الفهرس 
COMMUNITY ACQUIRED PNEUMONIAOnly 14 pages are availabe for public view
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Abstract
Community-acquired pneumonia (CAP) is the most severe form of an acute respiratory infection, accounting for 80% of all deaths from acute respiratory infections and 20% of all deaths in children.
Inadequate nutrition and acute lower respiratory infection (ALRI) are overlapping and interrelated health problems affecting children in developing countries.
Several studies have suggested that zinc supplementation prevents about one-quarter of episodes of acute lower respiratory tract infection (ALRI), which may translate into a modest reduction in (ALRI) mortality in children.
Iron deficiency anemia in children occurs most frequently between the age of 6 months and 3 years, the same period of age when repeated respiratory infections occur, some studies have suggested that improving the nutritional status in children by preventing low hemoglobin might influence the outcome of children with ALRTI.
The present study was designed to assess the relation between serum zinc and iron profile to community acquired pneumonia as regard; occurrence, short term morbidity and mortality in children.
The study was conducted at outpatient clinic and emergency room, children’s hospital, Ain Shams University.
Children were selected from the outpatient clinic and ER to participate in this study. Sixty seven patients were selected: 31 with community acquired pneumonia and 36 apparently healthy (control group).
A total 31 patients who presented to the emergency department and outpatient clinic diagnosed with community acquired pneumonia were admitted to the pediatric ward (15 male and 16 female) with age range (2-54months), weight centile range (25-97), height centile range (25-95), 5patients were below average in socioeconomic class, 25 were average and one above average.
In our study, as regard occurrence of CAP; there were no significant differences in age, sex, type of feeding, exposure to smoking, order of birth, residence, mother employment, father employment and education between patient group (31patients) and control group (36 apparently healthy).
Also, there was no association between these parameters and severity or outcome of community acquired pneumonia.
Except weight and height which were significantly decreased in patient than control group and lack of maternal education which was significantly prevalent among patient than control group.
Our study showed that 61.3% of the pneumonic children had been exposed to passive smoking.
Regarding clinical examination 22.6% of patients were cyanosed on admission.
All patients had dyspnea (9.7% grade I, 45.2% grade II, 32.3% grade III and 12.9% grade IV).
Regarding chest x-ray among patient group 54.8% showing patchy pneumonia, 19.4% showing lobar, 25.8% showing interstitial and 4cases showing complications; 3.2% showing hydropneumothorax, 3.2% showing pyopneumothorax, 3.2% showing pneumatocele and 3.2% showing pleural effusion.
Our study showed that there is no association between clinical data, radiological data or laboratory data and the severity of the community acquired pneumonia, except for zinc level which was lower in pneumonic group than healthy one.
In our study all complications were related to the severity of the disease which included Hydropneumothorax 25% of severe cases, Pyopneumothorax 25% of severe cases, Pneumatocele 25% of severe cases, and Pleural effusion also 25% of severe cases.
As regard hemoglobin level in our study showing that 64.5% of cases had HB level < 11gm/dl
In our study, there was no association between serum iron level and community acquired pneumonia.
We exclude serum ferritin from our study despite it is considered to be the most specific for identifying iron deficiency anemia as it is an acute-phase reactant and its levels may be elevated under certain conditions such as infection and inflammation.
In our study, serum zinc level was significantly lower in patient group than control group which mean that decreasing serum zinc level is associated with community acquired pneumonia.
And so, from our study it can be concluded that, adequate serum zinc and TIBC level may be protective against infection with community acquired pneumonia in children aged from 2 months to 5 years old but there is no relation between adequate serum iron level and community acquired pneumonia affecting the same age group.