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There is rapid increase in the global production and consumption in cement industry. Egypt is one of the greatest cement producers worldwide. Cement dust particles is the major source of occupational hazard in cement factory. The main routes of entry of cement particles are inhalation and swallowing leading to different clinical affection involving respiratory and non-respiratory systems. Prolonged exposure especially to high concentration of cement dust may provoke inflammation, resulted in functional and structural abnormalities. Objective: the current work aimed to explore the most important correlates associated with inflammation among cement workers Methodology: We conducted a cross-sectional study to elicit the effect of working in cement factory on the level of airway inflammations among workers. Inflammatory process was assessed by clinical manifestations, spirometer, fractional exhaled Nitric oxide (FeNO)( by Exhaled breath condensate method), blood sample (for complete blood picture and inflammatory markers: total IgE, IL10 and TNF alpha), sputum analysis for eosinophilia. Results: The total dust particles concentration ranged between 1.99mg/m³ in raw mills area to 3.35 mg/m³ in Quarry area. Total sample was 86 workers; from 4 main departments (quarry, production, packing and maintenance), There was significance difference in the level of markers between different departments; TNF alpha was higher in the packing area (p=0.002) and fractional exhaled nitric oxide was higher in the maintenance (p=0.02), Moreover there was negative mild correlation between dust particles concentrations (mg/m³) and FEV1 (predicted %) (r=-0.2,p=0.05) and FVC (predicted %)(r=-0.2,p=0.02).The difference in rates of respiratory symptoms among high vs. low exposed workers was statistically insignificant. TNF alpha was higher in high exposed workers than low exposed (p=0.01), there was positive strong correlation between TNF alpha and IL10 (r=0.8, p0.001). Conclusion: The study suggests that TNF alpha and exhaled NO are good predictors of early pulmonary inflammation even before symptoms and may be used in workers of cement factory especially those with higher exposure and in areas with higher dust concentrations ,the most important inflammation correlates among cement workers were job stress ,healthy nutrients and smoking. Recommendations: the finding of this research will help building new strategies to protect the most vulnerable workers.

Abstract Background and purpose: Delayed cerebral ischemia (DCI) is the worst sequel following subarachnoid hemorrhage (SAH), representing a challenge in prediction and prevention. The current study aims to identify the optimum predictors of DCI including CT perfusion (CTP) and to determine the best prognostic thresholds. Material and Methods: A prospective study included 49 SAH patients. All patients were treated with the standard therapy and underwent non-contrast CT, CTP, and CTA within 3 days after SAH. Hunt and Hess and Fisher scales were assessed besides quantitative CTP parameters. The primary endpoint was DCI within 21 days after SAH, defined as clinical deterioration or infarction. Results: Out of 49 eligible patients with SAH, 9 patients developed DCI. Univariate analysis revealed that Hunt and Hess scale, Fisher scale, presence of a cerebral aneurysm and mean transit time (MTT) were predictive for DCI. Diagnostic threshold values by ROC curve analysis with optimal sensitivity and specificity were Hunt and Hess > 2, followed by Fisher > 2 and MTT of 4.65 seconds. Conclusion: MTT is a sensitive and specific predictor of DCI. However, thresholds of Hunt and Hess is the best to distinguish between patients who developed DCI and clinically stable patients.  

Abstract Background and purpose: Delayed cerebral ischemia (DCI) is the worst sequel following subarachnoid hemorrhage (SAH), representing a challenge in prediction and prevention. The current study aims to identify the optimum predictors of DCI including CT perfusion (CTP) and to determine the best prognostic thresholds. Material and Methods: A prospective study included 49 SAH patients. All patients were treated with the standard therapy and underwent non-contrast CT, CTP, and CTA within 3 days after SAH. Hunt and Hess and Fisher scales were assessed besides quantitative CTP parameters. The primary endpoint was DCI within 21 days after SAH, defined as clinical deterioration or infarction. Results: Out of 49 eligible patients with SAH, 9 patients developed DCI. Univariate analysis revealed that Hunt and Hess scale, Fisher scale, presence of a cerebral aneurysm and mean transit time (MTT) were predictive for DCI. Diagnostic threshold values by ROC curve analysis with optimal sensitivity and specificity were Hunt and Hess > 2, followed by Fisher > 2 and MTT of 4.65 seconds. Conclusion: MTT is a sensitive and specific predictor of DCI. However, thresholds of Hunt and Hess is the best to distinguish between patients who developed DCI and clinically stable patients.  

Abstract Background and purpose: Delayed cerebral ischemia (DCI) is the worst sequel following subarachnoid hemorrhage (SAH), representing a challenge in prediction and prevention. The current study aims to identify the optimum predictors of DCI including CT perfusion (CTP) and to determine the best prognostic thresholds. Material and Methods: A prospective study included 49 SAH patients. All patients were treated with the standard therapy and underwent non-contrast CT, CTP, and CTA within 3 days after SAH. Hunt and Hess and Fisher scales were assessed besides quantitative CTP parameters. The primary endpoint was DCI within 21 days after SAH, defined as clinical deterioration or infarction. Results: Out of 49 eligible patients with SAH, 9 patients developed DCI. Univariate analysis revealed that Hunt and Hess scale, Fisher scale, presence of a cerebral aneurysm and mean transit time (MTT) were predictive for DCI. Diagnostic threshold values by ROC curve analysis with optimal sensitivity and specificity were Hunt and Hess > 2, followed by Fisher > 2 and MTT of 4.65 seconds. Conclusion: MTT is a sensitive and specific predictor of DCI. However, thresholds of Hunt and Hess is the best to distinguish between patients who developed DCI and clinically stable patients.  

Abstract Background and purpose: Delayed cerebral ischemia (DCI) is the worst sequel following subarachnoid hemorrhage (SAH), representing a challenge in prediction and prevention. The current study aims to identify the optimum predictors of DCI including CT perfusion (CTP) and to determine the best prognostic thresholds. Material and Methods: A prospective study included 49 SAH patients. All patients were treated with the standard therapy and underwent non-contrast CT, CTP, and CTA within 3 days after SAH. Hunt and Hess and Fisher scales were assessed besides quantitative CTP parameters. The primary endpoint was DCI within 21 days after SAH, defined as clinical deterioration or infarction. Results: Out of 49 eligible patients with SAH, 9 patients developed DCI. Univariate analysis revealed that Hunt and Hess scale, Fisher scale, presence of a cerebral aneurysm and mean transit time (MTT) were predictive for DCI. Diagnostic threshold values by ROC curve analysis with optimal sensitivity and specificity were Hunt and Hess > 2, followed by Fisher > 2 and MTT of 4.65 seconds. Conclusion: MTT is a sensitive and specific predictor of DCI. However, thresholds of Hunt and Hess is the best to distinguish between patients who developed DCI and clinically stable patients.  

Abstract Background and purpose: Delayed cerebral ischemia (DCI) is the worst sequel following subarachnoid hemorrhage (SAH), representing a challenge in prediction and prevention. The current study aims to identify the optimum predictors of DCI including CT perfusion (CTP) and to determine the best prognostic thresholds. Material and Methods: A prospective study included 49 SAH patients. All patients were treated with the standard therapy and underwent non-contrast CT, CTP, and CTA within 3 days after SAH. Hunt and Hess and Fisher scales were assessed besides quantitative CTP parameters. The primary endpoint was DCI within 21 days after SAH, defined as clinical deterioration or infarction. Results: Out of 49 eligible patients with SAH, 9 patients developed DCI. Univariate analysis revealed that Hunt and Hess scale, Fisher scale, presence of a cerebral aneurysm and mean transit time (MTT) were predictive for DCI. Diagnostic threshold values by ROC curve analysis with optimal sensitivity and specificity were Hunt and Hess > 2, followed by Fisher > 2 and MTT of 4.65 seconds. Conclusion: MTT is a sensitive and specific predictor of DCI. However, thresholds of Hunt and Hess is the best to distinguish between patients who developed DCI and clinically stable patients.