prevalence of gastro esophageal reflux disease [GERD] in copd patients and its effect on the number of exacerbations in dnmi

This study included 25 COPD inpatients in chest, ICU and internal medicine departments in Damanhur National medical Institute., 10 of them with moderate COPD and 15 of them with severe COPD [by gold 2007][1]. 21 were males and 4 were females [active or passive smokers]. The aim of the work was to study the prevalence of GERD in COPD patients and its effect on the number of exacerbations of COPD. Both groups were subjected to history taking, full clinical examination, full laboratory investigations, Chest radiography, spirometry, arterial blood gases and upper GIT endoscopy and biopsy. Results revealed that the prevalence of GERD in COPD patients by endoscopy was 36% in the moderate group, 64% in the severe group. By biopsy being more prevalent in the severe group of COPD 86.6% compared to70% in moderate COPD. GERD severity increases as the degree of COPD increases. GERD increases with increase in the smoking [pack/year] both in moderate, in the severe group. Moreover, there was increase in the frequency of exacerbations of COPD in GERD patients both in moderate and severe groups. This study revealed that the frequency of exacerbation was higher among GERD cases with statistically significant difference in between both group From this study we conclude that GERD is common in COPD patients being more among severe COPD. Also GERD increase the number of exacerbations of COPD

Pheochromocytoma Damanhour teaching hospital experience

Pheochromocytoma has low incidence of 2-8 case per million persons annually, but it is a lethal disease when it is functioning and undiagnosed. It constitutes 0.1% to 1% of hypertensive patients that is curable by surgery. Our study included twelve patients operated upon at our institute in the last 3 years. Two cases were none functioning; one case of them was presented by internal hemorrhage due to tumor rupture. There were 8 males and 4 females. One child has 10 years old. Two cases were extra adrenal. Three patients presented to us with a mass without hypertension and diagnosed post operatively. Preoperative preparation was done using alpha blocker and beta blocker until the hypertension became normalized. lntra operative and post operative control of blood pressure with caring our patients in ICU till the condition became stable. No mortality or significant morbidity had occurred. Post operative normalization of blood pressure had been achieved in all patients