Community acquired pneumonia (CAP) is a major contributing cause for the increased rate of childhood mortalities and morbidities in the developing countries. Thus, we aimed in this study to appraise the significance of acute phase reactant proteins in correlation with the modified pneumonia prognostic score to assess the disease severity and outcome in children.This study included 40 children with pneumonia ( age between 6 months 2 years ) and other 40 healthy controls ( age and sex matched). They were enrolled in the study and a detailedhistory’s obtained, full clinical examination and assessment of AGP, CRP and ferritin in serum in addition to CBC.AGP, CRP and ferritin showed significant higher levels in children with pneumonia than healthy controls. Also, their values were significantly higher in nonsuvivors than survivors.The present investigation provides a distinct evidence for the prominence of acute phase reactants (ferritin, CRP and AGP) in comparison with the clinical scores in predicting early high risk prognosis of pneumonia in children.

Background: The levels of transplacental transferred immunoglobulin (Ig) carry protective effect to the neonate and varies by many factors as gestational age, maturity, body weight, hemodynamics and maternal diseases. Aim: This study aimed to measure the serum levels of Ig A and Ig G in neonates in different settings and to correlate their levels with neonatal morbidities. Methods: The study conducted during the period from June 2020 to January 2021 in a tertiary level NICU and included a total number of fifty one neonates. The measurement of serum Ig G and Ig A levels were measured by mininef method. Results: The mean value of Ig G and Ig A were 898 mg g/l and 16.3 g/l respectively. Ig G was directly correlated with the maturity, weight, early starting of feeding (p-value 0.001) while they correlated inversely with respiratory and inotropic support and CRP levels (p=value 0.001). Ig G was correlated inversely with the respiratory support whether CPAP or mechanical ventilation; being higher in neonates who didn't receive assisted ventilation. A cut off level of 512 g/l of Ig G was needed to detect increased risk of neonates to sepsis. Preterm babies had lower values than full term ones (p-value 0.001). Conclusion: Transplacental transferred immunoglobulins had a protective effect for neonates and their levels were inversely correlated with neonatal morbidities either in preterm or fullterm neonates

Serum Transforming Growth Factor Beta2 and Feeding Intolerance in Premature Formula -Fed versus Breast Milk-fed Neonates Objectives: to assess occurance of feeding intolerance and NEC in relation to serum level of TGF-β2 in breast milk versus preterm formula fed neonates. Subjects and Methods: a prospective observational study on 80 preterm neonates(≤36weeks gestational age). They were divided to two groups; breast milk fed group(n = 40) and preterm formula fed group(n = 40). They were assessed clinically for feeding intolerance and NEC and laboratory by measurement of TGF-β2 using ELISA technique. Results: TGF-β2 serum level was significantly lower in preterm formula fed group than breast fed group;median(interquartile) 500(250-3000) pg/ml vs 7750(6500-11250) pg/ml (p < 0.0001). Both primary outcome(feeding intolerance and NEC) and secondary outcome(respiratory support and sepsis) were negatively correlated to TGF-β2 serum level. TGF-β2 serum level below 1250 pg/ml was found to be a good diagnostic test for feeding intolerance with sensitivity of 75.86% and specificity of 96.08%. Conclusion: low serumTGF-β2 level is a specific marker for feeding intolerance in preterm neonate. Using premature formula in premature neonates is not recommended as it is associated with lower serum TGF-β2 and higher incidence of feeding intolerance compared to breast feeding.

Introduction: Acute kidney injury (AKI) is a major contributor of neonatal mortality and morbidity. Understanding the different anatomy of the neonatal kidney could help physician understand pathology of AKI and consequently could treat it efficiently. Aim of the study: This one year duration prospective Cohort study involved twenty seven admitted neonates who had acute kidney injury (AKI). Methods: Laboratory and radiologic diagnosis of AKI, further AKIN and pRIFLE classification and follow up after one and three months. Results: AKI had an incidence of 1.35%, mainly in full-term (59%). Hypertension was presented in full-term (75%) and preterm (45.5%). Hematuria presented by 18.8% (full-term) and 27.3% (preterm). Proteinuria occurred in full-term (46.7%) and preterm (36.4%). Urinary tract infection was more among (45.5%) preterm than full term (25%). Oliguric AKI was found in full term (68.8%) and preterm (72.7%). Anuric AKI present in full-term (31.1%) and preterm (9.1%). Post renal AKI were present 18.8 %( full term) and 9.1 %( preterm). Perinatal asphyxia (18.8%) and sepsis (27.3%) were the most common risk factor. Both full-term (37.5%) and preterm (18.2%) needed peritoneal dialysis. Ultrasonography showed bilateral Grade 2 (50%) and 1(25%) nephropathy and bilateral back pressure (18%). pRIFLE was inversely correlate with age and urine output and positively correlated with hypertension at baseline. At one month; 43.8% full-term, 18.2 % preterm were found hypertensive, 18.8% fullterm had proteinuria, pRIFLE was inversely correlated with urine output and proteinuria and eCCL was significantly improved after one month in both preterm and full-term. At three month, chronic kidney disease was 12.5% and 9.1% in full-term and preterm respectively. Total recovery was higher in preterm neonates than in full-term ones. Conclusion: Sepsis and asphyxia are considered the most common causes of AKI. Limitation: A longer follow up is mandatory. Further follow up studies of AKI in preterm neonates are mandatory.