الفهرس 
Pediatric pneumoniaOnly 14 pages are availabe for public view
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Abstract
Emergency department and primary care clinicians commonly encounter pneumonia. Childhood pneumonia remains a significant cause of morbidity and mortality in developing countries, whereas mortality rates in the developed world have decreased secondary to new vaccines, antimicrobials, and advances in diagnostic and monitoring techniques
The incidence of pneumonia varies by age groups and between developing and developed countries. Worldwide, the overall annual incidence of pneumonia in children younger than 5 years is 150 million to 156 million cases, leading to an estimated 2 million deaths per year, most of which occur in developing countries. Forty percent of cases require hospitalization. In developed countries, the annual incidence of pneumonia is estimated at 33 per 10,000 in children younger than 5 years
TNF-α is a potential proinflammatory cytokine that plays a critical role in inflammatory and immune responses. TNF-α gene is located on chromosome 6, within the class III region of MHC. Several polymorphisms in the promoter region of TNF-α, such as −238A/G (rs361525), −308A/G (rs1800629), −857G/A (rs1799724), and −1031T/C (rs1799964), have been identified. These polymorphisms could alter the expression of TNF-α
The aim of this study was to Study the TNF alpha gene polymorphism as a risk factor for susceptibility to community-acquired pneumonia and the possible association of the gene polymorphism with indicators of CAP severity and its outcome.
This cross sectional study was conducted in Pediatrics department, Faculty of medicine, Menoufia University. Approval of the study protocol was obtained from the Ethical Committee at the Faculty of Medicine, Menoufia University. For every patient included in the study, an informed consent was obtained from parents before data collection.
I included two groups 45 Child aged 2 months to 5 years who were hospitalized for CAP and Control group, which included 45 age and sex-matched healthy child.
Exclusion criteria included age under 2 month or older than 5 years, Cough for > 14 days, antibiotic treatment in the last 48 hours, suspected tuberculosis, Severe malnutrition, Underlying chronic respiratory disease, persistent asthma and co- existence of another infection with CAP , Prior inpatient admission within 30 days of CAP onset, Congenital heart disease, neurologic disease, immune deficiency, immunosuppressive treatment.
Patients were assessed via history, physical examination, and investigations. Analysis of TNF alpha genotype was performed by DNA extraction followed by PCR and restriction fragment length polymorphism
The study revealed the following findings: Under the genotype model, the AG genotype frequency was significantly lower among patients compared with control, implying that the association was negative, that is, AG genotype decreases the risk of acquiring CAP.