Unveiling the organic chemical composition and sources of organic carbon in PM2.5 at an urban site in Greater Cairo (Egypt): A comprehensive analysis of primary and secondary compounds.

This work presents an exhaustive chemical characterization of the organic fraction of fine particulate matter (PM2.5) collected at an urban site in the Greater Cairo Area, Egypt, one of the most polluted megacities in the world. An intensive 2-month sampling campaign was conducted at an urban site in Giza (Dokki), from November 26, 2019, to January 28, 2020. Daily (24-h integrated) PM2.5 filter samples were then analyzed for their carbonaceous (OC, EC) and organic fractions including primary (n-alkanes, phthalates, fatty acids, polycyclic aromatic hydrocarbons, hopanes, sugars, and sugar alcohols) and secondary (isoprene and ß-caryophyllene oxidation products, and dicarboxylic acids) compounds. Average organic (OC) and elemental carbon (EC) concentrations were 17.8 ± 6.6 µg/m3 and 4.4 ± 1.5 µg/m3, respectively. Biomass burning was confirmed by high daily concentration levels of levoglucosan, mannosan, and galactosan (sum equals to 288 ng/m3). Road traffic was also highlighted by the relative abundance of tetracosane and a carbon preference index close to unity as well as by the concentration ratios of PAHs and hopanes. Moreover, phthalates were identified for the first time in Cairo with high concentrations (654 ng/m3) that might be attributable to open waste burning activities. Fatty acids and sugars were also investigated and assigned to cooking activities and primary biogenic sources, respectively. The average concentration of isoprene and ß-caryophyllene oxidation products were 0.89 ± 0.83 ng/m3, and 0.01 ± 0.02 ng/m3, respectively. These low values are expected since no pine trees or even forests exist in Egypt. The macrotracer approach was employed alongside Monte Carlo simulation to identify sources of primary OC and evaluate the uncertainties associated with source attribution and OC reconstruction. The findings revealed a strong contribution from cooking (31% of observed OC) and biomass burning (18%), with median reconstructed OC levels showing significant uncertainty (64%) as expected.

Submicron aerosol pollution in Greater Cairo (Egypt): A new type of urban haze?

Greater Cairo, the largest megacity of the Middle East North Africa (MENA) region, is currently suffering from major aerosol pollution, posing a significant threat to public health. However, the main sources of pollution remain insufficiently characterized due to limited atmospheric observations. To bridge this knowledge gap, we conducted a continuous 2-month field study during the winter of 2019-2020 at an urban background site, documenting for the first time the chemical and physical properties of submicron (PM1) aerosols. Crustal material from both desert dust and road traffic dust resuspension contributed as much as 24 % of the total PM1 mass (rising to 66 % during desert dust events), a figure not commonly observed in urban environments. Our observations showed significant decreases in black carbon concentrations and ammonium sulfate compared to data from 15 years ago, indicating an important reduction in both local and regional emissions as a result of effective mitigation measures. The diurnal variability of carbonaceous aerosols was attributed to emissions emanating from local traffic at rush hours and nighttime open biomass burning. Surprisingly, semi-volatile ammonium chloride (NH4Cl) originating from local open biomass and waste burning was found to be the main chemical species in PM1 over Cairo. Its nighttime formation contributed to aerosol water uptake during morning hours, thereby playing a major role in the build-up of urban haze. While our results confirm the persistence of a significant dust reservoir over Cairo, they also unveil an additional source of highly hygroscopic (semi-volatile) inorganic salts, leading to a unique type of urban haze. This haze, with dominant contributors present in both submicron (primarily as NH4Cl) and supermicron (largely as dust) modes, underscores the potential implications of heterogeneous chemical transformation of air pollutants in urban environments.

The digital health divide: Understanding telehealth adoption across racial lines in rural Illinois.

Due to long-standing barriers to healthcare access in rural areas, telehealth has been promoted as an effective means of delivering healthcare services. However, there is a general absence of quantitative data showing how geographic residence and race affect telehealth adoption. This study examines variations in telehealth adoption based on race and geographic residence in Southern Illinois using a mail survey. It finds that residents of urban Carbondale, compared to those in rural Cairo, have better access to broadband and are more likely to use telehealth. Respondents significantly differ from each other based on their geographic location of residence and race when it came to using telehealth to save money on travel and to save money on childcare. A significant barrier to telehealth adoption identified across all groups is privacy protection concern. The findings highlight the crucial role of broadband infrastructure in healthcare access and the need for trust in telehealth systems to ensure data privacy.

A Retrospective Study on the Status of Working Equids Admitted to an Equine Clinic in Cairo: Disease Prevalence and Associations between Physical Parameters and Outcome.

Working equids are often used to exhaustion, living and dying in conditions below minimal welfare standards. Due to their poor welfare status, euthanasia should be considered in certain conditions. The study aimed to describe the population and the disease frequency of the working equids admitted at an equine clinic in Cairo (i.e., Egypt Equine Aid (EEA)) from 2019 to 2022 and identify possible associations between physical parameters at admission and the outcome. Records of 1360 equids admitted at EEA were reviewed. The majority of the admitted equids were horses (65.6%), followed by donkeys (33%), in particular stallions (68.7%), from 1 to 15 years old (74.8%). Hospitalisation was mainly due to wounds (28.9%), orthopaedic problems (27.4%), colic (8.5%), or infectious diseases (7.4%). The majority of the equids were discharged, but 5.1% died on their own, without human intervention, and 23% were euthanised. Text mining revealed the anamnesis's most frequent words were 'accident', 'lameness', and 'wound'. In addition, owners sometimes reported using inappropriate remedies (e.g., firing) before hospitalisation. Multivariable ordinal regression analysis performed between physical parameters and the outcome (ordered based on severity: discharged, euthanasia, and dead) revealed that sex (male vs. female: OR = 1.33; p < 0.05), colour of the mucous membrane (pathological vs. physiological: OR = 1.72; p < 0.01), and capillary refill time (pathological vs. physiological: OR = 1.42; p = 0.02) increased the likelihood of a non-survival outcome. In conclusion, early euthanasia should be considered for these equids, to minimise prolonged suffering. Moreover, owners' education is recommended to guarantee minimal welfare standards to the working equids.

Assessing the Reliability of Miller's Classification and Cairo's Classification in Classifying Gingival Recession Defects: A Comparison Study.

Background and Objectives: Gingival recession results in adverse aesthetics and root sensitivity, and there is a need to treat and prevent its further progression. To overcome these problems, various advances have been made by clinicians in treating gingival recession based on the type of gingival recession. Miller's classification has been used for a long time to classify the type of recession. However, certain limitations have been found with use of Miller's classification such as a lack of clarity in the method for measuring soft and hard tissue loss in the interproximal area. Cairo classification was proposed to overcome limitations of Miller's classification to classify gingival recession. Cairo's classification is a treatment-oriented classification based on buccal and interproximal attachment loss. Therefore, the study was conducted to assess and compare the reliability of Miller's and Cairo's classifications in determining gingival recession. Material and methods: A total of 220 buccal gingival recession defects were included in the study based on the inclusion and exclusion criteria. Four examiners were included in the study. Two examiners classified the recession defects according to Miller's classification and the other two examiners classified recession defects according to Cairo's classification at baseline and at a 1-week interval. Statistical analysis was conducted using SPSS software version 25.0 using Cohen's kappa correlation coefficient and Chi-square test statistics to determine the intra- and inter-rater agreement among the examiners for the two gingival recession classification systems. A p value of <0.05 was considered statistically significant. Results: The intra-rater agreement for Cairo's classification was 0.86 and 0.82, whereas for Miller's classification, it was found to be 0.68. The inter-rater reliability agreement for Cairo's classification was 0.82 and 0.8, whereas for the Miller's classification, it was 0.56 and 0.67. Conclusions: Within the limitations of the study, it was found that Cairo's classification is clearer and more reliable than Miller's classification in the assessment of gingival recession.

Protozoan and helminths infestation of Nile tilapia Oreochromis niloticus and its correlation with certain water quality variables along river Nile in the area of Greater Cairo.

Pollutants and parasites represent stressors for fish at the individual, population, or community levels. The current study outlines the seasonal infestation pattern of Oreochromis niloticus by protozoan and helminths parasites linked to some physicochemical parameters (pH, dissolved oxygen, total dissolved solids, and electrical conductivity), and metals (Cd, Pb, Fe, Zn, and Ca), at nine selected sites in River Nile (Greater Cairo area) from summer 2019 till spring 2020. Most of the studied criteria in Nile water samples showed normal levels during all seasons compared to the recommended limits of EPA. The parasitological examinations recorded three protozoan categories: Myxobolus (8 species), hemoflagellates (Trypanosoma mukasi) and Ciliates (Trichodina compacta), and three helminths; Clinostomum sp., Acanthocephala sp. and Euclinostomum ardeola. The highest incidence of infection was determined for Clinostomum sp., followed in descending order by Myxobolus sp., Acanthocephala sp., T. mukasi, E. ardeolathen, and T. compacta. Notably, this study introduces the novel identification of new species of Myxobolus in the blood of Oreochromis niloticus. The histopathological examination of gills, muscles, and kidneys reveals serious changes and the presence of encysted trematodes, metacercariae, and cysts of protozoan parasites. Additionally, the study employs cluster analysis based on site similarity in water variables and canonical correspondence analysis, explaining 98.7 % of the variables and indicating correlations between parasite infestation and environmental factors. These analytical approaches reveal the impact of land use activities on water variables and the influence of adjacent activities on fish parasite infestation patterns. In conclusion, this study provides a comprehensive perspective by considering various factors to enhance our understanding of pollutants and parasites affecting fish in the River Nile.

Effect of concept mapping model on critical thinking skills of family medicine residents: A randomized controlled trial.

BACKGROUND: The cognitive process of critical thinking (CT) involves the examination of the existing reasons and an analysis of the information to draw conclusions and make decisions. The goal of the study was to determine how concept mapping (CM) technique affects family medicine residents' capacity for critical thought. MATERIALS AND METHODS: We conducted a randomized controlled trial among family medicine residents aged between 26 and 28 years. A total of 100 residents were involved; over the course of 3 months, 50 residents were exposed to the conventional teaching model and 50 residents to the CM model. Data was collected using California CT skills test (CCTST) modified Arabic version and a self-administered questionnaire. The primary intervention was teaching method, experimental group received CM lessons while control group had conventional lessons. First session was carried out at baseline and second session one week after baseline, whereas 3rd, 4th, and 5th sessions conducted at end of 1st, 2nd, 3rd months, respectively. Both groups were assessed at baseline and at end of 3rd month. Both groups were reassessed at end of three months. Quantitative data was presented as mean and SD, whereas frequencies and percentages used for qualitative data. Pre- and post-intervention CT scores for study groups were compared using t-test or Mann-Whitney U test, as appropriate. Groups were compared on pre- and post-intervention CT grades using Chi-square test. RESULTS: Vast majority (98%) of participants were females, nearly half were 27 year old, and belonged primarily to urban areas (76%). There was no difference in the CT scores between the groups at baseline. The post-intervention CT scores for study group were statistically significantly higher (18.36±2.68) compared to control group (15.94±1.94) (P = 0.001). CONCLUSION: The CM approach was superior to the conventional teaching approach in terms of improving CT.

Spontaneous Tumor Lysis Syndrome Secondary to Metastatic Small Cell Lung Cancer.

Tumor lysis syndrome (TLS) is an oncology emergency caused by the lysis of tumor cells that releases cell contents into the blood. TLS is typically associated with leukemia following the initiation of chemotherapy. Spontaneous TLS has been seen in hematologic malignancies, but the incidence of spontaneous TLS in solid tumors is rare, and only nine cases have been reported in small cell lung carcinoma. We present a case of a patient who presented with severe metabolic acidosis and electrolyte abnormalities consistent with TLS. At presentation, our patient was found to have small cell lung carcinoma with metastasis to the liver. This patient was managed with bicarbonate, rasburicase, allopurinol, and calcium replacement and started on continuous renal replacement therapy, but unfortunately was transitioned to comfort care and passed away. Risk factors for spontaneous TLS include bulky disease, elevated lactate dehydrogenase, elevated white blood cell counts, renal compromise, and abdominal organ involvement. The most common laboratory findings for TLS include metabolic acidosis and hyperuricemia, hyperphosphatemia, hyperkalemia, and hypocalcemia. Cases of spontaneous TLS, however, have been noted to have smaller elevations in phosphate levels. Spontaneous TLS is a rare but potentially fatal complication that can be seen in small cell lung carcinoma.

Perception of COVID-19-related stigma and associated psychological challenges among healthcare workers at Cairo University hospitals.

OBJECTIVES: The current study explores the level of perceived social stigma and associated psychological challenges among healthcare workers during the second wave of the COVID-19 pandemic in Egypt. METHODS: This was a cross-sectional study of 150 healthcare workers at Cairo University hospitals that were confirmed positive for COVID-19 infection. Participants were interviewed for assessment of perceived COVID-19-related stigma and associated psychological symptoms using the Patient Health Questionnaire for depression, the Generalized Anxiety Disorder Assessment for anxiety, and the Post-Traumatic Stress Disorder Checklist for post-traumatic stress symptoms. RESULTS: Two-thirds of participants perceived moderate-to-severe COVID-19-related stigma. Depression, anxiety, and post-traumatic stress symptoms were observed at varying levels in 58.0%, 38.0%, and 11.3% of participants, respectively. Female sex and occupation as a nurse were significantly associated with the total perceived COVID-19-related stigma score. COVID-19-related stigma perception significantly correlated with depression, anxiety, and post-traumatic stress. CONCLUSION: Perceived social stigma prevails among healthcare workers and is associated with numerous psychological disturbances.

Incidence of incidental positron emission tomography and computed tomography signs of COVID-19 in asymptomatic cancer patients in Egypt.

Background: COVID-19 was first reported in Egypt on 14 February 2020 and continues to be a major threat to public health. Aims: We studied the incidence of incidental positron emission tomography/computed tomography (PET/CT) signs of COVID-19 in asymptomatic cancer patients and compared this with the number of reported COVID-19 cases during the same period. Methods: We included all cancer patients who underwent PET/CT at Misr Radiology Center, Cairo, between 2 May and 7 August 2020. Results: There were 479 patients who underwent PET/CT primarily for follow-up, and 66 (13.78%) of them showed radiological signs of COVID-19, with the peak incidence in weeks 7-8 of the study. This coincided and strongly correlated with the peak incidence of COVID-19 in Egypt (Pearson's correlation coefficient test = 0.943). Conclusion: The incidence of incidental PET/CT signs of COVID-19 was in accordance with the officially reported incidence of COVID-19 in Egypt between 2 May and 7 August 2020. These results could be helpful for implementing and adjusting public health and social measures during the COVID-19 pandemic.

Computational prediction of dust deposition on solar panels.

This research is concerned with performing computational fluid dynamics (CFD) simulations to investigate the air flow and dust deposition behavior around a ground-mounted solar PV panel. The discrete phase model (DPM) is adopted to model the gas-solid flow. The influence of the wind speed, the dust particle size, and the dust material on the dust deposition rate was investigated based on the environment of Cairo, Egypt. The wind speeds range between 1 and 11.5 m/s with an average of 3.7 m/s. It is found that increasing the wind speed decreases the dust deposition rate. For wind speeds higher than 2 m/s, it is found that increasing the dust particle diameter or the dust density increases the dust deposition rate. For wind speeds lower than 2 m/s, it is found that there is a critical particle size before which increasing the dust density causes dust deposition rate to increase and after which increasing the dust density decreases the dust deposition. The maximum percentage of deposition rate equals 10.8% and occurs for the dolomite dust material at a wind speed of 2 m/s and particles diameter of 150 µm.

Hepatitis B Reactivation Following Eradication of HCV with Direct-Acting Antiviral Drugs (DAAs) in a Cohort of Patients from Different Institutions in Egypt.

Background: Concerns about HBV reactivation (HBVr) have been raised with the introduction of DAA for HCV treatment. The aim of the study was to assess the risk of HBVr in chronic HCV patients during or after DAA. Methods: A cohort of 166 chronic HCV patients who were treated with SOF-based DAA regimens and initially positive for HBcAb total were evaluated; 10 HBsAg-positive, 156 had past HBV exposure (HBsAg-negative/HBcAb-positive). Laboratory investigations, including liver functions tests, HBV-DNA, LSM by Transient elastography, and ARFI together with serum markers of fibrosis; APRI and FIB-4 were done at baseline and after 12 weeks of DAAs therapy. HBV-DNA levels and liver functions were monitored for assessment of HBVr. Results: Virological HBVr was diagnosed by ≥ 1 log10 IU/ml HBV-DNA levels in 2/166 patients (1.2%) among the whole HCV cohort, who were initially positive for HBsAg; 20%. Clinical HBVr (>3 folds liver enzyme elevation) was detected in one patient with virological HBVr. Conversely, none of past HBV-infected patients experienced HBVr. All patients achieved SVR12 and had a significant decline in serum transaminases, bilirubin, APRI, and LSM measurements after HCV eradication. Conclusion: HBVr might be considered after successful eradication of HCV following DAAs therapy, especially among patients who are positive for HBsAg, while past HBV infection does not seem to be a predisposing condition to HBVr.

Risk Assessment and Hazardous Effects of Metal Contamination in O. niloticus and S. galilaeus from Four Islands of the River Nile.

The Nile River islands are recognized as the most productive lands in Egypt. Although, these islands are vulnerable to several natural and man-made crises. The present study was aimed to evaluate the consequences of different anthropogenic activities on the heavy metals load and histological alterations in O. niloticus and S. galilaeus collected from four different Nile River islands along the Great Cairo sector (Egypt), and the possible health risks for human consumers. Metals were accumulated in both fish muscles in the following order: Fe > Zn > Cu > Mn > Pb. S. galilaeus was recorded higher metal pollution index than O. niloticus, while El-Warrak Island was documented the highest MPI and hazard quotient among all sampling sites. All sampled tissues were recorded histopathological lesions in both fish. The present study may be considered as an early alert for habitual consumers, particularly at high consumption rates of some fish species.

Spatial Distribution, Contamination Levels, and Health Risk Assessment of Potentially Toxic Elements in Household Dust in Cairo City, Egypt.

Urban areas' pollution, which is owing to rapid urbanization and industrialization, is one of the most critical issues in densely populated cities such as Cairo. The concentrations and the spatial distribution of fourteen potentially toxic elements (PTEs) in household dust were investigated in Cairo City, Egypt. PTE exposure and human health risk were assessed using the USEPA's exposure model and guidelines. The levels of As, Cd, Cr, Cu, Hg, Mo, Ni, Pb, and Zn surpassed the background values. Contamination factor index revealed that contamination levels are in the sequence Cd > Hg > Zn > Pb > Cu > As > Mo > Ni > Cr > Co > V > Mn > Fe > Al. The degree of contamination ranges from considerably to very high pollution. Elevated PTE concentrations in Cairo's household dust may be due to heavy traffic emissions and industrial activities. The calculated noncarcinogenic risk for adults falls within the safe limit, while those for children exceed that limit in some sites. Cairo residents are at cancer risk owing to prolonged exposure to the indoor dust in their homes. A quick and targeted plan must be implemented to mitigate these risks.

Tumor Lysis Syndrome in the Chronic Phase of Chronic Myeloid Leukemia Following COVID-19 Infection: A Case Report.

Tumor lysis syndrome (TLS) is a hematological emergency. This syndrome is characterized by metabolic derangements such as hyperkalemia and hypocalcemia, which result from rapid lysis of cells, especially rapidly growing tumors, after the initiation of chemotherapy. It is rarely seen in chronic myeloid leukemia (CML) and has not been previously reported to be triggered by coronavirus disease 2019 (COVID-19) infection. We report a case of a 45-year-old male, a known case of CML in the chronic phase, who presented with fatigue and abdominal pain for four days. Initial laboratory results were consistent with leukocytosis and positive COVID-19 antigen. The patient was started on intravenous fluids and hydroxyurea; however, over the next few days, he deteriorated quickly and developed oliguric acute kidney injury (AKI) with electrolyte disturbance consistent with TLS. The patient was shifted to the intensive care unit and underwent one sustained low-efficiency dialysis (SLED) session and received rasburicase. Over the next few days, the patient started to improve and was discharged in good shape. Although CML rarely presents with TLS, physicians should monitor their patients closely, especially those who have concurrent COVID-19 infection, as this condition may result in lethal sequelae such as AKI, severe arrhythmias, and multiorgan failure. Additionally, early detection and treatment lead to a better prognosis.

Assessment of air pollution at Greater Cairo in relation to the spatial variability of surface urban heat island.

Greater Cairo, Egypt, which lies in the apex of the Nile Delta, is one of the most populated regions in the world. Air pollution is a profound environmental issue prevailing in the urban/rural landscapes of this crowded megacity. The objectives of the present study were to utilize remotely sensed data in order to address the seasonal variations of the nocturnal surface urban heat island intensity (SUHII) as extracted from the American Moderate Resolution Imaging Spectroradiometer (MODIS) satellite and the related seasonal distribution of selected air pollutants, including nitrogen dioxide (NO2), sulphur dioxide (SO2), and carbon monoxide (CO) as extracted from the European TROPOspheric Monitoring Instrument (TROPOMI) for the period from 2018 to 2021. It is observed that there is clear nocturnal urban heat island over Greater Cairo, particularly at the administrative districts dominated by urban land use with high density of population and at the industrial and power generation locations. The highest SUHII is observed during winter. On the other hand, the selected pollutants also represent an urban pollution island (UPI) capping the regions of high SUHII. At the seasonal level, the highest NO2 correlation with the SUHII occurs during spring (R2 = 0.59), while the CO correlates maximum during winter (R2 = 0.51). Nonetheless, the seasonal SO2 distribution is poorly related to the SUHII as this specific pollutant is significantly associated with the industrial land use. Climatic and topographic factors could intensify the distribution of air pollution in the study area. Results of this study demonstrate the significance of geospatial technology tools in the subtle analysis and addressing regional air pollution. The outputs are also of a paramount implication on the management of urban environment and the adaptation of urban air quality.

Emissions Control Scenarios for Transport in Greater Cairo.

Air pollution is a major cause of premature death in Greater Cairo, but studies on emission control are limited. We used local and international data to predict the impact of transport emission control measures on sector parameters including congestion. The International Vehicle Emission model accordingly estimated quantities of criteria, toxic and global warming emissions produced by on-road vehicles. Emissions were estimated for 2019 base case (2019-BC) and projected for 2030 under the 'do nothing' scenario (2030-DNS) and five scenarios: fuel subsidy removal (2030-FSR), road expansions (2030-RE), public transport improvements (2030-PTI), inspection and maintenance (I/M) programs (2030-I/MP), and fuel enhancements (2030-FE). The 2030-FSR would reduce emissions by 11.2% versus 2030-DNS. The 2030-RE resulted in an average increase of 37% in emissions compared with 2030-DNS since it induces more traffic. The 2030-PTI provides alternatives to car travel; hence, cars result in an average drop of 32.8% for all emission types compared with 2030-DNS. The 2030-I/MP exhibited reductions in PM10 and toxic pollutants, of 35-54.8% compared with 2030-DNS. The 2030-FE reduced SOx, benzene and N2O emissions by 91.8%, 81% and 39.1%, respectively, compared with 2030-DNS. The 2030-I/MP is most effective in reducing health damaging pollutants while 2030-PTI positively impacts commuters' lifestyle.

A Rare Case of Spontaneous Tumor Lysis Syndrome in Hodgkin Lymphoma.

Tumor lysis syndrome (TLS) is an oncological emergency characterized by biochemical abnormalities such as metabolic acidosis, hyperkalemia, hyperphosphatemia, and hypocalcemia. The clinical outcome is directly related to the biochemical abnormalities. TLS can occur in any malignancy, but it is highly associated with rapidly proliferating tumors. Although the syndrome is commonly associated with hematological malignancies, particularly with leukemia and non-Hodgkin's lymphoma, it is rarely seen in patients with Hodgkin's lymphoma. In our case, a 7-year-old girl presented with intermittent fever, non-productive cough, fatigue, and night sweats for four months. On examination, she had an enlarged cervical lymph node of 5 cm in size on the left side accompanied by palpable supraclavicular lymphadenopathy. Past medical history was significant for the relapsing and remitting course of nephrotic syndrome diagnosed two years before presentation. The patient underwent a left-sided cervical node excisional biopsy, which confirmed classical Hodgkin's lymphoma of mixed cellularity type. Her baseline chest x-ray revealed a bulky anterior mediastinal mass. To stage the tumor, a bone marrow biopsy, CT, and positron emission tomography (PET) scan were done. Although the bone marrow biopsy report showed a normal pattern of trilineage hematopoiesis, the CT and PET scan results led to its classification under stage 4. During her stay in the hospital for further work-up and treatment, her condition suddenly deteriorated. There were biochemical derangements on lab reports that confirmed the Spontaneous Tumor Lysis Syndrome (STLS). She recovered completely due to immediate stabilization and correction of electrolyte abnormalities. STLS is a life-threatening condition that is rarely seen in patients with Hodgkin's lymphoma. The treating physicians should be vigilant about this possible sequela of Hodgkin's lymphoma and be aware of its different presentations.

The "Cairo Accord"- Towards the Eradication of RHD: An Update.

Rheumatic heart disease (RHD) is the most common cause of acquired heart disease in children and young adults. It continues to be prevalent in many low- and middle-income countries where it causes significant morbidity and mortality. Following the 2017 Cairo conference "Rheumatic Heart Disease: from Molecules to the Global Community," experts from 21 countries formulated an approach for addressing the problem of RHD: "The Cairo Accord on Rheumatic Heart Disease." The Accord attempts to set policy priorities for the eradication of acute rheumatic fever (ARF) and RHD and builds on a recent series of policy initiatives and calls to action. We present an update on the recommendations of the Cairo Accord and discuss recent progress toward the eradication of RHD, including contributions from our own Aswan Rheumatic Heart Disease Registry (ARGI).

Fine particulate matter exposure in four transport modes of Greater Cairo.

The number of daily commuters in Greater Cairo has exceeded 15 million nevertheless personal exposure studies in transport microenvironments are limited. The aim of this study is to quantify PM2.5 exposure during peak hours in four transport modes of Greater Cairo - car (windows-open, windows-closed with recirculation and AC-on), microbus (windows-open), cycling and walking - and understand its underlying drivers. Data was collected using a pDR-1500 monitor and analysed to capture concentration variations, spatial variability, exposure doses, commuting costs versus inhaled doses, health burden and economic losses. Car with recirculation resulted in the least average PM2.5 concentrations (32 ± 6 µg/m3), followed by walking (77 ± 35 µg/m3), car with windows-open (82 ± 32 µg/m3), microbus with windows-open (96 ± 29 µg/m3) and cycling (100 ± 28 µg/m3). Evening hours observed average PM2.5 concentrations by 26-58% lesser than morning. Spatial variability analysis showed that 75th-90th percentile PM2.5 concentrations coincided with congested spots. Cycling and walking lanes are rare hence commuters are exposed to surges in PM2.5 concentrations when passing near construction and solid waste burning sites. Cycling and walking also resulted in inhaling 40-times and 32-times higher PM2.5 dose per kilometre than for car with recirculation. Commuting by microbus cost (with windows-open) ~45% of car cost (with recirculation) but it resulted in 4-times higher inhaled PM2.5 dose. As expected due to the lowest PM2.5 exposure concentrations, health burden resulting from car travel (with recirculation) caused the least death rates of 0.07 (95% CI 0.07-0.08) prematures deaths per 100,000 commuters/year while microbus with windows-open resulted in the highest death rates; 0.52 (95% CI 0.49-0.56). Microbus deaths represent 57% of national economic losses due to PM2.5 exposure amongst the four transport modes. This study provides real-time exposure data and analyses its implications on commuter health as a first step in informed decision-making and better urban planning.