Hydatid cyst (HC) is a zoonotic disease that often affects regions where animal husbandry is common and preventive measures are not taken. This disease mostly affects the liver and the lungs. Involvement of other organs, such as the kidney, musculoskeletal system, and intracranial structures, is rare. In this case report we will be discussing a patient who was diagnosed with bacterial pulmonary empyema without proper response to treatment. In further management, a ruptured hydatid cyst was diagnosed along with a renal hydatid cyst.

Background: The coronavirus disease 2019 (COVID-19) dramatically impacts healthcare delivery. Pulmonary diagnostic procedures have had frequent disruptions during this pandemic. Objectives: This study aimed to discover how the COVID-19 pandemic affected pediatric flexible fiberoptic bronchoscopy. Methods: This retrospective cross-sectional study was carried out on pediatric patients who underwent fiberoptic bronchoscopy at a tertiary pediatric hospital affiliated to Tehran University of Medical Sciences. Procedural analysis was done from 20 March 2019 to 20 February 2020 (the pre-pandemic period) and 20 March 2020 to 20 February 2021 (during the pandemic period). The two groups were compared with regard to bronchoscopic indications and findings. Results: Our results from the data registry showed that within (group 1), 290 patients vs. 241 patients from 20 March 2020 till 20 February 2021 (group 2) were admitted to the operation room at least once for bronchoscopy procedures. Although the findings of foreign body aspiration in bronchoscopy were more frequent in group 2, this difference was not significant in the two groups (P = 0.055). The number of cases without abnormality in group 2 was significantly less than in group 1 (P = 0.006). The prevalence of Laryngomalacia was also significantly higher in group 2 (P = 0.000). Conclusions: Our results confirmed the reduction of bronchoscopy in children after the COVID-19 epidemic. However, there was no change in the immediate indications for bronchoscopy, and this pandemic had the most significant impact on elective bronchoscopy.

Background: The Lung Clearance Index (LCI) serves as a non-uniform ventilation index utilized for monitoring pulmonary function in patients with cystic fibrosis (CF). Lung Clearance Index exhibits higher sensitivity compared to forced expiratory volume in 1 second (FEV1) for early detection of lung disease and does not necessitate active patient cooperation, as required for FEV1 measured through spirometry. Presently, FEV1 is the standard parameter employed for monitoring lung function in CF patients. Objectives: The objective of this study was to assess the correlation between LCI and FEV1 in patients with cystic fibrosis. Methods: This cross-sectional study enrolled children aged 6 to 18 years with confirmed CF diagnosis, who were referred to the CF clinic at Children's Medical Center Hospital (Tehran, Iran). Participants completed consent forms and subsequently underwent pulmonary function tests. Lung Clearance Index was calculated using the exhaling-D device via the Multiple Breath Washout (MBW) method, followed by FEV1 assessment through spirometry. Results: The study included 52 patients with an average age of 12 years, among whom 52% were males. The mean ± standard deviation of FEV1 and LCI were 80.2% ± 25.3 and 8.9 ± 2.8, respectively. A significant inverse relationship was observed between these two parameters in the study (r = -0.49, P = 0.001). Conclusions: These findings further underscore the potential utility of LCI, which offers ease of administration and demonstrates high reliability and accuracy compared to FEV1 for monitoring pulmonary function in CF patients.

Charcot-Marie-Tooth is an inherited disorder involving multiple genes, causing progressive nerve damage affecting sensation and movement. The complexity of the condition often leads to various possible diagnoses along with neuropathic diseases, sometimes resulting in significant delays in diagnosis and treatment. Thorough clinical examinations, suspicion based on symptoms, electromyography, nerve conduction tests, and specific genomic testing can expedite diagnosis. Here, we will introduce a case of Charcot-Marie-Tooth disorder, initially presenting with stridor and hoarseness due to vocal cord paralysis, later progressing to atrophy and deformity of the limbs. Diagnosis was confirmed through whole genome sequencing, revealing mutations in genes associated with the disorder.

: The patient was an 11-year-old boy who was referred to our emergency department with a chief complaint of dry cough and shortness of breath. He was diagnosed with asthma when he was three years old and was treated with inhalers as needed. On physical examination, he had respiratory distress and biphasic wheezing. The patient was initially managed as an asthma attack; however, he did not respond to the treatment completely. After a pulmonology consult, he underwent a spirometry test, which was compatible with an obstructive pattern. He was a candidate for fiberoptic bronchoscopy, which revealed findings in favor of vocal cord dysfunction (VCD) and adult-onset laryngomalacia. As part of the management of VCD, we referred him to a psychiatric clinic, evaluating for psychological problems as aggravating factors. We found that he suffered from psychological disorders, including somatic symptoms disorders and mild to moderate depression. The patient was treated for his psychiatric problems. He responded to the treatment well, and the cough and dyspnea attacks resolved gradually after a few months.

Background: The early determination and treatment of lung exacerbation have a significant role in increasing the health and quality of life in patients with cystic fibrosis. The Multiple-breath washout (MBW) technique was used to discriminate between health and disease of the lungs recently, however, its role in the prediction of upcoming exacerbation is not clear .This study aims to clarify this ambiguity. Methods: We recruited 60 clinically stable children with cystic fibrosis who were coming to the CF clinic for periodic care. In addition to the routine pulmonary function tests (PFT), we performed MBW technique for all subjects as an annual assessment. Subsequently, in the follow-up period, we admitted all patients who had experienced exacerbation within two weeks after the MBWT for proper antimicrobial therapy. During admission, we reevaluated the PFT results of hospitalized subjects and compared them with the PFT results of subjects who had no exacerbation. Results: Overall 55 subjects finished the trial; 18 cases (32.7%) were hospitalized and 37 patients (67.3%) were not hospitalized. The LCI5% variable had no significant difference between hospitalized and non-hospitalized groups. The median of the LCI2.5% in the hospitalized group (13.26) was greater than in the non-hospitalized group(7.82), this difference was statistically significant (P = 0.0001). The mean value of M2 /M0 in hospitalized patients (16.31) was greater than in non-hospitalized patients (5.97) and this difference was statistically significant (P = 0.0001). Conclusion: Our study outcomes had a valuable ability to predict exacerbation, however, this hypothesis requires further studies with larger sample sizes.