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Background. Nephrotic syndrome is a common kidney disease among children which is characterized by proteinuria, hypercholesterolemia, hypoproteinemia, and edema. The urinary losses of proteins including albumin and thyroid-binding globulin might affect the thyroid hormone levels in those children. Objective. To assess the thyroid function in children with nephrotic syndrome during the nephrotic attack and after remission.Methods. This was a prospective study conducted at the Pediatrics department, Sohag University Hospital, Sohag, Egypt over a one-year period (from January to December 2017). Data were collected from 51 children with nephrotic syndrome aged between 1 and 12 years old. The study participants were subjected to investigations including thyroid-stimulating hormone (TSH), thyroxin (T4), triiodothyronine (T3), serum urea, creatinine, cholesterol, triglycerides, albumin, total proteins, urinary albumin-to-creatinine ratio and 24 hours urinary proteins during the nephrotic attack and after remission.Results. The mean age for the study participants was 6.1 ± 2.9 years. Thirty-one participants were males (60.8%). The study found that serum TSH levels were elevated while serum Total T3 and Total T4 were reduced during the nephrotic attack. As regards the thyroid hormone status, we found true hypothyroidism in 12 patients (23.52%) and subclinical hypothyroidism in 24 patients (47.06%) during the nephrotic attack. However, only one patient (1.96%) had true hypothyroidism and 14 patients (27.45%) had subclinical hypothyroidism after remission. Conclusion. A large proportion of children with nephrotic syndrome had thyroid dysfunction in the form of either true (overt) or subclinical hypothyroidism. Therefore, monitoring the thyroid function in those children is important.

Background: arrhythmia" refers to any change from the normal sequence of electrical impulses. Cardiac arrhythmias have been classified into tachycardia and bradycardia. Pediatric arrhythmias account for approximately 55 per 100,000 patients evaluated in pediatric emergency departments. Sinus tachycardia is by far the most commonly reported arrhythmia, followed by supraventricular tachycardia (SVT) which represents about 13%, and bradycardia accounting for about 6% of all cases Objective: To characterize patients attending pediatric arrhythmia outpatient clinic as regards the presence of cardiac rhythm abnormalities, the pattern of cardiac rhythm abnormalities and the impact of diagnosis and treatment on the patient morbidity.Methods: This prospective observational study was conducted on 500 pediatric patients from October 2016 to September 2017 in the Pediatric arrhythmia outpatient Clinics of the Pediatric Department. All patients in this study were subjected to complete clinical history including the cause of the referral, complete clinical examinations and twelve leads ECG. The following investigations were requested when indicated and its results were included in the study: Serum electrolyte, Echocardiography, Holter cardiac rhythm monitoring and Electrophysiological studies (EPS), and finally data was analyzed by SPSS software.

Background: Cardiac defects are the most common type of birth defects . Atrial Septal Defect (ASD) is a common cardio-vascular malformation, it is caused by the spontaneous malformation of the interatrial septum resulting in one or more openings, commonly referred to as holes in the heart .Patients and methods : This study is a prospective hospital based study involving all children at the age from 0 to 18 years diagnosed by echo-cardiography as having isolated atrial septal defect and admitted to paediatric department , intermediate care and neonatal intensive care unit (NICU) ; also out patient clinic at Sohag university hospital during the period from January 2012 to January 2013 .Results : We studied [65] patients diagnosed by trans-thoracic echo-cardiography as isolated atrial septal defect (ASD) ,Their ages ranged from 5 days to 13 years with Mean ± SD ( 2.27 ± 2.8 years) . The main presenting Symptoms included ; reccurent chest infections , respiratory distress, feeding difficulties, exertional dyspnea,failure to thrive, manifestations of heart failure , and permanent cyanosis . Echo findings demonstrated that,the majority of cases had ASDII , followed by ASDI , then combined ASD , and less common type was sinus venosus ASD . Conclusion : The great majority of infants with ASDII are most often asymptomatic. Frequently,the condition is detected by a murmur on routine physical examination when they are school-aged children.

Background:Scorpionism is an endemic health problem in Upper Egypt.This study shows theepidemiological,clinical and laboratory manifestations of scorpion envenomation and identify factors that are predictive of severe cases. Methods: Prospective study had been performed at Emergency Unit in the Sohag university hospital and Sohag General Hospital from January to December , 2016. It included 50 patients with definite history of scorpion sting envenomation.Theepidemiological,clinical,andlaboratory findings of patientswererecorded. Results: We found that 44% had abnormal serum troponin and 58% had abnormal serum CKmb. Also 54% had abnormal serum lactate dehydrogenase and 44% had abnormal serum myoglobin. ECG study revealed changes in the severe group in the form of low QRS, ST segment change, sinus tachycardia and ventricular ectopics. Severe group showed significant reduction in the %SF and LVEF in the comparison to the mild/moderate group. Conclusions:The present study is demonstrated that cTnI is a highly specific and sensitive indicator for myocardial injury and adverse outcome in victims of scorpion envenomation. So cTnI may be used in these cases for both diagnosis and prognosis. The use of cTnI in the immediate assessment of patients with severe systemic envenomation appears warranted to identify those at risk of myocardial injury.

Background and objectives: Growth failure is common among children with congenital heart disease (CHD). This study aimed at the assessment of the effect of therapeutic cardiac catheterization on the growth status of children with CHD.Patients and Method: This was a prospective observational study conducted at pediatric cardiac catheterization unit-Sohag university hospital, from October-2016 to September-2017, on children with congenital acyanotic heart diseases who were admitted for therapeutic cardiac catheterization. We assessed the growth parameters as a weight for age Z-score (WAZ), height for age Z-score (HAZ), body mass index and upper arm circumference before catheterization, at one month, three months and six months after catheterization. The growth status was considered normal when WAZ and HAZ were from -2 SD, underweight if WAZ was ≤ -2 SD and stunting if HAZ was ≤ -2 SD. Results: One-hundred and two children with congenital acyanotic heart diseases were included. The mean age was 3.95 ±3.11 years. Sixty participants(58.8%) were females. Before catheterization,70 patients (68.6%) had normal growth status, 20 patients (19.6%) had underweight and 19 patients (18.6%) had stunting. The prevalence of underweight significantly diminished to3.92% (p < 0.001) at the 6th month after catheterization. However, no significant differences in the prevalence of stunting were found during the follow-up period.Conclusion: Therapeutic cardiac catheterization had a significantly positive impact on weight gain shortly after catheterization. However, improvement in the height could not be detected in the first 6 months after catheterization and longer follow-up periods are required.

Background: persistent pulmonary hypertension of the newborn (PPHN) is a serious medical emergency in the neonatal period which occurs because of failure of transition of the fetal circulation into the normal circulation. The condition is characterized by persistently elevated pulmonary vascular pressures and carries with it a high rate of mortality and morbidity.Objective: to evaluate the effect of inhaled versus intravenous magnesium sulfate (MgSO4) as a treatment of pulmonary hypertension in neonates.Methodology: this is an observational prospective study done in Sohag university hospital in the neonatal intensive care unit during the period from January 2016 to December 2017 on 50 neonates who were diagnosed to have PPHN by echocardiography. In this study, we compared the effect of intravenous versus the inhalational MgSO4 on reducing the PHN and SILDENAFIL was used as an adjuvant treatment.Results: there was a statistically significant difference between the three studied groups as regard: age, sex, the degree of respiratory distress, the pulmonary artery pressure before treatment, side effects of treatment, duration of treatment and the SpO2 after treatment. Also there was a great difference in SpO2 in the right hand before and after treatment. Pulmonary artery pressure as well differs greatly before and after treatment in the three groups.Conclusion: based on this study we don't recommend the use of nebulized MgSO4 alone as a treatment of PPHN in neonates.