A. Youssef, T. Essawy, Koot Mohammad, Shaimaa Abo-Youssef
Background In the case of critically sick patients, acute respiratory distress syndrome (ARDS) may be life-threatening and necessitates the need for ICU admission. Continuous monitoring is required for mechanical ventilation and recruitment movements as necessary. In this research, the goal is to investigate the use of ultrasonography in the evaluation of positive end exhalatory pressure-induced lung recruitment in ARDS patients. Patients and methods A total of 25 ARDS patients were included in this research, which was done in the hospital’s respiratory care unit. All of the patients were seen by a doctor, had a chest radiograph, and had laboratory tests. Mechanical ventilation was used in the care of all patients. Using positive end-expiratory pressure (PEEP) values of 5 and 15, we measured pressure–volume (PV) and lung ultrasound tracings. The PV curve approach was used to assess PEEP-induced lung recruitment. Between PEEP 5 and PEEP 15, there was an extremely strong positive connection between reaeration score and the change in lung volume (r=0.737, P=0.001). Results Between PEEP 5 and PEEP 15, there was a substantial (r=0.577, P=0.003) positive association between the reaeration score and the decrease in PaO2. There was a substantial negative association between reaeration score and mortality (rpb=-0.842, P=0.001), in which mortality reduces as the score increases. Conclusion For quantitative evaluation of PEEP-induced lung recruitment, bedside lung ultrasound is equal to the PV curve approach. In patients with ARDS, PEEP-induced lung recruitment may be assessed using ultrasonography.
{"title":"The role of ultrasound in assessment of positive end-expiratory pressure-induced lung recruitment in acute respiratory distress syndrome patients","authors":"A. Youssef, T. Essawy, Koot Mohammad, Shaimaa Abo-Youssef","doi":"10.4103/ecdt.ecdt_92_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_92_22","url":null,"abstract":"Background In the case of critically sick patients, acute respiratory distress syndrome (ARDS) may be life-threatening and necessitates the need for ICU admission. Continuous monitoring is required for mechanical ventilation and recruitment movements as necessary. In this research, the goal is to investigate the use of ultrasonography in the evaluation of positive end exhalatory pressure-induced lung recruitment in ARDS patients. Patients and methods A total of 25 ARDS patients were included in this research, which was done in the hospital’s respiratory care unit. All of the patients were seen by a doctor, had a chest radiograph, and had laboratory tests. Mechanical ventilation was used in the care of all patients. Using positive end-expiratory pressure (PEEP) values of 5 and 15, we measured pressure–volume (PV) and lung ultrasound tracings. The PV curve approach was used to assess PEEP-induced lung recruitment. Between PEEP 5 and PEEP 15, there was an extremely strong positive connection between reaeration score and the change in lung volume (r=0.737, P=0.001). Results Between PEEP 5 and PEEP 15, there was a substantial (r=0.577, P=0.003) positive association between the reaeration score and the decrease in PaO2. There was a substantial negative association between reaeration score and mortality (rpb=-0.842, P=0.001), in which mortality reduces as the score increases. Conclusion For quantitative evaluation of PEEP-induced lung recruitment, bedside lung ultrasound is equal to the PV curve approach. In patients with ARDS, PEEP-induced lung recruitment may be assessed using ultrasonography.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"58 1","pages":"461 - 467"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80240037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Escalation to invasive mechanical ventilation in noninvasive ventilation failure: some insights about methodology","authors":"B. Lazovic, R. Dmitrović, A. Esquinas","doi":"10.4103/ecdt.ecdt_55_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_55_22","url":null,"abstract":"","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"30 1","pages":"468 - 469"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74404201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Morsy, Amany E. Sheta, Mohammed El Desoky Abo Shehata, Raed El Metwally Ali, Hala Samaha
Objective The study aims to identify the prevalence and risk factors for OSA in a group of Egyptian patients with type 2 diabetes. Methods 125 type 2 diabetes mellitus patients visited Mansoura University Hospital (Diabetes Mellitus Outpatient Clinic (OPC) at Specialized Medical Hospital and the Sleep Disordered Breathing Unit of the Chest Department), all of them exposed to history taking, the patients underwent anthropometric measurements (weight, height, body mass index, neck circumference), a test of their tonsillar size, Malampati score, Friedman OSA score, Epworth sleepiness scale (ESS), Berlin questionnaire, STOP BANG questionnaire, full-night polysomnography, fasting, and postprandial blood sugar. Results The study included 125 T2DM Egyptian patients with a mean age of 54.63 ± 9.47 years. Males accounted for 35.2 percent of patients, while females accounted for 64.8%. According to the study of co-morbidity, hypertension constituted 77 (61.1%), ischemic heart disease 28 (22.4%), other cardiac diseases 11 (8.8%), bronchial asthma 6 (4.8%), liver diseases 6 (4.8%), hypothyroidism 3 (2.4%), and renal diseases 3 (2.4%). A total of seven patients (5.6%) had no OSA symptoms, 87 had borderline symptoms, and 31 had positive symptoms. There were 51 (40.8%) normal patients, 12 (9.6%) borderline patients, and 62 (49.6%) sleepy patients on the Epworth scale. According to the Stop-Bang questionnaire, 121 (96.8%) patients answered positively. It was determined that 122 patients (97.6%) were at high risk based on the Berlin questionnaire. There were 17 patients (13.6%) with OSA on polysomnography, of which six were moderate (35.3%) and 11 were severe (64.7%). Among moderate and severe OSA patients, glycosylated hemoglobin levels differed significantly. Multivariate logistic regression analysis for independent predictors of OSA, chronic renal disease patients is the most common associated risk factor (OR = 14.3, CI = 1.2–67) then hypertension (OR = 5.6,CI=1.2–25.5) and heart failure (OR = 4.4). Conclusions OSA affects 13.6% patients with type 2 diabetes patients who are hypertensive are at higher risk of OSA, chronic renal failure is considered another risk factorFurthers studies are needed on a big scale of Egyptian diabetic patients to detect the prevalence of OSA
{"title":"Obstructive sleep apnea in type 2 diabetes mellitus patients","authors":"N. Morsy, Amany E. Sheta, Mohammed El Desoky Abo Shehata, Raed El Metwally Ali, Hala Samaha","doi":"10.4103/ecdt.ecdt_14_23","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_14_23","url":null,"abstract":"Objective The study aims to identify the prevalence and risk factors for OSA in a group of Egyptian patients with type 2 diabetes. Methods 125 type 2 diabetes mellitus patients visited Mansoura University Hospital (Diabetes Mellitus Outpatient Clinic (OPC) at Specialized Medical Hospital and the Sleep Disordered Breathing Unit of the Chest Department), all of them exposed to history taking, the patients underwent anthropometric measurements (weight, height, body mass index, neck circumference), a test of their tonsillar size, Malampati score, Friedman OSA score, Epworth sleepiness scale (ESS), Berlin questionnaire, STOP BANG questionnaire, full-night polysomnography, fasting, and postprandial blood sugar. Results The study included 125 T2DM Egyptian patients with a mean age of 54.63 ± 9.47 years. Males accounted for 35.2 percent of patients, while females accounted for 64.8%. According to the study of co-morbidity, hypertension constituted 77 (61.1%), ischemic heart disease 28 (22.4%), other cardiac diseases 11 (8.8%), bronchial asthma 6 (4.8%), liver diseases 6 (4.8%), hypothyroidism 3 (2.4%), and renal diseases 3 (2.4%). A total of seven patients (5.6%) had no OSA symptoms, 87 had borderline symptoms, and 31 had positive symptoms. There were 51 (40.8%) normal patients, 12 (9.6%) borderline patients, and 62 (49.6%) sleepy patients on the Epworth scale. According to the Stop-Bang questionnaire, 121 (96.8%) patients answered positively. It was determined that 122 patients (97.6%) were at high risk based on the Berlin questionnaire. There were 17 patients (13.6%) with OSA on polysomnography, of which six were moderate (35.3%) and 11 were severe (64.7%). Among moderate and severe OSA patients, glycosylated hemoglobin levels differed significantly. Multivariate logistic regression analysis for independent predictors of OSA, chronic renal disease patients is the most common associated risk factor (OR = 14.3, CI = 1.2–67) then hypertension (OR = 5.6,CI=1.2–25.5) and heart failure (OR = 4.4). Conclusions OSA affects 13.6% patients with type 2 diabetes patients who are hypertensive are at higher risk of OSA, chronic renal failure is considered another risk factorFurthers studies are needed on a big scale of Egyptian diabetic patients to detect the prevalence of OSA","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"116 1","pages":"420 - 426"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87461441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: One of the most common presentations of OSAS is daytime sleepiness, which is also seen in patients with hypothyroidism. We hypothesized that hypothyroidism is one of contributing factors in the development of OSAS; thus, adequate management of hypothyroidism can simply help to alleviate OSAS symptoms. Aim of the Study: The aim of this study was to evaluate the prevalence of hypothyroidism in OSAS patients in our locality and to compare respiratory polysomnographic parameters of OSAS patients with hypothyroidism versus those without hypothyroidism. Patients and Methods: In a descriptive prospective cross-sectional study, our patients attending Sleep Disordered Breathing Clinic at Sleep Disordered Breathing Unit, Chest Medicine Department, Mansoura University Hospital. All patients were subjected to full history taking with stress on sleep questionnaires, pulmonary complaints, physical examination, anthropometric measures, diagnostic PSG, laboratory evaluation (serum TSH and free T4 levels), and chest radiology and echocardiography. Results: There were two groups of OSAS participants (hypothyroid and euthyroid). Hypothyroidism was evident in 12% of patients;they were classified according to AHI, 13, 15, and 60 of Euthyroid patients had mild, moderate, and severe OSAS, respectively. hypothyroid patients, 2 mild OSAS, 1 moderate OSAS and 9 severe OSAS. Epworth sleepiness scale scores were significantly higher in the hypothyroid group with a mean score of 18 ± 4.8 vs 12.47 ± 6 in the euthyroid group (P = 0.003). Different PSG parameters showed no difference between the two groups. AHI, serum TSH level, and T4 levels were positively correlated but with insignificant P values. Conclusion: Hypothyroidism is thought to be one of the key players in the development of sleep-breathing disorders. It was evident in 12% of OSAS patients; however, the a proven insignificant difference in PSG parameters in OSAS with hypothyroidism versus euthyroid group, except for affection of daytime sleepiness.
{"title":"Prevalence of hypothyroidism in newly diagnosed patients with obstructive sleep apnea syndrome: a prospective cross-sectional study","authors":"Lucy El-Maboud Suliman, Raed El Metwally Ali, Magda Ahmed, Maged Aboelazm","doi":"10.4103/ecdt.ecdt_103_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_103_22","url":null,"abstract":"Introduction: One of the most common presentations of OSAS is daytime sleepiness, which is also seen in patients with hypothyroidism. We hypothesized that hypothyroidism is one of contributing factors in the development of OSAS; thus, adequate management of hypothyroidism can simply help to alleviate OSAS symptoms. Aim of the Study: The aim of this study was to evaluate the prevalence of hypothyroidism in OSAS patients in our locality and to compare respiratory polysomnographic parameters of OSAS patients with hypothyroidism versus those without hypothyroidism. Patients and Methods: In a descriptive prospective cross-sectional study, our patients attending Sleep Disordered Breathing Clinic at Sleep Disordered Breathing Unit, Chest Medicine Department, Mansoura University Hospital. All patients were subjected to full history taking with stress on sleep questionnaires, pulmonary complaints, physical examination, anthropometric measures, diagnostic PSG, laboratory evaluation (serum TSH and free T4 levels), and chest radiology and echocardiography. Results: There were two groups of OSAS participants (hypothyroid and euthyroid). Hypothyroidism was evident in 12% of patients;they were classified according to AHI, 13, 15, and 60 of Euthyroid patients had mild, moderate, and severe OSAS, respectively. hypothyroid patients, 2 mild OSAS, 1 moderate OSAS and 9 severe OSAS. Epworth sleepiness scale scores were significantly higher in the hypothyroid group with a mean score of 18 ± 4.8 vs 12.47 ± 6 in the euthyroid group (P = 0.003). Different PSG parameters showed no difference between the two groups. AHI, serum TSH level, and T4 levels were positively correlated but with insignificant P values. Conclusion: Hypothyroidism is thought to be one of the key players in the development of sleep-breathing disorders. It was evident in 12% of OSAS patients; however, the a proven insignificant difference in PSG parameters in OSAS with hypothyroidism versus euthyroid group, except for affection of daytime sleepiness.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"8 1","pages":"401 - 406"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84246607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. El-Bably, A. Galal, Riham Rafat, Samia El Rehem
Background Severe acute respiratory syndrome coronavirus 2 is a new strain of coronavirus that started in 2019 and causes a pandemic disease called coronavirus disease 2019 (COVID-19). The present report result was 80% of cases are asymptomatic or mild; 15% of cases are severe; and 5% are critical needing ICU and mechanical ventilation. Physiotherapy (PT) provides airway clearance techniques and improves physical fitness. Aim The aim of this study is to assess the effect of PT and the frequency of PT session on the outcome of patients with COVID-19 infection at an isolation unit of Ain Shams University. Patients and methods This is randomized controlled clinical trial that was applied on 264 confirmed adult patients with COVID-19, who were admitted to isolation units at Ain Shams University Hospitals over 6 months since March 2021 with 134 females and 130 males in the age range from 31 to 82 years. The breathing method was room air, oxygen mask and nasal cannula, HFNC, and ventilated patients (both invasive and noninvasive). The patients were divided randomly into two groups: one group received two sessions of PT per day and the other group received one session of PT per day. Results The patients were divided clinically into mild, moderate, severe, and severe-critical patients. In mild cases, the range of incentive spirometer (ml) after one daily PT became 2300–2800 ml, and for twice daily PT it became 2300–3300 ml with highly statistical difference (P=0.005) before and after one or two PT sessions. Regarding 6-min walking test (m) the range became 420–740 m for one PT session per day and 420–880 m for two PT sessions per day with significant statistical difference (P=0.010). In moderate cases, the SPO2 (%) became 88–98% after one daily PT session and 90–98% after twice daily PT sessions with significant statistical differences between the one and two PT (P=0.032) sessions. Regarding the incentive spirometer (ml) at the moderate group, after one daily PT session it became 1200–2500 ml and for twice daily PT it became 1500–2500 ml with significant statistical differences between one and two PT sessions (P=0.032). Conclusion Patients with mild and moderate COVID-19 infection had significant improvement in SPO2 (oxygen saturation), dyspnea scale, and incentive spirometer after receiving two daily sessions of PT compared with patients who received one daily PT session. There was no difference in both groups for severe and severe-critical cases.
{"title":"Effect of physiotherapy and its frequency on the outcome of COVID-19 patients regarding acute care setting at isolation unit of Ain Shams University","authors":"M. El-Bably, A. Galal, Riham Rafat, Samia El Rehem","doi":"10.4103/ecdt.ecdt_82_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_82_22","url":null,"abstract":"Background Severe acute respiratory syndrome coronavirus 2 is a new strain of coronavirus that started in 2019 and causes a pandemic disease called coronavirus disease 2019 (COVID-19). The present report result was 80% of cases are asymptomatic or mild; 15% of cases are severe; and 5% are critical needing ICU and mechanical ventilation. Physiotherapy (PT) provides airway clearance techniques and improves physical fitness. Aim The aim of this study is to assess the effect of PT and the frequency of PT session on the outcome of patients with COVID-19 infection at an isolation unit of Ain Shams University. Patients and methods This is randomized controlled clinical trial that was applied on 264 confirmed adult patients with COVID-19, who were admitted to isolation units at Ain Shams University Hospitals over 6 months since March 2021 with 134 females and 130 males in the age range from 31 to 82 years. The breathing method was room air, oxygen mask and nasal cannula, HFNC, and ventilated patients (both invasive and noninvasive). The patients were divided randomly into two groups: one group received two sessions of PT per day and the other group received one session of PT per day. Results The patients were divided clinically into mild, moderate, severe, and severe-critical patients. In mild cases, the range of incentive spirometer (ml) after one daily PT became 2300–2800 ml, and for twice daily PT it became 2300–3300 ml with highly statistical difference (P=0.005) before and after one or two PT sessions. Regarding 6-min walking test (m) the range became 420–740 m for one PT session per day and 420–880 m for two PT sessions per day with significant statistical difference (P=0.010). In moderate cases, the SPO2 (%) became 88–98% after one daily PT session and 90–98% after twice daily PT sessions with significant statistical differences between the one and two PT (P=0.032) sessions. Regarding the incentive spirometer (ml) at the moderate group, after one daily PT session it became 1200–2500 ml and for twice daily PT it became 1500–2500 ml with significant statistical differences between one and two PT sessions (P=0.032). Conclusion Patients with mild and moderate COVID-19 infection had significant improvement in SPO2 (oxygen saturation), dyspnea scale, and incentive spirometer after receiving two daily sessions of PT compared with patients who received one daily PT session. There was no difference in both groups for severe and severe-critical cases.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"92 1","pages":"433 - 442"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75930153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.4103/ecdt.ecdt_100_22
A. Halfawy, H. Amin, Muhammad Younis, U. Elhassan
Background Cryotherapy has emerged as an effective modality to manage patients with central airway obstruction (CAO). The aim was to assess the outcomes of using cryotherapy for managing CAO and its effect on the symptoms, and pulmonary function testing (PFT) in patients with CAO. Patients and methods This prospective protocol was carried out at the Chest Department, Cairo University Hospitals, in collaboration with the Military Chest Hospital over 6 months. Patients with CAO underwent cryotherapy and were assessed by the following: grade of airway obstruction, dyspnea, hemoptysis and quality of life scales, and PFT. Outcomes and safety of cryotherapy were evaluated. Results A total of 30 patients with CAO were enrolled and were divided into two groups: the malignant obstruction group (n=20) and the nonmalignant obstruction group (n=10). Complete restoration of the airway patency was achieved in 53.3% of patients. Only three (10%) cases encountered complications. There were significant postprocedural improvements of dyspnea, cough, hemoptysis, quality of life scales, and PFT. Logistic regression analysis showed that smoking was associated with worse outcomes. Conclusions Cryotherapy is a safe and successful method for both endobronchial exophytic tumor debulking and nonmalignant CAO. These benefits were reflected in the postprocedural improvement of clinical pulmonary scales, PFT, the grade of airway obstruction, and quality of life. Further prospective, multicenter studies are recommended.
{"title":"Cryotherapy in Egyptian patients with central airway obstruction: impacts on clinical pulmonary scores, pulmonary function tests and quality of life, a single center experience","authors":"A. Halfawy, H. Amin, Muhammad Younis, U. Elhassan","doi":"10.4103/ecdt.ecdt_100_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_100_22","url":null,"abstract":"Background Cryotherapy has emerged as an effective modality to manage patients with central airway obstruction (CAO). The aim was to assess the outcomes of using cryotherapy for managing CAO and its effect on the symptoms, and pulmonary function testing (PFT) in patients with CAO. Patients and methods This prospective protocol was carried out at the Chest Department, Cairo University Hospitals, in collaboration with the Military Chest Hospital over 6 months. Patients with CAO underwent cryotherapy and were assessed by the following: grade of airway obstruction, dyspnea, hemoptysis and quality of life scales, and PFT. Outcomes and safety of cryotherapy were evaluated. Results A total of 30 patients with CAO were enrolled and were divided into two groups: the malignant obstruction group (n=20) and the nonmalignant obstruction group (n=10). Complete restoration of the airway patency was achieved in 53.3% of patients. Only three (10%) cases encountered complications. There were significant postprocedural improvements of dyspnea, cough, hemoptysis, quality of life scales, and PFT. Logistic regression analysis showed that smoking was associated with worse outcomes. Conclusions Cryotherapy is a safe and successful method for both endobronchial exophytic tumor debulking and nonmalignant CAO. These benefits were reflected in the postprocedural improvement of clinical pulmonary scales, PFT, the grade of airway obstruction, and quality of life. Further prospective, multicenter studies are recommended.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"1 1","pages":"320 - 325"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89861956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammed Abdelghany, A. El-Karn, M. Sherif, M. Seddik, S. Eid, S. Youssif
Background Smoking influences the nature of airway inflammation in patients with bronchial asthma though synthesis of certain cytokines. Patterns of bronchial asthma are differentiated clinically, functionally, and regarding inflammatory biomarkers. Aim The research aimed to study the clinical, functional, sputum cytological differences, and serum eotaxin-2 and periostin levels in asthmatic patients regarding smoking status. Patients and methods The research was a cross-sectional study. The collection of cases began in August 2018 and ended in January 2020 at the Chest Department, Assiut University Hospital. We studied 117 asthmatic patients who were classified regarding their smoking status (45 nonsmokers, 42 smokers, and 30 former smokers) for serum eotaxin-2 and periostin by enzyme-linked immunosorbent assay. The effects of smoking were analyzed on inflammatory cells including eosinophilic and neutrophilic percentages in sputum and serum eotaxin-2 and periostin levels. Results Smokers with asthma had worse clinical and functional outcomes. Asthmatic smokers had mainly neutrophilic phenotype. Serum eotaxin-2 level was higher in smokers compared with nonsmokers and former smokers. However, serum periostin level was higher in nonsmokers compared with smokers and former smokers. Serum eotaxin-2 had a positive correlation with smoking index and eosinophilic and neutrophilic count in sputum, whereas serum periostin was correlated negatively with smoking index and positively with eosinophilic count. Conclusion Asthmatic smokers had worse clinical and functional outcomes with increased neutrophils in the sputum. The inflammatory biomarkers seen in smokers with asthma showed low serum periostin and increased serum eotaxin-2 levels.
{"title":"Changes in eotaxin-2 and periostin levels in patients with bronchial asthma according to their smoking status: a cross-sectional study","authors":"Mohammed Abdelghany, A. El-Karn, M. Sherif, M. Seddik, S. Eid, S. Youssif","doi":"10.4103/ecdt.ecdt_91_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_91_22","url":null,"abstract":"Background Smoking influences the nature of airway inflammation in patients with bronchial asthma though synthesis of certain cytokines. Patterns of bronchial asthma are differentiated clinically, functionally, and regarding inflammatory biomarkers. Aim The research aimed to study the clinical, functional, sputum cytological differences, and serum eotaxin-2 and periostin levels in asthmatic patients regarding smoking status. Patients and methods The research was a cross-sectional study. The collection of cases began in August 2018 and ended in January 2020 at the Chest Department, Assiut University Hospital. We studied 117 asthmatic patients who were classified regarding their smoking status (45 nonsmokers, 42 smokers, and 30 former smokers) for serum eotaxin-2 and periostin by enzyme-linked immunosorbent assay. The effects of smoking were analyzed on inflammatory cells including eosinophilic and neutrophilic percentages in sputum and serum eotaxin-2 and periostin levels. Results Smokers with asthma had worse clinical and functional outcomes. Asthmatic smokers had mainly neutrophilic phenotype. Serum eotaxin-2 level was higher in smokers compared with nonsmokers and former smokers. However, serum periostin level was higher in nonsmokers compared with smokers and former smokers. Serum eotaxin-2 had a positive correlation with smoking index and eosinophilic and neutrophilic count in sputum, whereas serum periostin was correlated negatively with smoking index and positively with eosinophilic count. Conclusion Asthmatic smokers had worse clinical and functional outcomes with increased neutrophils in the sputum. The inflammatory biomarkers seen in smokers with asthma showed low serum periostin and increased serum eotaxin-2 levels.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"15 1","pages":"305 - 312"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87332503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.4103/ecdt.ecdt_110_22
Amr A Abdelwahab, Heba Salem
Aims The objective of this study was to retrospectively evaluate the incidence, management, and outcome of occult pneumothorax (OPTX) in patients with blunt chest trauma (BCT). Settings and design A retrospective observational study was performed. Patients and methods Over 9 years, cases with BCT were identified retrospectively from the database between 2012 and 2021. Data were evaluated and compared based on the first management (conservative vs. intercostal tube). Results Of the 2113 cases, 51 (2.4%) admitted with BCT during the study period were found to have OPTX. The mean age of patients was 37 ± 6.58 years, and there was a male predominance (78.43%). Intercostal tube intervention was done in 29 (53.8%) cases, and conservative management was done in 22 (43.13%) cases. Cases that needed tube thoracostomy had significantly higher rates of lung and chest contusions and high Abbreviated Injury Scale compared with those who were treated conservatively. However, pneumonia, rib fracture, hospital length of stay, and ventilatory days were insignificantly different between both groups. Overall mortality was 9.8%. Conclusions In cases with BCT that did not require major interventions or needed to be mechanically ventilated, their OPTX can be safely managed conservatively.
{"title":"Occult pneumothorax in patients with blunted polytrauma: an experience of Tanta University Hospitals","authors":"Amr A Abdelwahab, Heba Salem","doi":"10.4103/ecdt.ecdt_110_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_110_22","url":null,"abstract":"Aims The objective of this study was to retrospectively evaluate the incidence, management, and outcome of occult pneumothorax (OPTX) in patients with blunt chest trauma (BCT). Settings and design A retrospective observational study was performed. Patients and methods Over 9 years, cases with BCT were identified retrospectively from the database between 2012 and 2021. Data were evaluated and compared based on the first management (conservative vs. intercostal tube). Results Of the 2113 cases, 51 (2.4%) admitted with BCT during the study period were found to have OPTX. The mean age of patients was 37 ± 6.58 years, and there was a male predominance (78.43%). Intercostal tube intervention was done in 29 (53.8%) cases, and conservative management was done in 22 (43.13%) cases. Cases that needed tube thoracostomy had significantly higher rates of lung and chest contusions and high Abbreviated Injury Scale compared with those who were treated conservatively. However, pneumonia, rib fracture, hospital length of stay, and ventilatory days were insignificantly different between both groups. Overall mortality was 9.8%. Conclusions In cases with BCT that did not require major interventions or needed to be mechanically ventilated, their OPTX can be safely managed conservatively.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"11 1","pages":"334 - 339"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87962917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.4103/ecdt.ecdt_117_22
Rana H. El Helbawy, Heba Maged Abo shady, Amal A. El-Koa
Background Women may have a wide range of symptoms in the menopausal period, which includes vasomotor, mood changes, and disturbances of sleep. Disturbance of sleep leads to adverse health problems with poor quality of life. This study researched the comparison of polysomnographic parameters between menopausal and childbearing women. Patients and methods This study was carried out on 47 women (divided into two groups of premenopausal and postmenopausal), who attended for polysomnography in the Unit of Sleep in the Department of Chest Diseases in Menoufia University Hospital from the period of September 2021 to September 2022. After taking informed written consent, all participants were subjected to history taking, full examination, Epworth sleepiness scale, STOP-Bang questionnaire, and polysomnography. Results This study was carried out on 47 women who were divided into two groups: group I (29 participants) in menopause with an age of 58.9 ± 6.3 (mean±SD) and group II (18 participants) in the childbearing period with an age of 37.28 ± 8.064 (mean±SD). Polysomnographic parameters showed statistically significant differences between both groups regarding sleep latency (min) (P=0.026), sleep efficiency% (P=0.019), apnea–hypopnea index (P<0.001), O2 desaturation index, and lowest O2 saturation during sleep (P<0.001 and 0.01, respectively). Conclusion Women in menopausal women experience more sleep disturbance, insomnia, and sleep breathing disorders than they did during the childbearing years. Women in this age group, therefore, require a more thorough assessment of sleep difficulties and other relevant variables.
{"title":"Polysomnography in women: is there any difference between childbearing period and menopause?","authors":"Rana H. El Helbawy, Heba Maged Abo shady, Amal A. El-Koa","doi":"10.4103/ecdt.ecdt_117_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_117_22","url":null,"abstract":"Background Women may have a wide range of symptoms in the menopausal period, which includes vasomotor, mood changes, and disturbances of sleep. Disturbance of sleep leads to adverse health problems with poor quality of life. This study researched the comparison of polysomnographic parameters between menopausal and childbearing women. Patients and methods This study was carried out on 47 women (divided into two groups of premenopausal and postmenopausal), who attended for polysomnography in the Unit of Sleep in the Department of Chest Diseases in Menoufia University Hospital from the period of September 2021 to September 2022. After taking informed written consent, all participants were subjected to history taking, full examination, Epworth sleepiness scale, STOP-Bang questionnaire, and polysomnography. Results This study was carried out on 47 women who were divided into two groups: group I (29 participants) in menopause with an age of 58.9 ± 6.3 (mean±SD) and group II (18 participants) in the childbearing period with an age of 37.28 ± 8.064 (mean±SD). Polysomnographic parameters showed statistically significant differences between both groups regarding sleep latency (min) (P=0.026), sleep efficiency% (P=0.019), apnea–hypopnea index (P<0.001), O2 desaturation index, and lowest O2 saturation during sleep (P<0.001 and 0.01, respectively). Conclusion Women in menopausal women experience more sleep disturbance, insomnia, and sleep breathing disorders than they did during the childbearing years. Women in this age group, therefore, require a more thorough assessment of sleep difficulties and other relevant variables.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"98 1","pages":"412 - 419"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85329909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.4103/ecdt.ecdt_114_22
Ahmed Azzouz, Raafat T. El-Sokkary, Lamiaa Wafi, Mohammad Khalaf
Background Tuberculosis (TB) commonly affects the lung (pulmonary TB). Extrapulmonary TB (EPTB) can involve many systems. Diagnosis is often difficult. EPTB may be misdiagnosed with many other inflammatory, granulomatous, and neoplastic disorders. GeneXpert mycobacterium tuberculosis /rifampicin is a valuable test in diagnosis of pulmonary TB. There is limited research about its diagnostic role in EPTB. Patients and methods The aim of this study was to assess the diagnostic value of GeneXpert in EPTB. Samples from EPTB cases were sent for standard mycobacterial culture and GeneXpert assay. The sensitivity and specificity of GeneXpert were calculated. Results A total of 100 patients were included. Overall, 61 cases were definitely diagnosed as EPTB, whereas 39 cases were negative according to culture. GeneXpert was positive in 40 cases, which represent 65.6% of EPTB cases, and negative in 21 (34.4%) cases. Sensitivity and specificity of GeneXpert was 65.6 and 97.4%, respectively. The positive predictive value and negative predictive value were 97.4 and 64.4%, respectively. Conclusion GeneXpert is a rapid, valuable tool in diagnosis of patients with EPTB. It is a highly specific test with fair sensitivity. A multicenter study with larger sample size is needed to evaluate the diagnostic role of GeneXpert in different sites of EPTB.
{"title":"Role of GeneXpert in extrapulmonary tuberculosis","authors":"Ahmed Azzouz, Raafat T. El-Sokkary, Lamiaa Wafi, Mohammad Khalaf","doi":"10.4103/ecdt.ecdt_114_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_114_22","url":null,"abstract":"Background Tuberculosis (TB) commonly affects the lung (pulmonary TB). Extrapulmonary TB (EPTB) can involve many systems. Diagnosis is often difficult. EPTB may be misdiagnosed with many other inflammatory, granulomatous, and neoplastic disorders. GeneXpert mycobacterium tuberculosis /rifampicin is a valuable test in diagnosis of pulmonary TB. There is limited research about its diagnostic role in EPTB. Patients and methods The aim of this study was to assess the diagnostic value of GeneXpert in EPTB. Samples from EPTB cases were sent for standard mycobacterial culture and GeneXpert assay. The sensitivity and specificity of GeneXpert were calculated. Results A total of 100 patients were included. Overall, 61 cases were definitely diagnosed as EPTB, whereas 39 cases were negative according to culture. GeneXpert was positive in 40 cases, which represent 65.6% of EPTB cases, and negative in 21 (34.4%) cases. Sensitivity and specificity of GeneXpert was 65.6 and 97.4%, respectively. The positive predictive value and negative predictive value were 97.4 and 64.4%, respectively. Conclusion GeneXpert is a rapid, valuable tool in diagnosis of patients with EPTB. It is a highly specific test with fair sensitivity. A multicenter study with larger sample size is needed to evaluate the diagnostic role of GeneXpert in different sites of EPTB.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":"10 1","pages":"382 - 385"},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82435779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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