Background: Despite the well-recognized effect of vitamin D in metabolism and homeostasis, there is now growing interest in its probable association with pneumonia. This study aims to supply vitamin D3 (Cholecalciferol) (100,000 IU) to pneumonic children to minimize the duration of illness and improve their outcome. Methods: A double-blinded, randomized, placebo-controlled trial was conducted in a Pediatric Cairo University affiliated hospital. An intervention arm (93 children) and a control arm (98 children), who had pneumonia with an insufficient or deficient level of vitamin D and whose parental permission was obtained, were enrolled in the trial. All children were treated with antibiotics according to WHO guidelines. Children were given a single injection of 1 mL of 100,000 IU of vitamin D3 or placebo. Clinical data were recorded every eight hours for all children. Outcomes were assessed 7 days after vitamin D injection. The primary outcome variable was the change in serum level of 25(OH)D, while the secondary outcomes were the medical state of the assigned cases (improvement or death) and duration between enrollment and hospital discharge for improved cases. Results: In the supplementation group, the percentage of patients who suffered either deficient (38.7%) or insufficient levels (61.3%) of 25 (OH)D at day one had significantly decreased in the seventh day to (11.8%) and (52.7%), respectively. Kaplan--Meier plots highlighted that the median time to recover of the placebo group was significantly longer than that of the supplementation group (Log Rank P value < .001). Conclusion: VDD was detected in pediatric critical care children. In pneumonic children with high VDD, it is illustrated that Vitamin D supplementation is accompanied by lowered mortality risk and pSOFA scores, reduced time to recover, and improved PaO 2 /FiO 2 . Trial registration: Trial Identifier number: NCT04244474. Registered on 27 January 2020- Retrospectively registered at ClinicalTrials.gov https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009JXO&selectaction=Edit&uid=U0004UO8&ts=152&cx=9cceq6

Summary Background Healthy work environment has a significant impact on patients, health care workers, and organizations. Objectives In a trial to set up strategies to control stressors and weaknesses in the work environment, the present study took place in pediatric intensive care units (PICUs) to explore the work environment and its impact on the organization commitment and caring efficacy of health care providers. Methods This study is a descriptive cross‐sectional study, conducted over a period of 9 months starting from October 2018. A self‐administered questionnaire, based on “The American Association of Critical Care Nurses Standards for Establishing and Sustaining Healthy Work Environments” and “Brewer & Look's organizational commitment scale and theory of self‐efficacy,” was given to 63 physicians and 73 nurses of PICUs at Cairo University Children Hospital in Egypt. Results Nurses were significantly more pleased with their work climate and more committed to their organization and had higher self‐efficacy than physicians. A significant direct correlation was detected between healthy environment perception and organizational commitment and between organization commitment and perceived caring efficacy. Conclusion and Recommendations The study findings might be incorporated into practice to create a positive PICUs' environment, enhance staff satisfaction, and efficiency to promote quality of care paying attention to the junior staff especially physicians. Additional studies are required to recognize the coping strategies that health care providers use and to test the effectiveness of professional development program along with healthy environment interventions.

Early identification of acute lung injury (ALI) in pediatric patients at risk of mortality is important for improving outcome.Assessment of soluble form of receptor for advanced glycation end products (sRAGE) as a valid biomarker for diagnosis of ALI among critically ill, pediatric patients in addition to correlating levels of sRAGE and different outcomes of those patients.A Hospital-based case-control study was conducted in pediatric intensive care units (PICUs) at Cairo University Hospital, along a period of 6 months. Total of 68 pediatric patients following inclusion criteria were classified into: patients with ALI; with both ALI and sepsis; with sepsis and control patients. They were prospectively followed and their laboratory and immunological workup (at days 1 and 9) was done to measure serum sRAGE levels and detect (sRAGE) genotypes.The age of the included children ranged from 8 to 84 months. Plasma level of sRAGE was significantly higher in plasma from patients with ALI regardless of associated sepsis. Plasma sRAGE levels were positively correlated with lung injury score. When assessing sRAGE genotypes, TA and TT genotypes were significant in most of the ALI with and without sepsis patients.Monitoring levels of sRAGE and genotypes can significantly affect the survival of ALI children.

Background: The study aimed to evaluate the direct effects of packed red blood cells (PRBCs) transfusions on neonatal blood lead levels (BLL) among the neonates admitted to Cairo University Pediatric Hospital (CUPH). Methods: It is a prospective cohort study including fifty-four premature neonates which took place over a period of 6 months starting from January 2018. Baseline and post-transfusion BLL were obtained. Neonatal BLL percent change was calculated to quantify the change levels before and after transfusion. Results: The neonatal BLL after transfusion was elevated one and half times more than that before transfusion. The median neonatal BLL% change was significantly higher in neonates diagnosed with extremely low birth weight and neonatal sepsis. BLL after transfusion showed a positive, moderate and significant relationship with neonatal weight, lead level in blood packs, gestational age, and blood creatinine level respectively. Multiple regression was used to explore the relationship between BLL% change and a number of predictors (e.g. neonatal age, weight, gestational age, number of transfusion times and lead level in blood packs). Conclusions: The study concluded that preterm neonates are at risk of lead exposure hazards due to receiving PRBCs transfusions. Higher lead levels in PRBCs denotes exposure of donors to higher lead levels and accordingly the recipient preterms.