Since the start of the pandemic, the number of cases has been increased rapidly. Due to asymptomatic and mild cases and restricted testing in many geographic locations, the overall number of actual COVID-19 cases is likely significantly higher than the number of verified cases. Several COVID-19-related comorbid diseases impair immune system function, which has an impact on COVID-19 responsiveness. So, we evaluated the immune response to SARS-CoV-2 after the third wave of COVID-19 and assessed the effect of comorbid diseases on this immune response. The current cross-sectional study was conducted in August 2021 after the third wave of COVID-19. The study included 287 participants. All participants were asked about their epidemiological data, comorbid diseases, data suggesting COVID-19 infection, and precautions measures to minimize the exposure to the disease. Of the 278 participants, 50% had a positive IgG response to COVID-19. Regarding comorbid diseases, the IgG antibody titer was significantly lower in patients with chronic kidney diseases (CKD) on dialysis, ischemic heart disease, and chronic obstructive lung diseases than other participants (p= 0.01, p= 0.02, p= 0.005, respectively). Neither precaution measures nor comorbid diseases had a role in risk factors of COVID-19 infections in our participants. In conclusion, high seroprevalence (50%) of SARS-CoV-2 IgG antibody after the third wave of COVID-19 was observed in the current study. Comorbid conditions as hypertension, chronic cardiac diseases, chronic chest problems, and CKD on dialysis could decrease the immune response against COVID-19 infection.

Objectives : Acute respiratory failure is a common clinical condition encountered in emergency department and intensive care units (ICU). The use of NIV during acute respiratory failure (ARF) has increased since the late 1990s for all diagnoses, including patients with and without chronic obstructive pulmonary disease (COPD). The use of NIV is associated with reduced tracheal intubation, duration of hospitalization, and mortality. Aim of the work: To evaluates the effectiveness of Non invasive ventilation in the management of acute hypercapnic respiratory failure of different aetiologies as acute exacerbation of COPD, and acute hypoxemic respiratory failure. Design of study: Prospective, Observational, Single-center study. Patients and Methods: 103 patients with acute respiratory failure (ARF) were admitted to Respiratory Intensive Care Unit (RICU) of Chest Department at Assuit University Hospital and received non invasive ventilation, in all patients demographic , clinical and functional parameters were recorded including the cause of acute respiratory failure. NIV success was defined as clinical and gasometric improvement and discharge to regular ward, while need of endotrachial intubation was considered NIV failure. Results: one hundred and three patients with mean age 59.1 years were included in the study,62 (60%) were males and 41(40%) were females, Baseline pH, PaCO2 and PaO2 were 7.51±0.09, 72±21.63and 59.41±20.34 mmHg respectively. The success rate with NIPPV was 69%, with 71of 103 patients weaned successfully. Significant improvements were observed at 2 hour,24-48hrs following institution of NIPPV in pH (7.34±0.08, P < 0.02), PaCO2 (62.87±17.94, P < 0.002) and PaO2(74.30±14.45 P < 0.001).These improvements maintained (within 24 hrs) postweaning from the ventilator, pH 7.39±0.04, PaCO2 56.76±10.18, PaO2 73.28±10.04 (P < 0.001). Duration of mechanical ventilation , length of ICU stay were significantly longer in NIV failure group (p<0.0001). , the complications and death were significantly higher in NIV failure group (p<0.00001),(p<0.0001). Serum albumin level was significantly lower in the NIV failure group (p<0.01). Conclusion: The use of NIV in patients presenting with ARF of diverse etiology has shown to be effective in the improvement of clinical and gasometric parameters, in preventing endotracheal intubation, and improving overall survival .

Introduction and aim Nonalcoholic fatty liver disease (NAFLD) is a very common disease, ranging from simple steatosis to nonalcoholic steatohepatitis (NASH) and is considered the hepatic expression of metabolic syndrome. Liver biopsy is currently considered the gold standard in diagnosis of NAFLD; however, it is an invasive technique and carries many risks. The serum anandamide level is recently discovered to play an important role as the potential indicator for NAFLD severity. The purpose of the study is to determine the association of endocannabinoid metabolite anandamide and NAFLD severity and to investigate its association with anthropometric and metabolic features in NAFLD patients. Methodology A case–control study on 36 NAFLD biopsy-proven NAFLD patients and 15 healthy volunteers. They were subjected to full clinical history and examination, laboratory tests, abdominal ultrasound and serological testing of anadamide. Results The anadamide level was significantly higher among NAFLD subgroups (simple steatosis and NASH) vs. the normal group (1.1, 0.29 vs. 0.2 P value = 0.00085), with cutoff 0.58 in the NASH group (accuracy 89%; sensitivity 66% and specificity 100%) (P value < 0.01). Conclusion Anandamide could be a specific serum marker for NASH and can be used to detect NAFLD severity.