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Background Nutritional status assessment in children with nephrotic syndrome (NS) is critical for identifying patients who are at risk of protein-energy wasting (PEW) and for determining their nutritional needs and monitoring nutritional intervention outcomes. Methods In a case-control study, we enrolled 40 children (age range: 2-16 years) with NS and 40 apparently healthy children (age and sex-matched) as a control group. Anthropometric data, as well as demographic, clinical, and laboratory data, were collected. A dietary intake assessment using a 3-day food intake record was done, and the quadriceps rectus femoris thickness (QRFT) and quadriceps vastus intermedius thickness (QVIT) were assessed using B-mode ultrasound and compared between both groups. Results Children with NS had lower QRFT and QVIT measurements than control groups (p < 0.001). Inadequacy in protein intake occurred in 62.5% and 27.5% of the NS and control groups, respectively (p = 0.002). The thickness of the rectus and vastus muscles by ultrasound was significantly associated with the percentage of protein intake (p < 0.001). The ROC curve revealed that the best cutoff value of QRFT for the prediction of the patient at risk of malnutrition was [less than or equal to] 1.195 with an area under curve of 0.907, with p < 0.001. Conclusion In children with NS, skeletal muscle ultrasound is a simple and easy-to-use bedside technique for the identification of patients at risk of malnutrition. Graphical abstract, Author(s): Mona Hamed Gehad [sup.1] , Yousif Mohamed Yousif [sup.1] , Maha Ibrahim Metwally [sup.2] , Amany Mohammed AbdAllah [sup.3] , Lamiaa Lotfy Elhawy [sup.4] , Amal S. El-Shal [sup.5] [...]

Key Clinical Message: The significance of taking femoral neck stress fractures into account as a possible consequence in sickle cell anemia patients is underscored by this case report. In this high‐risk group, early identification, timely diagnosis, and suitable care are crucial for averting major problems and improving results. When sickle cell anemia patients complain with hip or groin discomfort, healthcare practitioners should keep a high index of suspicion for femoral neck stress fractures to assure prompt management and prevent long‐term impairment. Sickle cell disease (SCD) is a prevalent genetic hemoglobinopathy with significant global implications, affecting a substantial portion of the population. Avascular necrosis of the femoral head is a common complication in SCD, leading to severe joint damage and immobility. This case report is of a 20‐year‐old male who presented with severe hip pain due to a femoral neck stress fracture, which progressed to a complete fracture. This patient had a past medical history of sickle cell anemia and a malunited subtrochanteric fracture that resulted in shortening, external rotation, and a limping gait. Surgical treatment via subtrochanteric osteotomy with fixation using a dynamic hip screw with or without iliac crest bone graft was planned, with a satisfactory reduction and closure of the fracture gap, postoperatively. In cases of sickle cell anemia patients, bone complications such as both osteonecrosis and stress fractures are common. As a healthcare provider, it is important to manage and address these not only through medical interventions, but also through counseling and patient education. Patients must be reminded about the importance of compliance with medical advice to avoid progression or recurrence of complications. [ABSTRACT FROM AUTHOR]

Background: Usingsteroids as a medical line of treatment for pediatric idiopathic nephrotic syndrome (INS) has a noxious aftereffect on the course of bone mineralization in the targeted children. Searching for new markers of bone mineralization seems to be an imperative issue. Sclerostin (Scl), a glycoprotein which is coded by the SOST gene, is noted as a pivotal controller of bone setup via its repressing outcome on Wnt signaling. The aim of this study was to assess the concentration of Scl level in children with INS and to correlate Scl level with other existing markers of bone metabolism. Method: A case control study achieved on 70 children including 35 patients with INS on corticosteroid therapy and 35apparently well age and sex alike children as a control group. Kidney function testing, bone markers, parathyroid hormone, and serum sclerostin, were assayed in both research groups. Results: There was a statistically significant difference in serum Scl level between the studied groups, being higher in the nephrotic children than the control group (mean ± SD: 10.07 ± 3.650 vs. 5.29 ± 1.92, respectively with p<0.001). Among factors significantly correlated with serum sclerostin, only serum calcium was significantly independently associated with it (unstandardized β=-1.356). There was a statistically significant relation between serum Scl, steroid response and disease activity (p value= 0.001, 0.001 respectively). Conclusion: The sclerostin serum level can serve as an indicator of bone mineralization in children with INS utilizing corticosteroids as a therapeutic agent. [ABSTRACT FROM AUTHOR]

Background: Childhood pneumonia continues to be a leading cause of morbidity and mortality in developing countries. In Egypt, pneumonia is prevalent and represents a socioeconomic burden on patients and their families due to recurrent absences from school and hospital stays. This study aimed to assess the clinical characteristics and epidemiology of pneumonia among children admitted in pediatric department, Zagazig university hospitals. Patients and methods: This cross-section study was carried out at pulmonology unit, Pediatric Department, on 159 children with pneumonia aged between 2 and less than 15 years. Treatment was tailored based on clinical presentation, special emphasis on the duration and severity of pneumonia and treatment given. The respiratory distress severity was assessed using a clinical Canadian emergency department triage. Chest x-ray on admission and before discharge, CT if needed, Laboratory investigations, Ddimer and Blood culture. Results: that pneumonia was most prevalent among preschool aged males from urban areas. Moderate pneumonia was most common, with the majority having right lung involvement. All patients presented with fever, tachypnea, dyspnea and cough, while additional symptoms like chest pain and oxygen desaturation below 92% were more associated with pleural effusion. Outcome, 90.6% of patients improved and discharged for follow up in our clinic while 9.4% of them cases needed ICU admission. Conclusion: Cultures most commonly yielded no growth, although Staph aureus from pleural fluid and Klebsiella form sputum were notable his attributed to high prevalence of viral causes of pneumonia among studied patients and confirms the importance of Staph aureus and Klebsiella. [ABSTRACT FROM AUTHOR]