AIM: The researchers conducted the study to assess intensive care units (ICUs) preparedness in Cairo University Hospitals to deal efficiently and effectively with COVID-19 upcoming waves. METHODS: An exploratory cross-sectional study was conducted at Cairo University Intensive Care Units 6 pediatric ICUs, and 2 adult ICUs in the period from the end of February to the first week of March, 2020; almost 2 weeks after the appearance of the first case of COVID-19 in Egypt by hand-delivered questionnaire method with one of the ICU staff members who were available and have time to take part in the study. WHO checklist for hospital readiness was used; this checklist based on current knowledge and available evidence on the COVID-19 pandemic for WHO’s Regional Office for the Eastern Mediterranean Region. The WHO has developed the checklist to help hospital managers prepare for COVID-19 patient management by optimizing each hospital’s capacities. The list composed of 10 key components: (1) Leadership and coordination; (2) operational support, logistics and supply management; (3) information; (4) communication; (5) human resources; (6) continuity of essential services and surge capacity; (7) rapid identification; (8) diagnosis; (9) isolation and case management; and (10) infection prevention and control. RESULTS: The overall preparedness in both pediatric and adult ICUs was 54%. Overall, adult ICUs were more prepared than pediatric ICUs, especially in communication; continuity of essential services and surge capacity; rapid identification; diagnosis; isolation; and case management. Both of them were comparable regarding operational support, logistics and supply management; human resources; and infection prevention and control, while information component was lower in both types but reached critical values 10% in adult ones. CONCLUSION: The current study demonstrated the intermediate readiness of ICUs at initial outbreak; further assessment during different phases of pandemic is required. Continues education of HCWs and active communication should be established.

IntroductionMechanical ventilation is one of the indispensable tools in pediatric intensive care units. Few studies addressed the epidemiology of pediatric patients on mechanical ventilation and the frequently used modes of ventilation. This is the first study to describe the practice of mechanical ventilation (MV) in Egyptian pediatric intensive care units (PICUs).MethodsThis prospective observational study was conducted from January 2014 to December 2014 in two pediatric intensive care units at Cairo University Pediatric Hospital. The study included all children who were intubated and mechanically ventilated for more than 12 hours of admission. Pre-coded data was entered into the SPSS version 21 for data analysis. Comparison between groups was performed using Mann Whitney test for quantitative variables and Chi square with Fisher’s exact test for qualitative ones. Multivariate logistic regression model was conducted to explore the significant predictors for PICU mortality.ResultsIn total, 893 children were admitted and 293 were mechanically ventilated. The incidence of utilizing MV in children was 32.8%. Neurologic causes were the most common reasons for initiation of MV, with 114 (38.9%) cases. The most commonly preferred mode for initiation of MV is SIMV with PS. Complication occurred in 117 (39.9%) of the cases. The most commonly preferred method of weaning was PS with CPAP in 115/154 (74.7%) cases. Mortality occurred in 134/293 (45.7%) of patients. Duration of mechanical ventilation was significantly longer with neuromuscular diseases, and with the occurrence of complications (p<0.001). There was a significant relationship between mortality and higher PRISM III score, cardiovascular cases, sepsis, multiple organ dysfunction syndrome (MODS), ventilator-associated pneumonia (VAP), and with barotrauma.ConclusionsIn our practice, MV is used oftentimes with almost a third of admissions requiring intubation for different reasons. Most children are ventilated due to neurologic causes. This study paves the way for improving our knowledge of MV with avoiding the fatal complications.

IntroductionMacrophage migration inhibitory factor (MIF) is a proinflammatory cytokine that plays an important role in the pathogenesis of asthma. Polymorphisms associated with inflammatory diseases exist in the promoter region of MIF, which alter its expression. We aimed to study the association of MIF promoter polymorphism –173G/C with childhood asthma.Material and methodsIn this case-control study, we recruited 60 pediatric patients with bronchial asthma and 90 age- and sex-matched healthy controls. MIF-173G/C was genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).ResultsGenotype distribution between cases and healthy controls was statistically evaluated. Our results revealed that the frequency of the MIF-173C allele was significantly higher in children with asthma than in the control group (p = 0.002, odds ratio [OR] = 3.61, 95% confidence interval [CI] = 1.63-7.97). The frequency of the MIF-173CC genotype was higher in the asthmatic children than in the controls (p = 0.028, OR = 6.24, 95% CI = 1.24-31.29). Comparing carriage of the MIF-173C allele in pediatric patients with asthma with that observed in healthy controls (GC + CC vs. GG) revealed a positive association with the disease (p = 0.019, OR = 3.12, 95% CI = 1.22-7.99).ConclusionsThese results suggest that MIF-173G/C polymorphism confers an increased risk of susceptibility to the development of childhood asthma in an Egyptian population.

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