R. Abdelfattah, R. Emam, Mohammad O. Abdel Aziz, Noha M. Abdullah, A. Abdelaziz
Background Secondary polycythemia is linked to cigarette smoking and chronic obstructive pulmonary disease (COPD). However, the prevalence of polycythemia and its possible risk factors in patients with COPD have not been widely studied. In the past, it was known that patients with COPD had a high prevalence of polycythemia.However, owing to the advances in the management of patients with COPD and the use of long-term oxygen therapy to correct hypoxemia in patients with advanced COPD, its frequency is decreasing. Aim The current research was done to evaluate the frequency of polycythemia and its effects in patients with COPD in Minia Cardiothoracic University Hospital. Patients and methods A total of 100 patients with COPD were included within the study. They were assessed for complete demographic and clinical data. Spirometry and arterial blood gases were evaluated. Complete blood count, serum iron, total iron-binding capacity, and erythropoietin level were measured.Patients were divided into two groups: group I, nonpolycythemic patients (86 patients), and group II, polycythemic patients (14 patients). Results Polycythemia was present in 14 (14%) patients. Polycythemic patients had a higher modified Medical Research Council dyspnea grade (P=0.001) and a higher number of exacerbations per year (0.02). There was also a significant increase in serum iron level (170.9 ± 9.6 µg/dl) and total iron-binding capacity (377.1 ± 14.8 µg/dl) with lower erythropoietin (24.04 ± 3.8 mU/ml) in group II compared with group I (134.4 ± 27.4 µg/dl, 310.9 ± 40.1 µg/dl, and 41.9 ± 10.3 mU/ml, respectively) (P=0.001, 0.001, and 0.001, respectively). Conclusion Polycythemia was present in 14% of the studied patients. It was associated with a significantly higher grade of dyspnea and an increased number of exacerbations.
{"title":"Polycythemia in chronic obstructive pulmonary disease in Minia Cardiothoracic University Hospital","authors":"R. Abdelfattah, R. Emam, Mohammad O. Abdel Aziz, Noha M. Abdullah, A. Abdelaziz","doi":"10.4103/ecdt.ecdt_59_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_59_22","url":null,"abstract":"Background Secondary polycythemia is linked to cigarette smoking and chronic obstructive pulmonary disease (COPD). However, the prevalence of polycythemia and its possible risk factors in patients with COPD have not been widely studied. In the past, it was known that patients with COPD had a high prevalence of polycythemia.However, owing to the advances in the management of patients with COPD and the use of long-term oxygen therapy to correct hypoxemia in patients with advanced COPD, its frequency is decreasing. Aim The current research was done to evaluate the frequency of polycythemia and its effects in patients with COPD in Minia Cardiothoracic University Hospital. Patients and methods A total of 100 patients with COPD were included within the study. They were assessed for complete demographic and clinical data. Spirometry and arterial blood gases were evaluated. Complete blood count, serum iron, total iron-binding capacity, and erythropoietin level were measured.Patients were divided into two groups: group I, nonpolycythemic patients (86 patients), and group II, polycythemic patients (14 patients). Results Polycythemia was present in 14 (14%) patients. Polycythemic patients had a higher modified Medical Research Council dyspnea grade (P=0.001) and a higher number of exacerbations per year (0.02). There was also a significant increase in serum iron level (170.9 ± 9.6 µg/dl) and total iron-binding capacity (377.1 ± 14.8 µg/dl) with lower erythropoietin (24.04 ± 3.8 mU/ml) in group II compared with group I (134.4 ± 27.4 µg/dl, 310.9 ± 40.1 µg/dl, and 41.9 ± 10.3 mU/ml, respectively) (P=0.001, 0.001, and 0.001, respectively). Conclusion Polycythemia was present in 14% of the studied patients. It was associated with a significantly higher grade of dyspnea and an increased number of exacerbations.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78397023","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}
Context Widespread prevalence of Coronavirus Disease 2019 (COVID-19) infection with high rates of morbidity and mortality necessitates early case definition and severity grading to predict prognosis and improve disease outcome parameters. Purpose To correlate computed tomography severity score (CTSS) in COVID-19-infected patients with their clinical, laboratory, method of ventilation, and disease outcome parameters. Patients and methods A retrospective analysis was performed on 139 COVID-19-infected patients with typical or indeterminate COVID radiological patterns with a correlation between CTSS and their clinical, laboratory, ventilation, hospital stay, and survival data. Results A total of 139 cases were included, with a mean age of 59.81 ± 12.29 years, 63.3% males, 28.77% were noncomorbid, and oxygen saturation of 82.53 ± 6.58 SD. They were subgrouped based on CTSS. A significant correlation was found between high CTSS and oxygen saturation, C-reactive protein, ferritin, D-dimer, lymphopenia, diabetes comorbid patients, need for high-flow oxygen therapy, need for noninvasive or invasive ventilation, mortality, and number of hospital stay in days. Conclusion Different parameters are correlated with high CTSS, especially low oxygen saturation, high C-reactive protein or ferritin values, diabetes, and long hospital stay.
{"title":"Correlation of clinical, laboratory, ventilation, and outcome parameters in hospitalized Coronavirus Disease 2019-infected patients with computed tomography severity score","authors":"Mohammed Ibrahim, A. AbdelKhalek, Mohammed Shehta","doi":"10.4103/ecdt.ecdt_95_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_95_22","url":null,"abstract":"Context Widespread prevalence of Coronavirus Disease 2019 (COVID-19) infection with high rates of morbidity and mortality necessitates early case definition and severity grading to predict prognosis and improve disease outcome parameters. Purpose To correlate computed tomography severity score (CTSS) in COVID-19-infected patients with their clinical, laboratory, method of ventilation, and disease outcome parameters. Patients and methods A retrospective analysis was performed on 139 COVID-19-infected patients with typical or indeterminate COVID radiological patterns with a correlation between CTSS and their clinical, laboratory, ventilation, hospital stay, and survival data. Results A total of 139 cases were included, with a mean age of 59.81 ± 12.29 years, 63.3% males, 28.77% were noncomorbid, and oxygen saturation of 82.53 ± 6.58 SD. They were subgrouped based on CTSS. A significant correlation was found between high CTSS and oxygen saturation, C-reactive protein, ferritin, D-dimer, lymphopenia, diabetes comorbid patients, need for high-flow oxygen therapy, need for noninvasive or invasive ventilation, mortality, and number of hospital stay in days. Conclusion Different parameters are correlated with high CTSS, especially low oxygen saturation, high C-reactive protein or ferritin values, diabetes, and long hospital stay.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86849837","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}
Doaa Elsherbiny, M. Abo-Shehata, E. Elgamal, Magda A Ahmed, M. Elgamal, Manar El-Sayed, D. Abdalla
Background Differentiation between gastric aspiration pneumonitis and bacterial aspiration pneumonia is important and difficult. This study aimed to evaluate the efficacy of bronchoalveolar lavage (BAL) in differentiation between them using different biomarkers. Patients and methods Cases were divided into two groups: group A (study group) included cases admitted with suspected aspiration pneumonia. Furthermore, the cases diagnosed as aspiration pneumonia were grouped as A1 and cases diagnosed as aspiration pneumonitis were grouped as A2. Group B (control group) included cases admitted with pneumonia without risk of aspiration. Patients were subjected to history and examination, plasma C-reactive protein (CRP), serum procalcitonin (PCT), chest radiograph, and flexible bronchoscopy. BAL was collected for pH, culture and sensitivity, lipid-laden alveolar macrophages (LLAM), and starch granules. Results Serum PCT and CRP were significantly higher in group B than group A (P=0.0173 and 0.0058, respectively). BAL-pH was significantly lower in group A than group B (P=0.0115). Group A showed significantly higher frequency of positive cases with LLAM (60%) than what was recorded in group B (only 20%) (P=0.0418). Seven (35%) cases in group A and no cases in group B had positive BAL for starch granules (P=0.035). Serum PCT and CRP were significantly higher in group A1 compared with group A2. BAL-pH was significantly lower in group A2 (P<0.0001). LLAM in group A2 showed highly significant increase in the number of positive cases (P=0.007). Conclusion Analysis of BAL biomarkers (starch granules and LLAM) and cultures has important diagnostic value in differentiation between bacterial aspiration pneumonia and gastric aspiration pneumonitis.
{"title":"Role of bronchoalveolar lavage in differentiation between bacterial aspiration pneumonia and gastric aspiration pneumonitis","authors":"Doaa Elsherbiny, M. Abo-Shehata, E. Elgamal, Magda A Ahmed, M. Elgamal, Manar El-Sayed, D. Abdalla","doi":"10.4103/ecdt.ecdt_16_20","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_16_20","url":null,"abstract":"Background Differentiation between gastric aspiration pneumonitis and bacterial aspiration pneumonia is important and difficult. This study aimed to evaluate the efficacy of bronchoalveolar lavage (BAL) in differentiation between them using different biomarkers. Patients and methods Cases were divided into two groups: group A (study group) included cases admitted with suspected aspiration pneumonia. Furthermore, the cases diagnosed as aspiration pneumonia were grouped as A1 and cases diagnosed as aspiration pneumonitis were grouped as A2. Group B (control group) included cases admitted with pneumonia without risk of aspiration. Patients were subjected to history and examination, plasma C-reactive protein (CRP), serum procalcitonin (PCT), chest radiograph, and flexible bronchoscopy. BAL was collected for pH, culture and sensitivity, lipid-laden alveolar macrophages (LLAM), and starch granules. Results Serum PCT and CRP were significantly higher in group B than group A (P=0.0173 and 0.0058, respectively). BAL-pH was significantly lower in group A than group B (P=0.0115). Group A showed significantly higher frequency of positive cases with LLAM (60%) than what was recorded in group B (only 20%) (P=0.0418). Seven (35%) cases in group A and no cases in group B had positive BAL for starch granules (P=0.035). Serum PCT and CRP were significantly higher in group A1 compared with group A2. BAL-pH was significantly lower in group A2 (P<0.0001). LLAM in group A2 showed highly significant increase in the number of positive cases (P=0.007). Conclusion Analysis of BAL biomarkers (starch granules and LLAM) and cultures has important diagnostic value in differentiation between bacterial aspiration pneumonia and gastric aspiration pneumonitis.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89832051","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 : 2023-04-01DOI: 10.4103/ecdt.ecdt_123_22
Hala Samaha, A. Al Nooryani, Sumaya Alzarooni, H. Ismail, Amina Aljasmi, S. Allam, Abeer Oraby, Wassan Idris, Khaled Donia, A. Eid
Objective To determine the risk factors for developing secondary fungal pneumonia in moderate to severe coronavirus disease 2019 (COVID-19) cases. Using predictors of fungal infection helps to guide the diagnosis and treatment in these cases and save their lives. Patients and methods A total of 257 patients with moderate to severe COVID-19 pneumonia were examined in this retrospective study at Al Qassimi Hospital of EHS. An assessment of clinical, laboratory, and radiologic findings was performed upon admission. The data were collected and analyzed. Results Overall, 32% of critically ill COVID cases had fungal infection; 47% of them were candida, whereas aspergillosis and yeast were positive in 26.5% each. At the time of hospitalization, computed tomography chest findings had a strong correlation with fungal culture results in COVID-19 cases. Fungal infection in COVID-19 cases correlated strongly with metabolic acidosis, high erythrocyte sedimentation rate, high blood sugar, need for mechanical ventilation at admission, vasopressor use, renal replacement, long duration of steroid treatment, long stay in ICU, and long duration on mechanical ventilation. The longer the duration of PCR positivity, the higher the incidence of positive sputum fungal culture result. Conclusion COVID-19-infected patients with other risk factors for fungal infections should always be considered to have fungal infections if pathogenic organisms are isolated from respiratory secretions or other microbiological or immunological markers appear positive. Computed tomography chest finding in COVID-19 cases is an important predictor for fungal infection.
目的探讨中重度冠状病毒病(COVID-19)继发真菌性肺炎的危险因素。使用真菌感染的预测因子有助于指导这些病例的诊断和治疗，并挽救他们的生命。患者与方法回顾性分析了EHS Al Qassimi医院收治的257例中重度COVID-19肺炎患者。入院时对临床、实验室和放射学检查结果进行评估。收集并分析了数据。结果总体上，32%的危重病例存在真菌感染;其中念珠菌占47%，曲霉菌和酵母菌各占26.5%。住院时，ct胸部检查结果与COVID-19病例的真菌培养结果有很强的相关性。COVID-19患者真菌感染与代谢性酸中毒、高血沉、高血糖、入院时需要机械通气、使用血管加压剂、肾脏替代、类固醇治疗时间长、ICU住院时间长、机械通气时间长密切相关。PCR阳性持续时间越长，痰真菌培养阳性的发生率越高。结论有其他真菌感染危险因素的covid -19感染患者，如果从呼吸道分泌物中分离到病原生物或其他微生物或免疫学标志物呈阳性，应始终考虑真菌感染。COVID-19病例的计算机断层扫描胸部发现是真菌感染的重要预测指标。
{"title":"Fungal pneumonia in COVID-19 patients: Risk factors and early prediction","authors":"Hala Samaha, A. Al Nooryani, Sumaya Alzarooni, H. Ismail, Amina Aljasmi, S. Allam, Abeer Oraby, Wassan Idris, Khaled Donia, A. Eid","doi":"10.4103/ecdt.ecdt_123_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_123_22","url":null,"abstract":"Objective To determine the risk factors for developing secondary fungal pneumonia in moderate to severe coronavirus disease 2019 (COVID-19) cases. Using predictors of fungal infection helps to guide the diagnosis and treatment in these cases and save their lives. Patients and methods A total of 257 patients with moderate to severe COVID-19 pneumonia were examined in this retrospective study at Al Qassimi Hospital of EHS. An assessment of clinical, laboratory, and radiologic findings was performed upon admission. The data were collected and analyzed. Results Overall, 32% of critically ill COVID cases had fungal infection; 47% of them were candida, whereas aspergillosis and yeast were positive in 26.5% each. At the time of hospitalization, computed tomography chest findings had a strong correlation with fungal culture results in COVID-19 cases. Fungal infection in COVID-19 cases correlated strongly with metabolic acidosis, high erythrocyte sedimentation rate, high blood sugar, need for mechanical ventilation at admission, vasopressor use, renal replacement, long duration of steroid treatment, long stay in ICU, and long duration on mechanical ventilation. The longer the duration of PCR positivity, the higher the incidence of positive sputum fungal culture result. Conclusion COVID-19-infected patients with other risk factors for fungal infections should always be considered to have fungal infections if pathogenic organisms are isolated from respiratory secretions or other microbiological or immunological markers appear positive. Computed tomography chest finding in COVID-19 cases is an important predictor for fungal infection.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88679366","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 : 2023-04-01DOI: 10.4103/ecdt.ecdt_132_22
S. Verma, Prem Parkash Gupta, Sandeep Nain, Pankaj Kumar Singh
Amebic lung abscess without involving another system like liver or colon is immensely uncommon. We want to report a case of a 72-year-old woman who presented in emergency with complaints of shortness of breath, loss of weight, right-side chest pain, and loss of appetite since 6 months. Thorax and abdomen sonography showed right-side massive pleural effusion with no significant finding in the abdomen. In pleural fluid reports, amebic serology IgG by indirect immunofluorescence assay and serum PCR for amoeba came positive. The patient was diagnosed with primary amebic lung abscess. After 14 days of treatment, the patient showed no signs of improvement. Pleural tap was done again and came positive for malignant cells. With ultrasound guidance, pleural biopsy was done, and histopathological investigations showed adenocarcinoma. This case exhibited that repetitive cytological examination of pleural effusion and histopathological examination should be used in cases showing recurrent effusion or unusual conditions, like our patient.
{"title":"Primary amebic pulmonary abscess with concurrent pulmonary adenocarcinoma: A rare presentation","authors":"S. Verma, Prem Parkash Gupta, Sandeep Nain, Pankaj Kumar Singh","doi":"10.4103/ecdt.ecdt_132_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_132_22","url":null,"abstract":"Amebic lung abscess without involving another system like liver or colon is immensely uncommon. We want to report a case of a 72-year-old woman who presented in emergency with complaints of shortness of breath, loss of weight, right-side chest pain, and loss of appetite since 6 months. Thorax and abdomen sonography showed right-side massive pleural effusion with no significant finding in the abdomen. In pleural fluid reports, amebic serology IgG by indirect immunofluorescence assay and serum PCR for amoeba came positive. The patient was diagnosed with primary amebic lung abscess. After 14 days of treatment, the patient showed no signs of improvement. Pleural tap was done again and came positive for malignant cells. With ultrasound guidance, pleural biopsy was done, and histopathological investigations showed adenocarcinoma. This case exhibited that repetitive cytological examination of pleural effusion and histopathological examination should be used in cases showing recurrent effusion or unusual conditions, like our patient.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75008666","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}
Background The main route for drug delivery in many respiratory illnesses is the inhalation route. Increasing number of inhaler devices have been approved by drug regulatory authorities. Failure to use the drug delivery devices properly has been shown to affect the control of diseases negatively. Research studies concerning the inhalation devices handling difficulties have been published previously; however, local data are lacking. Aim We aimed to study the technical errors among patients while handling the different available inhaler devices. We also aimed to compare between different devices regarding usage prevalence, duration of use and patient adherence. Patients and methods The study was a prospective, cross-sectional, observational study. It was conducted on patients aged greater than 12 years, who used an inhaler regularly for more than 4 weeks. Each patient demonstrated the inhalation technique using their inhaler, showing their usual inhalation technique. Technical mistakes that are likely to make therapy ineffective using devices metered-dose inhaler (MDI) and dry powder inhaler (Diskus, Turbohaler, Breezhaler, Handihaler, Ellipta) were recorded. A statistics analysis was then performed. Results A total of 221 patients were enrolled, comprising 116 (52.5%) males and 105 (47.5%) females, with a mean age of 47.6 ± 18.5 years. Bronchial asthma was the most frequent disease in 191 (84.6%) patients. The enrolled 221 patients used a total of 280 inhalation maneuvers with six different inhaler devices: 97 (34.6%) used MDI, 82 (29.3%) used Turbohaler, 58 (20.7%) used Diskus, 27 (9.7%) used Handihaler, and nine (3.2%) used Ellipta. A total of 167 (75.6%) patients used a single device, whereas the MDIs had the longest duration of use among the studied cases (mean: 56.15 months). The compliance was much higher among patients using Turbohaler and Handihaler (70 and 85%, respectively). Analysis of technical errors experienced by the studied patients shows that using Diskus or Turbohaler is accompanied by more frequent error compared with other devices (1.82 per patient and 1.73, respectively), whereas Handihaler had the least recorded error per patient (0.48). Conclusion Inhaler mishandling and compliance remain common problem in our locality. A good inhalation technique is mainly affected by the type of the device. Instructions given by health caregivers are the only modifiable factors useful for decreasing inhaler mishandling.
{"title":"Inhaler devices: A prospective cross-sectional study on inhaler mishandling","authors":"Mostafa Bakeer, Abdelfattah Touman, Ahmed Fouda","doi":"10.4103/ecdt.ecdt_79_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_79_22","url":null,"abstract":"Background The main route for drug delivery in many respiratory illnesses is the inhalation route. Increasing number of inhaler devices have been approved by drug regulatory authorities. Failure to use the drug delivery devices properly has been shown to affect the control of diseases negatively. Research studies concerning the inhalation devices handling difficulties have been published previously; however, local data are lacking. Aim We aimed to study the technical errors among patients while handling the different available inhaler devices. We also aimed to compare between different devices regarding usage prevalence, duration of use and patient adherence. Patients and methods The study was a prospective, cross-sectional, observational study. It was conducted on patients aged greater than 12 years, who used an inhaler regularly for more than 4 weeks. Each patient demonstrated the inhalation technique using their inhaler, showing their usual inhalation technique. Technical mistakes that are likely to make therapy ineffective using devices metered-dose inhaler (MDI) and dry powder inhaler (Diskus, Turbohaler, Breezhaler, Handihaler, Ellipta) were recorded. A statistics analysis was then performed. Results A total of 221 patients were enrolled, comprising 116 (52.5%) males and 105 (47.5%) females, with a mean age of 47.6 ± 18.5 years. Bronchial asthma was the most frequent disease in 191 (84.6%) patients. The enrolled 221 patients used a total of 280 inhalation maneuvers with six different inhaler devices: 97 (34.6%) used MDI, 82 (29.3%) used Turbohaler, 58 (20.7%) used Diskus, 27 (9.7%) used Handihaler, and nine (3.2%) used Ellipta. A total of 167 (75.6%) patients used a single device, whereas the MDIs had the longest duration of use among the studied cases (mean: 56.15 months). The compliance was much higher among patients using Turbohaler and Handihaler (70 and 85%, respectively). Analysis of technical errors experienced by the studied patients shows that using Diskus or Turbohaler is accompanied by more frequent error compared with other devices (1.82 per patient and 1.73, respectively), whereas Handihaler had the least recorded error per patient (0.48). Conclusion Inhaler mishandling and compliance remain common problem in our locality. A good inhalation technique is mainly affected by the type of the device. Instructions given by health caregivers are the only modifiable factors useful for decreasing inhaler mishandling.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80495973","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 : 2023-04-01DOI: 10.4103/ecdt.ecdt_102_22
E. Koraa, Iman Galal, E. AbdelFattah, Nermine Zein Alabdeen
Background Hepatitis C virus (HCV) is one of the most important infectious agents in Egypt. Studies have explored the relation between chronic hepatitis C (CHC) and interstitial lung disease (ILD), though it is still unclear if there is a role of viral load or not. Objectives To clarify the association between CHC infection and different interstitial patterns of lung affection in high-resolution computed tomography (HRCT). Patients and methods This observational prospective study included 50 patients with ILD from the outpatient clinic of Fayoum Chest Hospital. All patients had positive serology for HCV. They were categorized into two groups based on the results of a PCR test that determined their blood viremia: group 1 (viremic group) and group 2 (nonviremic group). Both groups were subjected to spirometry, HRCT of the chest, diffusing lung capacity for carbon monoxide, arterial blood gases, and abdominal ultrasound. Results The honeycombing pattern in HRCT was more common in the viremic group(P=0.006), especially with higher level of viremia. Moreover, forced vital capacity (FVC%) value showed statistically significant reduction in the viremic group (P=0.006). Overall, 100% of the patients with honeycombing changes in HRCT had cirrhotic liver changes in abdominal ultrasound (P=0.032). Conclusion There is a relationship between CHC and the prevalence of ILD. Moreover, there was an association between the honeycombing pattern and higher level of viremia.
{"title":"Relation between chronic hepatitis C infection and different radiological patterns of interstitial lung disease","authors":"E. Koraa, Iman Galal, E. AbdelFattah, Nermine Zein Alabdeen","doi":"10.4103/ecdt.ecdt_102_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_102_22","url":null,"abstract":"Background Hepatitis C virus (HCV) is one of the most important infectious agents in Egypt. Studies have explored the relation between chronic hepatitis C (CHC) and interstitial lung disease (ILD), though it is still unclear if there is a role of viral load or not. Objectives To clarify the association between CHC infection and different interstitial patterns of lung affection in high-resolution computed tomography (HRCT). Patients and methods This observational prospective study included 50 patients with ILD from the outpatient clinic of Fayoum Chest Hospital. All patients had positive serology for HCV. They were categorized into two groups based on the results of a PCR test that determined their blood viremia: group 1 (viremic group) and group 2 (nonviremic group). Both groups were subjected to spirometry, HRCT of the chest, diffusing lung capacity for carbon monoxide, arterial blood gases, and abdominal ultrasound. Results The honeycombing pattern in HRCT was more common in the viremic group(P=0.006), especially with higher level of viremia. Moreover, forced vital capacity (FVC%) value showed statistically significant reduction in the viremic group (P=0.006). Overall, 100% of the patients with honeycombing changes in HRCT had cirrhotic liver changes in abdominal ultrasound (P=0.032). Conclusion There is a relationship between CHC and the prevalence of ILD. Moreover, there was an association between the honeycombing pattern and higher level of viremia.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78831501","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}
Rasha H. Hassan, Dalia Abd El Sattar El Embaby, S. Samaan
Background Three years ago, the coronavirus disease 2019 (COVID-19) was the most threatening issue that the world was forced to fight. The interrelationship between COVID-19 and autoimmunity is complex and bidirectional. There was world concern about the severity of COVID infection in rheumatic patients; however, other studies have found no difference between them and the general population. Objectives To study the clinical character of rheumatic disease patients (RDP) with COVID and the outcome and compare this outcome with the nonrheumatic patients. Patients and methods This investigation was conducted retrospectively; all patients were recruited from quarantine hospitals. This study included 100 randomly selected COVID-19 patients with RDP and 200 COVID-19 patients with comorbidities other than rheumatological disease. Results The RDP presented with fever in 75%, and more than 60% developed cough and dyspnea. One-third of the patients developed anosmia and 25% lost the taste sensation; 72% of the studied RDP were admitted to Ain Shams University’s quarantine hospitals. Mean of the patients’ hospital stay of RDP was 15.4 ± 6.7; 38% of those were admitted to the ICU. Moreover, 27% had needed mechanical ventilation, 14% developed cytokine storm, and finally, 11% of RDP died due to COVID infection; 89% of RDP had been resolved from COVID infection. Conclusions Three-quarters of the recruited patients needed hospitalization. The mortality was 11%. The frequency of hospitalization and mortality of RDP were related significantly to the severity of COVID-19 infection, presence of comorbidity, and use of cyclophosphamide. Despite this, the outcomes of rheumatic patients and the general population were not significantly different.
{"title":"Relation between coronavirus disease 2019 severity and short outcome in rheumatic disease Patients","authors":"Rasha H. Hassan, Dalia Abd El Sattar El Embaby, S. Samaan","doi":"10.4103/ecdt.ecdt_78_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_78_22","url":null,"abstract":"Background Three years ago, the coronavirus disease 2019 (COVID-19) was the most threatening issue that the world was forced to fight. The interrelationship between COVID-19 and autoimmunity is complex and bidirectional. There was world concern about the severity of COVID infection in rheumatic patients; however, other studies have found no difference between them and the general population. Objectives To study the clinical character of rheumatic disease patients (RDP) with COVID and the outcome and compare this outcome with the nonrheumatic patients. Patients and methods This investigation was conducted retrospectively; all patients were recruited from quarantine hospitals. This study included 100 randomly selected COVID-19 patients with RDP and 200 COVID-19 patients with comorbidities other than rheumatological disease. Results The RDP presented with fever in 75%, and more than 60% developed cough and dyspnea. One-third of the patients developed anosmia and 25% lost the taste sensation; 72% of the studied RDP were admitted to Ain Shams University’s quarantine hospitals. Mean of the patients’ hospital stay of RDP was 15.4 ± 6.7; 38% of those were admitted to the ICU. Moreover, 27% had needed mechanical ventilation, 14% developed cytokine storm, and finally, 11% of RDP died due to COVID infection; 89% of RDP had been resolved from COVID infection. Conclusions Three-quarters of the recruited patients needed hospitalization. The mortality was 11%. The frequency of hospitalization and mortality of RDP were related significantly to the severity of COVID-19 infection, presence of comorbidity, and use of cyclophosphamide. Despite this, the outcomes of rheumatic patients and the general population were not significantly different.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76450856","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}
Adel A. M. Saeed, Karim Abdelfattah, A. Gomaa, Noha Ahmed
Background Interstitial lung diseases (ILDs) are a diverse set of diffuse parenchymal lung illnesses defined by decreased functional capacity and exercise-induced hypoxia. Despite the inadequacy of clinical guidelines for pulmonary rehabilitation (PR) in ILD, some recent studies have indicated that rehabilitation can help patients with ILD improve their dyspnea and functional capacity. Chest ultrasound (US) is a safe and effective method to assess diaphragmatic function and the impact of PR on it. Purpose Evaluation of diaphragmatic motion and thickness by chest US, spirometry, maximal inspiratory pressure (Pi Max), maximal expiratory pressure (Pe Max), 6-minute walk test (6MWT), and modified Medical Research Council (mMRC) Dyspnea Scale in ILD patients before and after PR program from January 2019 to June 2021. Patients and methods Our study was a prospective and analytical study that included twenty patients diagnosed with ILD in Ain Shams University Hospitals (inpatients and outpatients) in the duration from January 2019 to June 2021. All patients after informed written consent were subject to chest history and examination, high-resolution computed tomography chest prerehabilitation and postrehabilitation spirometry, chest US to assess diaphragmatic excursion both at rest and with forced respiration, assessment of diaphragmatic thickness, 6MWT, and mMRC. All patients took part in a home-based PR program (mostly an exercise training program) that included two sessions per week for 8 weeks (a total of 16 sessions), which included upper-extremity and lower-extremity endurance training, as well as respiratory muscle training. Follow-up visits were scheduled every 2 weeks and included diaphragmatic US and mMRC. Results There were 14 females (70.0%) and six males (30.0%) with age ranged from 38 to 66 years with mean±SD of 49.0 ± 8.44. There was a statistically significant increase in the pulmonary functions of the studied patients after 8 weeks of rehabilitation. There was also a statistically significant increase in diaphragmatic excursion and thickness of the studied patients at 2, 4, 6, and 8 weeks after rehabilitation. There was highly significant improvement in mMRC classification at 4, 6, and 8 weeks than before rehabilitation. As for 6MWT, there was a highly statistically significant increase in the 6-min walking distance after 8 weeks of rehabilitation. Conclusion In individuals with ILD, PR improves pulmonary function, diaphragmatic thickness, and excursion, mMRC, and 6-min walking distance.
{"title":"Study of diaphragmatic mobility by chest ultrasound and changes in maximal respiratory pressures in patients with interstitial pulmonary fibrosis before and after pulmonary rehabilitation","authors":"Adel A. M. Saeed, Karim Abdelfattah, A. Gomaa, Noha Ahmed","doi":"10.4103/ecdt.ecdt_66_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_66_22","url":null,"abstract":"Background Interstitial lung diseases (ILDs) are a diverse set of diffuse parenchymal lung illnesses defined by decreased functional capacity and exercise-induced hypoxia. Despite the inadequacy of clinical guidelines for pulmonary rehabilitation (PR) in ILD, some recent studies have indicated that rehabilitation can help patients with ILD improve their dyspnea and functional capacity. Chest ultrasound (US) is a safe and effective method to assess diaphragmatic function and the impact of PR on it. Purpose Evaluation of diaphragmatic motion and thickness by chest US, spirometry, maximal inspiratory pressure (Pi Max), maximal expiratory pressure (Pe Max), 6-minute walk test (6MWT), and modified Medical Research Council (mMRC) Dyspnea Scale in ILD patients before and after PR program from January 2019 to June 2021. Patients and methods Our study was a prospective and analytical study that included twenty patients diagnosed with ILD in Ain Shams University Hospitals (inpatients and outpatients) in the duration from January 2019 to June 2021. All patients after informed written consent were subject to chest history and examination, high-resolution computed tomography chest prerehabilitation and postrehabilitation spirometry, chest US to assess diaphragmatic excursion both at rest and with forced respiration, assessment of diaphragmatic thickness, 6MWT, and mMRC. All patients took part in a home-based PR program (mostly an exercise training program) that included two sessions per week for 8 weeks (a total of 16 sessions), which included upper-extremity and lower-extremity endurance training, as well as respiratory muscle training. Follow-up visits were scheduled every 2 weeks and included diaphragmatic US and mMRC. Results There were 14 females (70.0%) and six males (30.0%) with age ranged from 38 to 66 years with mean±SD of 49.0 ± 8.44. There was a statistically significant increase in the pulmonary functions of the studied patients after 8 weeks of rehabilitation. There was also a statistically significant increase in diaphragmatic excursion and thickness of the studied patients at 2, 4, 6, and 8 weeks after rehabilitation. There was highly significant improvement in mMRC classification at 4, 6, and 8 weeks than before rehabilitation. As for 6MWT, there was a highly statistically significant increase in the 6-min walking distance after 8 weeks of rehabilitation. Conclusion In individuals with ILD, PR improves pulmonary function, diaphragmatic thickness, and excursion, mMRC, and 6-min walking distance.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79493332","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. Zedan, Mona El wassefy, I. Nour, E. Khashaba, A. Osman, E. El Sherbiny
Background Asthma is a heterogeneous disorder, which is affected by interaction between genes and the surrounding environment. Chemokine receptor 3 (CCR3) which is expressed over eosinophils and Th2 lymphocytes has a significant role in chemoattraction of those cells to inflammatory sites which symbolizes a key mechanism in asthma. Aim A trial to detect the association between CCR3 T51C gene polymorphism and different asthma phenotypes (allergic march phenotype, cough-predominant asthma phenotype, and wheeze-predominant asthma phenotype). Patients and methods A case–control study was conducted comprising 60 asthmatic patients and 100 healthy controls. Asthmatic children were divided into three groups of 20 patients each, group 1 allergic march phenotype (wheeze asthma phenotype with allergic rhinitis and/or atopic dermatitis), group 2 cough-predominant asthma phenotype, and group 3 wheeze-predominant asthma phenotype. The included cases and controls underwent total serum immunoglobulin E (IgE) using the enzyme-linked immunosorbent assay technique, peripheral eosinophilic percent, and PCR-restriction fragment length polymorphism for CCR3 T51C gene polymorphism. Results Asthmatic children showed significant increase in crowding index, family history of bronchial asthma, parental smoking, parental consanguinity, and total serum IgE than controls. Also, the CCR3 T51C gene polymorphism was found in Egyptian asthmatic children but no significant association concerning this polymorphism and different clinical asthma phenotypes was detected. Conclusion In conclusion, allergic march phenotype showed significant higher frequency with positive family history of asthma when compared with cough and wheezy asthma phenotypes. Also, parental consanguinity showed higher frequency in cough phenotype compared with allergic march phenotype. Furthermore, the CCR3 T51C gene polymorphism is found to be present in Egyptian asthmatic children, but there is no significant association between CCR3 T51C gene polymorphism and different asthma phenotypes. So, larger scale studies are needed. However, the TT genotype showed higher frequency in the studied phenotypes compared with CC and CT genotypes while asthmatic cases with the CC genotype showed higher total serum IgE compared with those with TT and CT genotypes.
{"title":"Association between chemokine receptor 3T51C gene polymorphism and different clinical asthma phenotypes in Egyptian asthmatic children","authors":"M. Zedan, Mona El wassefy, I. Nour, E. Khashaba, A. Osman, E. El Sherbiny","doi":"10.4103/ecdt.ecdt_65_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_65_22","url":null,"abstract":"Background Asthma is a heterogeneous disorder, which is affected by interaction between genes and the surrounding environment. Chemokine receptor 3 (CCR3) which is expressed over eosinophils and Th2 lymphocytes has a significant role in chemoattraction of those cells to inflammatory sites which symbolizes a key mechanism in asthma. Aim A trial to detect the association between CCR3 T51C gene polymorphism and different asthma phenotypes (allergic march phenotype, cough-predominant asthma phenotype, and wheeze-predominant asthma phenotype). Patients and methods A case–control study was conducted comprising 60 asthmatic patients and 100 healthy controls. Asthmatic children were divided into three groups of 20 patients each, group 1 allergic march phenotype (wheeze asthma phenotype with allergic rhinitis and/or atopic dermatitis), group 2 cough-predominant asthma phenotype, and group 3 wheeze-predominant asthma phenotype. The included cases and controls underwent total serum immunoglobulin E (IgE) using the enzyme-linked immunosorbent assay technique, peripheral eosinophilic percent, and PCR-restriction fragment length polymorphism for CCR3 T51C gene polymorphism. Results Asthmatic children showed significant increase in crowding index, family history of bronchial asthma, parental smoking, parental consanguinity, and total serum IgE than controls. Also, the CCR3 T51C gene polymorphism was found in Egyptian asthmatic children but no significant association concerning this polymorphism and different clinical asthma phenotypes was detected. Conclusion In conclusion, allergic march phenotype showed significant higher frequency with positive family history of asthma when compared with cough and wheezy asthma phenotypes. Also, parental consanguinity showed higher frequency in cough phenotype compared with allergic march phenotype. Furthermore, the CCR3 T51C gene polymorphism is found to be present in Egyptian asthmatic children, but there is no significant association between CCR3 T51C gene polymorphism and different asthma phenotypes. So, larger scale studies are needed. However, the TT genotype showed higher frequency in the studied phenotypes compared with CC and CT genotypes while asthmatic cases with the CC genotype showed higher total serum IgE compared with those with TT and CT genotypes.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80426611","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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