الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
Acute respiratory infections together with diarrheal diseases and
malnutrition are the leading causes of deaths each year amongyoung children in
the third world. ARl concoartent with diarrhea is highly prevailing and its
complications may lead to death.
The aim of this study was to determine the extent of occurr-ence of diarrhea
with ARI. to identify the most important bacteriological agents concomitant With
ARIalone and that with diarrhea. to find biological factors predisposing to ARI
and that concomitant with diarrhea. and to determine the effectiveness of simple
recommendedregimens for therapy.
The study was carried out in Benha University Hospital outpatient pediatric
clinic from October. 1987 to September. 1988.
The total numberof cases was 313. 190 complaining of upper ARl. and 123
complaining of lower Alo/I.both were either with or without diarrhea.
They were followed up after one week to find out the effectiveness of
treatment and fate of cases with or without diarrhea after adminstration of ORS.
Wefouriclthat :
1- About 44.73 % of. cases were below the first year. comparedto 12.78 % above 3
years.
2- 58.79 % of cases were male. The male/female sex ratio was 1.31 / 1 in cases
without diarrhea and 1.69 / 1 in cases with diarrhea.
3-- Concerning vaccination state. 65.18 % of cases were partially vaccinated and
29.39 % were completely vaccinated. Vaccination status did not show a
significant correlation as to the classification into upper or lower ARI.
while significant correlation was found between the vaccination status and
presence or absence of diarrhea.
4- As for the type of feeding. breast feeding alone or in addition to hOlJlEHiiets
accounted for 63.26 %. comparedto 5.43 % on artificial feeding and 31.31 %
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on regular solid foods. Type of feeding was not significantly related to any
of the study parameters.
5- 14.20 % of cases with upper ARIwere below the 5th percentile for weight.
while 23.60 % of cases with lower ARIwere below the 5 th percentile for
weight.
It was found that in cases with upper ARI.23.68 % of cases were within the
standard limits. for midarmcircumference, comparedto 19.51 % of cases with
lower ARI. The studied growth parmneters showedno significant relation
either to the anatomical classification of ARIor to the presence or absence
of diarrhea.
6- Clinical examination of cases showedthat:
A- ARI concomitant with diarrhea had oocurred in 33.55 % of cases and
diarrhea was more prevalent with upper ARI (40%).
B- Whenclassified according to the severity. it was found that the vast
majority of cases with upper ARIwere mild (98.95 %). while most cases
with lower ARIwere of moderate severity (51.22 %). The remaining cases
with lower ARIwere either severe (28.45 %) or mild (20.33%).
C- Dehydration score according to Fortin and Parent classification (1978)
showeda significant correlation to the presence of diarrhea with ARI.
D- Norelation was found between the anatomical classification of ARI and
presence of vomiting. However a significant correlation was found
between presence of vomiting and diarrhea;
7- Throat culature for cases with upper ARIshowedbacterial growth in 28.18
% of cases with both streptococci and staIilyllococci being the most
prevalent bacterial organisms (11.27 %each). The remainder of cases with
upper ARIwere probably of non-bacterial origin. In cases with lower ARI
bacterial organisms’ were significantly more prevalent than in upper ARI
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with 60.38 % showirlJ bacterial growth. The more prevalent organiSIIIB were
pneueococcr (27.12 %) followed by staphyllococci (18.18 %) then gr1llll
negative bacilli (11.33 %).
8- Follow up of cases after one week showedthat 77.23 % of cases completely
recovered. while 18.7 % showed no recovery. Norecovery was more prevalent
in lower ARIaccoJntirlJ for 30.58 %. compared to 10.98 % in upper ARI.
Diarrhea continued in 3.39 % cafIeSam was more prevalent in lower ARI.
Case fatality was present only in cases with lower ARIaccountirlJ for 1.65
% of lower ARI.
In conclusion we feel that the association of diarrhea conccmitant with ARI
is an important problem am deserves muchstUdyirg. With the introduction of
oral rehydration therapy am successful management of many cases with
gastroenteritis. parenteral dianilea is beccmirlJ a more important problem that
deserves muchattention. care must be taken to consider the’ presence of diarrhea
in cases with ARIam on the other hand careful examination of the respiratory
tract must not be neglected in cases with diarrhea as the association between
diarrhea am ARIwas found to be a camnonam important problem. worth attention
and consideration.