COVID-19 is a severe respiratory disease with a spectrum of clinical presentations and complications. Warm autoimmune hemolytic anemia (WAIHA) is increasingly recognized in patients with COVID-19 either while infected or shortly after infection. We report a 36-year-old male with clinical and laboratory findings consistent with WAIHA. His medical history was significant for COVİD-19 infection three months before presentation. He was initially resistant to steroids but had substantial improvement following initiation of rituximab, with complete recovery thereafter. Therefore, serial assessment of complete blood cell count parameters and hemolysis markers post-COVID-19 infections is warranted for early detection and prompt treatment.
Keywords:Anemia, Hemolytic, Autoimmune; COVID-19; Rituximab; Cyanosis.
Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue neoplasm of low malignant potential often misdiagnosed clinically. It typically occurs in the superficial soft tissues of the extremities in children and young adults. It is characterized by recurrences and rarely metastases. Surgery remains the mainstay of management. Here, we present a rare case report of AFH in a 65-year-old male diagnosed using fine needle aspiration as spindle cell sarcoma. The patient underwent wide local excision. The patient is under follow-up. There is no evidence of metastases, and the patient is disease free three-years post-excision.
Keywords: Histiocytoma, Benign Fibrous; Soft Tissue Neoplasms; Recurrence.
Superior mediastinal syndrome is a life-threatening pediatric oncological emergency that requires high level of awareness and clinical suspicion to avoid misdiagnosis and devastating outcomes. Early diagnostic evaluation and management of underlying etiology are of utmost significance for optimal results. In children, it is most commonly caused by non-Hodgkin’s lymphoma and T-cell lymphoblastic leukemia. We report a case of a six-year-old boy with superior mediastinal syndrome secondary to T-cell acute lymphoblastic leukemia, initially misdiagnosed as foreign body aspiration and underwent a procedure with a life-threatening outcome.
Keywords:Chemotherapy; Lymphoblastic Leukemia; Vena Cava, Superior; T-cells.
A 29-year-old woman (gravida 3, para 2) presented at 28 weeks+2 days of gestation with a two-months history of dyspnea associated with orthopnea and occasional palpitations. On transthoracic echocardiography, she was diagnosed with a 3.2 × 2.7 cm left atrial myxoma. The patient underwent open surgical resection at 30 weeks of gestation. She had an uneventful postoperative recovery and was discharged on the ninth day. At 41 weeks of gestation, she gave birth by cesarean to a healthy baby of normal weight. Both the mother and the baby were discharged in stable condition.
Keywords:Atrial Myxoma, Familial; Pregnancy; Cardiac Tumors; Oman.
The endurance shuttle walk test (ESWT) is a simple, acceptable, field-based test first established in 1999 to measure endurance exercise capacity in patients with chronic obstructive pulmonary disease (COPD). The aim of this systematic review was to examine the reliability and responsiveness of ESWT in COPD. Of the 791 articles identified through electronic databases, 17 were included in this review. Qualitative and quantitative analyses were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and as per Consensus-Based Standards for the Selection of Health Status Measurements Instruments, the quality of the studies was graded as low for reliability and moderate for responsiveness. Qualitative analysis indicated inadequate evidence for the reliability of the ESWT in patients with COPD. The meta-analysis found strong evidence that ESWT was responsive to change following pulmonary rehabilitation with an estimated mean difference (ESWT time, seconds) 303.19 s (95% CI: 175.63–430.75; p< 0.001), ambulatory oxygen with a mean difference (ESWT time, seconds) 129.04 s (95% CI: 47.98–210.09; p = 0.002), and (ESWT mean distance, meters) 80.71 m (95% CI: 38.66–122.76; p < 0.001). The ESWT was also responsive to bronchodilation with a mean difference of 168.62 m (95% CI: 117.03–220.21; p < 0.001). Our findings suggest the strong potential of ESWT as a responsive test in COPD, but to draw a definitive conclusion regarding the reliability of the ESWT, further research is needed in this population.
Keywords: Exercise Tolerance; Walk Test; Pulmonary Disease, Chronic Obstructive.
Sleep is an imperative physiological aspect that plays a vital role in maintaining hormonal and humeral functions of the body and hence a healthy life. Circadian rhythms are daily oscillations in human activities and physiology that prepare human beings to better react to and anticipate challenges in the surrounding environment, which are a consequence of diurnal changes of day and night. The sleep/wake cycle is one of the most prominent manifestations of the circadian rhythm and communicates tightly with the immune system with daily oscillation of immunity. Sleep deprivation is now recognized as a common condition inherent to modern society, and it is detrimental to certain body functions, particularly immune function. The aim of this review is to explore the role of sleep in maintaining a healthy immune system during the COVID-19 pandemic. The review discusses sleep-regulatory substances that are linked to host defense mechanisms such as interleukin-1β, interleukin-6, tumor necrosis factor alpha, and interferon gamma. Cytokine levels also fluctuate with sleep/wake homeostasis and our review explores the relationship between sleep and cytokines and proposed therapeutics. The review will also cover sleep and immune response in children, adolescents, and healthcare workers, and finally it will touch on the effect of obstructive sleep apnea on immune response and the severity of COVID-19.
Keywords:Sleep; Circadian Rhythm; COVID-19; Immunity.
ISSN:2070-5204 (Electronic)