Background: The overlap between asthma and obesity is becoming an increasing health concern, as overweight and obesity are linked to a higher risk of developing asthma and a greater disease burden. Objective: To assess the association between obesity and hospital-related complications, as well as early readmission rates, in asthmatic patients. Methods: This prospective observational cohort study was conducted at the Department of Chest Diseases, Ain Shams University Hospitals, between January 2024 and January 2026. A total of 75 adult patients were included and classified into three BMI groups: normal weight, overweight, and obese (n = 25 each). Clinical characteristics, pulmonary function tests, and in-hospital outcomes were assessed. Results: Asthma severity increased with BMI, with severe asthma present in 96.0% of obese patients compared with 20.0% of overweight patients and none of the normal-weight patients (p < 0.001). Obese patients had lower pre-FEV₁ % predicted (47.5 ± 21.1%) than both overweight (58.5 ± 12.4%) and normal weight patients (65.2 ± 13.5%) (p = 0.003). They also had lower oxygen saturation and longer hospital stay (p < 0.001). ICU admission occurred only in obese patients (40.0%), with 20.0 % requiring mechanical ventilation. BMI correlated with longer hospital stay and lower oxygen saturation (p < 0.001). Predictors of ICU admission included obesity, severe asthma, ventilatory support, lower oxygen saturation, and reduced FEV₁. Conclusion: Higher BMI was associated with increased asthma severity, poorer control, impaired lung function, and worse clinical outcomes, including longer hospital stay and greater need for intensive care. These findings highlight the value of weight management and comprehensive care in improving outcomes for obese patients with asthma.

Background Appropriate inhaler techniques can enhance drug effectiveness and reduce side effects. However, limited research has explored how healthcare workers (HCWs) use inhalers. Aim This study assessed inhaler techniques in adult patients and compared Pressurized metered-dose inhalers (pMDI) between patients and HCWs and identified predictors of improper inhaler use. Patients and methods Our studied group was two groups; first group included 199 patients [chronic obstructive pulmonary disease (COPD) and asthma], and second group included healthcare providers: 80 physicians and 61nurses. We evaluated the inhalers techniques used by adult patients and compared the pMDI technique between patients and their HCWs. Results COPD patients were older (57.35 +/- 10.25 years) than asthma patients (39.42 +/- 8.83 years). Pulmonologists and internists demonstrated the best pMDI usage, on the other hand, the step of inhalation slowly while activating the pMDI was done incorrectly in respiratory and internist nurses, respectively, (10, 22.6%) in comparison to only 3.7% of patients. After adjusting other variables in the multivariate model, years of experience were the only significant predictor of inhaler errors among HCWs (P<0.001), while hospital admissions (P=0.040) and illness duration (P=0.034) were the only significant predictors among patients using pMDI. Conclusion Inaccurate inhalation technique is prevalent among COPD and asthma patients. It is fundamental to ensure that healthcare providers, particularly nurses, are qualified to teach patients the proper inhaler technique. Ongoing monitoring and reassessment of patients' inhalation techniques by healthcare providers are also fundamental for effective patient management.

BACKGROUND:Electronic cigarettes are widely used, and healthcare providers play an important role in advising patients about their safety and possible use in smoking cessation. However, differences in knowledge, attitudes, and confidence may affect the consistency and quality of counseling. AIM:This systematic review examined evidence on knowledge, attitudes, confidence, and information sources related to electronic cigarettes among healthcare providers and medical students. METHODS:A search of PubMed and Scopus was conducted for English-language studies published within the past 10 years. Quantitative, qualitative, and mixed-methods observational studies were included, and findings were synthesized narratively due to methodological differences across studies. RESULTS:Fourteen studies met the inclusion criteria. Although awareness was generally high (up to 79.3%), detailed knowledge was often limited. In Europe, about half of physicians rated their understanding as moderate, and 96.5% of Polish physicians considered e-cigarettes harmful, with only 11.5% supporting their use for smoking cessation. In the Middle East, fewer than 15% viewed them as safer than conventional cigarettes. Among students, 30-36% selected "don't know" when asked about safety. CONCLUSION:Confidence in counseling varied and was typically lower among students. Media and social networks were the most common sources of information. Despite high awareness, important knowledge gaps remain, highlighting the need for structured education and clearer clinical guidance.

Background Successful immunization in the public can be reached by raising vaccination rates, and this can be achieved by healthcare providers who have a vital role in recommending vaccinations. Aim We assessed the knowledge, practices, and attitudes of healthcare providers about influenza, pneumococcal, and coronavirus disease vaccines and compared them with the general population. Patients and methods The self-administered questionnaire translated into Arabic and obtained from previous studies was distributed to two groups; the first group included 65 healthcare providers (42 doctors and 23 nurses), and the second group included 96 of the general population in the Chest Disease Department in Ain Shams University. Results More than half of the participants were females, with the mean age in the doctors’ group being 28.05±2.31, in the nurses’ group 39.7±10.55, and in the general population group was 40.67±10.09. Doctors had the best knowledge and practice in comparison to nurses and the general population, and only half of nurses had informed their patients about vaccinations. Besides that, there was a significant relation between knowledge and practice towards vaccination and educational level in the general population and years of experience of healthcare providers. Conclusion Vaccines are crucial, and a strong predictor of vaccination is the recommendation of physicians. Despite the generally positive attitude of healthcare providers and the general population toward vaccination, there is a need for increased awareness among nurses. This increased awareness can positively impact the general population and lead to higher vaccine acceptance rates.

IntroductionOccupational lung diseases include a wide variety of respiratory diseases with clinical manifestations and diagnostic test results that have features similar to nonoccupational diseases.AimTo determine the prevalence of occupational Interstitial lung diseases (ILD) among confirmed ILD patients admitted to the chest department of Egyptian Railway Medical Centre and the assessment of the outcome.Patients and methodsA total of 155 patients with confirmed ILD, were subdivided into two groups: group (A) 79 patients with occupational exposure and group (B) 76 patients with nonoccupational exposure. Both groups were subjected to a detailed history, radiological assessment, arterial blood gases, and Spirometry. Data of days of hospital stay were also recorded.ResultsThe prevalence of confirmed cases of ILD among occupational exposure was 1.49% versus 1.1% in the nonoccupational. Range of age in occupational group was between (31and 68 years). Chest X ray (CXR) findings were positive in 58.2% and 30.2% of occupational and nonoccupational group, respectively. Among group (A), 47.1% of the patients stayed between 11 and 15 days), 15.76% admitted to ICU, and 5.2% were mechanically ventilated. While 48% of hospitalized nonoccupational patients stayed between 6 and 10 days, 8% were admitted to ICU and 4% were mechanically ventilated,ConclusionThe prevalence of interstitial lung diseases with occupational exposure was 1.49%, higher than non-occupational interstitial lung diseases. They were younger in age, had history of domiciliary oxygen therapy, frequent exacerbations, and previous hospital admissions. They had prolonged length of hospital stay, particularly those not using protective measures.

Background Although the interest in Idiopathic Pulmonary Fibrosis (IPF) has increased in recent years due to the appearance of new therapies however the interest has focused on pulmonary involvement with little concern for systemic manifestations such as the nutritional status abnormalities. Thus, our study assessed the malnutrition prevalence in patients with IPF and the best indicators for the assessment of malnutrition among them. Patients and methods This work was conducted on 110 stable IPF patients who attended the outpatient clinic of Ain Shams University Hospitals from October 2020 to July 2021. Data about the detailed history and nutritional assessment was collected. Results 22.7% and 20.9% were malnourished according to the definition of fat-free mass index (FFMI) and body mass index (BMI), respectively. Most malnourished patients according to low FFMI were female; not using PPI was a significant independent predictors of malnutrition. There was a statistically significant relation between low FFMI and low serum albumin, hemoglobin, and oxygen saturation. Our findings also revealed that measuring BMI and being less than or equal to 22.1 kg/m2 and mid-arm circumference (MAC) less than or equal 28.5 cm is significantly related to low free fat mass index (malnutrition) and increases that risk by 31.63 folds. Conclusion Nearly one-quarter of IPF patients were malnourished and it was found that measuring BMI less than or equal to 22.1 kg/m2 together with MAC less than or equal to 28.5 cm can predict low FFMI and that can be used in our clinical approach.

Background: Coronavirus became a pandemic worldwide and its awareness varied from one country to another across the whole world.Objective: The study aimed to evaluate the awareness of COVID-19 among a sample of Egyptian medical students who will be healthcare providers soon. Materials and Methods:The study included108 medical students (55 from 4 th year and 53 from 6 th year) during their clinical rounds in the Chest Department at Ain Shams University in January 2022.They answered a questionnaire about their awareness of COVID, which consisted of four major sections in the English language.Results: Mean age for 4 th year medical students was 21± 0.9 and 23 ± 0.6 years for 6 th year students.Vaccination status was 78.2% (2 doses) and 92.5% in 4 th and 6 th year students, respectively.Social media, doctors, or other medical staffs were the primary sources of their awareness.45.5% and 56.6% of the fourth and sixth year students had adequate awareness of COVID, with the best score in the precautionary measures (5 ± 0).Conclusions: 45.5% and 56.6% of fourth and sixth year medical students, respectively, showed an adequate awareness level of COVID-19 with the highest score in the precautionary measures, which is the cornerstone for stopping of the spread of infection.However, we still need additional educational programs for those with low scores to improve the overall awareness to end this outbreak.

Background and objective Nutritional impairment is a frequent issue in patients with chronic obstructive pulmonary disease (COPD) and has a negative effect on both morbidity and mortality. Therefore, this study was designed to explore the nutritional condition of stable COPD patients and to investigate their influence on dyspnea severity and quality of life (QoL). Patients and methods This case–control study was done on 100 stable COPD patients greater than or equal to 65 years old and 80 healthy controls who visited the outpatient clinic of El Demerdash Hospital between January 2019 and December 2019. All patients underwent spirometry and finished the Arabic version short form of the ‘mininutritional assessment’ test. Their dyspnea severity and QoL were also assessed. Results The patients were divided into three groups according to short form of the ‘mininutritional assessment’ test results: well-nourished (n=24, 24%), at risk of malnutrition (n=31, 31%), and malnourished (n=45, 45%). About 90.6% of malnourished patients had dyspnea grade 4; their mean score of COPD assessment test was 36 and they also had the lowest values of spirometric parameters. Conclusion About 45% of stable COPD patients were malnourished; they had a high sensation of dyspnea (higher modified Medical Research Council dyspnea grade) and poorer QoL (high COPD assessment test score).

Background and Objective: Pneumonia is a major reason for hospitalization for Acute Exacerbation of Chronic Obstructive Pulmonary Disease patients (AECOPD). There is limited data available on the outcomes of AECOPD patients with or without pneumonia. Therefore, the study investigates the prognosis of AECOPD patients with or without Community-acquired Pneumonia (CAP), concerning the Length of Hospital Stay (LOS), in-hospital complications and early readmission. Methods: This study was carried out on 100 male COPD patients without CAP, 90 patients with CAP who were admitted to the chest department of Ain Shams University hospital over a 1-year period. Data collection about LOS, in-hospital complications, was recorded and they were followed for 30 days to detect acute readmission. Results: The mean age was 64± 8 years old in COPD patients without CAP to 62± 12year old in patients with CAP, LOS in COPD patients with CAP was 11.30 ± 3.23 days to 7.57 ± 2.24 in patients without CAP, COPD patients with CAP had a higher rate of complications in comparison to those without CAP as 45.6%, 13% were admitted to Intensive Care Unit (ICU) respectively, 15.6%, 3% were mechanically ventilated respectively. LOS and C- Reactive Protein (CRP) were significant causes for readmission in COPD patients with and without CAP. Conclusion: COPD patients with CAP had longer LOS and more short term complications as ICU admission, mechanical ventilation and higher readmission rate in comparison to COPD patients without CAP.

BACKGROUND:Despite asthma being a worldwide disease, still little awareness regarding the sexual function of asthmatic patients exists. So this study attempts to assess the Female Sexual Dysfunction (FSD) amongst Egyptian females with asthma and its burden on their quality of life.MATERIALS & METHODS:The sample consisted of 180 subjects, comprising 90 asthma patients and 90 healthy controls aged between 20 - 45 years old, who visited the Chest Department Outpatient Clinic of Ain Shams University Hospital between January and December 2018. We reported all the subjects' demographic and clinical data; both groups answered an Arabic version of the Female Sexual Function Index (Ar FSFI) and World Health Organization Quality of Life Questionnaire abbreviated version (WHOQL-Bref).RESULTS:90% of asthmatic females had FSD; total Female Sexual Function Index score was 12.956 ± 10.3 in asthmatic females compared to 25.423 ± 5.521 in healthy controls; 45.6% of asthmatic females with sexual dysfunction had moderate asthma and 86.4% had uncontrolled asthma, 40.1% of them had a low educational level and 80.2% were unemployed.CONCLUSION:Jobless females with severe uncontrolled asthma and a low educational level had higher sexual dysfunction and a poor quality of life.

Ibrahim Dwedar Dina Ruby Aya Mostafa 1Department of Chest, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 2Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt Background: Electronic cigarettes are increasing in popularity, and they are easily accessible in a variety of locations. Despite increasing its popularity, little is known about its overall health effects. Physicians have rated the most trustful source of information about it and play also a role in disseminating information about it. Thus, this study identified the difference in knowledge and beliefs about electronic cigarettes between health care providers and the general population in Egypt. Methods: A cross-sectional study using the self-administered questionnaire in the Arabic language was conducted between December 2018 and March 2019 in the Chest Department in Ain Shams University Hospital in Egypt. Study population (n=610) was divided into health care providers (n=260) and general population (n=350). Result: A total of 593 respondents participated in this study and returned filled questionnaire with total response rate=97.2%, only 8.8% of all participates were smokers, none of the study population reported using electronic cigarettes, despite that, 79.3% of the participants have heard of electronic cigarettes, media advertisements were the main source of getting to know it and there was a statistically significant difference between both groups regarding most beliefs and attitudes toward electronic cigarettes. Conclusion: There was high awareness about electronic cigarettes in Egypt and more negative attitude about it among health care providers than the general population, but still educational programs and guidelines for health care providers are needed to raise more the awareness which will aid in counseling general population appropriately.

Background:Electronic cigarettes are increasing in popularity, and they are easily accessible in a variety of locations. Despite increasing its popularity, little is known about its overall health effects. Physicians have rated the most trustful source of information about it and play also a role in disseminating information about it. Thus, this study identified the difference in knowledge and beliefs about electronic cigarettes between health care providers and the general population in Egypt. Methods:A cross-sectional study using the self-administered questionnaire in the Arabic language was conducted between December 2018 and March 2019 in the Chest Department in Ain Shams University Hospital in Egypt. Study population (n=610) was divided into health care providers (n=260) and general population (n=350). Result:A total of 593 respondents participated in this study and returned filled questionnaire with total response rate=97.2%, only 8.8% of all participates were smokers, none of the study population reported using electronic cigarettes, despite that, 79.3% of the participants have heard of electronic cigarettes, media advertisements were the main source of getting to know it and there was a statistically significant difference between both groups regarding most beliefs and attitudes toward electronic cigarettes. Conclusion:There was high awareness about electronic cigarettes in Egypt and more negative attitude about it among health care providers than the general population, but still educational programs and guidelines for health care providers are needed to raise more the awareness which will aid in counseling general population appropriately.

Pneumonia is one of the most common diseases with a high hospitalization rate. Many studies have suggested that there is a correlation between pre-existing diabetes and the alterations in serum glucose levels in patients with community-acquired pneumonia (CAP) and high death rate. To study the impact of admission blood glucose level on patients’ outcomes with CAP. Sixty (30 nondiabetic and 30 diabetic patients) consecutive hospitalized adult patients with CAP were recruited over a 1-year period. Data on patients’ outcomes including duration of hospital stay, duration of antibiotic treatment, increase in oxygen requirements, increase in antibiotics coverage, ICU admission, mechanical ventilation, and in-hospital mortality were collected. Admission blood glucose level was elevated in diabetic patients (the mean plasma glucose level was 258.86 ±116.15 mg/dl in diabetics and 151.13±51.23 mg/dl in nondiabetics). There were statistically significant increases in the duration of hospital stay (7.633±3.567 nondiabetic vs. 11.267±4.291 diabetic patients in days), duration of antibiotic treatment (7.633±3.567 nondiabetic vs. 11.267±4.291 diabetic patients in days), increase in O2 requirements (33.33 vs.70%), increase in antibiotics coverage (16.67 vs. 63.33%), and ICU admission (30 vs. 63.33%) in the diabetic group on comparing nondiabetic versus diabetic patients with CAP. Also, the previously mentioned outcomes increased significantly with increasing blood glucose levels among the entire study population. On admission, CAP patients with increased blood glucose level, either diabetic or nondiabetic, are expected to have poor outcomes.

Malignant pleural effusions (MPEs) can produce significant respiratory symptoms and decreased quality of life in patients with terminal malignancies; palliation of respiratory symptoms can be performed by several different approaches, but a minimally invasive procedure to provide relief of respiratory symptoms would be optimal. This study aimed to evaluate the usage of a small bore catheter in outpatients as an alternative, effective, and safe method to the traditionally large bore chest tube in the management of MPE. Fifty patients with MPE were grouped randomly into two groups according to the method of drainage. The results showed that there were significant statistical differences in the results of both groups as the duration of catheter was 4 (3–5) days to 11 (10–10.25) days in the chest tube group; the cost of hospital and medication was 780±1400 LE in the pleural catheter group, whereas in the chest tube group, it was 11 520±1895.61 LE and the total cost was 5520±17 600 in the pleural catheter group and 14 020.00 ±1895.61 LE in the chest tube group. The modified Borg scale for dyspnea after insertion showed a 43% improvement in dyspnea in the small bore pleural catheter group compared with 41% in the chest tube group. On the basis of the results of this study and other studies, we conclude that a small bore catheter is as effective and safe as a large bore chest tube in the treatment of MPEs and use in the outpatient clinic led to few complications.