الفهرس 
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Abstract
The present case control longitudinal study was done to evaluate the effect of adjuvant vitamin A therapy on recovery from pneumonia in hospitalized infants and children under five years. It was conducted on 40 children with pneumonia recruited from inpatient department of the Pediatric Hospital; Ain Shams University. They were 22 (55%) males and 18 (45%) females with male to female ratio of 1.1:1, their ages ranged between 2 and 5years. The studied patients were randomly divided into 2 groups: Group I (vitamin A supplemented) and group 2 (nonvitamin A supplemented), each group included 20 patients.
All patients were subjected to detailed history taking, full clinical examination, and investigations including: Chest x-ray, complete blood count, CRP, and serum vitamin A on admission and 5 dayes later. All patients received empiric antibiotic therapy for pneumonia in the form of: parenteral fixed Penicillin combination (amoxicillin + flucloxacillin) 25-50 mg /kg/day plus cefotaxime 50-100 mg/kg/day. Group I (vitamin A supplemented) received adjuvant vitamin A supplementation in the form of vitamin A palmetate (60 mg vitamin A elemental) in a dose of 200000 iu once daily for 2 days. All patients were followed-up daily till discharge. The present study showed that most studied patients (77.5%) live in urban areas and most studied patients (55.5%) had below average social class. Most of studied patients (70%) were absolutely breast-fed during the first 6 months and 27% of studied patients had history of previous pneumonia. Cough was the most frequent symptom (100%) followed by difficult breathing (92 5%), fever (80%) and flue like symptoms (57.5%).The main auscultatory findings were decreased breath sounds in 70% of patients(50% bilateral and 20% unilateral), bronchial breathing in( 30%).
Opacities were found in 85% of studied patients (30% lobar opacities, 55 % patchy opacities and 12.5% peripheral). Exaggerated bronchovascular markings was found in 27.6%, peripheral hyperinflation in 25%, Pleural effusion in 5%.
The mean hemoglobin level of the studied patients was (11.59+1.07 gm/ dl) and 27.5% of patients were anemic with Hb level below 11 gm/ dl. The mean TLC was 10.320 ± 1.972 X 10³/ mm³; leucocytosis was found in (44.6%) of the studied patients, relative lymphocytosis in (28.7 %) and normal leucocytic count in (55.4%). Serum vitamin A was between 30 – 57 ug/ dl with a mean level of 44.025 ± 7.774 ug/ dl.
Regarding the rate of improvement of the clinical manifestations of pneumonia during follow up of the patients, the vitamin A supplemented group showed a statistically significant shorter duration of days for improvement of chest in drawing in comparison with non vitamin A supplemented group (P < 0.05). However, there is no statistical significant difference between both groups regarding the mean days for improvement of tachypnea or fever.