Work related asthma (WRA) refers to asthma induced by exposure to sensitizing agents and/or irritants in the workplace leaving health and economic consequences. Early diagnosis can improve the prognosis of WRA permitting sometimes full recovery. This study aimed to assess the prevalence of WRA among Egyptian adult agriculture workers. A multi-center cross sectional study included 150 adult workers from 4 different farms, during the period from 2019 and 2021. All participants were subjected to full medical history, clinical examination, chest x-ray, skin prick test and CBC to detect absolute eosinophilic count. Spirometry with post bronchodilatation test (reversibility test) at the farm (in the day of insecticide aerosol and without aerosol) and after a week off the farm was also done. Age, median ± SD, was 37.67 ± 9.75 years, duration of farming occupation was 21.84 ± 10.18 years. Of the 150 participants, 11 had WRA. Of these, 6 had allergic occupational asthma, 3/11 had work exacerbated asthma and only 2/11 had irritant occupational asthma. Of the allergic subjects, 7.3% tested positive to mixed pollens, 4.7% to Alternaria, 2% to penicillium and 2% to the farm pollens. The onset of respiratory symptoms was 13.45 ± 6.93 months after start working in the farm. A statistical significance was observed between WRA and non-WRA individuals regarding age, duration of farming occupation and asthma symptoms during workday (P <0.001). There was a statistical significance between WRA group and non-WRA group regarding FEV1, FEV1/FVC ratio carried out at work, during holidays and during spraying (P <0.001). Absolute eosinophilic count, mean among WRA group was 0.55 ± 0.13 (×103cells/mm3) with significance between WRA and non-WRA (P= 0.001). Farming occupation may cause WRA, therefore, more attention should be given to minimize exposure and risk of inducing WRA.
Many attempts have been made to repurpose existing and approved drugs for the treatment of COVID-19 infection. This involves anti-malarial drugs such as hydroxychloroquine and chloroquine, which have been shown to be less successful than initially believed, with a substantial risk of often fatal complications and interactions. This also involves Remdesivir, which has been shown to decrease recovery time significantly in hospitalized patients. However, for patients who are not yet hospitalized, there is no currently accepted treatment. Treating patients before they need to be admitted or even prophylactically could greatly decrease the load on hospitals, protect healthcare workers and reduce the spread of COVID-19. An in-vitro study indicated that Ivermectin was dynamic against COVID-19-infected cell. Ivermectin has antimicrobial, antiviral, and anticancer, immunomodulatory properties. This drug could reduce the viral load in COVID-9 infected patients, with potential effect on disease progression and spread. Therefore, Ivermectin may be a therapeutic choice for treatment of COVID-19, however, there is still a lack of evidence-based studies to support ivermectin treatment of patients with COVID-19.
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