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ObjectivesTo assess the frequency of primary multiple organ failure and the role of sepsis as a causative agent in critically ill pediatric patients; and calculate and evaluate the accuracy of the Pediatric Risk of Mortality III (PRISM III) and Pediatric Logistic Organ Dysfunction (PELOD) scores to predict the outcomes of critically ill children.MethodsRetrospective study, which evaluated data from patients admitted from January to December 2011 in the pediatric intensive care unit of the Children's Hospital of the University of Cairo.ResultsOut of 237 patients in the study, 72% had multiple organ dysfunctions, and 45% had sepsis with multiple organ dysfunctions. The mortality rate in patients with multiple organ dysfunction was 73%. Independent risk factors for death were mechanical ventilation and neurological failure [OR: 36 and 3.3, respectively]. The PRISM III score was more accurate than the PELOD score in predicting death, with a Hosmer-Lemeshow X2 (Chi-square value) of 7.3 (df = 8, p = 0.5). The area under the curve was 0.723 for PRISM III and 0.78 for PELOD.ConclusionA multiple organ dysfunctions was associated with high mortality. Sepsis was the major cause. Pneumonia, diarrhea and central nervous system infections were the major causes of sepsis. PRISM III had a better calibration than the PELOD for prognosis of the patients, despite the high frequency of the multiple organ dysfunction syndrome.

The deformation and orientation dependence of the real part of the interaction potential is studied for two heavy deformed nuclei using the Hamiltonian energy density approach derived from the well-known Skyrme NN interaction with two parameter sets SIII and SkM * . We studied the real part of the heavy ion (HI) potential for 238 U+ 238 U pair considering quadrupole and hexadecapole deformations in both nuclei and taking into consideration all the possible orientations, coplanar and noncoplanar, of the two interacting nuclei. We found strong orientation dependence for the physically significant region of the HI potential. The orientation dependence increases with adding the hexadecapole deformation. The azimuthal angle dependence is found to be strong for some orientations. This shows that taking the two system axes in one plane produces a large error in calculating the physical quantities.

a b s t r a c tIntroduction: Critical illness may trigger an acute phase response which is associated with several metabolic derangements. These include hypo-and hypercalcemia, hypo-and hyperphosphatemia, hypo-and hypomagnesaemia. Method: Therefore, we conducted a prospective, non-interventional study in 10 beds intensive care unit of the at Pediatric Intensive Care Unit, Cairo University Pediatric Hospital. During 6 months period to investigate the incidence & risk factors of magnesium, phosphorus & calcium deficiency in patients admitted to the intensive care unit (ICU) on admission and followed the course of deficiency at day 3 & ten during stay. Results: Out of 70 patients, the frequency of Calcium deficiency was (34%), magnesium deficiency (31%), phosphorus deficiency (47%) on admission. Calcium and magnesium deficiency frequency changed gradually after 72 h & 10 days; in response to intravenous supplementation for deficient patients. While phosphorus level declined during follow up. Respiratory failure (87%) was the most common organ failure followed by neurological failure. Patients with hypocalcaemia on admission had a higher PELOD score (P = 0.10), coagulopathy (P = 0.044), sepsis diagnoses (P = 0.007), metabolic acidosis (P = <0.001), hyperglycemia (P = 0.006) hypomagnesaemia (P = <0.001), hypoalbuminemia (P = 0.004). While hypomagnesaemia risk factors were coagulopathy (P = 0.039), inborn error of metabolism (P = 0.039), sepsis diagnoses (P = 0.045), hypocalcaemia (P = <0.001), hypophosphatemia (P = 0.004), hypoalbuminemia (P = 0.042). Hypophosphatemia was associated with hypokalemia (P = 0.003) & hypomagnesaemia (P = 0.004). Regression analysis revealed metabolic acidosis & hyperglycemia were associated with calcium deficiency, while inborn error of metabolism and hypophosphatemia with magnesium deficiency. Risk factors for Hypophosphatemia are hypokalemia & hypomagnesaemia. Conclusion: Hypophosphatemia was the most frequent and under estimated electrolyte disturbance in our study. Ó 2017 The Egyptian Pediatric Association. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). IntroductionDisorders of magnesium, calcium and phosphorus are common in patients admitted to intensive care units. 1 Routine monitoring and replacement of these ions are still underemphasized. 2 Most studies focus, on individual electrolytes without taking the interrelationship between specific deficits into account. Hypocalcaemia is a common derangement in both medical and surgical patients requiring intensive care. The reported prevalence varies significantly between studies due to differences in the population studied and the cutoff values used, with published figures ranging from 15% to 88%. 3 Magnesium is the fourth most common cation in the body and second most common intracellular cation after potassium, yet its deficiency is frequently overlooked. Various studies have reported the incidence of hypomagnesemia up to 65% in ...

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