Changes In Respiratory System Research Articles

Histopathological Analysis of Lung Lesions in Cases of Sudden Death: An Autopsy-based Study

Introduction: Cardiovascular and respiratory causes account for the major chunks in sudden death cases in various Western studies. Overall, a very limited number of studies have been conducted on respiratory system changes in cases investigated as sudden and unknown death in India. Pathological respiratory findings are said to be common in the autopsy population; however, their nature and prevalence are not well documented. Aim: To document the morphologic changes in lungs (both gross and microscopic) in cases of sudden death. Materials and Methods: The present study was a cross- sectional, prospective, and observational study conducted over a period of 12 months from 1st April 2010 to 31st March 2011. It was conducted on autopsy lung specimens received in the Department of Pathology, RG Kar Medical College and Hospital, Kolkata, West Bengal, India. For the purpose of present study, sudden death was defined as death occurring within 24 hours of the onset of the terminal symptoms. Unidentified subjects who were declared “Brought Dead” at the emergency room were also included in the study. The lungs were fixed in 10% formalin, weighed, and dimensions measured. Grossly, the lungs were examined for colour, volume, consistency, presence of any pathological changes, the status of bronchi and pleura, and findings were recorded. After routine processing and paraffin embedding, histological sections were stained with Haematoxylin and Eosin (H&E) stain and special stains as and when necessary. All the histological sections were examined microscopically, and findings were recorded. The obtained data were subjected to appropriate statistical analysis by entering the data in Microsoft (MS) excel 2010. Results: There were 46 males (88.46%) and 6 females (11.54%). The age range was 26-86 years, with a mean age of 51.02 years. Among the 52 cases, significant pulmonary pathology was found in 26 cases (50%), excluding postmortem changes. Extensive fibrocaseous pulmonary Tuberculosis (TB) 15 (28.85%) was the most common pulmonary lesion found, present in all age groups. The other major pathological lesions encountered were lobar pneumonia 4 (7.69%), emphysema 3 (5.77%), bronchopneumonia 2 (3.85%), etc. Conclusion: A significant number of cases with pathological lesions in the lung were detected during the histopathological examination of sudden death cases. All the lesions may or may not have contributed to death in a direct or indirect way. The undetected lung pathologies emphasise the importance of autopsy in cases of sudden death.

СТАН СЕРЦЕВО-СУДИННОЇ СИСТЕМИ У ХВОРИХ ІЗ ЗАДИШКОЮ, ЯКІ ПЕРЕНЕСЛИ ПНЕВМОНІЮ, АСОЦІЙОВАНУ З COVID-19

The aim of this study is to determine the contribution of cardiovascular system impairment to the development of dyspnea in post-acute COVID-19 pneumonia patients. Materials and methods. A total of 108 patients with dyspnea in the post-acute phase of COVID-19 (at 47 (38; 62) days after the onset of symptoms) were examined. These patients had experienced COVID-19associated pneumonia between April and November 2021. 21 patients were excluded due to comorbidities that could be a potential cause of dyspnea in the post-COVID-19 period. Thus, a group of 87 patients was formed, with an average age of 56 (49; 65) years, including 42 (48.3%) males. Patients were divided into three subgroups based on the severity of their acute COVID-19 illness: subgroup 1 (35 patients) — moderate, subgroup 2 (37 patients) — severe and subgroup 3 (15 patients) with critical. Investigation methods included clinical examinations, the mMRC dyspnea questionnaire, chest CT scans (both anamnestic and during examination), spirometry, ECG, echo-Doppler, serum NT-proBNP levels. Results. Patients in subgroups 1 and 2 in the post-acute phase of COVID-19 had less pronounced dyspnea compared to patients in subgroup 3 (1 (1; 2) and 2 (1; 3) vs. 3 (2; 4), respectively) (p < 0.001). Residual changes on chest CT scans were more frequently observed in subgroup 3 than in subgroups 1 and 2 (15 (100%) vs. 7 (20.0%) and 20 (54.1%), respectively) (p < 0.001). Obstructive ventilation disorders were only observed in subgroups 1 and 2 (in 15 (42.9%) and 6 (16.2%) patients, respectively), while restrictive disorders were found in subgroups 2 and 3 (in 14 (37.8%) and 12 (80.0%) patients, respectively). Clinically significant rhythm or conduction disturbances were not detected on ECG in any patient. According to echo-Doppler, subgroup 1 had diastolic dysfunction of the left ventricle (LV) in 3 (8.5%) patients; subgroup 2 had diastolic dysfunction of both the LV and right ventricle (RV) in 5 (13.5%) and 4 (10.8%) patients, respectively; and subgroup 3 had diastolic dysfunction of both the LV and RV in 4 (26.7%) patients. Mild pulmonary hypertension was observed only in subgroups 2 and 3 (in 13 (35.1%) and 14 (93.3%) patients, respectively). Elevated NT-proBNP levels were found in 22.9% of patients, with no significant differences between subgroups (p > 0.05). Conclusions. The severity of dyspnea in the post-acute phase of COVID-19 is related to the duration of lung involvement and the severity of the acute illness. In patients with moderate-severity acute COVID-19, dyspnea in the post-acute phase is primarily due to residual respiratory system changes (in 20.0% of patients) and mild obstructive ventilation disorders (in 42.9% of patients). Cardiovascular system involvement in these patients is mainly detected by elevated serum NT-proBNP levels (in 22.9% of patients), which may serve as a marker for the heart failure onset, necessitating consultation with a cardiologist. In patients with severe- acute COVID-19, dyspnea in the post-acute phase is due to residual morphological lesions in the respiratory system based on chest CT findings (in 54.1% of patients) and cardiovascular pathology (in 45.9% of patients). Therefore, managing this patient cohort in the post-acute phase requires collaboration between pulmonologists and cardiologists, especially when dyspnea does not correlate with morphological lesions in the respiratory system on chest CT. In patients with critical acute COVID-19, dyspnea in the post-acute phase is consistently caused by both residual morphological lesions in the respiratory system (in 100% of patients) and cardiovascular pathology (in 93.3% of patients). This substantiates the imperative for joint management by pulmonologists and cardiologists.

Prognosis of COVID-19 outcomes and risk prediction for the development of post-COVID syndrome

At the present time, the new laboratory diagnostic markers are required which may predict complications over the post-COVID period, as well as improve diagnostics of post-COVID syndrome in the patients who underwent COVID-19. Despite the fact that changes in respiratory system are the most common manifestations of COVID-19, extrapulmonary manifestations followed by the wide range of persistent symptoms and/or delayed complications may lead to multiple organ lesions of varying severity: from symptomless to fatal forms. A number of symptoms in the developed post-COVID syndrome may persist for 3 weeks, or to be prolonged up to 6 months and later. The purpose of the study was to investigate the informativity of an early integrative diagnostic index developed by us, enabling prediction of the COVID-19 outcome, and potential development of early post-COVID syndrome.
 Peripheral blood samples were examined in 60 patients (38-82 years old) diagnosed with COVID-19 of moderate severity (CT-2.3) during their inpatient treatment; 30 patients (38-62 years old) in the early post-COVID period and 34 patients (38-65 years old) with early post-COVID syndrome. The comparison group consisted of 100 healthy sex- and age-matched volunteers. The IDP, an integrative diagnostic index, was calculated as a marker including the ratio of the relative neutrophil-to-lymphocyte numbers, as well as the levels of C-reactive protein (CRP), by the following formule: IDP = (% neutrophilic granulocytes CRP) / % lymphocytes.
 We have found that, during the inpatient treatment, upon acute clinical manifestations, IDP in study group 1 was increased 12.5 times against the comparison group. It should be noted that all patients were discharged from the hospital in compliance with official criteria, according to Temporary Guidelines. In the study group 2, during early postcovid period, IDP remained 3.4-fold elevated against the comparison group. According to the chest CT data, the patients had signs of a fibrous component, organizing stage of pneumonia and consolidation foci in the lung tissue. Among the group 3 patients (early post-COVID syndrome), IDP was increased three-fold against the comparison group, accompanied by the documented signs of chronic fatigue syndrome and cognitive impairment.
 The IDP can be used as a marker for the prognosis of clinical outcome and a predictor of the evolving complications during the early post-COVID period and upon development of early post-COVID syndrome in the patients who have undergone COVID-19.

T095 Diabetes mellitus (DM) is a group of metabolic diseases. It is associated with well known complications linked to either microangiopathy, macroangiopathy or a combination of both. Some studies found that there were changes in respiratory system or PU

T095 Diabetes mellitus (DM) is a group of metabolic diseases. It is associated with well known complications linked to either microangiopathy, macroangiopathy or a combination of both. Some studies found that there were changes in respiratory system or PU

Effect of insufflated CO2 during laparoscopic surgeries on end tidal CO2 concentration using capnography

Use of laparoscopic surgeries become a best alternate for laparotomy and is used for the diagnostic as well as therapeutic purposes in patients presented for gynecological surgeries. Advantages include; reduction in postoperative persistent obstruction of intestine, aches, hospitalization, health expenses and problems relating to surgical wounds. Its procedure includes a brief period of intraperitoneal carbon dioxide (CO2) insufflation. Although this insufflation of carbon dioxide (CO2) is continued for a very short period of time causes deleterious physiological changes in respiratory system, lung volumes and gas exchange through alveoli. Purpose of conducting the study to understand the determination of effect of blowing of CO2 to intraperitoneal cavity during laparoscopic surgeries on end tidal CO2. A prospective descriptive study was done after the ethical approval from the concerned departments. End tidal CO2 (EtCO2) concentration was recorded in intervals at pre-induction of anesthesia before insufflation and termed this as baseline concentration of the said gas, then recorded at 10-mmHg, between 10-15 mmHg, at 15-mmHg of intraperitoneal pressure and at the cessation of the surgery. End tidal CO2 (EtCO2) after CO2 insufflation during laparoscopic surgeries is compared with the baseline EtCO2. Upon assessing the data, EtCO2 increased slightly after CO2 insufflation and considerably after the surgical incision. After completion of the laparoscopic surgery, the EtCO2 exhibited a trend to baseline value. This study concludes that the patients who were otherwise healthy and were just undergoing laparoscopic surgeries, EtCO2 surges slightly subsequent to CO2 insufflation and readily comes to baseline value.

COVID-19 in elderly: Management issues

Introduction: COVID 19 has once again brought to the forefront the issue of vulnerability of the geriatric population to diseases. Advanced age itself and comorbidities (obesity, DM, HTN/IHD, COPD, CLD, CKD, immunocompromised states, transplant, malignancy and CHD), which increase with age, are the main risk factors for contracting severe COVID 19. Immunosenescence, unpredictable disease course, atypical symptoms, pathophysiological changes in respiratory system and a state of hypercoagulability associated with aging are responsible for increased severity and mortality of SARS CoV 2 in the elderly. Management: Diagnosis: RT PCR is the gold standard investigation for diagnosis though it has approximately 33% false negative rate. Classification: On the basis of dyspnea, respiratory rate and SpO2 in room air, patients are classified as mild, moderate and severe cases. On the basis of severity of case, investigation and monitoring is planned. Treatment: Mild cases are advised home isolation whereas moderate and severe cases require hospitalization. Mild cases usually subside with use of anti pyretics, immunomodulators (Zinc, Vit C, D), hydration, anti tussives and anti virals (Doxycycline, Ivermectin, Favipiravir). Oxygen therapy and steroids form the mainstay of treatment in moderate and severe cases. Anti coagulants, anti viral (Remdesivir) and monoclonal antibody (Tocilizumab) are used as and when required. Newer drugs like antibody cocktail and 2-DG have also been developed. Chest physiotherapy (proning and spirometric exercise) enhances recovery. Prevention: COVID appropriate behavior (use of mask, hand hygiene and physical distancing) and priority vaccination of elderly are the most important tools to safeguard geriatric population.

The Effect of Tapping on Functional Changes in Spinal Mobility and Respiratory System in Adolescents with Idiopatic Scolosis: Pilot Study

Background. Scoliosis affects spinal mobility and the respiratory system. The Schroth method is an effective tool for the treatment of scoliosis. However, there is insufficient evidence for the efficiency of kinesio taping with the Schroth method to help manage the condition of spinal mobility and respiratory system changes for adolescents with idiopathic scoliosis.
 The aim. To evaluate the efficacy of the Schroth method and the Schroth method in combination with kinesio taping for spinal mobility and functional changes in the respiratory system in adolescents with idiopathic scoliosis.
 The methods. The study included 8 adolescent volunteers diagnosed with idiopathic scoliosis. The adolescents were divided into two groups. The Schroth method was used for the first group and the Schroth method with kinesiology taping for the second group. The study lasted 2 months, and both groups underwent 2 interventions per week. Both before and after the interventions, participants were assessed for trunk functional stability (Mathias test), lumbar and thoracic spine mobility (Schober and Otto tests), vital lung capacity (VC), and forced expiratory capacity in 1 s (FEV1).
 The results. In the analysed results of the interventions, it was found that the Mathias test, the Schober and Otto test, the VC and the FEV1 were improved in both groups. Comparing the results between the groups, it was established that the spinal mobility was better (p < 0,05) in the second group. However, lumbar and thoracic spinal mobility, VC, FEV1 were better (p<0,05) in the first group.
 The conclusion. The Schroth method with and without kinesiological taping increased trunk stability, spinal cord mobility, and VC and FEV1. The Schroth method with kinesio taping is more effective for trunk functional stability, however only the Schroth method is more effective with mobility of the lumbar and thoracic spine part as well as for VC and FEV1.
 Keywords: spinal cord mobility, trunk functional mobility, vital capacity.

Specific features of the pathology of the respiratory system in SARS-CoV-2 (Coronaviridae: Coronavirinae: Betacoronavirus: Sarbecovirus) infected Syrian hamsters (Mesocricetus auratus)

Verification of histological changes in respiratory system using Syrian (golden) hamsters (Mesocricetus auratus) as experimental model is an important task for preclinical studies of drugs intended for prevention and treatment of the novel coronavirus infection COVID-19.The aim of this work was to study pathological changes of pulmonary tissue in SARS-CoV-2 (Coronaviridae: Coronavirinae: Betacoronavirus; Sarbecovirus) experimental infection in Syrian hamsters. Male Syrian hamsters weighting 80-100 g were infected by intranasal administration of culture SARS-CoV-2 at dose 4 × 104 TCID50/ml (TCID is tissue culture infectious dose). Animals were euthanatized on 3, 7 and 14 days after infection, with gravimetric registration. The viral load in lungs was measured using the polymerase chain reaction (PCR). Right lung and trachea tissues were stained with hematoxylin-eosin and according to Mallory. The highest viral replicative activity in lungs was determined 3 days after the infection. After 7 days, on a background of the decrease of the viral load in lungs, a pathologically significant increase of the organ's gravimetric parameters was observed. Within 3 to 14 days post-infection, the lung histologic pattern had been showing the development of inflammation with a succession of infiltrative-proliferative, edematousmacrophagal and fibroblastic changes. It was found that initial changes in respiratory epithelium can proceed without paranecrotic interstitial inflammation, while in the formation of multiple lung parenchyma lesions, damage to the epithelium of bronchioles and acinar ducts can be secondary. The appearance of epithelioid large-cell metaplastic epithelium, forming pseudoacinar structures, was noted as a pathomorphological feature specific to SARS-CoV-2 infection in Syrian hamsters. As a result of the study, the specific features of the pathology of the respiratory system in SARSCoV-2 infected Syrian hamsters were described. These findings are of practical importance as reference data that can be used for preclinical studies to assess the effectiveness of vaccines and potential drugs.

Residual Symptoms in Patients After Acute COVID-19, Literature review

Gabija Pajedienė1, Gintarė Jonuškytė1, Monika Martusevičienė2 1Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine 2Lithuanian University of Health Sciences, Kaunas Hospital Abstract Background. COVID-19 pandemic caused by the SARS-CoV-2 virus has already affected at least 163 million people worldwide. The most common symptoms are cough, fever, dyspnea, musculoskeletal symptoms (myalgia, joint pain, fatigue), gastrointestinal symptoms, and smell and taste disturbances [1,2,3]. As the part of the population suffering from COVID-19 infection increases, we see more people with residual symptoms of COVID-19 infection. Aim: to find out the most common residual conditions after COVID-19 and the frequency of occurrence. Methods: the priority of studies chosen included systematic reviews, then moved on to literature reviews, prospective studies and the last choice – case reports. Literature analysis was performed using Pub Med database, and MeSH terms, such as „COVID-19 sequelae“, „COVID-19 outcomes“, additional terms were chosen based on organ system damaged, for example: (COVID-19) AND (cardiovascular) AND (long-term outcomes). Due to the fact, that all studies on this topic are not older than 2 years, we did not need to apply date filter for the articles. Using MeSH terms more than 1500 studies were found. When more detailed filters were applied, and relevant articles were chosen, studies were filtered to the ones used in this study. Inclusion criteria: All of the patient analyzed were tested positive for SARS-CoV-2 infection using PCR or serological testing. Studies only included humans. Exclusion criteria: Patients not confirmed SARS-CoV-2 with objective tests. Patients younger than 18 years old. Results: residual changes in respiratory system – restrictive changes and isolated decrease of DLCO found in pulmonary function tests. Changes in radiologic pulmonary tests were still seen 90 days after COVID-19 disease. Most common cardiovascular outcomes – pericarditis, perimyocarditis, or myocarditis, which causes heart failure, malignant arrhythmias and acute coronary syndromes. Nervous system damage includes the most common symptoms – olfactory and gustatory dysfunction. For 3% to 14% of patients’ olfactory dysfunction persists up to 30 to 40 days after onset of symptoms. Systemic neurologic symptoms include headache, myalgia, dizziness, confusion. These symptoms can persist for 55% of the patients up to 3 months after the disease. Severe neurologic complications are less common, they occur up to 18% of COVID-19 patients, the most common of them – acute cerebrovascular complications. Keywords: COVID-19, SARS-CoV-2, sequelae, complications.

Effect of nano-magnesium oxide and harmonic scalpel on lung lobectomy healing in dogs: Clinical and cytokine study

The aim of the present study was to evaluate the effect of magnesium oxide nanoparticles and the role of the harmonic scalpel in lung tissue healing at the site of a middle lobe resection of the right lung. Twenty-four adult domestic dogs were used. They were randomly divided into two equal groups (control and treated group). The middle lobe of the right lung was excised by harmonic scalpel with titanium clamps to control bleeding and infiltration of air bubbles. The clinical and physiological condition of the animals was studied in the two-week period after surgery and molecular evaluation at time of zero, first, third, fifth, seventh, fourteenth, twenty-first, twenty-eighth, and thirty-fifth days after operation by interleukin-6 and tumor necrosis factor-α. The result of clinical observation showed that dogs in both groups took 2-4 days after the operation to gain full activity. The heart and respiratory rate were within the normal level before and during the operation, and when the animal began to recover, the heartbeat and respiratory rate began to rise with irregularity and the irregularity continued for 3-5 hours after the completion of the operation and then returned to its normal level within 24 hours after the operation. These changes in heart rate and respiratory system were observed in all treated animals, while heart rhythm and respiratory rates persisted in the control group until several days after the operation. In the molecular evaluation, the results for interleukin-6 and tumor necrosis factor-α showed a significant difference in the mean values ​​of these two factors between control and treated.

Modificări clinice și radiologice în intoxicațiile acute cu hidrocarburi la copil

Acute chemical poisoning is an important cause of morbidity and mortality for the pediatric population, with hydrocarbon exposure accounting for a significant share. The route of exposure but especially the type of hydrocarbons are responsible for the effect that these substances exert on the body and implicitly the clinical picture and an understanding of them is used in the care of the patient exposed to hydrocarbons. Objectives. Outlining the clinical and radiological profile of accidental acute hydrocarbon poisoning in children. Material and method. Medical documents of patients hospitalized in the Pediatric Antitoxic Center with a diagnosis of acute hydrocarbon intoxication over a period of 2 years were retrospectively analyzed, taking into consideration demographic characteristics, type of hydrocarbons, clinical manifestations and radiological changes. Results. 25 cases of acute hydrocarbon poisoning were identified in children. Exposure was only accidental by ingestion, with males and the 1-5 age group occupying the largest share. The main clinical manifestations were respiratory, gastrointestinal and nervous system and radiological changes were associated in only 20% of cases. Conclusions. Acute hydrocarbon poisoning in children are frequently asymptomatic or causes mild symptoms, dominated by gastrointestinal, respiratory and neurological manifestations. Pulmonary radiography is mandatory in paraclinical diagnoses but there is no correlation between the severity of the clinical picture and the radiological aspects. There may be situations in which symptomatic patients do not have radiological changes or situations with pathological radiological aspects in asymptomatic patients.

Augmented Reality (AR) Enhances the Effectiveness of Lung Expansion in Spinal Surgery Patients -Preliminary Study

Background: After spinal surgery, patients often have changes in respiratory system due to general anesthesia. Preoperative respiratory rehabilitation and respiratory muscle training are found to be effective in reducing the postoperative pulmonary complications.Aim: Comparing the differences in the effects of postoperative lung expansion in patients with spinal surgery by using the conventional paper-based and the application of augmented reality (AR) health education methods, and understanding the acceptance of the use of AR by clinical nursing staff.Subject and methods: The quasi experiment was adopted; the control group was paper-based conventional health education and the experimental group was AR health education. The Trifflow breathing exercise was taught one day before operation. The frequency of exercise was 5-10 minutes each time and four times a day. The exercise was started from the day before operation and was continued until being discharged from the hospital. The pulmonary capacities were measured one day before the operation and on the day of leaving the hospital. Twenty people were recruited in both groups. There were 20 nursing staff participated in this study in total. The acceptance level of using AR was surveyed by using self-administered structured questionnaire.Result: In the experimental group, females were accounted for 65%, 55% of them were under 64 years old, and 30% of them with primary education level; in the control group, 85% of them were females, 70% of them were over 65 years old, and 30% with primary education level. The vital capacities measured at the time of discharge comparing with that before the operation were increased in both group, which reached a statistical difference (p=0.001). However, there was no significantly statistical difference between different groups. In terms of AR recognition by nursing staff: 75.0% thought that “the current health education tools are not enough”, 90% agreed that “acceptance of AR by patient and family”, 75% agreed that “the AR used in this health education process is convenient”, “the use of AR in this health education process is interactive”, and “AR health education makes the whole health education process more interesting”. Seventy percent agreed that “I have enough relevant resources to use AR health education”.Conclusion: Both traditional and AR health education models can improve the pulmonary function of patients, and there were significantly statistical differences. However, nursing staff felt that the current health education tools were not enough and thought that AR was interactive, interesting and convenient.Recommendation: The AR medical education has the advantages of interactive games and instant feedback. It can be utilized in clinical services to provide nurses with different models of health education.

Role of bovine respiratory syncytial virus in etiology of respiratory diseases on milk farms

Bovine respiratory syncytial virus (BRSV) is one of the etiological agents of respiratory diseases. The agent spreads widely in all the countries with intensive livestock farming and can cause pathologic changes in respiratory system either alone or in combination with other viruses and bacteria. It is a matter of crucial importance to study spread of the agent on large milk farms, to detect it in the internal organs of infected animals, and to quantify virus accumulation in them. The purpose of the research was to study peculiarities of RS infection spread, frequency of the virus detection in biomaterial samples (both alone and in associations with infectious bovine rhinotracheitis (IBR) and bovine viral diarrhea/mucosal disease viruses (BVDV) and with Pasteurellaceae bacteria) on large milk farms affected by respiratory animal diseases; and to determine virus concentration in the respiratory organs. BRSV alone was reported in 9.2% of the tested biomaterial samples, as associated with IBR and BVDV it was reported in 1.4% and 5.2% of samples, correspondingly. The number of samples containing simultaneously BRSV and Pasteurellaceae bacteria was 10.8%. The virus was reported in a maximum of 26.6% of the tested samples. With the help of real-time PCR the virus genome was detected in lungs (13.1%), in exudate from trachea, bronchi and nasal sinuses (6.0%), in nasal discharge (4.0%) and in bronchi (1.7%). The virus was seldom detected in trachea and bronchial mucosa (1.1%) and in pulmonary lymph nodes (0.8%). Quantification of BRSV RNA demonstrated that maximum virus accumulation was observed in lungs and nasal charges and it confirms data on its tropism to pulmonary interstitium.

The Overall Consequence of Antiviral Drugs Given to Pregnant Women with COVID-19

During pregnancy, the anatomical structure of the respiratory system changes, and the virus transmitted by droplets and aerosols are more easily inhaled and difficult to remove by pregnant women. Women are generally more susceptible to various pregnancy-related complications and respiratory pathogens, increasing the risk of developing adverse pregnancy and neonatal outcomes. Anecdotal evidence suggests that pregnant women do not appear to differ from the general population in terms of disease transmission, and to date, there is no evidence of vertical transmission from mother to fetus. However, in another study, it is known that members of the coronavirus family are responsible for serious complications such as miscarriage, fetal growth restriction, and congenital anomalies during pregnancy. To date, only a few studies have reported relatively higher rates of adverse birth outcomes in women affected by SARS-CoV-2 infection in late pregnancy. This literature review presents the use of drugs used for the treatment of COVID-19 disease in pregnancy and pregnancy outcomes. It is also aimed to examine the effective control and management of SARS CoV-2 infection in the pregnancy, delivery, and postpartum period in line with the existing literature and guide health personals. Large-scale epidemiological studies are needed to evaluate the course of the infection during pregnancy and the effects of the drugs used on pregnancy and fetus.

ARSENIC: IT’S TOXICITY AND IMPACT ON HUMAN HEALTH

Water pollution is a major problem in modern life. Almost all the heavy metals are toxic at higher concentrations and some are lethal at very low concentration. Arsenic is a naturally occurring element present in water, food and soil, but now-a-days this element is one of the rapidly emerging serious environmental pollutants; released into the environment through industrial and agricultural usage. In many parts of India, the ground water is contaminated with arsenic. The genesis of arsenic pollution is not understood fully, yet it is thought that natural geological weathering is mostly responsible for the dissolved arsenic in ground water. Arsenic exposure to human causes degenerative, inflammatory and neoplastic changes in skin, respiratory system, blood, lymphatic system, nervous system and reproductive system. There is no particular remedial action for chronic arsenic poisoning. Nearly 100 million people are to be affected by arsenic diseases like spots on the skin, high blood pressure, diabetes, skin cancer, cancer of urinary bladder, kidney and lungs. Low socio-economic status and malnutrition may increase the risk of chronic toxicity. There is a strong relationship between chronic ingestion of arsenic and deleterious human health effects. Safe drinking water and well-nourished food is essential for the prevention of chronic arsenic toxicity. Balance nutritious-supplements play a major role in the prevention of chronic arsenic poisoning. In this review article, authors tried to provide an overview of some of the major effects documented in the scientific literature.

Features of the course of chronic obstructive pulmonary disease in patients with respiratory tuberculosis in modern conditions

Abstrаct. The features of the course of chronic obstructive pulmonary disease are considered. It was established that this pathology is widespread in patients with tuberculosis and is determined in one third of patients. Moreover, the combination of respiratory tuberculosis and chronic obstructive pulmonary disease have a mutual aggravating effect, and the patients serious condition can be caused by both exacerbation of chronic obstructive pulmonary disease and progression of the tuberculosis process. The severity of the comorbid state is associated with a decrease in adaptive-adaptive mechanisms and a violation of the state of the homeostasis of the body. Patients with a combination of pulmonary tuberculosis and chronic obstructive pulmonary disease are characterized by intense types of adaptive reactions, with their extreme manifestations, a deep and pronounced disturbance in homeostatic balance and a decrease in the reactivity of the body. Such changes are combined with functional disorders of the respiratory system (changes in spirometric indicators, impaired airway, impaired ventilation function and diffusion capacity of lung tissue). The combined course of pulmonary tuberculosis and chronic obstructive pulmonary disease affects the effectiveness of the treatment and its outcome. In patients with comorbid pathology, there is a decrease in the frequency of abacillation and closure of decay cavities, the formation of pronounced residual tuberculous changes in the lungs. At the same time, in patients with pulmonary tuberculosis, chronic obstructive disease has a more severe course, with a pronounced symptom complex and a high probability of frequent exacerbations. In more than half of cases, chronic obstructive pulmonary disease is characterized by an unfavorable course with a high risk of exacerbations, more than twice a year, which is an extremely unfavorable factor for predicting the course of chronic obstructive pulmonary disease and the development of complications. Identified violations impair the quality of life of patients suffering from comorbidity. Therefore, it is diagnostically important to assess the initial state of chronic obstructive pulmonary disease in patients with tuberculosis, to predict its course and the risks of exacerbations.

Hypoxic events during non-obstetric abdominal surgery in pregnant women.

Every year 0.5-2% of women undergo non-obstetric surgery in pregnancy. Hypoxic events with short-term and long-term consequences are one of the most frequent complications in surgery. There is only limited data available regarding the impact of these events. This review aims to analyze the current literature on hypoxic events occurring in non-obstetric abdominal surgery in pregnant women, focused on maternal and fetal outcomes. We performed a non-systematic review of the literature, through a PubMed search using the key words "hypoxemia", "non-obstetric surgery", "surgical procedures", "pregnancy", "pregnant women" and "outcome". There is little data available regarding maternal and fetal outcomes after hypoxic episodes during non-obstetric surgery in pregnancy. In these cases, conservative intrauterine resuscitation maneuvers or immediate delivery should be taken into account. Perimortem cesarean section can be lifesaving for both mother and fetus when maternal collapse is non responsive to resuscitation procedures. Inaccurate information regarding maternal and fetal outcomes is due to the lack of robust data and the heterogeneity of the causes underlying maternal respiratory complications during surgery. Non-obstetric surgery during pregnancy must be performed when indicated. An expert multidisciplinary team, composed of obstetricians, surgeons, and anesthesiologists need to be included, giving appropriate attention to the physiological changes of respiratory, cardiovascular, and gastrointestinal system that occur during pregnancy. The shortest operative time and peri-operative assistance should be ensured. Complications, such as hypoxic events in pregnant patients need adequate assistance. Multidisciplinary cooperation, continuous training and simulation for anesthesiology and resuscitative procedures can guarantee this.

Histological Changes for Stachybotryschartarum Fungus in the Lungs and Nose for Infant White Mice

Stachybotryschartarum in one of fungi that cause respiratory system infection to human and animals therefore this study it done to evaluation histological changes in some respiratory organs such as nose and lung induced by this fungus suspension . Detection of Stachybotryschartarum fungus confirmed by cultured samples which collected from baths floor on potato dextrose agar in room temperature for seven days. Then the suspension of positive samples of this fungus diluted by phosphate buffer saline and counted the spores by using hemocytometer before used experimentally in lab animals (Balb/C mice) to study histological changes in respiratory system . Twelve mice used in this study divided into two groups. first group consist of six mice induced with 0.5 ml from one positive sample of fungus suspension contain 2×10 4 spore/mm 3 (for month : one dose daily) according to count of hemocytometer to evaluate some histopathological changes in nose and lung .Second group induced with 0.5 ml from phosphate buffer saline only. The results revealed that the nose of mice injected with 0.5 ml contain 2×10 4 spore/mm 3 from Stachybotryschartarum fungus suspension causefocal superficial necrosis of the respiratory epithelial cells with acute inflammatory cells and infiltration of the mucosa while the lung of group mice treated with same concentration of fungus has interstitial pneumonia with thickening of inter alveolar space due to infiltration and chronic inflammatory cells especially mononuclear cell.

Physiological and anatomical changes during pregnancy

The body undergoes numerous physiological changes during pregnancy in order to provide an adequate environment for fetal development, meet the increased metabolic demands and prepare for childbirth Pregnancy is a natural but altered physiological state resulting in major changes in cardiovascular system, respiratory system, endocrine system, reproductive system and skeletal and bone changes. The body undergoes a number of physiological changes over the course of pregnancy. For both doctors and patients, the cutaneous findings may be most obvious and sometimes alarming. Obstetricians and dermatologists ought to be able to differentiate between normal changes and unhealthy ones. The pregnant mother undergoes essential physiological changes during pregnancy in order to support and accommodate the developing fetus. These modifications start after conception and affect every organ system in the body. This review underlines the major changes that occur during normal pregnancy.

Механизмы взаимодействия сердечно-сосудистой и дыхательной систем

In this review we discuss the mechanisms of cardio-pulmonary interaction during spontaneous respiration and mechanical lung ventilation. We noted the interrelations between the changes of the intrathoracic pressure, venous return and cardiac output; the changes of the intrathoracic pressure and pulmonary hemodynamics; the values of the intrathoracic pressure and right and left ventricular myocardial contractility; the changing of respiratory phases and heart rate; the changes of respiratory muscles contraction and circulatory system. The phasic changes of the venous flow (it increases during respiration and decreases during expiration) are caused by the changes of both the intrathoracic and transdiaphragmatic pressures. However, the sucking thoracic effect is practically absent to the mean values of the venous return. During phasic respiratory changes the shifts of the venous return and pulmonary artery flow are opposite to the changes of the cardiac output and arterial pressure as a result of the changes of capacitance and resistance of the pulmonary vessels. In case of positive end expiratory pressure ventilation the changes of the cardiac output are dependent from the interrelations of the venous return, right ventricular myocardial contractility, pulmonary veins outflow and left ventricular myocardial contractility. The reflectory neurogenic influences on the heart and vessels from the pulmonary and respiratory muscles receptors are important during the cardio-pulmonary interaction.