BackgroundDespite the development and dissemination of guidelines for the diagnosis and management of asthma, a gap remains between current recommendations and actual practice.ObjectivesTo assess the physicians attitude towards asthma guidelines and their adherence to its recommendations.MethodsThree hundred and fifty two clinicians (101 General practitioners, 131 pediatric specialists, 35 pediatric consultants and 85 doctors did not report the qualification) engaged in direct childhood asthma care in Cairo, Egypt were subjected to a self-administered questionnaire with 35 questions of which most were multiple choices, aiming at assessment of three important aspects about the involved physicians; physician's knowledge, practice and attitude. 165 of the clinicians were working in governmental hospitals, 68 clinicians work in private clinics and 119 clinicians work in both.ResultsAgreement with asthma guidelines was present in 76.2% of the studied physicians, however those who not in agreement with the guidelines claimed that this was mainly due to patient factors, firstly the poor socioeconomic standard of the patient (18.1%) and secondly due to poor patient compliance (16%). Poor knowledge was found in 28.5%, poor practice was found in 43.6% and poor attitude was found in 14.4% of the studied physicians. There was positive highly significant correlation between qualification and knowledge, (p < 0.01), positive highly significant correlation between qualification and practice, (p < 0.01), and positive highly significant correlation between qualification and attitude, (p < 0.01).ConclusionThe attitude of the studied physicians revealed agreement of their majority with the guidelines, while the disagreement was mainly explained by the poor socioeconomic standard of the patients. The degree of poor practice is more marked than that of poor knowledge or poor attitude reflecting resources limitations and applications obstacles in the physician's practice.

Objectives: Chemotherapy-induced cognitive impairment (CICI) is one of the most prominent side effects as it negatively impacts activities of daily life of the affected role. These problems can range from subtle to severe and last for months or years after discourse. As cognition is an important predictor of survival in patients with hematological malignancy, savvy factors that lead to CICI in hematological malignancies warrant attention. Patients and methods: This is a cross-sectional discipline that was conducted at the Clinical Hematology Section in Ain Shams University Hospital during the period from March 2017 to September 2017. We studied the prevalence of cognitive deterioration among treated patients with chemotherapy for hematological malignancy, and we described its correlation to demographic data and risk agent. Test of cognitive function has been done by using Montreal Cognitive Assessment (MoCA). Results: Out of 150 patients with different hematological malignancies who finished their chemotherapy at least 6 month ago, we found that 93 patient roles (62%) are cognitively impaired. The average score of Montreal test for all patient role was 23.913 ± 3.997. CICI is more among patient who received parenteral chemotherapies and closely related to premedication comorbidities, and all patients with myelodysplastic syndrome (MDS) were cognitively impaired. Also, there was a positive correlation between patient age and cognitive handicap as mean age of patients with abnormal cognitive function was 51.151 ± 9.933 (p value < 0.001) while period of hospital admission was showing significant correlation with impaired abstraction function (p value 0.003), and number of chemotherapy cycles showed significant correlation with naming and orientation cognitive impairment (p value 0.029 and 0.022, respectively). We found that female patients had significant shortcoming in naming ingredient more than male (p value 0.009). The type of chemotherapy regimen received did not significantly affected the overall cognitive impairment, but patients who had received Velcade-based chemotherapy had significantly lower executive and abstract function (p value 0.026). Patient roles which did not achieve remission at follow-up have markedly significant lower scores of most of the cognitive social function. Conclusion and recommendation: CICI is a major problem in patient role with hematological malignance postchemotherapy that can affect their quality of life, so fixture follow-up of the cognitive functions in those patients for early interference with proper management of risk factor is recommended.

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Background Nilotinib has been shown to be a more potent inhibitor of BCR-ABL than imatinib. We evaluated the efficacy and safety of nilotinib, as compared with imatinib, in patients with newly diagnosed Philadelphia chromosome–positive chronic myeloid leukemia (CML) in the chronic phase Aim of the work Comparsion between the early reach ability of major molecular response (MMR) in chronic phase of CML patients on first(1st) and second(2nd) generation TKI(as regard 1st and 2nd line of treatmen t Patients and methods major molecular response (MMR) was assessed by quantative PCRfor BCR –ABL in 100 paients with newly diagnosed CML d ivided to three groups, group 1 included 40 patients on first generation tKI(imitinib), group 2 included 40 patients shifted from 1st generation (imitinib) to 2nd generation (nilotinib) and groups 3 included 20 patients on 2nd generation (nilotinib) from the start. The patients were recruited from clinical hematology department at Ain shams university hospital over the period from1/2018 to1/2019 Results in CML patients, rate of MMRat 12 months of treatment on 2nd generation TKI (nilotinib) as 1st line was higher than other groups (p = 0.025*), rate of EMR was higher in patients on nilotinib 300 mg than on imitinib 400 mg(p = &lt;0.001) in CMl patients started on imitinib 400mg with additional cyto genetics abnormalities had high numbers of failure of MMR(p = 0.001) in comparsion to patients on nilotinib either 1st line or shifted. in CMl patients started on nilotinib 300mg had rising of liver functions than patients on imitinib(p = 0.002 in CMl patients started on nilotinib 3oomg as 1st line had high numbers of ECG chnges than patients on imitinib4oomg(p = 0.005) in CMl patientswith high sockal score started on imitinib 400mg had high number s of failure of MMR in comparsion to patients on nilotinib 300 mg(p &lt; 0.001) in CMl patients, rateof CCR at6 and 12month had higher in patients started on nilotinib 300mgthan imitinib 400mg (p = 0.020) Conclusion treatment with first-line nilotinib is a better clinical strategy than starting with imatinib followed by switching to nilotinib for inadequate responses

Background Invasive fungal infection (IFI) is a major cause morbidity and mortality among patients with hematological malignancies who receive chemotherapy or hematopoietic stem cell transplantation (HSCT). Thus, early diagnosis and treatment of these infections are of crucial importance. Certain factors have been identified as risk factors for IFI. Objectives Assessment of incidence and outcome of IFI in Egyptian patients with febrile neutropenia. Patients and Methods 50 febrile neutropenia episodes were studied. Patients were all subjected to history taking, clinical examination and further investigations including imaging studies, Galactomannan and Mannan antigen assays, and patients were followed up for observing the outcome. Results Our study found that hypertensive patients had significantly reduced LA function as measured by speckle tracking when compared to normotensive controls (P-value &lt; 0.001). Also, many factors were associated with worse LA function in hypertensive patients as old age, high BMI, DM, LV diastolic dysfunction, high LV mass index, larger LA size, lower LA expansion index and higher systolic BP. Conclusion IFI incidence is affected by age, gender, primary diagnosis and severity of neutropenia, and IFI has a worse outcome compared to other causes of febrile neutropenia.