The authors would like to express their sincere gratitude to the Rheumatology Department at Tanta University Hospital for providing the clinical setting and support for conducting this research
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Take the following steps: Immediate management during an episode: Move to a quiet, safe space if possible Practice controlled breathing: breathe in slowly through your nose for 4 counts, hold for 4, exhale through your mouth for 6 counts Use grounding techniques: focus on physical sensations (feet on floor, objects you can see, sounds you can hear) Remind yourself that panic attacks, whilst distressing, are not dangerous and will pass If symptoms include chest pain, severe breathlessness, or you're unsure whether it's a panic attack, seek immediate medical attention by calling 999 or NHS 111 for urgent but non-emergency advice If experiencing thoughts of self-harm or suicide, seek urgent help via your local crisis team, A&E, or call 999 Follow-up actions: Contact your GP or prescribing clinician within 1-2 days to discuss your symptoms

39 Therapy with semaglutide resulted in significant weight loss, an increase in 6MWT distance, improvement in quality of life (KCCQ-CSS), and a significant reduction in CRP
By treating obesity as a chronic metabolic condition, semaglutide injections have achieved successful results in many patients seeking to lose weight