Patients undergoing chemotherapy are vulnerable to infection because of immunosuppression and prolonged hospitalizations. Chemotherapy drugs affect neutrophil production through myelosuppression (1) and low inflammatory response so that fever maybe the manifestation of infection (2). The purpose of this study was to analyze febrile neutropenic episodes associated with infections in the 1st three phases of acute lymphoblastic leukemia (ALL) treatment, document the risk factors affecting morbidity, mortality, treatment and the outcome of treatment. The study was a cross-sectional hospital-based descriptive survey in the Hematology-Oncology Unit at Children’s Hospital. It included all cases of (ALL) who were diagnosed within two years and treated with the Berlin Frankfurt Munich (BFM) protocol who developed fever during a neutropenic period. Data was recorded as gender, age, residence, nationality, number of episodes per patient, treatment phase, admission duration, length of stay (LOS) per episode, symptoms, physical examination and severity of fever. Investigations, the antibiotic used and the outcome were also recorded. A total 27children, males accounting for 63%, 67<5 were included in the study. Febrile neutropenic episodes ranged 1–12. Their peak was in January. 40% were in phase II. LOS range 2-35 days. Fever showed a median of 38.8 °C, higher in phase II and III. Admission and therapy phases were longer in children ˂ 2 years old and in males. The neutrophil median was 270/mm3. Stomatitis was seen in70% of episodes, gastroenteritis in 65%, fever of unknown origin (FUO) in 16%and pneumonias in 15%. 20/23 bacterial infections were Gram-negative. 40% of episodes required a change of antibiotics. The mortality rate was 22%.

Background: The most important tick-borne infectious disease in North Africa is Mediterranean spotted fever, which is endemic in Libya's green mountain region, with dogs serving as the main domestic reservoir. Aim of this study is to identify the epidemiological, clinical, and laboratory profile of spotted fever in children in the Almarj region, as well as the treatment response. Materials and Methods: A cohort study with prospective data collection of 60 patients visiting Almarj teaching hospital as outpatients or admitted from January 1ST 2018 to December 31ST 2019. Results: The median age of the 60 children was 3.3 years. The 55% were males. A tick-bite history were given in three cases. Majority of the cases had direct contact with domestic animals, all had a high-grade fever and rash (purpuric in 29% and 71% maculopapular). Arthralgia, myalgia affect the joints and muscles of the lower limbs in the majority of cases. One case with Hepatomegaly. In our sample, white blood cell count 56% was normal and thrombocytopenia in 37% of the patients. A mild hyponatremia was the most common electrolyte disturbance 56.9%. High liver enzymes in three cases. The antibiotics used in treatment were well tolerated and there were no deaths. Conclusions and Recommendations: Spotted fever group Rickettsiosis (most likely type is Medritanian spotted fever) is common in Almarj area, and it is curable. Rickettsia should be considered as a possible diagnosis of any febrile disease in summer or spring even before the rash appearance, or when there is no rash at all, particularly in those living in rural areas. The oral antibiotics (doxycycline and azithromycin) had a great response.

Introduction: Children are known to receive antibiotics more often than any other type of drug, as they are frequent subjects of infections of various etiologies. The improper use of antibiotics is the most important cause of the modern expansion of antibiotic resistance. The development of antibiotic resistance, with its clinical and economic consequences. Increased bacterial resistance is threatening the therapeutic effectiveness of antibiotics. High level of antibiotic use is probably the main factor driving the emergence of resistant. Objectives of the Study: To determine the level of awareness of antibiotic use in Benghazi 2021 among parents of children and to identify factors associated with parent’s decision regarding use of antibiotics. Materials and Methods: A convenient sample of 2000 questionnaires was distributed among parents of their children aged from 6moths to 6 years. By direct an interview to the parents at Benghazi city during the period from September to December –2021 who agreed for an interview survey. The questionnaire was developed by the researcher, and the data collected by well- trained interviewer team (the researcher and his colleagues, including doctors, medical students and pharmacists). The questionnaire contains were focused on the knowledge and attitude and practice of parents including the general knowledge on antibiotics, side effects of antibiotics use, the ideal mechanism of action of antibiotics and if antibiotics can cause allergy. If the parents use antibiotics to their children without a doctor's prescription, the reasons for use antibiotics without doctor's prescription. A score technique was chosen as suitable method to identify the level of awareness among parents regarding antibiotics use. A Scoring for questions knowledge five questions, every question gives 2 marks. We Categorize Score as: Deficient (poor), intermediate (average), Optimum (good) marks. The participants responded to the questionnaire without any .......

Autism spectrum disorder (ASD) is one of the most worldwide neurodevelopmental disorders is characterized by the core domains of persistent deficits in social communication and restricted-repetitive patterns of behaviors, interests, or activities and language delay. Pro-inflammatory events and immune system dysfunctions are cellular and molecular events associated with ASD. Several conditions co-occur with ASD: seizures, gastro-intestinal problems, attention deficit, anxiety and depression, and sleep problems. The occurrence of ASD has been increasing worldwide, with the most recent prevalence studies indicating that they are present in 6 per 1000 children. Although the cause of these disorders is not yet known, studies strongly suggest many risk factors have been identified that may contribute to the development of ASDs. These risk factors include genetics, environmental factors, prenatal and perinatal factors, and neuroanatomical abnormalities a genetic basis with a complex mode of inheritance. More research is needed to explore factors that could be contributing to the cause of these disorders. Continued evaluation of genetic factors in combination with these different factors, is critically needed to take this Genetic progress even further in our understanding of, and ability to have a positive impact on, ASD. Inherited factors contribute to ASD etiology, remains incompletely understood. The objectives of this article are to investigate the main cause of ASD provide physicians with relevant information needed to eliminate the incidence of ASD and to eliminate the etiology and management of these disorders. It seemed reasonable to surmise that ABO blood type was functionally related to ASDs. Blood types are inherited from both parents. We hypothesized that if parental ABO blood type were associated with the development of filial ASDs, there would be a higher probability of filial ASDs in parents with a specific ABO blood type. If so, medical workers can .........