Adult onset still disease associated with endogenous lipoid pneumonia

Cholesterol pneumonia or endogenous lipid pneumonia (ELP) is a rare disease that can occur in the context of a systemic diseaseor following a bronchial obstruction. It is characterized by a wide range of diverse symptoms and various disease course. Thepresent report introduces a young woman diagnosed with adult onset still disease three years ago, who has been referred withmacrophage activation syndrome (MAS). She underwent biopsy due to dyspnea and a crazy paving pattern in HRCT of the lungs,leading to the diagnosis of lipoid pneumonia based on the interstitial lymphocytic inflammation and cholesterol granulomas. Sofar, there has been no report indicating MAS associated with cholesterol pneumonia. This is the second case reporting ELP inthe adult onset still disease

Adult onset still disease associated with endogenous lipoid pneumonia

Cholesterol pneumonia or endogenous lipid pneumonia (ELP) is a rare disease that can occur in the context of a systemic disease or following a bronchial obstruction. It is characterized by a wide range of diverse symptoms and various disease course. The present report introduces a young woman diagnosed with adult onset still disease three years ago, who has been referred with macrophage activation syndrome (MAS). She underwent biopsy due to dyspnea and a crazy paving pattern in HRCT of the lungs, leading to the diagnosis of lipoid pneumonia based on the interstitial lymphocytic inflammation and cholesterol granulomas. So far, there has been no report indicating MAS associated with cholesterol pneumonia. This is the second case reporting ELP in the adult onset still disease. Key words: endogenous lipoid pneumonia; cholesterol pneumonia; adult onset still diseas

Comparing respiratory symptoms and spirometry disorders among healthy people and workers of indoor swimming pools: A case–control study

BACKGROUND: The water disinfection of swimming pools through chlorination method causes unwanted changes such as chlorine‑containing byproducts within the air, which might affect the swimming pool workers’ respiratory health. The present study is aimed to determine the frequency of respiratory symptoms and spirometry abnormalities among the workers of indoor swimming pools (instructors and lifeguards). MATERIALS AND METHODS: The present case–control study was conducted on forty individuals working in indoor swimming pools and forty others working at chlorine‑exposure‑free jobs as the control group. A questionnaire, including demographic information, smoking information, respiratory symptoms, and years of employment in the swimming pool, was completed for every participant. All the personnel, as well as the participants in the control group, underwent pulmonary examinations and spirometry tests. Then, the obtained data were analyzed using the SPSS 16 software as well as the statistical tests, including t‑test, Chi‑square test, correlation coeffcient, and regression analysis. RESULTS: The mean age of the participants in the case and control groups was 32.3 and 32.5 years, respectively. Both the case and control groups consisted of 18 males (45%) and 22 females (55%). Among the respiratory symptoms, lacrimation, rhinorrhea, sneeze, throat irritation, and chest tightness were signifcantly higher in the case group than that of the control group (15%, 80%, 35%, 57.5% and 72.5% vs. 0%, 40%, 12.5%, 2.5% and 27.5%, respectively). The pulmonary examinations indicated a statistically signifcant difference between the two groups in terms of the prevalence of wheeze and rhonchi (P = 0.014 and 0.006, respectively). Moreover, showing a statistically signifcant difference, the forced vital capacity (FVC) and forced expiratory volume in 1 s/FVC indicators were lower in the case group than the control group (P = 0.04 and 0.016). CONCLUSION: Regarding the fndings, there was a direct relationship between working in indoor swimming pools and the prevalence of respiratory symptoms and pulmonary dysfunction. Keywords: Chlorine compounds, respiratory symptoms, spirometry, swimming pool

Association of sleep quality components and wake time with metabolic syndrome: The Qazvin Metabolic Diseases Study (QMDS), Iran

A B S T R A C T Purpose: The aim of this study was to determine the association of sleep quality and sleep quantity with metabolic syndrome in Qazvin, Iran. Methods: this cross sectional study was conducted in 1079 residents of Qazvin selected by multistage cluster random sampling method in 2011. Metabolic syndrome was defined according to the criteria proposed by the national cholesterol education program third Adult treatment panel. Sleep was assessed using the Pittsburgh sleep quality index (PSQI). A logistic regression analysis was used to examine the association of sleep status and metabolic syndrome. Results: Mean age was 40.08 � 10.33 years. Of 1079, 578 (52.2%) were female, and 30.6% had metabolic syndrome. The total global PSQI score in the subjects with metabolic syndrome was significantly higher than subjects without metabolic syndrome (6.30 � 3.20 vs. 5.83 � 2.76, P = 0.013). In logistic regression analysis, sleep disturbances was associated with 1.388 fold increased risk of metabolic syndrome after adjustment for age, gender, and body mass index. Conclusion: Sleep disturbances component was a predictor of metabolic syndrome in the present study. More longitudinal studies are necessary to understand the association of sleep quality and its components with metabolic syndrome

Speleotherapy as an Effective Treatment of Chronic Obstructive Pulmonary Disease

Abstract Objectives: Chronic obstructive pulmonary disease (COPD) as a liberal illness requires constant anti-inflammatory therapy. As praise of conventional treatments, patients ofen turn to alternate therapy. Current study aimed to evaluate the frst study in Iran emphasizing on halotherapy influence on improving lung function testing results and relieving symptoms of Chronic Obstructive Pulmonary Disease patients, presented at respiratory referral hospital, Tehran in 2016. Materials and Methods: In this double-blind clinical study, 84 components suffering from COPD detached to two experimental and control groups. Following two months treatment with salitair or placebo, one month clearance phase was carried. Eventually, groups were treated with salitair and placebo for next two months. Influence was determined assessed6-minute walk distant, arterial oxygen saturation drop of six minutes walking, CAT enquiry and spirometry FEV1, FVC and FEV1/ FVC parameters. Results: Current study revealed that halotherapy might exert a positive effect on 6-minute walk distant and arterial oxygen saturation drop of six minutes walking parameters, since has no effect on CAT enquiry and FEV1, FVC and FEV1/FVC parameters. Conclusions: Advice for containing halotherapy as a healing treatment for COPD is doubtful. More studies are recommended to be done, including a larger study group to supply the best evidence. Keywords: Chronic obstructive pulmonary disease (C08.381.495.389); Spirometry (E01.370.386.700.750); Vaporizers (E07.605); Halotherapy; Spleotherapy; Salitai

Investigating the Criminals Exposed to Inter‑partner Violence and Child Abuse: A Case–control Study

Background: Decreasing hospitalization as a result of chronic obstructive pulmonary disease (COPD) exacerbations is a major objective in an effective process of the disease management. This study aimed to investigate the association between physical activity level in COPD patients, and specifc-cause hospitalization in a prospective study of patients referred to a pulmonologist offce in Qazvin, Iran.. Methods: A prospective study was conducted among 150 patients with COPD from the population of Qazvin, a North West, industrialized city of Iran, from December 2017 to December 2018. Participants were enrolled among patients who referred to an outpatient respiratory care center to undertake respiratory function tests. Patients were followed up for 1 year and their related measures were gathered and recorded at two phases including baseline and 12 months. To assess the effect of several covariates on the response variable, a multivariate regression analysis was applied. Results were reported in the form of odds ratios, incident rate ratio (IRR), and their 95% confdence intervals (CIs) Results: The study fndings revealed that individuals with severe pulmonary obstruction (<30%) were 4.21 times more likely to be hospitalized than those with a mild level of disease. Furthermore, the likelihood of hospitalization was ≥3 times higher among current smokers compared with nonsmokers. The history of hospitalization due to COPD 1 year before the enrolment was another significant factor which increased 21% the odds of being hospitalized during follow-up. In a multivariate model with the number of hospitalizations as an outcome variable, patients who reported moderate level of physical activity encountered a lower risk of COPD hospitalization compared to those who had a very low level of physical activity (IRR = 0.66; 95% CI = 0.44–0.92; P = 0.001). Conclusion: To decrease the risk of hospitalization among COPD patients, it is recommended to include regular physical activity in their integrated care program. Keywords: Chronic obstructive pulmonary disease, exacerbation, hospitalization, physical activit

Association of sleep quality components and wake time with metabolic syndrome: The Qazvin Metabolic Diseases Study (QMDS), Iran

Purpose: The aim of this study was to determine the association of sleep quality and sleep quantity with metabolic syndrome in Qazvin, Iran. Methods: this cross sectional study was conducted in 1079 residents of Qazvin selected by multistage cluster random sampling method in 2011. Metabolic syndrome was defined according to the criteria proposed by the national cholesterol education program third Adult treatment panel. Sleep was assessed using the Pittsburgh sleep quality index (PSQI). A logistic regression analysis was used to examine the association of sleep status and metabolic syndrome. Results: Mean age was 40.08 � 10.33 years. Of 1079, 578 (52.2%) were female, and 30.6% had metabolic syndrome. The total global PSQI score in the subjects with metabolic syndrome was significantly higher than subjects without metabolic syndrome (6.30 � 3.20 vs. 5.83 � 2.76, P = 0.013). In logistic regression analysis, sleep disturbances was associated with 1.388 fold increased risk of metabolic syndrome after adjustment for age, gender, and body mass index. Conclusion: Sleep disturbances component was a predictor of metabolic syndrome in the present study. More longitudinal studies are necessary to understand the association of sleep quality and its components with metabolic syndrome

Association of Anthropometric Indexes With Disease Severity in Male Patients With Chronic Obstructive Pulmonary Disease in Qazvin, Iran

Malnutrition is one of the most important factors that lead to lower quality of life in patients suffering from chronic obstructive pulmonary disease (COPD). There are several methods for assessing malnutrition including anthropometric indexes. The aim of this study was to determine the association of anthropometric indexes with disease severity in male patients with COPD in Qazvin, Iran. This cross-sectional study was conducted on 72 male patients with COPD in Qazvin, Iran, from May to December 2014. Spirometry was performed for all participants. Disease severity was determined using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline. Body mass index (BMI), mid-arm muscle circumference (MAMC), and triceps skinfold thickness (TSF) were measured. MAMC and TSF were categorized into three subgroups as 75th P (Where P is the abbreviation for percentile.). Data were analyzed using ANOVA and logistic regression analysis. Mean age was 60.23 ± 11.39 years. Mean BMI was 23.23 ± 4.42 Kg/m2 , mean MAMC was 28.34 ± 3.72 cm2 , and mean TSF was 10.15 ± 6.03 mm. Mean BMI and MAMC in the GOLD stage IV were significantly lower than other stages. Of 72, 18.1% were underweight while 6.9% were obese. The GOLD stage IV was associated with 16 times increased risk of underweight and nine times increased risk of MAMC < 25th P. Disease severity was associated with BMI and MAMC as indexes of malnutrition in patients with COPD in the present study. The GOLD stage IV was associated with increased risk of underweight and low MAMC. Keywords Chronic obstructive pulmonary disease, malnutrition, body mass index, thinness, obesit

Evaluation of the Effect of Combination Therapy on Treatment of COVID-19: A Cohort Study

Background: COVID-19 is a new disease for which a definitive treatment has not yet been proposed. Objectives: The present study aimed to investigate the effect of combination therapy on the treatment of COVID-19 due to the importance of finding an appropriate treatment for this epidemic disease. Methods: This two-center cohort study included 175 confirmed COVID-19 inpatients at two medical centers designated for the treatment of COVID-19 patients in Qom and Qazvin, Iran. In this study, four different groups of drug regimens were studied which included G1 (azithromycin, prednisolone, and naproxen), G2 (lopinavir/ritonavir, azithromycin, naproxen, and prednisolone), G3 (hydroxychloroquine, azithromycin, naproxen, and prednisolone), and G4 (levofloxacin, vancomycin, hydroxychloroquine, and oseltamivir). It should be noted that G1, G2, G3, and G4 treatment regimens were used on 48, 39,30, and 77 patients, respectively. Results: The study participants included 175 confirmed COVID-19 patients with mean±SD age of 58.9 ±15.1 years, out of whom 80 (46%) patients were male and the rest were females. The results indicated that the hospital stay period was significantly shorter in the G1 compared to other groups (G1:5.9±2.4, G2:8.1±4.2, G3: 6.3±1.7, and G4: 6.4±2.9; [P-value=0.008]). It should be noted that pulse rate, oxygen saturation, hemoglobin, and platelet count (PLT) changed significantly during the study in four treatment groups; however, a significant change in temperature, creatinine, and white blood cell (WBC) was observed only in G3, G4, and G1 groups, respectively. The number of ICU admissions and deaths were not statistically significant among the patients who received the four treatment regimens (P=0.785). Based on the results, the history of ischemic heart disease, baseline oxygen saturation, WBC, neutrophil, lymphocyte count, and C-reactive protein (CRP) are the risk factors for the prolonged hospital stay in COVID-19 patients. Conclusion: The obtained results in this study indicated that the combination of azithromycin, prednisolone, and naproxen is the most effective regimen for the treatment of COVID-19, compared to three other combination treatment regimens. Keywords: Anti-inflammatory drugs, Antiviral drugs, Combination therapy, Corticosteroid, COVID-19, Immunomodulators drug

Adult Onset Still Disease Associated with Endogenous Lipoid Pneumonia

Cholesterol pneumonia or endogenous lipid pneumonia (ELP) is a rare disease that can occur in the context of a systemic disease or following a bronchial obstruction. It is characterized by a wide range of diverse symptoms and various disease course. The present report introduces a young woman diagnosed with adult onset still disease three years ago, who has been referred with macrophage activation syndrome (MAS). She underwent biopsy due to dyspnea and a crazy paving pattern in HRCT of the lungs, leading to the diagnosis of lipoid pneumonia based on the interstitial lymphocytic inflammation and cholesterol granulomas. So far, there has been no report indicating MAS associated with cholesterol pneumonia. This is the second Case Reporting ELP in the adult onset still disease