A Rare Case of Pleural Tuberculosis with Tuberculous Pyomyositis

Introduction: Tuberculosis (TB) gained recognition throughout the 19th century as it inflicted significant mortality rates upon a vast number of individuals across the globe. Pleural tuberculosis and tuberculous pyomyositis are infrequently documented extra-pulmonary manifestations, with limited coverage in the medical literature, and their underlying pathophysiological mechanisms remain unclear. There is a scarcity of published evidence about the management of pleural tuberculosis with tuberculous pyomyositis. Case report: We reported a case of a 51-year-old female patient who presented with progressive exacerbation of dyspnea, elevated body temperature, nocturnal diaphoresis, active cough, and pleuritic chest discomfort localized to the right side for twelve weeks duration. This patient also had multiple bulges in the left lumbal, left upper chest, and axillary regions. Several people living near the patient's home were diagnosed with tuberculosis. During the examination, the patient exhibited decreased breath sounds and a dull percussion note in the right lung field. The chest radiograph revealed a substantial pleural effusion in the right hemithorax. She was subsequently started on four daily anti-tuberculosis therapy and pleural fluid drainage. On the fifth month of follow-up, the patient showed improvement in symptoms and the bulging has reduced in size. Discussion: Pyomyositis is a suppurative infection of skeletal muscle that typically arises from the dissemination of pathogens through the bloodstream. The infection is commonly observed in tropical regions among persons who have significant underlying comorbidities or are immunocompromised. Conclusion: Pleural tuberculosis accompanied by tuberculous pyomyositis is an uncommon manifestation outside of the lungs, nevertheless, it is crucial to maintain vigilance regarding this condition. The timely identification of a disease is crucial for the implementation of appropriate treatment and subsequent resolutio

Numerical Study of a Wind Turbine Blade Modification Using 30° Angle Winglet on Clark Y Foil

The depletion of fossil fuels and the worsening environment motivate engineers and researchers to explore renewable energy resources. One of the promising renewable energy is wind energy. The wind turbine extracts wind energy to generate electricity. This study aims to modify a wind turbine blade using Clark Y foil to improve the lift force. The modification is employed by forming a winglet profile with a 30° angle on the foils tip. The result shows that the 30° winglet enlarges the lift coefficient to 1.3253 from 1.2795 of the original blade lift coefficient.

Hemoptysis in a patient with pulmonary aspergilloma and type 2 diabetes mellitus: A rare case in an Indonesian adult

Background The success rate of surgery on aspergilloma is quite low since aspergilloma generally spreads throughout the lung cavity. Case presentation A 45-year-old woman with a past history of type 2 diabetes mellitus presented with chronic hemoptysis. Clinical presentation and work up revealed a left lung aspergilloma, with x-ray and CT-scan showing a mass in the upper lobe of left lung and FNAB showing Aspergillus sp. The patient underwent thoracotomy with left superior lobectomy. Histopathological examination of specimens showed hyphae with septa. The patient had postoperatively controlled pleural effusions. Discussion T2DM is a risk factor for Aspergillus sp infection because it is immunocompromised when hyperglycemia occurs. Pulmonary aspergilloma has a poor prognosis during surgery. Removing aspergilloma in the lung cavity and maintaining blood glucose levels can provide a good prognosis. Keeping the amount of fluid from increasing is the main focus of post-surgery. Conclusion Pulmonary aspergilloma that only occurs in one lung lobe has a good prognosis after surgery

Interleukin-6 (IL-6) expression of lung tissue in COVID-19 patient severity through core biopsy post mortem

Introduction: In COVID-19 patients, Interleukin-6 (IL-6) will increase, and the production of antigens will be excessive, which will cause excessive inflammation of the tissues, especially the respiratory tract, which causes fibrosis in the lungs and can lead to death. Objective: To analyze IL-6 expression of lung tissue in COVID-19 patient severity. Methods: The study is an observational analytic design from July to December 2020. COVID-19 patient severity who died was examined for IL-6 expression on lung tissue. The lung tissue sampling uses the core biopsy method. Results: The total number of samples obtained was 38 samples. Characteristics of patients with a mean age of patients were 48 years, male, the most common chief complaint was shortness of breath, mean symptom onset was 5 days, patient length of stay was 10 days, the most common cause of death was a combination of septic shock and ARDS and the most common comorbid diabetes mellitus. There is an increased WBC, neutrophils, platelets, procalcitonin, CRP, BUN, creatinine serum, AST, ALT, and D-dimer. In this study, the average tissue IL- 6 expression was 72.63, with the highest frequency of strong positive 47.4%. Conclusion: An increase in IL-6 expression on lung tissue showed the severity of COVID-19 infection

Correlation of serum D-dimer level and the event microvessel cardiac thrombosis observed on core biopsy in post mortem COVID-19 Patients in Dr. Soetomo Hospital Surabaya, Indonesia

Abstract Link of Video Abstract: https://youtu.be/ivpwfj9PxWQ Background: Microvascular coronary thrombosis is an emerging risk factor that worsens the prognosis of COVID-19 patients. This study aims to show for the first time a descriptive of histopathologic findings from post-mortem COVID-19 patients and to analyze whether D-Dimer serum level, a marker of hyper-coagulopathy, correlates with coronary microvascular thrombosis from the cardiac core biopsy. Method: This was an observational analytic study with a retrospective cohort design from July-December 2020. Cardiac core biopsy was taken from patients who died while treated at the isolation ICU at Dr. Soetomo due to severe COVID-19. The samples were taken in 1-hour post-mortem and then analyzed histopathologically with Hematoxylin-eosin staining under a light microscope to evaluate the presence of coronary microvascular thrombosis and other pathological findings from the cardiac biopsy. Clinical information and D-Dimer levels from medical records and analyzed for coronary microvascular thrombosis using Man-Whitney and C-statistic analysis using SPSS 22 software. Result: There were 39 samples of post-mortem patients in this study. The majority were men (71.8%), with a mean age of 48.9 years old. Focal microvessel coronary thrombosis was found in 28%). The median D-Dimer level was increased from the average baseline (3460 mg/dl). However, there was no significant difference in D-dimer levels between focal microvessel coronary thrombosis incidents (p-value 0.827, C statistic AUC 0.523). The lack of focal necrosis in the surrounding tissue suggests that the thrombosis resulted from proximal embolization to distal capillary coronary, which already happened before, rather than the primary in-situ process in microvascular, hence may explain why D-Dimer was not correlated with the finding of coronary microvascular thrombosis in this study. Conclusion: D-dimer serum levels were not associated with focal microvessel thrombi in post-mortem COVID-19 patients. This result supports previous studies that showed D-Dimer was not specific to detect thrombosis in microvascular

Differences in interleukin-6 and interleukin-17 expression in covid-19 post-mortem lung tissue biopsy compared with noncovid- 19

Abstract: Background: COVID-19 has spread rapidly around the world. It is necessary to study lung tissue of postmortem COVID19 patients to determine the molecular alteration particularly the role of IL-6 and IL-17 in causing fatality. Objective: This study aims to determine the differences in the expressions of IL-6 and IL-17 in lung tissue of post-mortem COVID-19 patients compared to non-COVID-19 patients. This study also aimed to analyze the correlation between the expressions of IL-6 and IL-17 in lung tissue of post-mortem COVID-19 patients. Methods: This research is an observational analytic study with crosssectional approach. The samples were 15 paraffin blocks of post-mortem lung tissue biopsy of COVID-19 patients, and 15 paraffin blocks of inflammatory lung tissue biopsy or surgery of non-COVID-19 patients. IL-6 and IL-17 expressions were evaluated by immunohistochemical procedure. Result: There was a significant difference in the expression of IL-6 in the COVID-19 group and the non-COVID-19 group with a p-value = 0.001 (p < 0.05). There was a significant difference in the expression of IL-17 in the COVID-19 group and the non-COVID-19 group with p-value = 0.001 (p < 0.05). There was a significant correlation between the expressions of IL-6 and IL-17 in the COVID-19 group, with the Spearman coefficient value (rs) of 0.548 with p = 0.034 (p < 0.05). Conclusion: There are differences in the expression of IL-6 and IL-17 between COVID-19 and non-COVID-19 lung tissue. There is a significant correlation between the expressions of IL-6 and IL-17 in post-mortem lung tissue of COVID-19 patients