Chronic lung disease (CLD) in children represents a heterogeneous group of many clinico-pathological entities with risk of adverse impact of chronic or intermittent hypoxia. So far, few researchers have investigated the cognitive function in these children, and the role of auditory P300 in the assessment of their cognitive function has not been investigated yet. This study was designed to assess the cognitive functions among schoolchildren with different chronic pulmonary diseases using both auditory P300 and Stanford-Binet test. This cross-sectional study included 40 school-aged children who were suffering from chronic chest troubles other than asthma and 30 healthy children of similar age, gender and socioeconomic state as a control group. All subjects were evaluated through clinical examination, radiological evaluation and spirometry. Audiological evaluation included (basic otological examination, pure-tone, speech audiometry and immittancemetry). Cognitive function was assessed by auditory P300 and psychological evaluation using Stanford-Binet test (4th edition). Children with chronic lung diseases had significantly lower anthropometric measures compared to healthy controls. They had statistically significant lower IQ scores and delayed P300 latencies denoting lower cognitive abilities. Cognitive dysfunction correlated to severity of disease. P300 latencies were prolonged among hypoxic patients. Cognitive deficits in children with different chronic lung diseases were best detected using both Stanford-Binet test and auditory P300. P300 is an easy objective tool. P300 is affected early with hypoxia and could alarm subtle cognitive dysfunction.

Background: Community-acquired pneumonia (CAP) is one of the most common infectious diseases affecting the respiratory tract and is responsible for a high mortality rate in children less than 5 years of age. The mortality rate due to CAP is much higher in low/middle-income countries than in high-income countries due to malnutrition and different micronutrient deficiencies that weaken the immune system.Aim: The aim of this study was to compare the effects of zinc and vitamin A, as two elements of micronutrient agents, on the recovery rate of children suffering from CAP aged from 6 months to 5 years. The length of hospital stays was also investigated.Method: A comparative, randomized, open-label, controlled, interventional study was carried out among children less than 5 years of age in the pediatric intensive care unit (PICU) diagnosed with CAP who were randomly divided into three groups. In addition to the standard therapy, group 1 was given zinc, group 2 was given vitamin A, and group 3 was the control group, given the standard therapy only. We compared the three groups in terms of recovery rate and hospital stay.Result: The duration of hospitalization following zinc and vitamin A supplementation was reduced by an average of 3.21 days (95% CI: 5.01–1.41, p = 0.01) and 2.43 days (95% CI: 4.29–0.57, p = 0.01), respectively, compared to the control group. In addition, the two groups of vitamin A and zinc supplementation were associated with a shorter duration of pneumonic effusion (p < 0.001) in comparison to the control group. Additionally, there was no significant difference between the effects of zinc and vitamin A when compared to each other in terms of duration of hospital stay and pneumatic effusion.Conclusion: The administration of zinc or vitamin A supplementation proved to be useful as an add-on therapy in community-acquired pneumonia, where it reduced the length of hospital stay and the duration of pneumonic effusion in pneumonic children less than 5 years of age.

Background: Asthma among obese represents a unique phenotype. Mast cells are more abundant in obese. Serum tryptase (ST) is a marker of mast cell numbers or activity. Since obesity and asthma have been linked in epidemiological studies, a possible higher mast cell activity in obesity could be a factor between the two conditions. This study was to investigate ST and its potential association between obesity and childhood asthma.Methods: Study recruited 60 asthmatic children, their age ranged from 5-16 years. They were divided according to BMI centile to 30 obese and 30 non-obese asthmatics. Thirty healthy non-asthmatic, nonatopic and non-obese children; were included as a healthy control. Serum tryptase, atopy (skin prick test reactivity) and spirometry were assessed.Results: Frequency of atopy and positive skin prick test signifi cantly increased among obese more than non-obese asthmatics (P<0.05, OR = 1.96, 95% CI = 1.27-3.24). FEV1% of predicted mean levels were lower among obese than non-obese asthmatics (p<0.05). ST was signifi cantly higher in asthmatics than in controls with a mean ±SD of 53.3±13.78 ng/ml and 10.06±4.39 ng/ml respectively. ST was higher in obese than non-obese asthmatics with a mean ±SD of 71.73±19.17 ng/ml and 34.5±8.68 ng/ml respectively (P<0.05). There was a negative correlation between ST and FEV1 % of predicted and positive correlations between ST and age, BMI, and waist circumference among asthmatics. Conclusion:Mast cells play a role in both obesity and asthma, serum tryptase, being a marker of mast cell activation, could represent a link between them.

Background Intravenous immunoglobulin G (IVIG) has been used as an antibody replacement therapy in primary immunodeficiency (PID) for more than 50 years. Most routinely, IVIG is used in patients with predominantly antibody deficiency such as: X-linked Agammaglobulinemia, common variable immunodeficiency and combined immunodeficiency such as: severe combined immunodeficiency. Aim To evaluate the efficacy and safety of regular IVIG therapy among patients with predominantly antibody deficiency in terms of frequency of infection and adverse effects. Methods Thirty patients diagnosed with predominantly antibody deficiency were recruited from the Pediatric Allergy and Immunology Unit, Children’s Hospital, Ain Shams University. These patients were followed up for one year in order to evaluate the frequency of infection and and adverse reactions of regular monthly IVIG therapy. The adequacy of IVIG dose was evaluated by the trough level of serum immunoglobulin G (IgG). Results Of the 30 patients, 21 (70%) were males and 9 (30%) were females. They had a median age of 87 months (range:15-294). Their median age at presentation and at diagnosis were 36 months (range :3-168) and 87 months (range:15-204) respectively. The mean ± SD of serum IgG before commencement of IVIG and after were 265.10 ± 108.39mg/dl and 572.04 ± 186.72 respectively. The rate of major infection dropped after starting replacement therapy with a median of 2 (1-2) before and 0 (0-1) after treatment. In spite of the reduction in the rate of pneumonia occurrence in patients with IgG trough level &gt;500 mg/dl, it had no statistical significance. This could be attributable to small sample size. One patient developed anaphylaxis and was shifted to another brand. Conclusion IVIG is a safe and effective drug for patients with predominantly antibody deficiency. Compliance, adherence to therapy and appropriate dosage is needed to achieve better infection control.