Introduction Malnutrition is defined as an imbalance between requirements and intake of energy and/or nutrients that affect the growth—physical and cognitive functions. It is a major public health problem worldwide especially in children under five years. It includes under-nutrition either stunting, wasting, or micronutrient deficiencies and overweight or obesity. Several nutritional screening tools had been designed to detect nutritional risk of hospitalized children at an early stage. There are six tools, however, there is no consensus on which is the best tool to be used. In clinical practice, the most frequently used screening tools are: Screening of Risk for Nutritional Status and Growth (STRONGkids) and the Subjective Global Assessment of Nutritional Status (SGA). The study aimed to assess the nutritional status of hospitalized children at the time of admission and to evaluate the usefulness of STRONGkids. Patients and Methods A cross sectional study was conducted in Benghazi Medical Center (BMC), from July 2020 to November 2020. A total of 116 under five children admitted to the hospital were included in the study. Result and Discussion The study showed that 53.45% of children were males and 46.55% were females and showed that by using STRONGkids score, 42.2% of children were at low risk of malnutrition, 50.0% at medium risk, and 7.8% at high risk. There was an accordance between result of STRONGkids and weight for age, p = 0.000, similarly for height for age and weight for height. conclusion The STRONGkids screening tool could be used as an initial screening tool for children on admission to provide the right intervention at the right time.

Background: Cyclic vomiting syndrome (CVS) is a functional disorder characterized by repeated episodes of sudden onset of intense vomiting that is followed by symptom-free periods. The diagnosis is based on the fulfillment of Rome IV criteria. The Cyclic vomiting syndrome shares similar features to migraine headaches. It is under-recognized and often misdiagnosed with significant delays in therapy. Aims: To evaluate the clinical characteristic of pediatric patients diagnosed with cyclic vomiting syndrome in our institution and their response to treatment. Patients and Methods: A prospective case series of 13 pediatric patients with cyclic vomiting syndrome seen between period of November 2018 to November 2020 at pediatric gastroenterology outpatient’s clinic in Benghazi medical center. All relevant data including; age and sex, age of presentation, duration of symptoms, age at diagnosis, presence of aura or prodromal symptoms, patient or family history of headache, treatment and their response to treatment were collected. Results: The mean age for diagnosis was 112.2 ± 37.7 months. 46.2% of patients had recognizable prodromal symptoms. Patients with CVS had intense nausea and persistent vomiting that requiring hospitalization. In 44.4% of patients had stopped the episodes as a response to propranolol. Conclusion: Cyclic Vomiting Syndrome (CVS) is a functional, an under-recognized, and misdiagnosed episodic. The illness is characterized by stereotypical pattern of vomiting leading to frequent hospitalizations.

Hemophagocytic lymphohistiocytosis (HLH) is a lethal and rapidly progressive hyper-inflammatory state that lead to development of fulminant multi-organ failure. HLH is divided into primary or familial HLH (FHL) and secondary HLH (sHLH). It can be triggered by a variety of agent that affect the immune system, infection is a common triggering agent. Recently, Coronavirus disease (COVID-19) has spread all over the world and was declared a pandemic. COVID-19 infection in children can induce serious hyper-inflammatory syndrome termed multisystem inflammatory syndrome (MIS-C). Clinically MIS-C patients present with features that resemble Kawasaki’s disease or toxic shock syndrome and the clinical and laboratory manifestations may also similar to that of secondary hemophagocytic lymphohistiocytosis, or macrophage activation syndrome (MAS). The reported HLH syndrome in children with COVID-19 increased during 2020-2021. In this case series we present two pediatric patient diagnosed as sHLH post- COVID-19 infection with a brief literature review of similar pediatric patients.