Behçet's disease (BD) is an idiopathic multisystem disorder. Involvement of CNS occurs in 4-48% of cases. This study was designed to evaluate the prevalence of subclinical neuropsychiatric affection in asymptomatic Egyptian BD patients using psychometric tests and brain imaging with single photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI), also to assess possibly associated clinical predictive variables. Twenty-five BD patients without overt CNS involvement and ten healthy controls matched for age, education, and sex completed a comprehensive neuropsychological battery including Hamilton scales for anxiety and depression and Wechsler memory scale-revised. Disease activity was assessed using Behçet's Disease Current Activity Form (BDCAF). SPECT was done for all subjects, and 12 patients underwent brain MRI. Compared to controls, 23 (92%) and 24 (96%) patients had anxiety and depression scores respectively above normal range; also, BD patients had significantly lower memory quotient (MQ). SPECT revealed abnormalities in 16/25 (64%), while in 3/12 patients (25%), MRI was abnormal. Subjects with abnormal SPECT had significantly higher ages than those with normal SPECT (P = 0.02) and were more frequently males (P = 0.03). No statistically significant differences between cases with normal or abnormal SPECT were found regarding disease duration, frequency of headache, BDCAF, frequency of active eye disease, major vascular involvement, mean Hamilton anxiety and depression scores, and mean MQ. Early diagnosis of neurological involvement in BD is important in reducing or preventing complications. Neuropsychiatric evaluation and HMPAO brain SPECT were found to be useful for detecting subclinical neurological abnormalities in BD patients.

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Background: accurate selection of the patients with known or suspected coronary artery disease (CAD) who will benefit from additional CT-based attenuation correction (CT-AC) images to gated 99m Tc -MIBI myocardial perfusion scintigraphy (MPS) is mandatory to compromise the increased sensitivity demand for the unnecessary radiation doses exposure concerns. Aim of the work: to evaluate the value of added CT-AC to gated MPS in the clinical diagnosis of CAD for appropriate selection of the patient who will benefit from this additive technique. Patients and methods: 90 patients (53, SD ± 12 year-old, 66%males) were retrospectively included in the study. Two days protocol gated MPS and additional CT-AC images were performed for all patients. The final clinical diagnosis was reached by consensus after interpreting the gated MPS images and correlating them with the clinical risk factors and other available cardiac diagnostic modalities. Comparison was done between the final diagnosis and the CT-AC images to evaluate the performance of the latter. Results: 159 segmental perfusion defects were elicited; 93 (58%) and 66 (42%) perfusion defects were finally interpreted as attenuation artifact and true ischemic defects respectively. The CT-AC images show good performance with 100% sensitivity and specificity in the inferior and lateral walls perfusion defects while it shows poor performance in the anterior and septal walls due to false positive results resulting in reduced specificity of 75 %.

Background: Nasopharyngeal carcinoma (NPC) is one of the few epithelial-origin tumors observed in pediatric population accounting for around 1-5% of all pediatric cancers and characterized with higher incidence of advanced loco-regional compromise. Aim of the work: to explore the impact of 18 F-FDG-PET/CT in pediatric nasopharyngeal carcinoma (PNPC) either during initial staging or restaging after end of therapy versus conventional imaging (CI) modalities (MRI and Ce-CT). Patients and methods: 40 patients with biopsy proven PNPC (mean age 13, SD ± 2.3; range 9-17) mostly of non-keratinizing undifferentiated type III (95%) were included in the study. Whole body 18 F-FDG-PET/CT, MRI and In respect of the M stage; the sensitivity values were 80%, 60% and 25% for PET/CT, MRI, and CT respectively. In re-staging; PET/CT has higher sensitivity than CI modalities for local residual/recurrence (T), nodal (N) and distant metastases (M) with values of 100% vs. 86% in T stage, 100% vs. 91% in N stage and 100% vs. 66% in M stage for PET/CT and CI modalities respectively. Conclusion:18 F-FDG-PET/CT is considered a potentially valuable imaging tool in PNPC either in initial staging or restaging which could effectively change the overall staging and hence the management.

Background Under diagnosis of COPD is serious problem in many countries world-wide because there are no generally detection tools available to detect high-risk patients for spirometry, and patients will not go for COPD check-up until a serious issue happens like exacerbation. Objective The aim of the work is trying to assess a new screening tool for early diagnosis of COPD. Patients and Methods The present study was conducted upon 500 subjects during the period from march 2018 to august 2018 who admitted to our chest department or visit our outpatient clinic, employees and visitors to Ain Sham hospitals.All subjects >40yrs who smoker or ex-smoker(≥10pack-years) applied a six variants(age,sex,packed years smoked during life ,dyspnea,chronic phlegmand chronic cohgh)questionnaire modified from PUMA questionnaire Subjects with score ≥5 did spirometry Results 500 subjects shared in the study 497 of them were males ( 99.4% )and 3 were females (.6%). 152of them(30.4%) had score <5 and 348 of them (69.6%)had score ≥5 who did spirometry.152 subjects did not perform spirometry. By spirometry we diagnosed 81(23.3) case COPD (fev1-fvc <.7) out of 348 subjects under gone spirometry and 16.2% of total subjects(500) . Conclusion Modified puma score is a simple and easy screening questionnaire for early detection of COPD cases and spirometry should be done to confirm the diagnosis or rule out.COPD is prevalent in many healthy apparent persons.