62.6±16.02; P=0.011], and lower ferritin [37.612±19.85 vs. 80.624±31.57; P <0.001]. Correlation analysis revealed a significant negative correlation between serum ferritin and frequency of febrile seizures [P=0.025]Conclusions: Iron deficiency and iron deficiency anemia were more common among children with simple febrile seizures, and they were associated with increase in the duration and frequency of seizures. Special attention should be paid for the assessment of iron status among children with febrile seizures.

Background: Pneumonia is a life-threatening disease in children. Diagnosis of pneumonia is mainly clinical. However, some clinical features may be subtle or not specific. Lung ultrasound (LUS) might be used as a diagnostic tool in pneumonia as it is an easily accessible and safe imaging technique. Aim of the work:This study aimed to investigate the role of lung ultrasound in diagnosing pneumonia compared to chest x-ray in children. Subjects and methods: This cross-sectional study was carried out at the general pediatric wards and pediatric intensive care units [PICUs], Department of Pediatrics, Al-Azhar University Hospital [Damietta]. It included 120 patients who were clinically diagnosed to have pneumonia. Each legal guardian signed informed consent. Then, everyone was subjected to chest x-ray and lung ultrasound, and results were compared. Results: Sonographic findings in children with pneumonia as consolidation was detected in 114/120 (95.6%), air bronchogram in 104/120 (86.7%), fluid bronchogram 37(31.1%), multiple B-lines in 68/120 (56.7%), pleural effusion in 29/120 (24.4%). The lung ultrasound [LUS] showed higher diagnostic accuracy (94.45%), sensitivity (95.6%), and specificity (93.3%). There was a statistically significant good agreement between LUS and chest X-ray [CXR]. Conclusion:LUS is safe, accurate, and more sensitive for the diagnosis of suspected pneumonia in the pediatric age group and had the advantage of reducing radiation hazard when compared to chest X-ray