Riham Farouk, Gamal Abdel-latif, Ibrahim A Dwedar, Dalia Abdel-sattar Mohammed
Background Although studies show that most people successfully control their asthma, polls consistently show that this is not the case in real life. The present study aimed to validate assessment of asthma control using a risk stratification approach in comparison with global strategy for asthma management and prevention (GINA) guidelines with particular attention to high-risk group of asthmatic patients. Patients and methods This was a prospective interventional cohort trial that enrolled 30 patients with asthma in the outpatient department of Ain Shams University Hospital between January 2019 and January 2020. There were 10 female patients and 20 male patients, with a mean age of 51.43 ± 14.94 years. They were enrolled and randomly grouped 1: 1 into group A, which followed asthma risk stratification therapy (ARST), and group B, with the standard GINA approach, within 1-year follow-up period. Following visit 1 in a 2-week interval as a washout period, there were five consecutive visits on 3 months apart, and then visit 6 at the end of treatment at a 2-week interval. All patients were subjected to the Asthma Control Test Questionnaire for assessment of asthma control by GINA approach and to objective control assessments in ARST by Morisky Medication Adherence Scale-8 for adherence assessment, pulmonary function test for evaluation of annual decline of forced expiratory volume in the first second, and the annual rate of exacerbations. Results The results obtained from visits 1 to 6 showed nonstatistically significant differences in forced expiratory volume in the first second (75 vs. 81.82 ml, P=0.820) and in adherence scale (Morisky Medication Adherence Scale-8) on visits 2–5 (40 vs. 17, P=0465), or the rate of exacerbation (two exacerbations in each group), with no statistically significant differences (0 vs. 13.3%, P=0.143) in group A and group B, respectively. On the contrary, the assessment of severity tools in ARST was based on the level of sustainability of the asthma stepwise categorization among the duration therapy. Using ARST for the aims of control and severity assessments on the studied group, in comparison with the GINA assessment approach, there were highly significant statistical differences in numbers of controlled patients as well as numbers of patients with mild and moderate asthma for severity assessments (t=13.263, P=0.001 vs. t=22.941, P=0.0001, respectively). It could be concluded that applying the GINA approach on studied group A revealed underestimation of control and probably overestimation of asthma severity, or better called asthma stability. Conclusion ARST is noninferior to the GINA approach in the norms of asthma control when objectivity was measured, whereas the levels of sustainability or stability among the duration therapy for assessment of asthma severity were statistically overestimated when measured by GINA. These measures could help most patients with asthma, and there should be a concerted action for their i
{"title":"Validation of asthma management approach according to risk factors","authors":"Riham Farouk, Gamal Abdel-latif, Ibrahim A Dwedar, Dalia Abdel-sattar Mohammed","doi":"10.4103/ecdt.ecdt_49_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_49_22","url":null,"abstract":"Background Although studies show that most people successfully control their asthma, polls consistently show that this is not the case in real life. The present study aimed to validate assessment of asthma control using a risk stratification approach in comparison with global strategy for asthma management and prevention (GINA) guidelines with particular attention to high-risk group of asthmatic patients. Patients and methods This was a prospective interventional cohort trial that enrolled 30 patients with asthma in the outpatient department of Ain Shams University Hospital between January 2019 and January 2020. There were 10 female patients and 20 male patients, with a mean age of 51.43 ± 14.94 years. They were enrolled and randomly grouped 1: 1 into group A, which followed asthma risk stratification therapy (ARST), and group B, with the standard GINA approach, within 1-year follow-up period. Following visit 1 in a 2-week interval as a washout period, there were five consecutive visits on 3 months apart, and then visit 6 at the end of treatment at a 2-week interval. All patients were subjected to the Asthma Control Test Questionnaire for assessment of asthma control by GINA approach and to objective control assessments in ARST by Morisky Medication Adherence Scale-8 for adherence assessment, pulmonary function test for evaluation of annual decline of forced expiratory volume in the first second, and the annual rate of exacerbations. Results The results obtained from visits 1 to 6 showed nonstatistically significant differences in forced expiratory volume in the first second (75 vs. 81.82 ml, P=0.820) and in adherence scale (Morisky Medication Adherence Scale-8) on visits 2–5 (40 vs. 17, P=0465), or the rate of exacerbation (two exacerbations in each group), with no statistically significant differences (0 vs. 13.3%, P=0.143) in group A and group B, respectively. On the contrary, the assessment of severity tools in ARST was based on the level of sustainability of the asthma stepwise categorization among the duration therapy. Using ARST for the aims of control and severity assessments on the studied group, in comparison with the GINA assessment approach, there were highly significant statistical differences in numbers of controlled patients as well as numbers of patients with mild and moderate asthma for severity assessments (t=13.263, P=0.001 vs. t=22.941, P=0.0001, respectively). It could be concluded that applying the GINA approach on studied group A revealed underestimation of control and probably overestimation of asthma severity, or better called asthma stability. Conclusion ARST is noninferior to the GINA approach in the norms of asthma control when objectivity was measured, whereas the levels of sustainability or stability among the duration therapy for assessment of asthma severity were statistically overestimated when measured by GINA. These measures could help most patients with asthma, and there should be a concerted action for their i","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90712882","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}
Bachouch Imen, N. Belloumi, S. Racha, Houcine Yoldez, C. Habouria, Jrad Sonia, Chermiti Fatma, E. M. Faouzi, Fenniche Soraya
Oral soft tissue metastases may be presented as rapidly progressive hyperplasic growths mimicking benign processes. Gingival metastases from pulmonary sarcomatoid carcinoma are extremely rare and have poor prognosis. We report in this publication a case of a 65-year-old male patient, presenting asarcomatoid carcinoma of the right upper pulmonary lobe. Clinical examination found a gingival swelling initially considered as a benign lesion. Gingival biopsy showed aspects of undifferentiated sarcomatoid carcinoma of pulmonary origin according to the immunohistochemical staining. Even rarely described, benign-mimiking lesions may be the first sign of an aggressive underlying malignancy, and, therefore, periodontists should be vigilant. Any abnormal lesion must be evaluated by histopathological investigations.
{"title":"Pulmonary sarcomatoid carcinoma revealed by gingival metastases","authors":"Bachouch Imen, N. Belloumi, S. Racha, Houcine Yoldez, C. Habouria, Jrad Sonia, Chermiti Fatma, E. M. Faouzi, Fenniche Soraya","doi":"10.4103/ecdt.ecdt_39_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_39_22","url":null,"abstract":"Oral soft tissue metastases may be presented as rapidly progressive hyperplasic growths mimicking benign processes. Gingival metastases from pulmonary sarcomatoid carcinoma are extremely rare and have poor prognosis. We report in this publication a case of a 65-year-old male patient, presenting asarcomatoid carcinoma of the right upper pulmonary lobe. Clinical examination found a gingival swelling initially considered as a benign lesion. Gingival biopsy showed aspects of undifferentiated sarcomatoid carcinoma of pulmonary origin according to the immunohistochemical staining. Even rarely described, benign-mimiking lesions may be the first sign of an aggressive underlying malignancy, and, therefore, periodontists should be vigilant. Any abnormal lesion must be evaluated by histopathological investigations.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78226507","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 Coronavirus disease 2019 (COVID-19) infection is currently the greatest atypical pneumonia outbreak, causing widespread anxiety and fear. Objectives To study cases with clinical manifestations that have been identified as COVID-19 according to the Egyptian Ministry of Health’s criteria, their management protocol, and outcome data at the isolation department of El-Dakhla General Hospital. Patients and methods This work was performed upon 106 patients with clinical symptoms of COVID-19 at the isolation department of El-Dakhla General Hospital. Results Mortality was associated with older age. No patients within the died group had been vaccinated. Vaccination was significantly associated with decreased severity of chest affection, admission to the ICU, and duration of admission. Mortality was associated with severity of chest affection. All died patients were admitted to the ICU. This study also revealed that abnormal vital and laboratory data were significantly associated with mortality. On using binary regression analysis of factors to be significantly associated with mortality, lower duration of admission and not being admitted to ICU decreased the risk of mortality among the studied patients, yet was statistically nonsignificant (P>0.05), whereas higher C-reactive protein on admission increased the risk by 1.186 folds. Conclusion Age, vaccination state, severity of chest affection, ICU admission and duration, use of some medications, vital data, and laboratory data are important factors to assess the prognosis and severity of COVID infection.
{"title":"Study of coronavirus disease 2019 cases at the isolation department of el-dakhla general hospital","authors":"Mohamed Tageldein, Mahmoud Mohamed, M. Ibrahim","doi":"10.4103/ecdt.ecdt_36_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_36_22","url":null,"abstract":"Background Coronavirus disease 2019 (COVID-19) infection is currently the greatest atypical pneumonia outbreak, causing widespread anxiety and fear. Objectives To study cases with clinical manifestations that have been identified as COVID-19 according to the Egyptian Ministry of Health’s criteria, their management protocol, and outcome data at the isolation department of El-Dakhla General Hospital. Patients and methods This work was performed upon 106 patients with clinical symptoms of COVID-19 at the isolation department of El-Dakhla General Hospital. Results Mortality was associated with older age. No patients within the died group had been vaccinated. Vaccination was significantly associated with decreased severity of chest affection, admission to the ICU, and duration of admission. Mortality was associated with severity of chest affection. All died patients were admitted to the ICU. This study also revealed that abnormal vital and laboratory data were significantly associated with mortality. On using binary regression analysis of factors to be significantly associated with mortality, lower duration of admission and not being admitted to ICU decreased the risk of mortality among the studied patients, yet was statistically nonsignificant (P>0.05), whereas higher C-reactive protein on admission increased the risk by 1.186 folds. Conclusion Age, vaccination state, severity of chest affection, ICU admission and duration, use of some medications, vital data, and laboratory data are important factors to assess the prognosis and severity of COVID infection.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76198598","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 Bronchiectasis is a persistent dilatation of the proximal and medium-sized bronchi greater than 2 mm in diameter caused by weakening or fibrosis of the bronchial walls’ muscular and elastic components. Aim To measure the severity of bronchiectasis utilizing bronchiectasis-severity ratings in conjunction with transthoracic lung sonography and sputum-culture findings. Patients and methods This study was conducted at Chest Department Nasser Institute during the period from January 2020 to June 2021 and included 20 patients: nine females and 11 males with localized symptomatizing bronchiectasis. Results In total, 20 patients, 11 (55.0%) males and nine (45.0%) females, were included in this study where Pseudomonas aeruginosa was detected in 12 patients, Haemophilus influenza, and Klebsiella detected in six patients. There was a significant relation between FACED score, Bahalla score, and thoracic ultrasound (US) (P<0.05), also there is significant correlation between bronchiectasis severity index (BSI) score and FACED score (P<0.001). Meanwhile, there was insignificant relation between BSI score and thoracic US. Conclusion US is a valuable technique in relation to the BSI, FACED, and Bahalla scores.
{"title":"Relation between bronchiectasis severity index and chest ultrasound in noncystic fibrosis bronchiectasis patient","authors":"A. Abdelwahab, Mohammad Eldin, Hossam Abdel-Hamid","doi":"10.4103/ecdt.ecdt_25_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_25_22","url":null,"abstract":"Background Bronchiectasis is a persistent dilatation of the proximal and medium-sized bronchi greater than 2 mm in diameter caused by weakening or fibrosis of the bronchial walls’ muscular and elastic components. Aim To measure the severity of bronchiectasis utilizing bronchiectasis-severity ratings in conjunction with transthoracic lung sonography and sputum-culture findings. Patients and methods This study was conducted at Chest Department Nasser Institute during the period from January 2020 to June 2021 and included 20 patients: nine females and 11 males with localized symptomatizing bronchiectasis. Results In total, 20 patients, 11 (55.0%) males and nine (45.0%) females, were included in this study where Pseudomonas aeruginosa was detected in 12 patients, Haemophilus influenza, and Klebsiella detected in six patients. There was a significant relation between FACED score, Bahalla score, and thoracic ultrasound (US) (P<0.05), also there is significant correlation between bronchiectasis severity index (BSI) score and FACED score (P<0.001). Meanwhile, there was insignificant relation between BSI score and thoracic US. Conclusion US is a valuable technique in relation to the BSI, FACED, and Bahalla scores.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83501199","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}
Mervat A Abou Ismail, Ahmed Y Gad, Hatem A Elmallawany, Hany H Moussa
Abstract Context Parapneumonic effusion and empyema are commonly encountered by the pulmonologist. The decision regarding management is still challenging. Aim To compare outcomes of intrapleural streptokinase with pigtail catheter drainage versus medical thoracoscopy in complicated parapneumonic effusion. Methods and material Forty patients with complicated parapneumonic effusion were randomly allocated to one of two groups. Twenty patients underwent streptokinase intrapleural instillation via pigtail catheter. The other twenty patients underwent medical thoracoscopy. Results Intrapleural streptokinase instillation procedure was significantly shorter duration (12.80 ± 3.05 min) than medical thoracoscopy procedure (25.26 ± 4.66 min). However medical thoracoscopy showed a significant less days required to remove the drainage system (5.80 ± 1.70 days) versus intrapleural streptokinase instillation procedure (9.40 ± 3.91 days). Both groups had no significant complications. Lung expansion was achieved in 90% of patients treated with intrapleural streptokinase instillation and in 95% of patients treated with a medical thoracoscopy technique, with no statistically significant difference between the two groups. Conclusions Treatment of complicated parapneumonic effusions is undeniably interdisciplinary. Both intrapleural streptokinase with pigtail catheter drainage and medical thoracoscopy are safe and improve outcomes in complicated parapneumonic effusion. Medical thoracoscopy has an advantage of fewer days required for tube withdrawal. Pigtail insertion has an advantage of shorter procedure time compared to medical thoracoscopy
{"title":"Intrapleural streptokinase with pigtail catheter drainage versus medical thoracoscopy in complicated parapneumonic effusion","authors":"Mervat A Abou Ismail, Ahmed Y Gad, Hatem A Elmallawany, Hany H Moussa","doi":"10.4103/ecdt.ecdt_3_23","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_3_23","url":null,"abstract":"Abstract Context Parapneumonic effusion and empyema are commonly encountered by the pulmonologist. The decision regarding management is still challenging. Aim To compare outcomes of intrapleural streptokinase with pigtail catheter drainage versus medical thoracoscopy in complicated parapneumonic effusion. Methods and material Forty patients with complicated parapneumonic effusion were randomly allocated to one of two groups. Twenty patients underwent streptokinase intrapleural instillation via pigtail catheter. The other twenty patients underwent medical thoracoscopy. Results Intrapleural streptokinase instillation procedure was significantly shorter duration (12.80 ± 3.05 min) than medical thoracoscopy procedure (25.26 ± 4.66 min). However medical thoracoscopy showed a significant less days required to remove the drainage system (5.80 ± 1.70 days) versus intrapleural streptokinase instillation procedure (9.40 ± 3.91 days). Both groups had no significant complications. Lung expansion was achieved in 90% of patients treated with intrapleural streptokinase instillation and in 95% of patients treated with a medical thoracoscopy technique, with no statistically significant difference between the two groups. Conclusions Treatment of complicated parapneumonic effusions is undeniably interdisciplinary. Both intrapleural streptokinase with pigtail catheter drainage and medical thoracoscopy are safe and improve outcomes in complicated parapneumonic effusion. Medical thoracoscopy has an advantage of fewer days required for tube withdrawal. Pigtail insertion has an advantage of shorter procedure time compared to medical thoracoscopy","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135667821","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}
YasserHamed Mostafa, M. Khalil, S. Hegazy, Marwa Daif
Background Coronavirus disease (COVID-19) is a recently prevalent infectious disease that is caused by a virus from the coronavirus family and causes acute respiratory syndrome. It is a pandemic catastrophe that has affected more than 60 million people around the world and has caused about 1.5 million deaths, as reported by the WHO. This disease affects the respiratory system and leads to different forms of symptoms and signs. Pneumonia is a common cause for hospitalization, with most patients treated in hospital wards and others requiring ICU. Although the number of complete recoveries from COVID-19 has increased, there is still concern about complications associated with the disease that appear after recovery. The studies that have looked at past types and other forms of coronavirus epidemics, such as SARS have shown that some cases had respiratory complications from the infection after being full recovered, as 36 and 30% of the entire study population had clinical and high-resolution computed tomography (HRCT) changes at 3 and 6 months after recovery, respectively. Mostly, the abnormalities seen in pulmonary function test (PFT) results are sequelae of diffusion capacity defect. In recovered cases of Middle East respiratory syndrome, 36% of patients showed HRCT sequelae at follow-up of 6 weeks, because of fibrosis. Data on COVID-19 indicate that prolonged disease and persistent symptoms show post-PFT affection and follow-up radiographic changes after recovery from COVID-19 as interstitial pulmonary changes and a degree of pulmonary vasculopathy. In recovered cases of COVID-19, capacity of diffusion is the commonest defect in lung function, followed by the restrictive pattern defects on spirometry; both are related to the degree of severity of pneumonic COVID-19. PFTs (involving spirometry as well as diffusion capacity) are considered as routine follow-up examinations for some of the recovered cases, especially severe cases. Rehabilitation programs of the respiratory system are an option strategy that might be considered. This study aims to show changes in pulmonary function and HRCT of chest in post-COVID-19-infected patients to detect long-term effects on the lungs after 3 months as obstructive or restrictive, or both, lung diseases. Patients and methods The study was conducted on 100 confirmed PCR-positive COVID-19 cases that were admitted to Ain Shams University Isolation Hospitals, and the follow-up was performed in the outpatient clinic. PCR samples (Combined nasopharyngeal and oropharyngeal swab) were taken after 3 months from discharge of patients above the age of 18 years who become negative with clinical improvement. PFT [spirometry and diffusion for carbon monoxide (DLCO)] and chest HRCT were done. All patients’ clinical data were recorded, and CT chest imaging data of these patients were correlated with the clinical data. Results A total of 100 patients were included in this study, where males represented 58% and female represented 4
{"title":"The outcome of pulmonary function tests and high-resolution computed tomography of chest in post-coronavirus disease 2019-confirmed cases after 3 months of recovery","authors":"YasserHamed Mostafa, M. Khalil, S. Hegazy, Marwa Daif","doi":"10.4103/ecdt.ecdt_41_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_41_22","url":null,"abstract":"Background Coronavirus disease (COVID-19) is a recently prevalent infectious disease that is caused by a virus from the coronavirus family and causes acute respiratory syndrome. It is a pandemic catastrophe that has affected more than 60 million people around the world and has caused about 1.5 million deaths, as reported by the WHO. This disease affects the respiratory system and leads to different forms of symptoms and signs. Pneumonia is a common cause for hospitalization, with most patients treated in hospital wards and others requiring ICU. Although the number of complete recoveries from COVID-19 has increased, there is still concern about complications associated with the disease that appear after recovery. The studies that have looked at past types and other forms of coronavirus epidemics, such as SARS have shown that some cases had respiratory complications from the infection after being full recovered, as 36 and 30% of the entire study population had clinical and high-resolution computed tomography (HRCT) changes at 3 and 6 months after recovery, respectively. Mostly, the abnormalities seen in pulmonary function test (PFT) results are sequelae of diffusion capacity defect. In recovered cases of Middle East respiratory syndrome, 36% of patients showed HRCT sequelae at follow-up of 6 weeks, because of fibrosis. Data on COVID-19 indicate that prolonged disease and persistent symptoms show post-PFT affection and follow-up radiographic changes after recovery from COVID-19 as interstitial pulmonary changes and a degree of pulmonary vasculopathy. In recovered cases of COVID-19, capacity of diffusion is the commonest defect in lung function, followed by the restrictive pattern defects on spirometry; both are related to the degree of severity of pneumonic COVID-19. PFTs (involving spirometry as well as diffusion capacity) are considered as routine follow-up examinations for some of the recovered cases, especially severe cases. Rehabilitation programs of the respiratory system are an option strategy that might be considered. This study aims to show changes in pulmonary function and HRCT of chest in post-COVID-19-infected patients to detect long-term effects on the lungs after 3 months as obstructive or restrictive, or both, lung diseases. Patients and methods The study was conducted on 100 confirmed PCR-positive COVID-19 cases that were admitted to Ain Shams University Isolation Hospitals, and the follow-up was performed in the outpatient clinic. PCR samples (Combined nasopharyngeal and oropharyngeal swab) were taken after 3 months from discharge of patients above the age of 18 years who become negative with clinical improvement. PFT [spirometry and diffusion for carbon monoxide (DLCO)] and chest HRCT were done. All patients’ clinical data were recorded, and CT chest imaging data of these patients were correlated with the clinical data. Results A total of 100 patients were included in this study, where males represented 58% and female represented 4","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90910439","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. Mousa, M. Elshazly, M. E. El Salam, Salwa Ahmed, A. Tantawy
Objectives Severe acute respiratory syndrome coronavirus 2 has infected millions of people worldwide with extensive affection and damage to body systems and organs; hence, the study of post-coronavirus disease (COVID) sequences is mandatory. Till now, reports are upcoming on the considerable effects of COVID-19 on male sexual health with no final data. Patients and methods Our cohort study included 76 male COVID-19-infected patients, confirmed positive via nasopharyngeal PCR swab. The rationale of this study was to estimate the influence of clinical, laboratory, and radiological severity parameters of COVID-19 on male erectile dysfunction based on erectile scores and male sex hormones (follicle-stimulating hormone, luteinizing hormone, testosterone, and estradiol). Results Our results have demonstrated a highly statistically significant correlation between COVID-19 severity (mild, moderate, and severe cases) and both erectile scores (erection hardness score and International Index of Erectile Dysfunction-5) and testosterone hormones at first and third month after COVID (P<0.001), except for testosterone level at third month and COVID-19 severity, which showed a statistically significant difference, with P value of 0.031. Conclusions The current study correlated the effect of COVID-19 severity in the terms of clinical, laboratory, and radiological presentations on male sexual dysfunction (erectile scores and testosterone hormone) at first and third month after hospital discharge, with statistical significance being highly affected in severe rather than moderate and mild cases. This strengthens the obvious effect of COVID-19 infection on male sexual dysfunction.
{"title":"The effect of coronavirus disease 2019 severity on male sexual functions among patients on follow-up after hospital discharge","authors":"M. Mousa, M. Elshazly, M. E. El Salam, Salwa Ahmed, A. Tantawy","doi":"10.4103/ecdt.ecdt_68_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_68_22","url":null,"abstract":"Objectives Severe acute respiratory syndrome coronavirus 2 has infected millions of people worldwide with extensive affection and damage to body systems and organs; hence, the study of post-coronavirus disease (COVID) sequences is mandatory. Till now, reports are upcoming on the considerable effects of COVID-19 on male sexual health with no final data. Patients and methods Our cohort study included 76 male COVID-19-infected patients, confirmed positive via nasopharyngeal PCR swab. The rationale of this study was to estimate the influence of clinical, laboratory, and radiological severity parameters of COVID-19 on male erectile dysfunction based on erectile scores and male sex hormones (follicle-stimulating hormone, luteinizing hormone, testosterone, and estradiol). Results Our results have demonstrated a highly statistically significant correlation between COVID-19 severity (mild, moderate, and severe cases) and both erectile scores (erection hardness score and International Index of Erectile Dysfunction-5) and testosterone hormones at first and third month after COVID (P<0.001), except for testosterone level at third month and COVID-19 severity, which showed a statistically significant difference, with P value of 0.031. Conclusions The current study correlated the effect of COVID-19 severity in the terms of clinical, laboratory, and radiological presentations on male sexual dysfunction (erectile scores and testosterone hormone) at first and third month after hospital discharge, with statistical significance being highly affected in severe rather than moderate and mild cases. This strengthens the obvious effect of COVID-19 infection on male sexual dysfunction.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85211735","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}
Naglaa F Ahmed, Amany Abou Zeid, Mai Abo Elhasab, Gihan S. ABO ELWAFA
Introduction Noninvasive ventilation (NIV) has been recognized as a mean to avoid intubation and to reduce the risk of complications. Aims To study the role of NIV in acute respiratory failure in patients with interstitial lung diseases (ILD). Settings and design This was a prospective study. Patients and methods The present study included 30 mechanically ventilated patients through noninvasive masks subjected basically to informed consent, clinical data collection, laboratory investigations, chest radiograph, and arterial blood gas samples. Results A total of 20 patients were found to be survivors, whereas 10 patients were found to be nonsurvivors. The most common type of ILD in our study was hypersensitivity pneumonitis (53.3% of all patients) with fibrosis, and ground glass opacities were the most common radiological findings on high-resolution computed tomography, and moderate restrictive pattern in pulmonary function tests. Infection was the main cause of exacerbation as evidenced by fever, elevated total leukocytic count, staff neutrophilic count, and erythrocyte sedimentation rate. None of our patients developed complications or intolerance to NIV. Conclusion There was improvement in oxygenation parameters, so NIV could be a valuable option for management of acute type I mild to moderate respiratory failure in patients with ILD.
{"title":"Noninvasive ventilation in acute exacerbation of interstitial lung diseases","authors":"Naglaa F Ahmed, Amany Abou Zeid, Mai Abo Elhasab, Gihan S. ABO ELWAFA","doi":"10.4103/ecdt.ecdt_40_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_40_22","url":null,"abstract":"Introduction Noninvasive ventilation (NIV) has been recognized as a mean to avoid intubation and to reduce the risk of complications. Aims To study the role of NIV in acute respiratory failure in patients with interstitial lung diseases (ILD). Settings and design This was a prospective study. Patients and methods The present study included 30 mechanically ventilated patients through noninvasive masks subjected basically to informed consent, clinical data collection, laboratory investigations, chest radiograph, and arterial blood gas samples. Results A total of 20 patients were found to be survivors, whereas 10 patients were found to be nonsurvivors. The most common type of ILD in our study was hypersensitivity pneumonitis (53.3% of all patients) with fibrosis, and ground glass opacities were the most common radiological findings on high-resolution computed tomography, and moderate restrictive pattern in pulmonary function tests. Infection was the main cause of exacerbation as evidenced by fever, elevated total leukocytic count, staff neutrophilic count, and erythrocyte sedimentation rate. None of our patients developed complications or intolerance to NIV. Conclusion There was improvement in oxygenation parameters, so NIV could be a valuable option for management of acute type I mild to moderate respiratory failure in patients with ILD.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77597960","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 : 2023-01-01DOI: 10.4103/ecdt.ecdt_125_22
Reham M El-Morshedy, Maha M El-kholy, Nermeen A M H Kamel, Samiaa H Sadek, Alaa S Abdel Ghany, Marwan N Mohamed
Abstract Context Exudative pleural effusion is a diagnostic dilemma that includes many steps; one of them is obtaining a definite diagnosis through pleural biopsy. Cryoprobes are being increasingly used for obtaining larger specimens with fewer crush artifacts. However, the safety and feasibility of cryoprobe biopsy compared with standard forceps for pleural biopsy have not been fully assessed. Aims To evaluate the diagnostic value, size, and quality of the specimens obtained by flexible cryoprobe in comparison with those obtained by flexible forceps probe during medical thoracoscopy in patients with exudative pleural effusion and to assess the possible complications from the procedure. Settings and design This interventional prospective study was carried out at the endoscopy unit at Chest Department and Tuberculosis Assiut University Hospital. Patients and methods This study included 60 patients with undiagnosed exudative pleural effusion. Medical thoracoscopy was carried out for all the patients, and pleural biopsies were taken from the parietal pleura using a conventional rigid forceps probe and flexible cryoprobe in the same settings. Results Cryoprobe biopsy established a definite diagnosis in 55/60, with 91.6% diagnostic yield, whereas forceps biopsy had a definite diagnosis in 53/60, with 88.3% diagnostic yield. The size of cryoprobe biopsy was significantly larger in comparison with the forceps biopsy (26.56 ± 22.16 vs. 17.38 ± 12.08 mm 2 ; P <0.001). The depth of pleural biopsy was evaluated by the presence of extrapleural fat cells, which were significantly higher in cryoprobe biopsy in comparison with forceps biopsy [21 (35%) vs. 11 (18.3%); P =0.03]. There were no significant complications or procedure-related deaths. Conclusions Cryobiopsy is a possible safe and effective alternative to conventional forceps probe biopsy in the diagnosis of exudative pleural effusion with a larger, deeper, and less number of biopsies. It was also found that cryoprobe biopsy had a better diagnostic yield, sensitivity, and accuracy.
摘要背景渗出性胸腔积液是一个诊断难题，包括许多步骤;其中之一是通过胸膜活检得到明确的诊断。冷冻探针越来越多地用于获得更大的标本，更少的挤压伪影。然而，冷冻探针活检与标准钳进行胸膜活检的安全性和可行性尚未得到充分评估。目的比较医用胸腔镜下柔性冷冻探头与柔性钳探头对胸腔渗出性积液的诊断价值、标本的大小和质量，并对其可能出现的并发症进行评价。背景和设计本介入前瞻性研究在阿西尤特大学医院胸科内窥镜科进行。患者与方法本研究纳入60例未确诊的渗出性胸腔积液患者。所有患者均接受内科胸腔镜检查，并在相同环境下使用常规刚性钳探针和柔性冷冻探针从胸膜壁层进行胸膜活检。结果冷冻活检确诊率为55/60，诊断率为91.6%;钳活检确诊率为53/60，诊断率为88.3%。冷冻探针活检组织的大小明显大于钳活检组织(26.56±22.16 vs. 17.38±12.08 mm 2;P & lt; 0.001)。通过胸膜外脂肪细胞的存在来评估胸膜活检的深度，与钳活检相比，冷冻探针活检的胸膜外脂肪细胞明显更高[21(35%)比11 (18.3%);P = 0.03)。无明显并发症或手术相关死亡。结论低温活检在诊断渗出性胸腔积液中具有较大、较深、较少活检次数的优点，可替代传统的钳探针活检，是一种安全有效的方法。我们还发现冷冻活检具有更好的诊断率、敏感性和准确性。
{"title":"Comparison between thoracoscopic pleural cryobiopsy and conventional forceps biopsy in diagnosis of exudative pleural effusion: Assiut University experience","authors":"Reham M El-Morshedy, Maha M El-kholy, Nermeen A M H Kamel, Samiaa H Sadek, Alaa S Abdel Ghany, Marwan N Mohamed","doi":"10.4103/ecdt.ecdt_125_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_125_22","url":null,"abstract":"Abstract Context Exudative pleural effusion is a diagnostic dilemma that includes many steps; one of them is obtaining a definite diagnosis through pleural biopsy. Cryoprobes are being increasingly used for obtaining larger specimens with fewer crush artifacts. However, the safety and feasibility of cryoprobe biopsy compared with standard forceps for pleural biopsy have not been fully assessed. Aims To evaluate the diagnostic value, size, and quality of the specimens obtained by flexible cryoprobe in comparison with those obtained by flexible forceps probe during medical thoracoscopy in patients with exudative pleural effusion and to assess the possible complications from the procedure. Settings and design This interventional prospective study was carried out at the endoscopy unit at Chest Department and Tuberculosis Assiut University Hospital. Patients and methods This study included 60 patients with undiagnosed exudative pleural effusion. Medical thoracoscopy was carried out for all the patients, and pleural biopsies were taken from the parietal pleura using a conventional rigid forceps probe and flexible cryoprobe in the same settings. Results Cryoprobe biopsy established a definite diagnosis in 55/60, with 91.6% diagnostic yield, whereas forceps biopsy had a definite diagnosis in 53/60, with 88.3% diagnostic yield. The size of cryoprobe biopsy was significantly larger in comparison with the forceps biopsy (26.56 ± 22.16 vs. 17.38 ± 12.08 mm 2 ; P <0.001). The depth of pleural biopsy was evaluated by the presence of extrapleural fat cells, which were significantly higher in cryoprobe biopsy in comparison with forceps biopsy [21 (35%) vs. 11 (18.3%); P =0.03]. There were no significant complications or procedure-related deaths. Conclusions Cryobiopsy is a possible safe and effective alternative to conventional forceps probe biopsy in the diagnosis of exudative pleural effusion with a larger, deeper, and less number of biopsies. It was also found that cryoprobe biopsy had a better diagnostic yield, sensitivity, and accuracy.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135667633","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 : 2023-01-01DOI: 10.4103/ecdt.ecdt_113_22
Wael Abdelfattah, Majid A Darraj, Abuobaida K Yassin, Heba M Shalaby
Abstract Background Drug-resistant tuberculosis (DR-TB) is a global challenge. Owing to its high annual mortality and morbidity rates, as stated in the annual global TB reports provided by WHO, the prevalence of multidrug-resistant tuberculosis (MDR-TB) or rifampicin-resistant tuberculosis was shown to be increasing worldwide in 2021. Patients with tuberculosis from 2018 to 2022 represented ~40 million individuals, including 1.5 million with DR-TB. The study’s goal was to identify MDR-TB prevalence and risk factors in Jazan, Saudi Arabia. Patients and methods The research was done on 114 patients diagnosed with pulmonary TB in Jazan Chest Hospital from January to April, 2019. Demographic data were collected. Monteux test, chest radiograph, sputum smear, and Lowenstein–Jensen culture were performed for all patients with pulmonary TB. Patients were allocated in either group A, with 103 (90.4%) patients, if they had Mycobacterium tuberculosis -susceptible isolates, or in group B, with 11 (9.7%) patients, if they had M. tuberculosis -resistant isolates. Results The observed overall DR-TB prevalence was 9.7%. The proportion of MDR isolates was 7%, polyresistant isolate TB was 0.9%, rifampicin-resistant tuberculosis was 0.9%, and ethambutol-resistant TB was 0.9%. Females were more in group B (54.5%) than in group A (26.2%). Unmarried patients were higher in group A (60.2%) than in group B (29.3%). Comorbidities had significant values in the drug-resistant groups (90.9%). Conclusion The study showed that screening and treatment of DR-TB are crucial for the control of TB in Jazan and Saudi Arabia as a whole.
{"title":"Prevalence and risk factors of multidrug-resistant tuberculosis in Jazan, Saudi Arabia","authors":"Wael Abdelfattah, Majid A Darraj, Abuobaida K Yassin, Heba M Shalaby","doi":"10.4103/ecdt.ecdt_113_22","DOIUrl":"https://doi.org/10.4103/ecdt.ecdt_113_22","url":null,"abstract":"Abstract Background Drug-resistant tuberculosis (DR-TB) is a global challenge. Owing to its high annual mortality and morbidity rates, as stated in the annual global TB reports provided by WHO, the prevalence of multidrug-resistant tuberculosis (MDR-TB) or rifampicin-resistant tuberculosis was shown to be increasing worldwide in 2021. Patients with tuberculosis from 2018 to 2022 represented ~40 million individuals, including 1.5 million with DR-TB. The study’s goal was to identify MDR-TB prevalence and risk factors in Jazan, Saudi Arabia. Patients and methods The research was done on 114 patients diagnosed with pulmonary TB in Jazan Chest Hospital from January to April, 2019. Demographic data were collected. Monteux test, chest radiograph, sputum smear, and Lowenstein–Jensen culture were performed for all patients with pulmonary TB. Patients were allocated in either group A, with 103 (90.4%) patients, if they had Mycobacterium tuberculosis -susceptible isolates, or in group B, with 11 (9.7%) patients, if they had M. tuberculosis -resistant isolates. Results The observed overall DR-TB prevalence was 9.7%. The proportion of MDR isolates was 7%, polyresistant isolate TB was 0.9%, rifampicin-resistant tuberculosis was 0.9%, and ethambutol-resistant TB was 0.9%. Females were more in group B (54.5%) than in group A (26.2%). Unmarried patients were higher in group A (60.2%) than in group B (29.3%). Comorbidities had significant values in the drug-resistant groups (90.9%). Conclusion The study showed that screening and treatment of DR-TB are crucial for the control of TB in Jazan and Saudi Arabia as a whole.","PeriodicalId":46359,"journal":{"name":"Egyptian Journal of Chest Diseases and Tuberculosis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135667642","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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