Our report describes a sudden flare-up of a skin rash (Grade 3) after the 5th cycle of cetuximab following use of OTC skin care remedies, which was unusual for this patient, suggesting a possible relation to the therapy. Skin crucially depends on EGFR for its normal function and becomes extremely sensitive during cetuximab therapy. Topical OTC acne and dry skin remedies can suddenly change the mild acneiform rash into severe skin toxicity associated with marked desquamation and exfoliation. Avoidance of further skin damage caused by topical applications and the use of doxycycline and diphenhydramine show a significant success in the management of skin toxicity.

Introduction: High quality cardiopulmonary resuscitation (CPR) performed according to international guidelines has a vital impact on survival of cardiac arrest. Objective: To investigate different variables affecting return of spontaneous circulation (ROSC) and survival to discharge (STD) after in-hospital cardiac arrest (IHCA) and evaluate adherence to CPR guidelines using a modified Utstein-style template. Methods: A prospective observational study of 126 IHCA out of 5479 admissions to cardiology units of 3 Cairo University hospitals. Results: CPR was not attempted in 7 futile cases. ROSC was achieved in 50.4%, while STD was achieved in only 7.6% of 119 attempted resuscitations. CPR was started by a physician in 114 cases (95.8%) and by the on duty nurse in only 5 cases. The initial rhythm was shockable rhythm (SR) in 19 cases; 13 (68.4%) of whom achieved ROSC and 6 (31.6%) STD and non SR (pulseless electric This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/). activity/asystole) in 100 cases; 47 (47%) of whom achieved ROSC and 3 (3%) STD. Chest compressions were observed appropriate P100/min, P2 inches deep and interrupted <10 s in 99.2%, 92.4% and 48.7% of cases respectively. Initial SR and duration of CPR were independently associated with ROSC (both P = 0.01) and STD (P = 0.008 and 0.02 respectively). A cut-off value for CPR duration of 22.5 min had a sensitivity of 86.7% and a specificity of 81.4% in predicting ROSC by receiver-operator characteristics analysis. Conclusion: The poor STD despite a relatively good ROSC calls for improvement of CPR education and training for hospital personnel and better post CA care.

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Background Numerous epidemiological investigations and randomized clinical studies have determined that dyslipidemia is a major contributor to atherosclerotic cardiovascular disease (ASCVD). Consequently, the management of serum cholesterol and low-density lipoprotein levels has become a central objective in the effort to prevent cardiovascular events. Main body Many guidelines were issued by different organizations and societies to define patient risk and establish important recommendations for management strategies. Newer cholesterol-lowering agents (non-statin drugs) are described, and their use is directed primarily to secondary prevention in patients at very high risk of new ASCVD. Conclusion The present guidance summarizes the current methods for risk estimation and outlines the most recent data on lipid management in a simple user-friendly format, to improve physician awareness and help implement guidelines in the daily practice.

Background The COVID-19 pandemic poses a major burden to the healthcare system in Egypt, and in the face of a highly infective disease which can prove fatal, healthcare systems need to change their management protocols to meet these new challenges. Main body This scientific statement, developed by the cardiology department at Cairo University, emphasized 6 different aspects that are intended to guide healthcare providers during cardiopulmonary resuscitation (CPR) in the era of the COVID-19 pandemic. It highlighted the importance of dealing with all cardiac arrest victims, during the pandemic, as potential COVID-19 cases, and the use of appropriate personal protective equipment (PPE) by health care providers during the procedure. It also stated that the CPR procedure should be done in a separate room with the door closed and that the number of providers present during the procedure should be limited to only those who are essential for patient resuscitation. It also stressed that family members and accompanying personnel of patients with possible COVID-19 should not be in the vicinity of CPR site. The statement also pointed out that CPR procedure should be done in the standard manner with precautions to minimize spread of infection to the staff and accompanying people. Early intubation was prioritized, and the use of rapid sequence intubation with appropriate PPE was recommended. For delivery of CPR for the prone ventilated patient, delivery of chest compressions by pressing the patient’s back, while a team prepares to turn the patient supine, was recommended. During intra-hospital transport, it was emphasized that the receiving intensive care unit (ICU) should be notified about the possibility of the patient being COVID-19 positive, so that appropriate infection control precautions are taken. Conclusion Cardiopulmonary resuscitation of cardiac arrest patients in the COVID-19 era poses a significant challenge, and all health care providers should deal with any cardiac arrest victim presenting to the emergency department as potential COVID-19 suspects and should use the appropriate PPE.