Background Pulmonary rehabilitation (PR) is crucial in managing chronic obstructive pulmonary disease (COPD) and enhancing functional capacity and health status. Oxygen therapy and noninvasive ventilation (NIV) may be needed to be incorporated into rehabilitation to augment the effectiveness of physical training. Objectives To compare and assess the impact of the PR programme alone and with augmentation with O 2 or NIV on COPD patients. Methods Seventy-five COPD patients were equally divided into three groups: group 1 patients performed 8 week-PR programme only. Group 2 performed the PR programme while receiving O 2 . Group 3 completed the PR programme plus NIV. Modified Borg scale, VO 2 max, modified Medical Research Council Dyspnea Scale, 6-minute walk test, COPD assessment test score, spirometric measures and arterial blood gases were assessed before and after the programme. Results The outcome measurements showed meaningful improvement compared with the baseline in the three studied groups. However, VO 2 max in group 3 showed higher significant improvement than both groups 1 and 2. Regarding 6-minute walk test, groups 2 and 3 had a higher significant improvement than group 1. COPD assessment test score in group 3 showed higher significant improvement than groups 1 and 2. Arterial blood gases in groups 2 and 3 showed significant increase in partial pressure of arterial oxygen and arterial oxygen saturation, but group 3 only had a significant decrease in PaCO 2 . Conclusion O 2 supplementation and NIV help severe to very severe COPD patients to perform higher exercise intensity, so they augment the benefits of PR.

Musculoskeletal Ultrasound is a quick, inexpensive, non-invasive modality for early diagnosis of hyperuricemia and gout. US waves are more intensely reflected by crystalline material than by the tissues around it, which are found to be in the cartilage, synovial fluid, tendon sheaths, and subcutaneous tissue. Power Doppler Imaging is especially helpful for tiny vessels as well as those having low-velocity flow since it has the sensitivity for flow identification. The existence of double contour sign, aggregates, tophi and hyperechoic spots are more specific ultrasonographic findings for diagnosis of gout. Furthermore, Hyperuricemia was found to be linked with cardiovascular diseases which reflected as increase in the carotid artery intima thickness in addition to carotid artery plaque formation that can be easily detected by ultrasound helping in early cardiovascular diseases screening and management.