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Background: A systematic ultrasound has been validated across a wide span of ages using both chest anatomic structures (ie, ribs , pleural line)and artifact images ,such as the B-lines. Multiple diffuse bilateral B-lines are suggestive of interstitial syndrome . In the neonate, one can accurately differentiate the aerated dry lung, appearing as uniform hypoechogenic pattern, sliding with respiration and showing horizontal (the A-lines) ,from the hyperechogenic “white” pattern of the markedly “wet” or inflamed organ. Objective To study the value of chest ultrasound in neonates with RD And its value in comparison with chest x –rays.Methods: This prospective hospital based study was conducted on 74 neonates (October 2017to September 2018 in the Neonatal intensive care unit at Sohag university hospital with any degree of RD .All cases was involved with physical examination, chest x-ray and chest US. finally data was analyzed by SPSS software.Results: In the all the 74 cases chest ultrasound was applied and the disease was further categorized into RDS 25 cases (33.78%) .Pneumonia13 cases (17.56%), (TTN) 25 cases (33.7%) , (MAS), 9cases(12.16%).Pleural effusion4 cases (5.40%). We found that there no difference between diagnosis of the cases by(clinically ,history , and chest x-rays ) versus chest sonar diagnosis (p value=0.157) which was statistically in significant . Conclusion: no difference between diagnosis of the cases by(clinically ,history , and chest x-rays ) versus chest US diagnosis.Study Limitation:: we conduct only the neonatal group suffered from limited disease as RDS,TTN,MAS ,Pneumonia, excluding cases with congenital malformation .

Neutrophil gelatinase-associated lipocalin (NGAL) is a rapidly emerging biomarker for early detection of acute kidney injury (AKI). The aim of the study is to evaluate the impact of sepsis on serum NGAL in critically ill children and to investigate whether the presence of sepsis affects the ability of serum NGAL to predict AKI. Sixty-eight patients, who met criteria of sepsis and related syndromes, were classified into two groups (septic shock and severe sepsis). They were reclassified regarding who developed AKI into AKI and non- AKI groups. Twenty sex and age-matched healthy subjects served as a control group. Serum NGAL was assayed using Enzyme-linked Immunosorbent Assay (ELISA), and serum creatinine was measured using the kinetic spectrophotometric method. Serum NGAL levels were significantly high in critically ill septic patients compared to healthy controls (median: 100.4ng/ml vs. 47.1 ng/ml, P>0.0001), and were significantly higher in septic shock (median 105.1ng/ml) than in severe sepsis (median 96ng/ml) with P values of 0.005. However, there was no significant difference in the levels of serum NGAL between AKI patients and non- AKI patients (P=0.3). Receiver operating characteristic (ROC) curve analysis of serum NGAL for prediction of AKI in critically ill septic children showed an area under the curve (AUC) was 0.56 (95% C.I. =0.42-0.70) with an optimal cutoff value of 102.5ng/ml, sensitivity=56.2%, specificity 55.6%, PPV =52.9%, NPV =58.8%, and accuracy=55.9%. For serum creatinine, the AUC was 0.97 (95% C.I. =0.94- 1.00) with an optimal cutoff value of 0.6 mg/dl, sensitivity= 90.6%, specificity 91.7%, PPV=90.6%, NPV=91.7% and accuracy=91.2%. In conclusion, serum NGAL is raised in critically ill septic children and is a marker of bacterial infection and systemic inflammation. However, in AKI associated with sepsis, serum NGAL is not a specific biomarker for the prediction of AKI and it loses its early predictive property. In such patients, serum creatinine is more specific than serum NGAL.

Background: Infantile spasms (IS) are a unique form of seizure disorder that their occurrence is almost entirely limited to infancy (the first year of life) and they are refractory to conventional anticonvulsant drugs. IS usually are associated with developmental retardation or deterioration and a characteristic electroencephalographic (EEG) pattern (hypsarrhythmia) that together form a syndrome . IS involves a sudden, generally bilateral and symmetric contractions of muscles of the neck, trunk, and extremities. Patients with IS can be classified into focal IS and diffuse groups. Objective: Our main objective in this study is to evaluate the clinical profile, laboratory data, and outcome of children having infantile spasms in Sohag University Hospital. Methods: This retrospective study was conducted on 540 patient (mean age 8.4 ± 6.9 months.: ) from December 2015 to November 2016 in neuropediatric outpatient Clinic, Pediatric department at Sohag University Hospital. Detailed clinical data of the patient, Investigation done for the patient including the neuroimaging (MRI or CT) , EEG pattern, basic metabolic studies , serum enzymes and Karyotyping were retrospectively collected from files and records . Results: In this study ; ( 66.1%) of cases were males.(33,9% ) of cases were females ,mean age of presentation (8.4± 6.9 months). Positive consanguinity was found in (7.6%) of cases. (79.2%)of cases presented with flexor spasms, (8.9%) with extensor spasms and (11.9%) with mixed spasms . (8%) of cases were idiopathic, (13.5%) of cases were cryptogenic and (78.5%) of cases were symptomatic,(15.2%) of cases showed favorable outcome, and (84.8%) cases showed unfavorable outcome, of them (11.5%) of casesdeveloped othertype of seizures, (54.3%) of caseshad mental retardation, (28.8%) of cases diedand (5.2%) of cases had autistic features . In univeriate analysis (symptomatic) etiology (P=

thy objective of this study was to evaluate the use of central venous catheters (CVCs) in the Pediatric intensive care unit (PICU) of Sohag University Hospital . We reviewed the records of all children that had CVCs and were hospitalized between 1st of January 2016 to the end of December 2016. Patients were evaluated with respect to their age, gender, catheter type, indication for CVC insertion, site and side of the body of CVC insertion. The duration of catheter use and eventual complications were also taken into consideration. A total of 115 CVCs were inserted in 100 children. Patient age ranged from 1 month to 16 years. The average catheter insertion time was 12 days. We noted 80 (80%) CVC-related complications. Complications related to CVCs insertion were infection(40%),occlusion(10%),local edema(8%),hematoma(5%), pneumothorax(4%),catheter displacement(4%),hemothorax(4%),thrombosis(3%),air embolism(2%) were complications associated with lenght of CVCs use. We conclude that central venous catheterization is a safe and efficient procedure with many complications in pediatric patients.