Background: In the past, ultrasound has not been widely used for neonatal chest imaging due to the obscuring artifact generated by normal air-filled lung. Aim of work: This study aimed to determine the value of chest ultrasonography in comparison to chest x-rays in diagnosis and follow up of neonates with respiratory distress. Methods: This prospective study has been conducted at Neonatal Intensive Care Unit (NICU), Al-Azhar Assiut University Hospital from 1 st November 2019 to October 2020. The study was conducted to 50 neonates with moderate respiratory distress, 14 of them were females (28%) and 36 of them were males (72%). All newborns included in the study admitted to neonatal intensive care unit: 13 of them stabilized on nasal oxygen, 37 of them stabilized on Nasal Continuous Positive Airway Pressure (NCPAP) for 6 hours. 8 of them need mechanical ventilation based on clinical, arterial blood gases and lung ultrasonographic findings. Lung ultrasound was performed within 2 hours and repeated after 6 hours. Chest x-ray was performed and scored. Both Lung ultrasound score and chest x-ray score were used and compared for respiratory distress in neonates. Results: Lung ultrasound has important role in diagnosis and follow up of neonates with respiratory distress and considered higher than chest X-ray regarding its ability to detect different patterns of white lung in term of pulmonary oedema (B-Lines) (40%),consolidation(62%) and pleural effusion (8%). Conclusion:Lung ultrasound is a non-invasive, bedside and reproducible method that could improve the management of neonatal respiratory distress. After 6 hours of Nasal Continuous Positive Airway Pressure (NCPAP), neonatal lung ultrasound is a useful predictor of the need for intubation over chest x-ray.Respiratory distress syndrome was the main diagnosis of respiratory distressed infants followed by transient tachypnea of newborn, pneumonia, meconium aspiration syndrome (MAS), and finally pleural effusion.

Background Glutaric acidemia type 1 (GA1) is an inherited neurometabolic disease with significant morbidity. However, neuro-radiological correlation is not completely understood. Objective The study aimed to characterize the neuroimaging findings and their association with neurological phenotype in GA1 children. Methods Twenty-six Egyptian children (median age = 12 months) diagnosed with GA1 underwent clinical evaluation and brain magnetic resonance imaging (MRI). We objectively assessed the severity of neurological phenotype at the time of MRI using movement disorder (MD) and morbidity scores. Evaluation of brain MRI abnormalities followed a systematic and region-specific scoring approach. Brain MRI findings and scores were correlated with MD and morbidity scores, disease onset, and presence of seizures. Results Fifteen (57.7%) cases had insidious onset, eight (30.8%) manifested acute onset, whereas three (11.5%) were asymptomatic. Ten (38.5%) cases had seizures, five of which had no acute encephalopathic crisis. Putamen and caudate abnormalities (found in all acute onset, 93.3 and 73.3% of insidious onset, and one of three asymptomatic cases) were significantly related to MD (p = 0.007 and 0.013) and morbidity (p = 0.005 and 0.003) scores. Globus pallidus abnormalities (50% of acute onset, 46.7% of insidious onset, and one of three of asymptomatic cases) were significantly associated with morbidity score (p = 0.023). Other MRI brain abnormalities as well as gray and white matter score showed no significant association with neurological phenotype. Younger age at onset, acute onset, and seizures were significantly associated with worse neurological manifestations. Conclusion Patients with GA1 manifest characteristic and region-specific brain MRI abnormalities, but only striatal affection appears to correlate with neurological phenotype.

Background: Pneumothorax (PTX) is a common complication and potentially life threatening condition for neonates in the neonatal intensive care unit (NICU). The use of ventilatory support and neonatal resuscitation procedures with positive pressure is deemed necessary. Aim of work: The aim of this study is to identify the risk factors which predispose or relate to pneumothorax in neonates admitted in NICU of AL-Azhar Assuit University Hospital and the outcome of this problem. Patients and Methods: This is a retrospective descriptive study was carried out on mechanically ventilated neonates admitted to NICU of AL-Azhar Assuit University Hospital during the period from 1 st January 2018 to 1 st January 2020. Results: On studying the demographic and clinical characteristics of cases and risk factors implicated in incidence of pneumothorax, it's reported that 41.7% of cases were males, 75% born by caesarean section, most of cases with gestational age < 34 weeks, with birth weight < 2 kilogram.Respiratory distress syndrome (RDS) was the most prevalent underlying lung disease, as 75% of pneumothorax patients were having RDS, probably being the most common cause of admission and need for ventilatory support. During admission, 4 patients died with mortality rate 33.3% of all patients presenting with pneumothorax. Conclusion: The incidence of PTX was high due to positive pressure ventilation. It was higher in neonates on synchronized intermittent mechanical ventilation (SIMV) than on continuous positive airway pressure (CPAP) in preterm infants, in those of elective CS and neonates with low birth weight. Respiratory distress syndrome was the most prevalent underlying lung disease.Mortality was high due to lower birth weight and gestational age, the need of these patients to mechanical ventilation and more severe chest condition than other patients. Recommendation:Intensive care for neonates who develop pneumothorax is necessary as they have higher mortality rates.

Background: Environment influences infant feeding decisions of mothers, which have influence on growth, development, health and nutrition of infants and children. Objectives: To assess the maternal knowledge and practices towards breast-feeding among mothers in Sohag. To correlate breast-feeding practices with maternal education, parity, mode of delivery, socioeconomic status and employment. Patients and methods: This cross-sectional study included 500 mothers of infants attending some primary health centers from 1 st January to 30 th November 2020. Data were collected using a self-administered standardized questionnaire. Results: Information present in this questionnaire were taken from 500 mothers, their information was founded to be taken from what friends (33%), media (10%) and primitives (57%). 52% of mothers knew that breast feeding was used as contraceptives. 63% of mothers agreed that babies breast fed naturally were healthier than those who breast feed artificially. 67%of mothers agreed that breast milk is useful but not satisfy the nutritional needs to sustain optimal growth beyond 6 months not due to decrease quality of breast milk but increased demand. Breast-feeding is related to educational level, parity, and socioeconomic status, in which (58%) and ( 80) of mothers had moderate educational level and moderate socioeconomic level respectively. Despite 61% of mothers disagree with the concept that they should stop nursing after only one year. Only 20% of them agreed to give bottle-feeding as complementary. Conclusion:It is really an encouraging observation that majority of the mothers had good knowledge and a positive attitude towards breast-feeding. Majority of the mothers fed the baby colostrum. Late initiation of breast-feeding has implications for health education programs and neonatal feeding strategies.

Background: Neonatal hypothyroidism is a serious endocrinal disorder that must be diagnosed promptly to avoid irreversible neurological deficits. Aim of work: screening of all preterm infants for thyroid dysfunction. Patients and methods: All preterm infants enrolled to this study were subjected to thorough history taking and complete physical examinations. Investigations: initially screening for hypothyroidism was done according to Egyptian screening program and serum TSH, T4, and free T4 were done within the 1st week of life and repeated at the end of 2nd and 4th week of life for those with abnormal results only. Results: Abnormal thyroid function was detected in 178 (50%) preterm infants.Twenty-two infants were excluded from the study. Mean serum levels of TSH, T4 and free T4 were higher among group II infants (more mature) than 1st group (less mature). The mean levels of T4 and free T4 were higher at the end of 4th week of life than their levels during the 1st week of life. Transient hypothyroxinemia was more frequent thyroid dysfunction disorders among both groups (52.5 % and 38 % for 1st and 2nd groups respectively). Neonatal hypothyroidism, transient primary neonatal hypothyroidism, and transient hyperthyrotropinemia were detected in 9 (11.25%), 18 (22.5%), and 11 neonates (13.75%), respectively for the 1st group and observed in 7 (9.2%), 14 (18.4%), and 9 neonates (11.8%), respectively for the second group Conclusions: Thyroid dysfunction was moderately common among preterm neonates. Protocol for thyroid function tests among preterm infants is essential.