Background: Coronavirus disease-19 [COVID-19] is a pandemic spreading all over the world. The novel corona virus has a specific tropism for the low respiratory airways causing viral pneumonia. Early diagnosis of suspicious COVID-19 pneumonia represents a pillar for immediate management. Computed tomography [CT] scan is considered the gold-standard screening tool, but it has several limitations. A chest ultrasound could play a role in COVID-19. Aim of the work: To evaluate the role of lung ultrasound [LUS] in diagnosis of suspicious COVID-19 pneumonia. Patients and Methods: Sixty patients with suspected COVID-19 pneumonia were included. They were initially evaluated in triage and initial diagnosis [Al-Azhar University Hospital; Damietta] and followed up by the surveillance and infection control team till the final diagnosis or discharge from isolation hospitals. All were evaluated clinically, by imaging modalities [LUS, chest computed tomography [CT]] and diagnosis confirmed by polymerase chain reaction. Data of LUS and chest CT compared to results of PCR. Results: LUS had sensitivity of 88.2%, specificity of 11.5%, PPV of 56.6%, NPV of 42.8% and overall diagnostic accuracy of 55.0%. on the other side, CT scan had 94.1%, 3.85, 56.14%, 33.33% and 57.0% for sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic accuracy, successively. Results of LUS are slightly lower than CT. Conclusion: US is a useful screening and monitoring tool in suspected COVID-19. It is feasible, portable with an accepted rate of sensitivity. However, it is advisable to be used as an integrated diagnostic tool.

Background: Bronchial asthma is the most prevalent illness among children and teenagers. It is considered a major cause of morbidity. The physical, social, and psychological domains of childhood asthma are all affected. Aim of the work:To measure the pediatric asthma quality of life [PAQOL] levels within asthmatic children and its main predictors in Damietta, Egypt.Methods: An analytical cross-sectional survey was carried out utilizing a questionnaire that assesses [PAQOL] levels with related socio-demographic factors and asthma control levels. Asthma control level was tested by an asthma control test questionnaire. PAQLQ as a dependent variable and other plausible independent variables were analyzed by a stepwise linear regression model. Results: Two hundred participants, aged 7-17 years were included; [56%] were females, [30.5%] residing in urban areas, and [77%] had belonged to middle and low socioeconomic classes. Gastro-esophageal reflux [GER] was shown to have a significant positive correlation with allergic rhinitis [P< 0.01] and obesity [P< 0.01]. Otherwise, GER was shown to be negatively correlated with asthma control status [P< 0.01]. Mean ± standard deviation [SD] of overall, activity and Emotion domains scores of QOL were 4.51± 1.3, 4.52± 1.25, and 4.54± 1.39 respectively. While more than 50% of the symptoms domain scores were more than 4.7. Low socioeconomic level [P< 0.01], poor asthma control [P< 0.01], and positive history for controller medications [P< 0.05] were significant predictors for lower asthmatic children's quality of life. Conclusion:Asthmatic children tend to have a poorer quality of life. To provide effective asthma treatment to the general public, prescribers and patients must both understand and be educated. Healthcare providers should consider PAQOL with greater attention to children with poor socio-economic standards and uncontrolled asthma in the management plan.

Background: Obesity reaches the epidemic situation. Obstructive sleep apnoea is a major concern in obese patients. Aim of the work:To analyse apnoea hypopnea index and to evaluate changes in pulmonary functions before and after bariatric surgery in obese patients. Patients and Methods:We identify 160 patients who met our inclusion criteria. However, 121 patients returned for follow up evaluation. They were 98 women and 23 men. 84 had Raux-en-Y gastric bypass and 37 had sleeve gastrectomy. They were subjected to full history taking, clinical examination, objective measures of obstructive sleep apnoea [apnoea hypopnea index, body mass index, mean oxygen saturation, low oxygen saturation, nasal continuous positive airway pressure and Pulmonary function tests]. In addition, all patients were submitted to a sleep study.Results: Statistically significant improvement was obtained postoperative for apnoea hypopnea index, body mass index, nasal continuous positive airway pressure requirement, mean oxygen saturation and low oxygen saturation. The spirometry and lung volume finding showed statistically significant improvement in lung function parameters after surgery. There was a significant positive correlation between body mass index and apnoea hypopnea index, with significant negative correlation between body mass index and forced vital capacity. Conclusion:Bariatric surgery is associated with significant improvement in pulmonary functions and obstructive sleep apnoea indices.

Background: Interstitial lung disease [ILD] is a difficult-to-treat disease. The patient continues treatment for his/her whole life. However, certain causes -when diagnosed -could change their treatment plan. Radiological investigations cannot elicit the underlying pathology 100%. Thus, transthoracic lung biopsy is of utmost importance, especially in undiagnosed patients. But, it is not free of risk, and thus, its use is still controversial. Aim of the work:This work aims to evaluate the role of medical thoracoscopic lung biopsy [TLB] in diagnosing diffuse parenchymal lung diseases.Patients and Methods: Fifty patients with diffuse lung infiltrate on high-resolution computed tomography [HCRT] of unconfirmed diagnosis were included. All patients have been submitted to detailed clinical examination and specific laboratory investigations. Furthermore, all had high resolution computed tomography, pulmonary function tests], echocardiography, arterial blood gas analysis, and bronchoalveolar lavage assessment. The thoracoscopic lung biopsy was performed under local anesthesia. The specimens were preserved in formalin containing cups till examination. Patients were followed up, and any complications were documented. Results:The lung HCRT revealed ground-glass opacity [44%], reticulonodular interstitial pattern [38%], honeycombing [14%], crazy paving [10.0%], and consolidation [20.0%]. The histopathology revealed alveolar proteinosis [2.0%], alveolar hemosidrosis [2.0%], hypersensitivity pneumonitis [24.0%], sarcoidosis [8.0%], nonspecific interstitial pneumonia [20%], Idiopathic pulmonary fibrosis [12.0%], respiratory bronchiolitis ILD [18%], and desquamative ILD [14.0%]. All patients positive on HCRT had pathological change. Complications were [12%] bulla in partnehymea, [4%] plural disear, [2%] pneumothorax, and 2% died during follow up duration. Conclusion:TLB is an effective and relatively safe, minimally invasive intervention for interstitial lung disease diagnosis. Accordingly, it must be considered a standard diagnostic tool for undiagnosed suspected cases.

Background: The link between parasitic infections and either allergic diseases or unexplained neurologic manifestations was hypothesized especially in children. However, the debate continues regarding this link. Aim of the work: To determine the seroprevalence of toxocariasis in children with different allergic diseases [bronchial asthma and skin allergy], besides the unexplained neurological manifestations [epilepsy and focal neurologic deficits] in children. Patients and methods: Children with bronchial asthma [40 children], skin allergy [40 children], and unexplained neurological manifestations [epilepsy and focal neurologic deficits], [40 children] were included. All underwent a full history taking, clinical examination, lab investigations and determination of seropositivity for Toxocara canis. Results: Eosinophilia was reported in 22.5%, 30.0% and 17.5% of asthma, skin and unexplained neurological manifestations groups respectively. In patients with asthma, the prevalence of toxocariasis was 15.0%, in skin disease, the incidence was 7.5% and in unexplained neurological manifestations, it was 12.5%. There was no significant difference between positive and negative toxocariasis in regard to patient demographics. But there was a significant increase in contact with pets, chronic urticaria, lymph nodes involvement and eosinophilia in positive when compared to negative groups. Conclusion: The association between Toxocara canis infection and allergic diseases such as bronchial asthma, chronic urticaria and unexplained neurological manifestations [epilepsy and focal neurologic deficits], was confirmed in the present work. The contact with dogs and cats [pets] was the major determinant risk factor explaining such association. Prospective cohort studies were warranted to examine the cause effect relationship.