Sara El-Sayed Abd El-Ghani

Bronchial asthma remains a significant public health challenge, especially among school-aged children. Schoolteachers are often the initial responders to asthma attacks, making their role vital for early symptom recognition and first aid provision. Therefore, this study aimed to explore the knowledge, awareness, and response of schoolteachers to students with asthma. Between March 2024 and October 2024, a self-administered questionnaire was created on Google Forms and distributed to schoolteachers through WhatsApp groups of private and public schools across different districts in Greater Cairo. The questionnaire consisted of three sections assessing: (1) teachers’ experience and demographics, (2) basic knowledge of asthma, and (3) knowledge related to first aid response in an asthma attack. A total of 634 schoolteachers participated in the study. Of these, 361 (57%) reported having previously taught students with bronchial asthma, whereas only 176 (27.8%) had witnessed a student having an acute asthma attack before. A majority of participants (445/634, 70.2%) correctly identified the short-acting beta agonist (SABA) inhaler or nebulizer as appropriate first aid for an acute asthma attack. However, only 187/634 (29.5%) reported knowing the correct technique for using SABA inhalers or nebulizers during an asthma attack. More than half of the participants, 362/634 (57.1%), provided appropriate answers regarding the etiology of the disease, specifically whether it was a contagious disease or not. There was no statistically significant association between teachers’ knowledge level and their sociodemographic characteristics. Teachers in Greater Cairo demonstrated fair knowledge and awareness regarding asthma. However, they did not fully understand appropriate first-aid responses, a gap that underscores the need for more asthma education programs.

Background: The COVID-19 pandemic has complicated health services for cancer patients. Patients with hematological malignancies (HMs) are at high risk for COVID-19-related complications, resulting in elevated mortality rates. Vaccination serves as a crucial strategy for the primary prevention of COVID-19, particularly for high-risk patients, to mitigate morbidity and mortality associated with the virus. Patients with HMs demonstrate diminished seroconversion rates post-COVID-19 infection or vaccination compared to other cancer patients and are more vulnerable to viral infections. In addition, COVID-19 vaccine response in HM patients is inadequate, attributed to factors such as hypogammaglobulinemia, advanced age, ongoing treatment, and previous administration of immunosuppressive drugs. Aim: This study aimed to evaluate the antibody levels to COVID-19 infection and vaccination among patients with HMs. Methods: Eighty-six Egyptian patients aged more than 18 years were recruited from the Kasr Al-Ainy Hospital outpatient clinic with different HMs. The detection of immunoglobulin (IgG to COVID-19) titers in vaccinated and unvaccinated patients and the detection of COVID-19 anti-spike IgM antibodies in vaccinated patients were performed. Results: Most recruited patients (83.7% of the study group) developed a positive antibody response to COVID-19 infection. Among 43 vaccinated patients, anti-spike IgM was assessed, revealing a positive titer of 86%. Our findings indicate that patients with lymphoma exhibited the lowest antibody level to COVID-19 infection, whereas patients with acute leukemia (ALL) demonstrated the highest level. Conclusion: Vaccination is highly advised for individuals with HMs. Further studies involving a larger patient population and various types of HMs are recommended.

ITP is an immune-mediated disorder showing increased platelet destruction and reduced platelet production. Glucocorticoids are the first-line treatment, but 10-20% of patients are insensitive to them. We should avoid the irrational use of steroids for treating ITP. No markers exist to predict treatment responses in ITP. Recently, a few studies showed abnormal ratio and function of Tregs in ITP patients and that the levels of Tregs change after glucocorticoid treatment. We aimed to study the value of CD8+ CD25+ Tregs in predicting glucocorticoid sensitivity in newly diagnosed ITP patients. This cohort (longitudinal) study included 60 ITP patients. The baseline platelet counts and levels of CD8+ CD25+ Tregs were measured at diagnosis. The response to steroids was evaluated after 2 weeks of treatment, then after 3 months and 6 months. The ROC curve was plotted, and the p value was not significant; therefore, the optimal critical value, specificity and sensitivity could not be determined. This study couldn't confirm the value of CD8+CD25+ Tregs in predicting glucocorticoid sensitivity in ITP, but there was a significant positive correlation between the CD8+CD25+ Tregs percentage and the steroids' response after 2 weeks. Therefore, further studies are recommended.

Mature B-cell non-Hodgkin lymphoma (B-NHL) occurs due to uncontrolled B-lymphocyte clonal expansion. Cytokines can directly stimulate B-cell proliferation and prevent B-cell apoptosis. Dysregulation of cytokines may play an important role in the development of B-NHL by enhancing chromosomal translocation, which is the hallmark of B-NHL. Both interleukin 2 and tumor necrosis factor-α are proinflammatory cytokines and play important roles in the growth, differentiation, and apoptosis of B cells.We conducted a prospective case-control study applied to 50 patients with B-NHL at Kasr Al Aini Hospital, Cairo University, and 50 age- and sex-matched controls. Clinical, laboratory and imaging data were collected. In all patients and controls, sIL-2R and sTNF-R2 levels were measured by enzyme-linked immunosorbent assay (ELISA). The Spearman correlation test was used to evaluate the correlation between the studied cytokines and clinical, laboratory and imaging findings. Sensitivity analysis was conducted to detect the cutoff values of the studied cytokines.Serum levels of sIL-2R and sTNF-R2 were significantly higher in patients than in controls. Additionally, their levels were significantly higher in aggressive types and advanced stages of lymphoma. Also, the studied cytokines were significantly correlated with different clinical and laboratory parameters of lymphoma. The level of sIL-2R and sTNF-R2 were closely related to the type of lymphoma (P value ˂ 0.001 and 0.012, respectively), further it was also associated with the natural history of lymphoma (aggressive vs. indolent) (P value ˂0.001 and 0.04 respectively).We concluded that Pretreatment levels of sIL-2R and sTNF-R2 may play a role in the natural history and prognosis of lymphoma. They may be used as a prognostic factor for B-NHL patients and may also help with treatment decisions.

BackgroundIdentifying migraine comorbidities may guide prognosis and treatment options. This study aimed to assess the frequency of comorbid conditions among adults with migraine living in Greater Cairo.MethodsIn this cross-sectional study, Egyptian migraine sufferers aged & GE; 18 years living in Greater Cairo were consecutively recruited (April 2019 - April 2021). Following The International Classification of Headache Disorders-third edition, diagnosis of migraine was confirmed, and the type of migraine was defined as whether episodic or chronic, with or without aura, with childhood/adolescence or adulthood onset. Specialist physicians from the research team assessed comorbid conditions among the respondents.ResultsThe mean age of respondents (n = 1064) was 35 & PLUSMN; 7. Irritable bowel syndrome represented the most common comorbidity in our patients (45.5%), followed by vitamin D deficiency (41.8%). The frequency of epilepsy, stroke, multiple sclerosis, and systemic lupus erythematosus was significantly higher in patients with chronic than episodic type (& chi;2 = 4.514, P = 0.034), (& chi;2 = 12.302, P = 0.001), (& chi;2 = 12.302, P = 0.001), (& chi;2 = 4.806, P 0.028), respectively. Females with menstrual migraines had a significantly higher frequency of generalized anxiety disorder, panic attacks, and restless leg syndrome than those with non-menstrual migraines (& chi;2 = 7.636, P 0.006), (& chi;2 = 9.245, P = 0.002), and (& chi;2 = 11.997, P = 0.001), respectively. The frequency of diabetes was significantly higher in patients with migraine with aura than in those without aura (& chi;2 = 4.248, P value 0.039).ConclusionThis study provides a better understanding of the comorbidities in Egyptian patients with migraine and will provide new avenues for developing individualized therapy for migraine patients.

Background: Thromboembolism was a chief cause of mortality in 70% of patients with COVID-19. Our objective was to see if serum interleukins 1 beta (IL-1β) and soluble platelets selectin (sP-selectin) could serve as novel markers of thromboembolism in COVID-19 patients. Methods: This cross sectional study involved 89 COVID-19 patients who were recruited from 1st of February to 1st of May 2021. Clinical and laboratory data were collected, and chest imaging was performed. The levels of IL-1β and sP-selectin were assessed in all cases through ELISA kits. Comparisons between groups were done using an unpaired t-test in normally distributed quantitative variables. In contrast, a non-parametric Mann-Whitney test was used for non-normally distributed quantitative variables. Results: Severe COVID-19 infection was associated with higher serum levels of CRP, Ferritin, LDH, D dimer, IL-1β and sP-selectin (P < 0.001) with significant correlation between levels of IL-1β and sP-selectin (r 0.37, P <  0.001), D-dimer (r 0.29, P 0.006) and Ferritin (r 0.5, p <  0.001). Likewise, a positive correlation was also found between levels of sP-selectin, D-dimer and Ferritin (r 0.52, P <  0.001) (r 0.59, P <  0.001). Imaging studies revealed that 9 (10.1%) patients developed venous and 14 (15.7%) developed arterial thrombosis despite receiving anticoagulant therapy. Patients with thrombotic events had significantly higher levels of IL-1β, sP-selectin and LDH serum levels. Meanwhile, there was no statistical significance between CRP, D-dimer or Ferritin levels and the development of thrombotic events. Conclusion: IL-1β and sP-selectin levels can be promising predictors for severe COVID-19 infection and predictable thrombosis.