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Background: Community acquired pneumonia (CAP) is a serious illness with significant costs to the society. Clinical decisions based on evidence based medicine (EBM) improve the outcome of management in an approach for appropriate treatment and prompt referral for care. Objective: Observing cases managed on EBM and comparing the outcomes with cases managed without EBM in a community hospital, providing approach for the clinician in evaluating and treating children. Methodology: A descriptive study on 56 children divided into 28 children EBM group and 28 children Non- EBM group, from June 2015 to May 2016 at Abo El Resh hospital, reviewing demographic, clinical data, observing therapies and outcomes. Results: EBM group showed statistically significant short days (6.8+2.1 days) for antimicrobial therapy than NEBM group (P= 0.001). Outcomes of Non-EBM group who needed admission to ICU for 4.2+ 2.6 days, while no children of EBM group need admission (P= 0.001). Conclusion: Effective case management is strategy to reduce pneumonia- related morbidity. Guidelines based on sound evidence are available but used variably. Recommendation: Unifying clinical practice and scientific evidence could rationalize the use of health resources, improving health care quality

Background: Mental disorders and suicide can result from the interaction of mental disorders and cither factors were the second leading cause of death among children aged (12-17) ys in 2010 at United States. Objective; To study the prevalence of main psychiatric health problems in Egyptian children and adolescents for early intervention to help raising the new generations in an appropriate way assuring building up healthy society. Methodology: Fust phase; a meta- analysis study data derived from Egyptian psychiatric informatics in children (EPIC), which were conducted from 1980 to 2005, including 57.802 subjects, studying the trend of main psychiatric health problems among children and adolescent at different govemorates. Second Phase; Attention deficit hyperactivity disorders (ADHD) data are added to the data of EPIC regarding ADHD to study the prevalence of disease at different govemorates. Results; The first phase includes 57.802 subjects from different govemorates in Egypt. Among this group there are 38.731 subjects (67.0%), without psychiatric health problems and 19.071 subjects (33.0%), with psychiatric health problems, the trend of psychiatric health problems among children and adolescence at different periods. In general there was increase in psychiatric health problems prevalence among this age group and this difference statistically highly significant (P=0.0 001). Also, the prevalence of main psychiatric health problems increase among those who lose their parent (81.5%) and (43.6%) on the other group and this difference was statistically highly saignificant (P=0.0 001). Second phase, prevalence of ADHD at different govemorates showed non- significant difference between all studied govemorates (P=0.999). Conclusion: About 33% of the studied group had main psychiatric health problems that showed increase by the time. A plan must be designed to overcome this problem which may lead to high morbidity and mortality among this important age group.

Background: Meningitis is defined as an inflammation of the membranes and cerebrospinal fluid that cover completely and bathes the brain and spinal cord, If is a'senous disease arid may result in permanent complications if not diagnosed and treated early, the initial treatment: approach to the patient with suspected acute bacterial meningitis depends on early recognition of the meningitis syndrome, rapid diagnostic evaluation,'and emergent antimicrobial and :adjunctive therapy. Objectives: To compare the short course antimicrobial treatment of acute bacterial meningitis versus long course; wheather the organism identified of not in Abbassia Fever Hospital. Methodology: Prospective.study; in Abbassia Fever Hospital from June 2013 till December 2014. Results: N. meninigitidis were only three cases (three from 84cases); mean 14.33 and SD ± 6.03. All these cases received R, V as line of treatment while other organisms as enterococci most of them received the same line (i. e. R, V) 45.8% and only two cases (2.8%) received R, U, and E. The patients whom fully recovered most of them used the treatment plan R, V {38, 63.3%) followed by R, V, E (9, 15%) and to a lesser extent R, U (7,11.7%). There was statistical highly significance between the treatment plan chose and the outcomes of the patients and the p value was 0.010. R, V is the most common.treatment plan used (44 cases) followed by R, V, E (17 cases) and the least common plan used was R, U, E (2 cases). The absence of hydrocephalus or shunt operation was the most prevalent (81 cases) where the mean was 11.63 and SD ± 3.93. Conclusions: The most commonly used treatment plan was ceftriaxone and vancomycin. Only 10 patients received short duration of therapy. Recommendations: Further studies should be conducted on more national level to discuss the importance of short course therapy and which cases can receive it

Aim: Was to examine the time effects on these leading causes of death from non-Communicable diseases in Egypt. Methodology: It is a cross, sectional historical National Egyptians secondary data [CAPMAS. Egypt] study along the years 2008 to 2014. Results: Diseases of the circulatory system (48.1%, 2014) and GIT system, 11.1%, 2014 by far were the leading causes of death in Egypt. This study shows an escalation from 36.5% in 2008 up to 48.1% in 2014 in Egypt, with a notable increase in females more than males. 1.0 to 0.9 respectively. Second to cardiovascular diseases were GIT system leading causes of death in Egypt, raising from 9.3% in 2008 up to 11.1% in 2014 more predominantly in males (from 10.7% in 2008 to 12.3 in 2014) than females (from 7.5 in 2008 to 9.5 in 2014). Respiratory system diseases leading to death increased from 5.3% at 2008 up to 8% at 2014 in Egypt. The fourth leading cause in Egypt is cancers (about 6.7% at 2014). Moreover, the study provides information about the relative distribution of deaths caused by car accidents in Egypt from 2011 to 2015 per 100000 populations.Conclusion: Deaths due to cardiovascular diseases [CVDs] make up around one-half of the population mortality. GIT diseases come second in rank, followed by respiratory system diseases and cancers.

Background: Cardiovascular disease remains the leading cause of mortality, disability, and morbidity in technologically developed countries. Although cardiovascular disease death rates are declining but it is still number one cause of death in the United States, and risk factors control remains a challenge for many, risk factors for cardiovascular diseases include obesity, dyslipidemia, smoking, atherosclerosis and inactive lifestyle. Methodology: Data from project of Monitoring Cardiovascular Diseases Network, MCDN, Egypt. Data collected from four participating medical centers; Assiut health district, Ain-Shams University Hospital, Suez Canal University Hospital, and El-Mahala Heart Center from October 1998 to February 2000. Trying to connect other centers but they are not cooperative. Data were analyzed with SPSS version 12, one way, two ways and multiple analyses was done. Results: Data analysis, study included the relation between sex difference and history of angina. The risk difference between male and female about 6.1%, (41) of male had history of angina and only 3.5% (31) of female had history of angina (p=0.01). Regarding the relation between smoking and history of angina; about 10% (16) with history of angina and they are smoker, 9.6% (8) occasionally smoker and had history of angina and only, 3.5% (45) of non smoker had history of angina (p=0.0001). Also, about 36.8% (7) had history of angina and they are hyperlipidamic but only 4%(62) of non hyperlipidamic with history of angina (p=0.0001). About 30.5% (80) of the diabetic had chronic ischemic heart diseases and only 19.2% (251) of non- diabetic with chronic ischemic heart diseases (p=0.0001). Multiple regression analysis was performed studying the effect of different variables as sex, age, smoking, history of angina, myocardial infarction, hypertension, cardiac ischemia, hypertension, history of diabetes, hyperlipidamia, weight in kilogram and body mass index on chronic ischemic heart diseases as dependent variable. The analysis shows that the most effective variables on chronic ischemic heart diseases are age (beta=0.102, p=0.005), previous history of angina (beta=0.229, p=0.0001), previous myocardial infarction (Beta=0.531, p=0.0001), cardiac ischemia (beta=0.277, p=0.0001), hypertension (beta=0.139, p=0.0001), and weight in kilogram (beta=0.072, p=0.024). Conclusion and recommendation: it is shown from the study that the most effective risk factors are modifiable. So recommendation for more care about smoking cessation program and exercise motivation early started in life to control weight and hyperlipidemia.