Turning Ratios Into Prognosis: Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Powerful Predictors of ARDS in Pediatric Burn Patients: A Prospective Evaluation

Inclusion Criteria: * Age 1-12 years. * Patients presenting within 24 hours of burn injury. * Patients presenting with severe burns 20-40% of total body surface area (TBSA). * Thermal burns or scalds. * Both sexes. Exclusion Criteria: * Patient refusal to participate in the trial. * Age \<1 \& \>12 years. * Delayed admission \>24h post-injury. * Patients presenting with burns \<20% or \>40% of TBSA. * Non-thermal burns. * Associated medical comorbidities: Chronic liver or kidney diseases, anemia. * Preexisting chronic lung disease (e.g., cystic fibrosis, severe bronchopulmonary dysplasia). * Inflammatory conditions (e.g., inflammatory bowel disease). * Immunocompromised individuals, autoimmune diseases, those undergoing treatment with immunosuppressants, corticosteroids, cytotoxic chemotherapy. * Known malignancies, hematologic malignancy or conditions altering WBC/platelets significantly. * Previous malnutrition. * Immunosuppressive therapy prior to admission (e.g., chronic steroids).