Objective. To evaluate acute pulmonary embolism in patients with 2019 novel coronavirus (COVID-19) pneumonia using pulmonary CT angiography. Subjects and Methods. From 95 symptomatic patients confirmed with COVID-19 by RT-PCR from 1 May to 14 July 2020 in Dallah Hospital, Riyadh, Saudi Arabia, CT angiography was done for 25 patients suspected to have pulmonary embolism and have no contraindication for contrast study. 11 cases of them showed CT evidence of acute pulmonary embolism (PE). Retrospectively, CT angiography was analyzed and detailed findings were recorded. This study was approved by the Institutional Review Board of our hospital, and the patient consent was waived. Results. The mean age of the included patients was 49 ± 11 years; the youngest was 22 years, and the oldest was 64 years. Common symptoms in the 25 cases that underwent CT angiography were fever that was noted in 21/25 cases (84%), shortness of breath in 18/25 cases (72%), cough in 16/25 cases (64%), and severe myalgia/body fatigue in 13/25 cases (52%). The less common symptoms were sore throat in 11/25 cases (44%) and headache in 10/25 cases (40%). Regarding CT findings, 4/25 cases (16%) had unilateral lung disease and 21/25 cases (84%) had bilateral disease, with slight predilection for the right lower lobe (10/25 cases, 40%). Pure ground-glass opacity (GGO) was seen in 13/25 cases (52%), and GGO with consolidation was seen in 12/25 cases (48%). Common accompanying CT signs included crazy paving stone sign in 15/25 cases (60%) and air bronchogram in 12/25 cases (48%). From the 25 patients that showed respiratory deterioration and elevated serum D-dimer level, 11 cases confirmed to have acute pulmonary embolism, while 14 cases showed negative result for pulmonary embolism. 6/11 were male and 5/11 were female. Pulmonary embolism was diagnosed at a mean of 21 days from symptom onset. Unilateral acute pulmonary embolism was seen in 3/11 cases, while 8/11 cases showed bilateral distribution. Among 11 cases with acute pulmonary embolism, no emboli at the central level could be seen, but 3 cases showed pulmonary embolism at the lobar level, 3 cases at the segmental level, and 5 cases at lobar, segmental, and subsegmental levels. Conclusion. In patients with confirmed COVID-19, we should maintain a high suspicion for its thromboembolic complications such as acute pulmonary embolism that was mainly diagnosed at the end of 3rd week from symptom onset. We suggest that whenever a CT evaluation of the parenchymal involvement of COVID-19 pneumonia is performed, a simultaneous evaluation of the pulmonary arteries is also essential in order to identify early signs of associated pulmonary embolism.

No abstract

Objective To analyze computed tomography (CT) features of symptomatic patients with coronavirus disease 2019 (COVID-19). Methods Ninety-five symptomatic patients with COVID-19 confirmed by reverse-transcription polymerase chain reaction from 1 May to 14 July 2020 were retrospectively enrolled. Follow-up CT findings and their distributions were analyzed and compared from symptom onset to late-stage disease. Results Among all patients, 15.8% had unilateral lung disease and 84.2% had bilateral disease with slight right lower lobe predilection (47.4%). Regarding lesion density, 49.4% of patients had pure ground glass opacity (GGO) and 50.5% had GGO with consolidation. Typical early-stage patterns were bilateral lesions in 73.6% of patients, diffuse lesions (41.0%), and GGO (65.2%). Pleural effusion occurred in 13.6% and mediastinal lymphadenopathy in 11.5%. During intermediate-stage disease, 47.4% of patients showed GGO as the disease progressed; however, consolidation was the predominant finding (52.6%). Conclusion COVID-19 pneumonia manifested on lung CT scans with bilateral, peripheral, and right lower lobe predominance and was characterized by diffuse bilateral GGO progressing to or coexisting with consolidation within 1 to 3 weeks. The most frequent CT lesion in the early, intermediate, and late phases was GGO. Consolidation appeared in the intermediate phase and gradually increased, ending with reticular and lung fibrosis-like patterns.

Background: There is a wide variation of the prevalence of patellofemoral pain (PFP), there is limited studies concerning the prevalence of PFPS in Arabic population and specifically medical students in the universities. Objectives: The aim of this study was to evaluate the prevalence of PFP in the medical students of Cairo University (aged 18–25 years) using a self-report online questionnaire. Methods: The present cross-sectional study was conducted in Cairo city on 532 medical students of age 18-25 years. Data was collected through online questionnaire. Results: Overall prevalence rate of PFP was 28.76%. PFP was higher in females than males (23.5% and 5.3%, respectively), it was insignificantly associated with BMI, time of sitting with bending knee (P>0.05), while significantly associated with time of standing (P<0.05). Conclusions: Patellofemoral pain is common among young active medical students in Cairo University with higher prevalence in females than males.

Aim: Of our study is to evaluate the efficacy of transcutaneous electrical stimulation (Vitalstim therapy) to treat patients with dysphagia and to determine the impact of the modified barium swallow study (MBSS) on patient management. Material and methods: From June 2014 to April 2016, seventy three patients with dysphagia were included. All the patients underwent pre vitalstim-therapy evaluation by speech-language pathologists, including clinical evaluation of swallowing and modified barium swallow study (MBSS). In MBSS we evaluate the following, delay in oropharyngeal swallowing phase, closure of epiglottis, laryngeal elevation, passage of contrast behind the epiglottis that denoting penetration, presence of aspiration and presence residual barium after swallowing. After VitalStim therapy, all patients underwent MBSS assessments and also underwent a follow up survey months (range, 1 to 6 months) after their therapy to assess whether the improvement was worthwhile and sustained. Results: In our study our 73 patients showing radiological findings denoting neurological swallowing disorders, 65 patients (89%) showing delay in oropharyngeal swallowing phase, weak laryngeal elevation found in 58 patients (79%) , 68 patients (93%) showing aspiration and 70 cases (96%) showing penetration and incomplete closure of the epiglottis. Presence of residual barium after swallowing within the vallecula was seen in 68 patients (93%). 52 of the 73 patients (71%) showing complete improvement at first follow up study after VitalStim therapy. 21 of the 73 patients (29%) showing some improvement and need another therapy sessions and in the next follow up study 15 cases showing complete improvement. However, 7 cases of the 21 patients having severe dysphagia before therapy, only 2 of 7 showed any improvement, and these patients still required a feeding tube for adequate nutrition, however, the 5 of 7 showing complete improvement after another session of therapy. Conclusion: We conclude that the modified barium swallow is valuable in the rehabilitation of patient with swallowing disorders helps speech pathologist to identify and modify swallowing abnormalities as well as management program. We also conclude that VitalStim therapy is effective and safe in the treatment of patients suffering with the swallowing difficulties.