पल्मोनरी एवं श्वसन चिकित्सा

The COVID-19 pandemic has left our world in a state of disarray as patients have been suffering from recurrent pneumothoraces, acute liver failure, increase clotting risk, and conditions we are still learning about. We treated a patient who developed bilateral pneumothorces that ultimately worsened and lead to pneumomediastinum, subcutaneous emphysema, and pre-peritoneal free air. The best management of such cases remains unknown. Now more than 5 million COVID-19 cases globally, we should continue to report on the associated morbidity and potential treatment

Introduction: Recently, pulmonary tuberculosis (PTB) incidence is a serious co-infection and an emerging global concern for children living with human immune deficiency virus (HIV). However, the incidence of PTB among adult HIV patients is exhaustively studied; the incidence of PTB among children on ART is overlooked. This research provide indispensible time-based relevant interventions clues.

Objective: Hospital-based retrospective cohort study was conducted among 359 HIV infected children, those registered on ART since 2009-2018. Time to develop PTB was defined as the time from enrollment for ART care until the development of PTB. Survival analysis was used and the proportional hazard assumption was checked for each variable and no variable was found with Schoenfield test <0.05. Variables with P-value <0.25 in bivariate Cox regression analysis were entered into the multivariable Cox model. Multivariable Cox regression model with 95%CI and AHR was used to identify the significant predictors.

Materials and Methods: We conducted facility based retrospective cohort study from January 1/2009 to December 31, 2018 at Assosa and Pawe general hospitals in Benishangule Gumuz region. Both hospitals are located in North West Ethiopia; this region is one of the regional states established in 1994 by the constitution of Ethiopia. It is located in the western part of Ethiopia between 34° 10’N and 37° 40’E; and in the latitude 09° 17’N and 12° 06’ N. Assosa is the capital city of the region, it is located at a distance of 659 km in the west, and Pawe is located a distance from 565 km from in North West direction of Addis Ababa.

Results: This included individual records of 359 HIV-infected children initiated ART with in the period of January 1st 2009 to December 31 2018. During the follow-up period, totally 686.5 Persons per Year of observation (PYOs) were produced with minimum and maximum follow-up time on ART was 0.34 & 5.1 years, respectively. The overall incidence rate of PTB was found 2.78 (95% CI: 2.4-5.76) per 100 child-years of observation. Age group >= 11 years (AHR=5.1 95%CI: 1.4-18), advanced Who stage III&IV (AHR=3.4 95%CI: 1.2-9.7), Being severed underweight (AHR=3.2 95%CI: 1.3-7.8), Not started Isoniazid preventive therapy (INH) (AHR=2.8, 95%CI: 1.1-7.2) and having previous opportunistic infections (OIs) (AHR= 2.34 95%CI: 1.3-4.1) were significantly associated with PTB occurrence.

Conclusion: The findings of this study indicated, the incidence rate of PTB among HIV infected children remains has high health impact. Concerning associated factors such as advanced who stage III& IV, being severe underweight, not started, isoniazid prophylaxis, and previous OIs is significantly associated with PTB incidence.

Introduction: COVID-19 is a serious rapidly spread viral infectious disease that appear in Wuhan city in China in December 2019 and soon became pandemic infection; the disease shows high mortality throughout the world that increased with complications, pulmonary complications of COVID-19 may be the corner stone of both morbidity and mortality as hypoxia secondary to lungs involvement may be the cause of other complication or  may worse it, so early detection of pulmonary complication and early suitable intervention no doubt improve the outcome of COVID-19. The stander investigation to detect pulmonary complication is computed tomography (CT), but it is not available in many centers or there may be barriers to use it, so this study done to evaluate the role of thoracic ultrasound in detecting pulmonary complications in COVID-19, as it is bed side easy procedure that available in most centers.

Materials and Methods: This is a prospective interventional hospital base study, done in Port Sudan COVID isolation centre from July to September 2020, using portable ultrasound with 7mm convex probe following BLUE protocol, and indicated therapeutic intervention done according the diagnosis.

Result: 24 patients were enrolled in this study, 70.8% male and 29.2 % female. 12 patients (50 %) showed features of pulmonary oedema, 4 patients (16.7 %) showed features of pneumonia, other 4 (16,7 % ) patients showed sonological features of ILD, 2 patients (8.3%) showed features of ARDS, and 2 patients (8.3%) showed feature of pleural effusion regardless the cause of effusion.

Conclusion: Thoracic ultrasound is an effective diagnostic tool that detect the pulmonary complications in COVID-19 with reasonable sensitivity and specify that in addition to clinical background give high diagnostic value and it should be the choice in area of constrained facilities or whenever computed tomography can't be used.

The editorial mission of Pulmonary & Respiratory Medicine is to report scientific research findings that advance understanding of all aspects of pulmonology and respiratory. Research covering a wide range of topics and emerging challenges in pulmonology and respiratory medicine is published. Pulmonary intervention and outcome research furthermore as qualitative and mixed methods analysis are within the editorial focus of Pulmonary Research. Basic, translational, and clinical research is published. Research about Pulmonary and Respiratory, Respiratory therapy is also published as is research describing new or advanced Research methods, Analytic strategies, and Analysis protocols. Our mission at Pulmonary & Respiratory Medicine is to report scientific research findings that advance understanding of all aspects of pulmonology and respiratory. We intend to do this in the way we understand best-through editorial assessment, peer review, academic editing, and highly efficient production processes. We hope that all researchers strive to make their research findings known through careful, unbiased publication such as we aim to provide at Pulmonary & Respiratory Medicine. We welcome your comments and importantly, your continued contributions to achieve the mission we have set for ourselves.

The editorial mission of Pulmonary & Respiratory Medicine about the total journal academic performance and quality of publication articles,Pulmonary & Respiratory Medicine is a peer reviewed, double-blind journal. It is our pleasure to announce that during year 2019, all issues of volume 9 were published online on time and the print issues were also brought out and dispatched within 30 days of publishing the issue online.

The editorial mission of Pulmonary & Respiratory Medicine is to report scientific research findings that advance understanding of all aspects of pulmonology and respiratory. Research covering a wide range of topics and emerging challenges in pulmonology and respiratory medicine is published. Pulmonary intervention and outcome research furthermore as qualitative and mixed methods analysis are within the editorial focus of Pulmonary Research. Basic, translational, and clinical research is published. Research about Pulmonary and Respiratory, Respiratory therapy is also published as is research describing new or advanced Research methods, Analytic strategies, and Analysis protocols. Our mission at Pulmonary & Respiratory Medicine is to report scientific research findings that advance understanding of all aspects of pulmonology and respiratory. We intend to do this in the way we understand best-through editorial assessment, peer review, academic editing, and highly efficient production processes. We hope that all researchers strive to make their research findings known through careful, unbiased publication such as we aim to provide at Pulmonary & Respiratory Medicine. We welcome your comments and importantly, your continued contributions to achieve the mission we have set for ourselves.

Aspergillus species can cause a variety of lung diseases. However endobronchial aspergilloma is an entity rarely encountered in clinical practice. An 82-year-old woman presented to the outpatient setting with wheezing, shortness of breath and productive cough. CT of the chest showed the presence of airway enlargement in a finger in glove pattern in the right upper lobe suggestive of allergic bronchopulmonary aspergillosis. Despite adequate treatment the abnormality persisted on repeat imaging. Bronchoscopy with biopsies eventually revealed the presence of hyphal elements suggestive of Aspergillus and poorly differentiated adenocarcinoma. Endobronchial aspergilloma is rare and not included in the classification of Aspergillus lung diseases. It is thought to result from airway colonization by Aspergillus species. Occasionally it can obscure an underlying lung carcinoma and thus delay the diagnosis. Diagnosis is made by pathological examination of biopsy specimens. Optimal treatment is not well established.

Introduction: The COVID-19 till date has groped in around 750,000 lives across the globe that includes children and elderly who became a victim of this pandemic. During course of this pandemic, there has been discussion of age related vulnerability to the disease and the preventive measures and policies implemented by various countries across the globe.

Literature Review: The elderly have suffered a disproportionate burden of COVID-19. Patients associated co-morbidities pose a greater threat to that group as compared to general population. The epidemiological data and Case Fatality Ratio (CFR) collected from countries vary significantly but give a vivid picture of the situation of the pandemic in each region. Hence, the author reviewed the published data from several countries to investigate relationship between age and COVID-19 mortality and morbidity. The author also took the time to study briefly about the role of angiotensin converting enzyme 2 (ACE2) as a receptor against the new coronavirus SARS-CoV-2.

Conclusion: The author also reviewed the literature for studies explaining the difference in the physiological inflammatory response to SARSCoV-2 infection according to age. Thus, the information achieved from these data will prove to be useful in determining the precautionary and preventive policies irrational treatment of COVID-19.