BackgroundDespite the development and dissemination of guidelines for the diagnosis and management of asthma, a gap remains between current recommendations and actual practice.ObjectivesTo assess the physicians attitude towards asthma guidelines and their adherence to its recommendations.MethodsThree hundred and fifty two clinicians (101 General practitioners, 131 pediatric specialists, 35 pediatric consultants and 85 doctors did not report the qualification) engaged in direct childhood asthma care in Cairo, Egypt were subjected to a self-administered questionnaire with 35 questions of which most were multiple choices, aiming at assessment of three important aspects about the involved physicians; physician's knowledge, practice and attitude. 165 of the clinicians were working in governmental hospitals, 68 clinicians work in private clinics and 119 clinicians work in both.ResultsAgreement with asthma guidelines was present in 76.2% of the studied physicians, however those who not in agreement with the guidelines claimed that this was mainly due to patient factors, firstly the poor socioeconomic standard of the patient (18.1%) and secondly due to poor patient compliance (16%). Poor knowledge was found in 28.5%, poor practice was found in 43.6% and poor attitude was found in 14.4% of the studied physicians. There was positive highly significant correlation between qualification and knowledge, (p < 0.01), positive highly significant correlation between qualification and practice, (p < 0.01), and positive highly significant correlation between qualification and attitude, (p < 0.01).ConclusionThe attitude of the studied physicians revealed agreement of their majority with the guidelines, while the disagreement was mainly explained by the poor socioeconomic standard of the patients. The degree of poor practice is more marked than that of poor knowledge or poor attitude reflecting resources limitations and applications obstacles in the physician's practice.

Background Asthma accounts for about one in every 250 deaths worldwide. Many of the deaths are preventable, being due to suboptimal long-term medical care and delay in obtaining help during acute exacerbation. Aim to assess knowledge, attitude and practice of Egyptian physicians about childhood asthma exacerbation treatment guidelines and to identify the barriers against application of guidelines in different hospital settings in Egypt. Methods a written questionnaire with different topics were added aiming at assessment of four important aspects about the involved physicians; physician's knowledge, practice, attitude and barriers against application of guidelines. This questionnaire was fulfilled by 200 pediatricians, all of them deal with childhood asthmatics. As regards Academic degrees, 94 (47.7%) had the Bachelor degree, 70 (35.5%) had Master degree, 23 had Diploma degree (11.7%), and 10 (5.1%) had Doctorate. As regards Hospital settings, 102 (51.8%) of the pediatricians were working in governmental hospitals, 76 (%38.6) of them were working in University hospitals, 13(6.6%) pediatricians worked in private hospitals and 6 (3%) pediatricians worked in other types of hospitals. Results low level of knowledge was found in 80.2% of participants, non adherence to guidelines was found in 59.4 % and negative attitude towards guidelines was found in 65.3% of them. Conclusion Most of the studied physicians have low level of knowledge, non adherence to guidelines and negative attitude towards guidelines. The main barriers against guideline application were the external barriers followed by patient related barriers then personal barriers. Guideline related barriers were in the last rank. So, Continuous training of physicians, increasing people’s awareness and improving facilities in hospitals are required to get better adherence to guidelines

Background Systemic lupus Erythematous (SLE) is an autoimmune inflammatory disease characterized by antibodies directed against self-antigens, resulting in multi-organ damage. Up to 20% of cases are diagnosed during childhood with 55% of these patients are expected to develop lupus nephritis (LN). Objective At comparing the efficacy of mycophenolate mofetil versus pulse intravenous cyclophosphamide in induction of remission in pediatric patients with lupus nephritis. Subjects and Methods This is a retrospective study that was conducted in Pediatric Allergy and Immunology Unit, Children’s Hospital, Ain-Shams University from the period of December 2007 to January 2017 on 65 pediatric patients with lupus nephritis taking either cyclophosphamide or Mycophenolate Mofetil as an induction therapy. Patients’ data was gathered from their medical records in the Pediatric Allergy and Immunology Unit, Children’s Hospital, Ain-Shams University. Patients enrolled in the study after consideration of inclusion and exclusion criteria. Results Our studied patients were 65 patients divided into 58(89%) female and 7(11%) male with female: male ratio (8: 1) and their age ranged between (5- 18) years. There was no statistically significant difference between different laboratory parmaters used to compare between both groups (C3, 24 hour urinary protein, anti-DNA). However, the rate of change in SLEADI score was higher in patient receiving Cyclophosphamide and Mycophenolate mofetil, but with no significant difference. Conclusions No significant difference between group taking cyclophosphamide and mycophenolate mofetil.