Background: Meningitis, is a potentially life-threatening condition that can rapidly progress to permanent brain damage, neurologic problems, and even death. Bacteria and viruses cause the great majority of meningitis disease in infants and children. CRP is used mainly as a marker of inflammation.Objective: This study was conducted to assess the diagnostic value of CSF-CRP levels for differentiating between septic (bacterial) and aseptic infantile meningitis.Methods: 49 hospitalized infants aged less than two months with suspected meningitis were enrolled in a cross-sectional analytic study. All of patients underwent lumbar puncture to obtain CSF. smears, cultures, cytological and biochemical analysis and latex agglutination testing were carried out on all CSF samples. Latex agglutination test was carried out on all CSF samples using a commercially available kit. CSF-CRP level of all infants was measured using the immunoturbidometric technique.Results: Of 49 infants in this study, 20 and 29 cases were diagnosed as septic and aseptic meningitis, respectively. The CRP levels were obtained as 0.95±0.68 mg/L in septic and 0.16±0.36 mg/L in aseptic meningitis groups and this difference was statistically significant (p<0.001) between the two groups (0.79±0.32 mg/L). Based on the ROC curve, cut off levels for CRP was obtained 0.17 mg/L. At this level, there was 95% sensitivity and 86% specificity to differentiate septic and aseptic meningitis.Conclusion: CSF-CRP has suitable diagnostic value in distinguishing between infantile bacterial from aseptic meningitis especially in cases of negative bacterial culture of the blood and spinal fluid.Keywords: C-reactive protein, cerebrospinal fluid, septic/aseptic meningitis, infant, diagnostic value.

Laparoscopic sleeve gastrectomy (LSG) is an effective treatment option in patients with morbid obesity, with rare long-term sideeffects. In this report, we present a 42-year-old woman who reported positional vertigo and unilateral gradual hearing loss plus continuous tinnitus after LSG. The patient had no signs or symptoms of mental health disorders and the results of the haematological and serum biochemical tests were normal. However, audiometric test revealed mild sensorineural hearing loss with magnitude in high-frequency tones. Also, acoustic reflex threshold showed neural pathway damage, particularly at high frequencies, with no reflex. Pure tone audiometry showed signs of nerve damage in the inner ear. One possible justification for these complications might be eustachian tube dysfunction due to muscle relaxation. Muscle relaxation itself may occur as a result of adipose tissue loss around the ear muscles. Further evidence, however, would be required to better determine whether these complications are attributable to LSG, and to illuminate exact underlying reasons for such complications.

Searching the H. pylori -DNAs in adenoid and IgA, IgG antibodies in serum of children. A cross- sectional study had done upon 53 children (Mean age 8 ±1.9 years) with adenoid surgery in ENT and Pediatric Department of Rasul Akram Hospital (2008-2010). Of 53 cases with adenoid surgery, 40 cases had rhino sinusitis (in sinus CT scan). The resected adenoid tissues (n=40) centrifuged and homogenized and its DNAs extracted and searched for H. pylori- DNAs by qualitative PCR. Serum H. pylori antibodies (IgG &IgA ELISA) calculated quantitatively. Chi square values (p < 0.05) calculated for all categorical variables. The agreement between serologic test and PCR was assessed by the calculation of kappa statistic. Positive PCR for H. pylori detected in 15%of cases; regardless of sex and age of cases. Positive IgA: 17.5% (7/40) and IgG: 20% (8/40) respectively. All cases with positive H. pylori- IgG were female; p=0.003 and meaningful differences in mean age of cases observed for positive IgA (p=0.001) and IgG (p=0.01). Poor agreement observed between positive PCR and serum IgG&IgA (Fisher's Exact test=0.3; 0.5). Positive PCR in adenoid tissue (15%) was very close to positive serum IgA (15%) but without any agreement for each case. The H. pylori infection may have a relative role at least in 15% of children with adenoid surgery. Chronic sinusitis and ear infection might be added to infected adenoid tissue as a reservoir for bacteria. The search by specific culture may elucidate better the role of H. pylori infections in both gastric and adenoid tissues. The decision for use of antibiotics to eradicate the H. pylori infection in recurrent or chronic adenotonsillar infections (with rhinosinusitis) before adenoid surgery needs Randomized Control Trial (RCT) studies. Drug of choice for eradication of H. pylori dependent to antibiotic sensitivity test in each country.

Background: Lead elements have an adverse effect on human health. The most important complications of lead poisoning are disorders of nervous system particularly seizure .This study aimed to evaluate the blood lead levels and its association with convulsion in a group of hospitalized febrile children.