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Background: Pediatric pleural effusion, particularly empyema, is a serious cause of childhood morbidity and prolonged hospitalization. Objective: This study objective was to evaluate the effectiveness of pigtail catheter placement plus alteplase (tPa) instillation intrapleural in treatment of parapneumonic effusion. Methods: A two-arm study was inducted to compare children who treated by pigtail catheter plus intarpleura tissue plasminogen activator (tPa) with children who were treated by thoracostomy tube drainage alone. Also, a cost effectiveness analysis was conducted on the basis of clinical outcomes and cost data available about each treatment strategy group. Result(s): Over the preiod of our study, 46 children were involved in group I with parapneumonic effusion treated by pigtail catheter plus intrapleural TPA and 24 children were involved in group II who were treated by thoracostomy tube drainage alone. The Length Of hospital Stay (LOS) was significantly shorter for 1 st treatment strategy (group I) in addition to 0% failure rate (no surgical intervention needed). Group I strategy of management was the least expensive. Conclusion(s): Pigtail cathter plus intrapleural tPa is the more effective least expensive treatment strategy in management of children with parapneumonic effusion.

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Introduction:Nosocomial infections NIs are one of the leading causes of mortality and morbidity in neonatal intensive care units NICUs and pediatric intensive care units PICUs. The incidence of infections varies widely among NICUs (7-25.5%), and (18-30%) among PICUs depending on environmental factors and differences in clinical practice (Brito et al., 2010). Objective: To investigate the prevalence of bacterial contamination of mobile phones of HCWs in pediatric departments (ward, NICU and PICU) of Zagazig University Hospital and Al-Mabarrah General Hospital, and characterize their antibiotic sensitivity patterns. Besides, this study aimed to identify the possible potential risk factors for acquisition of colonizing or pathogenic bacteria on HCWs mobile phones, and assess the attitude of HCWs towards mobile phone use during their clinical practice. Methods: This is a prospective cross sectional study, This study included 350 health care workers (HCWs). Questionaire was distributed through the selected HCWs. Bacterial isolation from swabs from cell phones of HCWs was conducted according to standard bacteriology methods. Results: The most common organism isolated was S.epidermidis (72.8%), followed by S.aureus (16.7%), Bacillus spp.(6.2%) and E.coli (3.1%).There was statistaclly significant association between the bacterial culture results with HCWs acceptance to restrict mobile use inside hospitals (p=0.038*), using phones inside toilets (p=0.038*), and keeping phones in the uniform pocket(p=0.00*). Conclusion: Use mobile phones by HCWs during the work in the NICUs and PICUs carry ahigh risk for the NIs, Regular cleaning of the phones is recommended to decrease the contamination rate.