A 21 Years Old Woman, with Chest Pain and Cardiac Dextroposition Pulmonary Hypoplasia or Scimitar Syndrome?

Background: Physicians seldom encounter chest x-ray of adult patients diagnosed with dextrocardia. Case presentation: Here, we present the case of a 21-year-old woman who referred to the hospital with the clinical diagnosis of dextrocardia but, she has pulmonary hypoplasia and this rare disease in adults may be a component of scimitar syndrome and scimitar sign is not pathognomonic to define the syndrome. MR angiography was done, but finally the diagnosis was hypoplasia of right upper lobe and aplasia of middle lobe. Conclusion: As lung hypoplasia is rare in adults, some cases are misdiagnosed as dextrocardia on chest x-ray

Unsuspected Tracheal Web with Asthma-Like Symptom in a Young Female: Case Report

Background: Although most patients with asthma are easily controlled with appropriate medication, a small proportion of patients (approximately 5% of asthmatics) are difficult to control despite maximal inhaled therapy.Case Report: A 20-year-old girl admitted to the emergency ward (EW) of loghman hakim hospital in tehran with severe dyspnea. She was born with asphyxia for which oxygen therapy prescribed for two days.  Conclusion: Congenital abnormality of the trachea can rarely present as asthma symptoms in adulthood. It is important to know, when encounter too difficult to treat asthma as the condition can be curable surgically

Eventration of Diaphragm or Pseudo Pleural Effusion?

Background: Physicians frequently encounter chest-x ray reports of pleural effusion in patients. Thoracocentesis is the second step to diagnosis, but if there isn’t any effusion actually, thoracocentesis may lead to complication. Case Report: A 47-year-old man with a history of dyspnea and dry cough and posteroanterior (PA) chest x-ray (and right lateral decubitus) report of pleural effusion referred for thoracocentesis, but vesicular sounds at over the lungs were normal. Spiral lung CT scan revealed localized eventration of diaphragm. Conclusion: Localized eventration of right diaphragm may cause the appearance of pleural effusion in PA and also right lateral decubitus chest x-ray

A Cross-Sectional Survey of Acquired Subclinical Methemoglobinemia among Hospital Healthcare Professionals in Sandstorm Episode of Ambient Air Pollution: Tehran-Iran, Pulse Co-Oximetry

Background: Subclinical methemoglobinemia (MetHb) is an occult disease. Clinical diagnosis is difficult. Acquired MetHb is a most common presentation in practice, and its detection help to improve health status of involved individuals. Healthcare professionals enumerate as one of the at risk groups against adverse health effects. Method: All the participations were hospital healthcare professionals and to follow designed criteria to the study. Results: A total of 117 healthcare professionals fulfilled the criteria of study. Mean age was 39±9 SD years, ranged 20-60 years. Female sex included 52%. Frequency of MetHb was detected in 6% of population. Of them, 71% were male. All the subjects were diagnosed with MetHb located at the poor-ventilated workplaces. There were significant differences between MetHb and carboxyhemoglobin levels (P<0.001). Conclusion: Subclinical MetHb was meaningful in the target of population. It may be originated due to ambient air pollution. There was high-frequency levels of involvement in men had. Evaluation the causal factors are an impact that will require the future studies

Screening Indoor Threshold Levels of Carbon Monoxide (CO) Toxicity among Hospital Health Care Professionals in Sandstorm Ambient Air Pollution: Pulse CO-oximetry:Tehran-Iran;2011

Background:Carbone’s monoxide is a poisoning gas and a pollutant of ambient air. Sandstorm is episodic dust-laden that reinforced CO toxicity levels in the environment. Hospital healthcare professionals are the first line healthy system organization and hospital workplace should be safe. The objective of this study was to determine the threshold levels of CO toxicity among hospital healthcare professionals in thesandstorm ambient air pollution through pulse CO-oximetry method. Method: Participations recruited base on the designed protocol and following inclusion and exclusion criteria. Results:A total of 117 subjects enrolled with means age ± SD; 38.97±9.03 years. It ranged between 20-60 years. Of those, 68 subjects was female and 49 male. Mean level of carboxyhemoglobin concentration (COHB %) was 2.52±3.40 SD,(P=0.03). 43% of sample study had CO toxicity upper than the normal set point. COHB% level noticeably increased in the female sex respect to male subgroups (χ =0.019). Conclusion:The resultant’s study was indicated particularity in female sex that a significant carboxyhemoglobin concentration found an above- normal set point level among target of population. As well as, threshold levels of CO toxicity in the workplace setting were noticeably high. Intervals of toxicity are nearby hazardous action level. The outcome of the study should be considered as an alarm for the public health program and presenting occult indoor CO poisoning

Status of 25-OH Vitamin D Serum Level among Wheezy Chronic Respiratory Diseases with Airway Obstructive Patterns; Office- Base Study

 Background: Vitamin D is a homeostasis hormone of the calcium and bone metabolism. It has additional effects in the infections, cardiovascular, immunity, anti- inflammatory, chronic respiratory diseases and small airway disease (SAD). Wheezing is the common clinical feature of small airway obstructive diseases. Prevalent of asthma and chronic obstructive pulmonary disease (COPD) are noticeable among SAD. Propose of the study assessed status of vitamin D level among wheezy chronic respiratory diseases with airway obstructive pattern. Methods: Sample population sequentially enrolled among office base- wheezy patients with chronic obstructive pattern. Vitamin D level was measured by ELISA. Results: We studied on 67 patients. Mean age was 42.9±1.5 SD years, ranged between 17-76 years. Their sex distribution was male 51% and female 49%. Vitamin D deficiency and insufficiency recorded 13% and 40%, respectively. Frequency of lower than set point value of vitamin D among subtypes of SAD was asthma, COPD and other subtypes of SAD, respectively. Conclusion: Outcome of the study disclosed relevant 25-OH vitamin D deficiency and insufficiency among wheezy respiratory diseases with airway obstructive pattern. COPD and asthma small airways were noticeable within population. Deficiency and insufficiency of vitamin D were considerable in female and male, respectively.