Background: Gastroesophageal reflux disease (GERD) is a common disease that is often diagnosed based on typical symptoms of heartburn and regurgitation. In addition to these more classic manifestations, GERD is increasingly associated with extra-esophageal symptoms, including chronic cough, asthma, laryngitis, and aspiration pneumonia. Management of GERD may help in management of these respiratory diseases. Aim of Study:To study the presence of chest diseases in non-smoker patients complaining of GERD. Subjects and Methods:The study was carried out on 100 patients attended to Al-Hussein and Sayed Galal Al-Azhar University Hospitals in the period from September 2017 to May 2018. Patients were categorized into two groups: Group 1: Included 100 patients complaining of heartburn, epigastric pain and respiratory symptoms confirmed to have GERD by upper GI endoscope. Group 2: Include fifty patients apparently healthy (as regard GERD symptoms) confirmed that they were not have GERD by upper GI endoscope. All patients underwent history taking, examination, routine lab investigations, upper GI endoscopy, chest X-ray and spirometry. C.T. chest was done on need according to symptoms and chest Xray finding.Results: Respiratory disorders occurrence was more in GERD group than in negative group as regard GERD with statistically significant difference between the two groups in chronic laryngitis, bronchial asthma, COPD, and pneumonia, but no significant difference between the two groups wos found as regard ILD. Conclusion:GERD is a considrable risk factor for the development of respiratory disorders. This study proved that pulmonary symptoms was elevated among those with frequent GERD compared to those without GERD.

Background. Spontaneous bacterial peritonitis (SBP) is a fatal complication of liver cirrhosis with high mortality rates. Objective: The aim of this study is to investigate the diagnostic utility of absolute neutrophil count (ANC) as a non-invasive marker for SBP diagnosis. Methods. Six hundred patients with cirrhotic ascites were included in the study. All patients underwent abdominal paracentesis and the ascitic fluid was processed for cell count and culture. Results. Absolute neutrophil count was significantly higher in SBP versus non-SBP and in culture positive SBP versus culture negative SBP. ANC at cutoff value > 2.804 has 84% sensitivity and 78% specificity for diagnosis of SBP with positive and negative predictive values (79.4% and 83.6 respectively). At a cut-off point > 5.6, ANC is capable of differentiating culture positive SBP from culture negative SBP cases with 62.07% sensitivity and 60.87 % specificity. Increased ANC, WBC, CRP, creatinine and decreased platelet emerged as independent risk factors for SBP development, while increased ANC, WBC and decreased platelets were independent predictors of culture positive SBP. Conclusion. This study demonstrates that, ANC count is simple, non-invasive diagnostic marker for SBP. Increased ANC, WBC, CRP, creatinine and decreased platelet emerged as independent risk factors for SBP development.