Objectives. This study was carried out to delineate the patients’ characteristics and the imaging findings and their relation to some biochemical markers of 31 critically ill patients with MIS-C. Design. A retrospective cross-sectional study including all critically ill MIS-C patients admitted to the PICU from June 23rd to July 22nd, 2020. Results. Eighteen males and 13 females, with a median age of 9 years (interquartile range 6-11) presented mainly with fever (100%) and hypotension (100%). Abnormalities in the chest computed tomography were detected in 22 cases (71%). Consolidation and architecture distortion were detected in 58.1% of patients; bilateral lesions and lower lobe infiltrates, each, was evident in 64.5% of patients, while the peripheral distribution of lesions was seen in 71% of the cases. Pleural thickening and effusion, each, was found in 51.6% of the patients. In this small case series, the presence of high ferritin was significantly associated with the bilaterality of the lesions. Elevated C-reactive protein was associated with the peripheral distribution of the lesions. Thrombocytopenia and hypoalbuminemia were significantly correlated with the CT disease stage and CT severity score respectively. Conclusions. Although a few children in this group of MIS-C patients presented with respiratory manifestations, yet, most of them demonstrated significant radiological lung involvement, which necessitates a longer-term follow-up.

Background Acute respiratory failure develops in infants with bronchiolitis and Community acquired pneumonia (CAP) because of hypoxemia, due to mismatch between ventilation and perfusion. Nasal continuous airway pressure (nCPAP) and high-flow nasal cannula (HFNC) improve the work of breathing and oxygenation .High flow nasal cannula (HFNC), also called heated humidified high flow nasal cannula (HHHFNC), is a new non-invasive ventilation therapy that seems to be well tolerated in infants with hypoxemic respiratory failure. Aim To compare the effectiveness and the outcome of Heated Humidified High Flow Nasal Cannula (HFNC) versus Nasal Continuous Positive Airway Pressure (NCPAP), as a primary mode of respiratory support, in patients with respiratory failure due to pneumonia or bronchiolitis at PICU regarding demographic data, length of admission, increasing of positive pressure and need of intubation. Patients and Methods observational study was conducted on 40 patients with acute respiratory failure due to either bronchiolitis or community acquired pneumonia (CAP), admitted to Paediatric ICU, Children Hospital, Ain Shams University, in the time period between February 2018 to July 2019. The patients, aged between 1 month to 5 years, were subjected to detailed clinical history and examination.All patients received continuous monitoring of electrocardiograph ,pulse oximetry and respiratory rate .The patients were treated either with (HFNC) Humidified high flow nasal cannula or continuous positive airway pressure (CPAP). Studied groups were compared regarding demographic data, increasing in respiratory support ,need of intubation, fate and length of admission during PICU stay. Results HFNC was as efficient as CPAP in lowering RR(respiratory rate) and HR(heart rate) in infants with bronchiolitis and community acquired pneumonia. Thus HFNC group was as significant as NCPAP group in treatment of bronchiolitis and CAP regarding length of admission ,increasing of positive pressure and need of iintubation in PICU . Conclusion This study concluded that HFNC is as efficient as nCPAP for initial respiratory support in young infants, hospitalized in a PICU for moderate to severe acute respiratory failure.

Background Obstructive sleep apnea (OSA) and asthma are common inflammatory respiratory diseases of childhood. The similarities between and the parallel rise of both diseases raise the question of whether OSA is indeed more common in asthmatic children. Objectives The present study is cross section study conducted on fifty children with bronchial asthma the aim of study was to evaluate the frequency of obstructive sleep apnea in asthmatic patients, and impact of OSA on asthma control. Patients and Methods The present work is a Cross-sectional study conducted on fifty Children (27 females and 23 males) aging 5 to 18 years diagnosed as bronchial asthma following up in pulmonology clinic or admitted to pulmonology department in Pediatric Hospital- Ain Shams University. Patients were excluded from presence of any other chronic chest diseases, any congenital malformation in upper respiratory, any genetic disease or inborn error of metabolism, morbid obesity and other medical co morbidities that might interfere with sleep quality. All patients were subjected to full history taking, meticulous general and local chest examination, pulmonary function tests and exposed questionnaire: Asthma control questionnaire (ACQ) and OSA-18 quality of life questionnaire. Children were positive OSA with OSA-18 quality of life questionnaire referred to sleep study. Results 54 % of cases were females and 46% were males. There mean age=10.1, mean of OSA score =75.6. 20% diagnosed OSA according to questionnaire. OSA score increased in patients with history of PICU and hospital admission. OSA score was highly correlated with severity and degree of control of bronchial asthma. 10% of children were positive OSA with OSA-18 quality of life questionnaire suggestive have obstructive sleep apnea according to polysomnogram. Conclusion OSA has a direct and significant impact on asthma severity and control. Asthma and OSA are common disorders, and the concomitant presence of both conditions can be detrimental. Due to the bidirectional association of both conditions, we as clinicians should be aware of it.