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BackgroundHospital acquired infection (HAI) and multiple organ dysfunctions (MODS) remain a leading cause of death in pediatric intensive care unit (PICU) despite the great efforts to control it.ObjectiveOur objective was to assess the mRNA of TNFα and BCL2 for prediction of HAI and/or MODS in our community.Patients and methodsFifty children, admitted to PICU, were included in the study after exclusion of cases of end-stage renal failure, end-stage liver failure and congenital immune deficiency. Serial Blood samples were collected for complete blood count (CBC) and other routine investigations. Gene expression of (TNFα and BCL2) was quantified using quantitative real time PCR (qRT-PCR). Centers of disease control (CDC) criteria were used to detect HAI, and organ failure index (OFI). Pediatric logistic organ dysfunction (PELOD) and pediatric risk of mortality (PRISM) scores were used for follow up. The results were compared between the group who acquired HAI and who didn't. Gene expression was tested with a ROC curve to detect its ability to predict HAI.Main resultsThe overall complication (HAI and/or MODS) rate was 52%, Complicated cases had a significantly longer duration of stay in PICU (0.002) and in overall hospital stay (p = 0.013) and a higher death rate (p = 0.000). On day1; TNFα, BCL2 and lymphocytic count were lower in patients who developed complications (p = 0.02, p = 0.000 and p = 0.04, respectively), all had the ability to predict the complications with AUC (0.7, 0.8 and 0.67 respectively). On day 4: TNFα and BCL2 returned to normal levels while the lymphocytic count still lower in complicated cases, p = 0.001 and AUC = 0.73.ConclusionsTNFα and BCL2 on admission can predict HAI and MODS (AUC = 0.7 and AUC = 0.8), but were of no use in the follow-up, however, the lymphocytic count is a rapid, easy and cheap test to assess the immune state with a good predictive and follow up values.

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Autism spectrum disorder is a neurodevelopmental disorder with a strong genetic basis. This study has been conducted to determine prevelance and the possible risk factors of autism. . This studty is a retrospective study that included101 children (67 males and 34 female). Their ages ranged from 26 years with mean age 3.87±1.03 (26) . Cases was collected from KGs, special centers and psychiatry clinic, Pediatric Department , Benha univeristiy hospital and Benha specialized Hospital . The included child was subjected to: the followings tools: Confirmation of diagnosis using DSMV criteria,, and assessment of severity of autistic symptoms using childhood autism rating scale (CARS). A small structured questionnaire and complete medical history stressing on developmental, therapeutic and behavioral histories were also developed and administered . ASD prevalence was 1 in51 childrenThe current study was conducted on 101 autistic children, their ages range from2 -6 years with a mean value of 3.87±1.03 years, 66.3 of autistic children were males and 33.7 were females, with a male/female ratio of 2:1; (p > 0.05 all).Advanced paternal age (father, P35 years) at birth was found in 91% of cases and the difference was statistically significant. Positive family history was found to be statistically unsignificant. As regards natal factors, a history of low birth weight, delivery by ceserian section were significantly higher among cases . Also postnatal factors as history of hypoxia, resuscitation and history of jaundice were considered significantly risk factors for autism(p=0.000).

Asthma is a chronic ,inflammatory ,respiratory tract disease accompanied by hypersensitivity of airways, recurring wheezing episodes, respiratory distress and coughing. The aim of this study was to estimate vitamin D level and specific IgE level in asthmatic children who were on controller medication and correlated their serum level with asthma control . Our results clarified that The serum vitamin[D] levels were closely related to asthma attacks. As,There were statistically significant positive correlations between serum vitamin D level and asthma control in asthmatic children. There were no significant difference in mean serum vitamin [D] between male and female and according to parent consanguinity while shows significant difference regarding order of sibling. there were no significant difference in mean serum vitamin [D] according to family history of atopy and passive smoking, while shows significant difference regarding family history of asthma, associated allergic condition, day time symptoms, night time awakness, degree of asthma control, recurrent hospital admission , interference with activity and frequency of exacerbation and influenza &pneumococcal vaccination. significant difference in mean serum vitamin [D] according to food born allergen: apple ,banana ,casein ,cow milk ,egg white, peanut while regarding airborne allergen shows nonsignificant difference with ,Der.pteronyssinus, Der.farinae ,Cockroach and Honey bee venom and Aspergillus fumigatus . Common wasp venom , Altearia alternate, Honey bee venum,Birch ,Candida albican ,Dog epith. and cat epithelium demonstrated significant difference. From our results, it would be concluded that there was a significant correlation between vitamin [D] level and asthma control in asthmatic children .