The aim of this study was to evaluate the efficiency of multiple abdominal fat indices measured by ultrasound and anthropometric indices to predict the presence and severity of coronary artery disease (CAD) assessed by coronary angiography. Patients and Methods: All participants subjected to clinical and laboratory assessments. Anthropometric measurements were taken followed by an ultrasound examination to measure fat thickness at multiple abdominal areas. Lastly, selective coronary angiography performed by the Judkins technique. Statistical analysis was performed to detect the association between all variables and CAD, followed by regression analysis, and Odds ratio (OR) was used to quantifies the strength of the association between two events. Results: From the abdominal indices, the posterior right perinephric fat thickness (PRPFT) above the best cutoff value had the highest hazard ratio (HR: 12.3, p = 0.001), followed by visceral adipose tissue volume (VAT) (HR: 10.7, p < 0.001), waist circumference (WC) (HR: 6.7, p = 0.001), visceral fat thickness (VFT) (HR: 5.7, p = 0.002), and body mass index (BMI) (HR: 5.48, p = 0.017). It also showed an independent association between the severity of CAD and WC (HR: 4.28, p = 0.012), VFT (HR: 3.7, p = 0.032), VAT (HR: 3.7, p = 0.034), and waist to height ratio (WHtR) (HR: 3.3, p = 0.033). Conclusion: Posterior perinephric fat thickness and visceral adipose tissue volume measured by ultrasound are strong noninvasive predictors for coronary artery disease, followed by body mass index, waist circumference and visceral fat thickness.

Background:severe preeclampsia (PET) is one of the hypertensive diseases of pregnancy associated with significant morbidity and mortality and require special monitoring, lung ultrasonography is a novel monitoring and diagnostic tools in intensive care and widely used nowadays with early detection of pulmonary oedema. Patients and Methods:this was a cross sectional study of 55 patients with severe preeclampsia,35 case with eclampsia and 60 healthy controls. Lung ultrasonography was done to detect B lines in 12 lung zone postoperatively in both cases and controls fluid input and output is encounted. Results:Median (Min-Max) of lung sonar was higher in severe PET than in controls p value = .0001. B lines were observed in 47.2% and 8.3% in eclampsia ,severe PET and controls respectively. There was highly statistically significant difference between cases and controls as regards input and output as (P=.005), (P=.003) respectively as input and output was higher in control group than cases group) While there was no statistical significance difference between cases and controls as regards net balance as (P=.09). complications occur in higher percentage in cases than control. Conclusions: Restrictedfluid policy is indicated with the finding of B pattern especially with higher lung ultrasound score. Early management in patients with high B line score (pulmonary congestion) even before development of clinical manifestations should be considered.

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Background: Diabetes is associated with increased risk of a large number of complications including microvascular and macrovascular diseases, blindness, some cancers, gallstones and all-cause mortality. Objective: The aim of the research is to study the prevalence of macrovascular complications among rural and urban diabetic patients in Sohag Governorate, Upper Egypt. Methods: This Study was conducted in Sohag Governorate as cross sectional study on diabetes mellitus in Upper Egypt. The study included 500 diabetic patients randomly selected from various cities and villages (rural and urban) of Sohag Governorate. all patients were subjected to: history taking, clinical examination, blood pressure and pulse evaluation, ECG, echocardiography and laboratory investigations including blood glucose and HbA1c estimation. Results: 500 diabetics patients included in then study, 239 from rural areas and 261 from urban areas. No statistically significant difference between patients from urban and rural areas as regard age, gender and smoking while body mass index was higher in patients from urban areas. Both groups were badly controlled on anti-diabetic medications. The prevalence of HTN was higher in rural than urban. The prevalence of IHD and diastolic dysfunction were higher in urban than rural areas with significant difference. The prevalence of stroke was nearly equal and the prevalence of PAD was higher in rural with no significant difference. Conclusion: Macrovascular complications are prevalent among diabetic patients either from rural or urban residence. Ischemic heart disease and diastolic dysfunction is significantly prevalent among urban diabetic patients than rural ones.

Introduction: Anaphylaxis is a potentially life threatening allergic reaction that is rapid in onset and multisystemic in nature. Distribution of anaphylaxis tends to fluctuate based on age, gender, race, geographical residence and socioeconomic status of the involved subjects. Diagnosis of anaphylaxis in children is generally underestimated particularly in developing countries, and when diagnosed, proper management is occasionally lacking. Aim of the study: to evaluate the frequency and pattern of anaphylaxis and mistakes in diagnosis and treatment among a group of Egyptian children and adolescents. Subjects and methods: This observational study was conducted over 6 months duration, from 1st of September 2019 to the end of February 2020, in Children’s hospital, Ain Shams University, Cairo, Egypt, on children presenting to emergency department (ED). Anaphylaxis frequency, presentation, triggers, diagnosis, management and long term follow up were assessed. Results: frequency rate of anaphylaxis among children and adolescents was 0.43% (80/18816) over a year. Sixty percent of patients were infants. Biphasic reactions were reported in 11.3% of patients. The commonest trigger was food (22.5%) followed by medications (8.8%). Epinephrine was given to all patients, in proper dosage and method in most occasions (78.7%). Long term management and follow up appointment were deficient. In conclusion: Anaphylaxis in children was relatively high, with food being the most common trigger. Diagnosis and early management of anaphylaxis was satisfactory, however, long term management and follow up were defective.