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Background: Anxiety and depression are mental health problems that result in reduced health-related quality of life (HRQL), and increased mortality. Patients with COPD have a higher risk of anxiety and depression compared to healthy individuals. Recent studies reported a significant relationship between the presence of anxiety and depression and the functional status of COPD patients.Objectives: To study the effect of treatment of anxiety and depression on the physiological status in COPD patients.Materials and methods: The study included 50 severe COPD patients with depression and/or anxiety as evaluated and scored by Montgomery and Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating (HAM-A) Scale. They were classified into 2 groups: group I included 25 patients who received antidepressant/anxiolytic therapy in addition to COPD treatment and group II included 25 patients who received COPD treatment only. Modified Borg scale dyspnea score, spirometry (vital capacity, forced vital capacity, forced expiratory volume in first second and forced expiratory flow through 25-75% of expiration), arterial blood, MADRS and HAM-A scale were assessed in all patients at the start of the study and after 3 months.Results: Patients with severe COPD who were treated for depression and/or anxiety showed a significant improvement in MADRS, HAM-A and dyspnea scales, spirometeric parameters and oxygenation. MADRS and HAM-A scale showed a significant negative correlation to FEV1.

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Non-invasive ventilation (NIV) is the provision of ventilatory support to the lungs without the use of an endotracheal airway. It has emerged as an important tool in the treatment of diverse forms of acute respiratory failure. It not only reduces the need for invasive mechanical ventilation and its associated complications, but also reduces the complications associated with stay in the intensive care unit, length of hospital stay, and mortality in selected patients. This descriptive study was conducted on 50 critically ill patients with acute respiratory failure. All patients were subjected to full history taking, complete physical examination, chest and cardiac imaging and laboratory investigations.

Introduction:Covid-19 presents with a wide spectrum of illness, ranging from asymptomatic to critical disease and multi-organ dysfunction.Objectives: Detection and following up early and remote complications and cause of mortality in severe and critically ill COVID-19 patients post their ICU discharge.Patients and methods: Informed written consent, full clinical history and examination, full labs including d-dimer level and different body imaging according to patient clinical situation (ECG, echo, vascular duplex, CT chest, CT brain, MRI brain, abdominal ultrasonography.…) Results: COVID-19 is a systemic disease affecting multiple systems e.g. respiratory, cardiovascular, gastrointestinal, neuropsychiatric, haematological, and endocrinal systems leading to chronic critical illness and multi-organ failure with high mortality post ICU discharge. Conclusion:Severe and critical COVID-19 with prolonged ICU stay considered as a multi-organ disease affecting both functional and biological status which need close follow-up of COVID-19 survivors from their families and their health care team for early screening and adequate treatment of fatal complications with physical and mental rehabilitation.

Aim of the work: To evaluate the incidence and types of cardiac arrhythmias in non-cardiac critically ill patients admitted to the general ICU and the relation of arrhythmias to different comorbidities and patient outcomes. Patients and methods: prospective study on 72 non-cardiac critically ill patients admitted to the general intensive care unit of Critical Care Department of Fayoum University Hospital from May 2015 to November 2016 presenting with different causes of admission. Results: 136 episodes of arrhythmias occurred in all of the studied patients, the most frequent was sinus tachycardia as it occurred in 72 non-cardiac patients in the form (30.15 % of attacks were sinus tachycardia) followed by 22.97% for atrial extrasystoles, 14.71% for ventricular extrasystole, 9.56% for SVT, 9.56% for AF, 8.09% for MAT. Sinus tachycardia was the most common to occur and mortality incidence was 34.7% among the study group. Conclusion: Supraventricular arrhythmias were more common to occur in non-cardiac critically ill patients than ventricular arrhythmias. Patient with AF developed in the setting of critical illness carries higher propensity to mortality

Venous thromboembolism (VTE) remains a major cause of morbidity and mortality. There are three factors that contribute to DVT.These factors are called Virchow's triad :venous stasis,hypercoagulability and changes in the endothelial blood vessel lining. Upper extremity deep vein thrombosis (UEDVT) is an increasingly recognized complication in medical ICU, especially after the increase in usage of central venous catheters (CVC) for different purposes.In our study we aimed to determine the prevelance and risk factors that make the incidence of central line associated deep venous thrombosis increase. This descriptive study was conducted on 80 critically ill patients with inserted central venous catheter. Venous duplex was done before, 5th and 10th day of (CVC) insertion.

Background: Strokes due to Cardioembolic causes are the most severe in ischemic stroke subtypes. LAA flow patterns and function could be assessed accurately by TEE. The study aimed to present the importance of Transesophageal echocardiography in the assessment of LAA function and its relation to cardioembolic stroke. Methods: 120 patients were enrolled in the study and were subdivided into 3 subgroups, each group included 40 patients. Group A; patients had a stroke with normal sinus rhythm, Group B; patients had a stroke with atrial fibrillation, and Group C; normal control subjects. The study participants were evaluated by medical history, physical examination, standard 12-leads electrocardiogram, a transesophageal echocardiographic detailed evaluation of the LAA, and brain CT and/or MRI for patients with stroke. Results: both stroke patients with AF and sinus rhythm had significantly higher LAA mean orifice diameter and higher LAA length than control patients, significantly lower mean LAA medial wall tissue Doppler upward and downward motion velocities than control patients and that patients with stroke and AF had significantly lower mean LAA pulsed wave emptying and filling velocities than both patients with stroke and sinus rhythm and control patients. Presence of LAA thrombi, spontaneous echo contrast, and stroke recurrence were higher in stroked AF patients than stroke patients with sinus rhythm. Conclusion: increased LAA orifice diameter, LAA length, and reduced filling and emptying velocities and upward and downward motion velocities of the medial wall of LAA as detected by TEE are associated with stroke and cardio embolization.