Background: Acute Lower Respiratory Tract Infections (ALRTIs) remain a leading cause of morbidity and mortality in children under five years, particularly in low- and middle-income countries, where socioeconomic and environmental factors contribute to disease burden. Aim: To determine the distribution pattern of ALRTIs and associated risk factors among children under five years admitted to Children Hospital, Kirkuk City. Patients and Methods: This descriptive cross-sectional, hospital-based study was conducted in Kirkuk City from 1 November 2024 to 30 May 2025. A total of 241 children aged <5 years admitted with ALRTI (bronchitis, bronchiolitis or pneumonia) were consecutively enrolled. Data were collected using a structured questionnaire covering demographic characteristics, feeding practices, household smoking exposure, vaccination status, past medical history and clinical features. Data were analyzed using SPSS v26; categorical variables were presented as n (%) and associations were tested using Chi-square/Fisher’s exact test, with p<0.05 considered significant. Results: Infants aged 0-12 months represented 165 (68.46%) of cases. Males were more frequently affected than females (139 [57.68%] vs. 102 [42.32%]) and urban residence predominated (179 [74.27%]).  Nearly  half  of  mothers  were  illiterate (111 [46.06%]).   Bottle   feeding   was   the   most   common   feeding   type (78 [32.36%]), while exclusive breastfeeding was low (35 [14.52%]). Household smoking exposure was reported in 127 (52.70%) children. The most common presenting features were productive cough (231 [95.85%]), wheezing (219 [90.87%]) and fever (201 [83.40%]). Most children presented after 4-7 days of illness (114 [47.30%]) and required short hospital stays of 1-3 days across age groups. Bottle-fed children had the longest mean illness duration (8.71±5.42 days) compared with exclusively breastfed children (6.68±5.18 days) (p = 0.023). Conclusion: ALRTIs in Kirkuk predominantly affected infants, males and urban residents. Low maternal education, household smoking exposure and low exclusive breastfeeding rates were prominent among hospitalized cases. Breastfeeding was associated with shorter illness duration, supporting its protective role. Strengthening health education, promoting exclusive breastfeeding and enforcing smoke-free home practices are recommended to reduce ALRTI burden.

Background: Acute streptococcal tonsillitis is a common upper respiratory tract infection that may be complicated by peritonsillar abscess (PTA), a condition associated with increased morbidity and the need for urgent intervention. Early differentiation between uncomplicated tonsillitis and PTA remains clinically challenging and reliance on imaging may be limited by availability, cost and radiation exposure. Therefore, readily available blood-based biomarkers may assist in early risk stratification. Objective: This study aimed to evaluate mean platelet volume (MPV), systemic immune-inflammation index (SII) and plateletcrit (PCT) as potential biomarkers for distinguishing uncomplicated streptococcal acute tonsillitis from tonsillitis complicated by peritonsillar abscess. Methods: This hospital-based case-control study was conducted at Imam Ali Hospital and Al-Kindy Teaching Hospital, Baghdad, Iraq, between February and December 2025. A total of 120 participants were enrolled, including 60 patients with streptococcal acute tonsillitis (with or without PTA) and 60 age- and sex-matched healthy controls. Complete blood count parameters were obtained at presentation. MPV was directly measured, while SII and PCT were calculated using standard formulas. Statistical comparisons, receiver operating characteristic (ROC) curve analysis and multivariate logistic regression were performed to assess diagnostic performance and predictive value. Results: MPV was significantly lower, while SII and PCT were significantly higher in cases compared with controls (p <0.01 for all). Among patients, those with PTA demonstrated significantly lower MPV and higher SII and PCT than those with uncomplicated tonsillitis. ROC analysis showed moderate diagnostic accuracy for MPV (AUC = 0.66), SII (AUC = 0.69) and PCT (AUC = 0.67) in predicting PTA. Multivariate analysis identified low MPV, elevated SII and elevated PCT as independent predictors of PTA. Conclusion: MPV, SII and PCT are inexpensive, readily available biomarkers that reflect inflammatory burden and platelet dynamics in streptococcal tonsillitis. Their combined assessment may aid early identification of patients at increased risk of peritonsillar abscess and support timely clinical decision-making, potentially reducing unnecessary imaging and delays in management.

Introduction: Testicular torsion is a surgical emergency, a twisting of the spermatic cord leading to acute testicular ischemia, associated with a very high risk of necrosis if treatment is not initiated within 6 hours. The incidence is 1 in 4,000 boys. The clinical presentation is dominated by sudden scrotal pain. Early treatment is essential. We report the epidemiological and therapeutic aspects of spermatic cord torsion in the pediatric surgery department of the Libreville Mother and Child University Hospital from January 2019 to October 2022. Materials and Methods: This was a retrospective descriptive study, conducted from January 2019 to October 2022, which systematically included all children diagnosed with spermatic cord torsion at the Libreville Mother and Child University Hospital during the study period. Results We collected 13 cases of spermatic cord torsion out of 2950 hospitalizations, representing a frequency of 0.4% of hospitalizations in the department. The mean age was 11.6 years (±4.2). All children presented with testicular pain on clinical examination. Patient management was exclusively surgical. Postoperative outcomes were favorable for 12 of the 13 patients. Conclusion: Spermatic cord torsion is infrequent but nonetheless significant. Its prognosis was improved thanks to rapid intervention in our setting, thus limiting complications.

Introduction: Urethral mucosal prolapse is the circumferential eversion of the urethral mucosal epithelium through the urethral meatus. The objective of this study was to report the epidemiological, diagnostic and therapeutic aspects of urethral prolapse in our setting. Materials and Methods: We present here the experience of the pediatric surgery department at the Jeanne Ebori Foundation Mother and Child University Hospital. We conducted a retrospective descriptive study of 7 patients treated for urethral prolapse in our department between 2019 and 2023. Results: The mean age of the patients, all female, was 4.6±2.9 years, with a range of 2 to 11 years. The main reason for consultation was genital bleeding. All patients underwent surgical treatment. Postoperative recovery was uneventful in all cases. Conclusion: Urethral prolapse remains a rare condition in prepubertal girls of black race. Although benign, its initial, often hemorrhagic form can pose a medico-legal problem due to suspicion of rape or sexual assault. Diagnosis is clinical. The outcome of surgical treatment is satisfactying.

Background: Otitis media (OM) is a prevalent ear infection that contributes significantly to outpatient consultations, particularly in developing regions. Accurate identification of the causative organisms and their antibiotic susceptibility patterns is essential to guide effective treatment and prevent chronic complications. Objective: This study aimed to determine the bacterial etiology of OM, evaluate antibiotic resistance patterns, and analyze the associated clinical and biochemical features among patients in Kirkuk city, Iraq. Methods: A cross-sectional study was conducted from February to November 2024 in outpatient clinics of the Kirkuk Health Directorate. Ninety patients diagnosed clinically with OM were included. Ear discharge samples were collected and subjected to culture, biochemical identification, and antibiotic sensitivity testing using the Kirby-Bauer disc diffusion method. Blood samples were analyzed for white blood cell count, CRP, ESR, and other hematological parameters. Results: Clinical manifestations were dominated by ear pain (75.6%), ear discharge (57.8%), and hearing loss (48.9%). Microbiological analysis revealed Streptococcus pneumoniae (27.78%) and Pseudomonas aeruginosa (22.22%) as the most common isolates, followed by Klebsiella pneumoniae, Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, and Staphylococcus epidermidis. Antibiotic susceptibility testing showed S. pneumoniae had the highest sensitivity to ceftriaxone (26.67%), levofloxacin (25.56%), and ciprofloxacin (24.44%). In contrast, P. aeruginosa exhibited resistance to several agents, responding best to gentamicin (16.67%). Biochemical markers supported a bacterial etiology, with elevated white blood cell counts (11.2 × 10³/μL), C-reactive protein (18.5 mg/L), and erythrocyte sedimentation rate (24.3 mm/hr). Neutrophil predominance (68.3%) reinforced the inflammatory nature of the disease. Acute OM was the most frequent presentation (46.7%), with unilateral involvement seen in 67.8% of cases. Conclusion: This study highlights the bacterial spectrum and resistance trends in OM patients, underscoring the importance of local microbiological surveillance and targeted antibiotic therapy to improve patient outcomes and guide antimicrobial stewardship efforts in Iraq