Bilateral Pulmonary Artery, Inferior Vena Cava, and Cardiac Echinococcosis: A Rare Presentation of Zoonotic Diseases

Introduction:Cystic hydatidosis is a zoonoticdisease thatis mostly observedin the Mediterranean region. This infectious disease may present throughdifferent manifestations that may delay the diagnosis and cause various complications for the patients. Most of the cases are usually diagnosed by imaging studies and the related management could be medical or surgical depending on the patient’s clinical condition and disease severity. Case presentation:In the present report, we present the case ofa 50-year-old female patient with a positive history of liver and splenichydatid cysts with hemoptysis and dyspnea. The diagnosis of pulmonary and cardiac involvement wasmade usingcomputed tomography angiography. Despite the immediate surgery, the patient died from hemorrhage after 3 days. Conclusion:Themanagement of pulmonary embolism due to Echinococcus highly depends on the clinical judgment and the outcomes are subject to the history and extent of the involvement

Restless legs syndrome in lung chemical warfare patients

BACKGROUND: Restless legs syndrome (RLS) has been associated with a variety of diseases, including chronic obstructive pulmonary disease (COPD), which can worsen the symptoms of underlying disease and correlates with co-morbidities. We aimed to investigate RLS in patients with chemical warfare-induced lung diseases. METHODS: This cross-sectional study recruited patients with sulfur mustard (SM) lung injury, their healthy family members, and patients with COPD from August 2018 to August 2019. COPD was confirmed by medical history, physical examination, and spirometry according to GOLD COPD guidelines. RLS diagnosis was recognized by the International Restless Legs Syndrome Study Group (IRLSSG) and severity was assessed using the International Restless Legs Scale (IRLS) rating scale. Other research measures were COPD Assessment Test (CAT), modified Medical Research Council (mMRC) scale for dyspnoea severity, and Epworth Sleepiness Scale (ESS) for daytime somnolence. Laboratory values included hemoglobin, ferritin, creatinine, and fibrinogen. RESULTS: This study was conducted on 143 men in three groups: 40 (30.0%) SM-exposed veterans, 73 (55.3%) patients with COPD, and 30 (20.9%) healthy cases. Due to the high prevalence of COPD and better comparison with the control group, more patients with COPD were selected. 20 cases (50%) of the veterans group had RLS, while 25 (32.9%) cases of COPD were affected by this disorder. One normal case (3.33%) suffered from RLS. The chemical veterans who suffered from cough, sputum production, chest pain, and hemoptysis had a higher incidence in proportion to patients with COPD (P < 0.001). The CAT score was significantly higher in SM-exposed veterans with RLS (P = 0.004). CONCLUSION: RLS is more common in SM lung injuries with higher CAT scores; therefore, evaluation and treatment of RLS are recommended in mustard lung victims

Leukopenia and leukocytosis as strong predictors of COVID‐19 severity: A cross‐sectional study of the hematologic abnormalities and COVID‐19 severity in hospitalized patients

Abstract Background and Aims Predicting severe disease is important in provocative decision‐making for the management of patients with the coronavirus disease 2019 (COVID‐19); However, there are still some controversies about the COVID‐19's severity predicting factors. This study aimed to investigate the relationships between clinical and laboratory findings regarding COVID‐19's severity in patients admitted to a tertiary hospital in Mashhad, Iran. Methods A cross‐sectional study was conducted on patients with documented COVID‐19 infection based on the reverse transcription‐polymerase chain reaction test. Clinical symptoms, vital signs, and medical history of the patients were recorded from their medical records. Laboratory findings and computed tomography (CT) study findings were documented. Disease severity was defined based on CT scan findings. Results A total of 564 patients (58.8 ± 16.8 years old) were evaluated. The frequency of severe disease was 70.4%. There was a significant difference in heart rate (p = 0.0001), fever (p = 0.002), dyspnea (p = 0.0001), chest pain (p = 0.0001), diarrhea (p = 0.021), arthralgia (p = 0.0001), and chills (p = 0.044) as well as lymphopenia (p = 0.014), white blood cell count (p = 0.001), neutrophil count (p < 0.0001), lymphocyte count (p < 0.0001), and prothrombin time (p = 0.001) between disease severity groups. Predictors of severe COVID‐19 were pulse rate (crude odds ratio [cOR] = 1.014, 95% confidence interval [CI] for cOR: 1.001, 1.027) and leukopenia (cOR = 3.910, 95% CI for cOR: 1.294, 11.809). Predictors for critical COVID‐19 were pulse rate (cOR = 1.075, 95% CI for cOR: 1.046, 1.104), fever (cOR = 2.516, 95%CI for cOR: 1.020, 6.203), dyspnea (cOR = 4.190, 95% CI for cOR: 1.227, 14.306), and leukocytosis (cOR = 3.866, 95% CI for cOR: 1.815, 8.236). Conclusions Leukopenia and leukocytosis have the strongest correlation with the COVID‐19 severity. These findings could be a valuable guild for clinicians in COVID‐19 patient management in the inpatient setting