Background Some of the pulmonary tuberculous patients who completed their medication course experience lung function impairment which may influence their quality of life. However, the pattern and nature of post-tuberculosis lung impairment are still not identified. Thus, the aim of this study was to determine the type and degree of lung physiology changes in previously treated tuberculous patients which latter may affect their quality of life, thus helping clinicians for early diagnosis of lung impairment, especially in tuberculous endemic areas. Results Adults (≥18 years) who were treated from first attack pulmonary tuberculosis were included in the study. Demographic data, respiratory symptoms, smoking history, comorbidities, Medical Research Council dyspnea score (MRC), spirometry, chest radiography, and oxygen saturation were collected. One hundred ninety-seven participants were finally included in the study. The mean age was 49.50±13.26 years with males representing 75.6% of total patients. MRC dyspnea scale grading showed that about 13.2% and 5.1% of patients suffer from dyspnea grade II and grade III, respectively. Main respiratory symptoms were cough in 38.1%, sputum production in 24.9%, and hemoptysis in 6.6% cases. Normal spirometry was documented in 53.3%, obstructive pattern in 31.98%, and mixed pattern in 7.11%, whereas 7.61% cases had a restrictive pattern. According to ATS staging of obstructive pattern, 27 patients (42.8%) had mild obstruction, 22 (34.9%) patients had moderate obstruction, 13 (20.6%) patients had moderate to severe obstruction, and one patient (1.6%) had severe obstruction. Conclusions Impairment of respiratory function after tuberculosis is one of the causes of chronic lung disease that is underestimated, especially in endemic countries. This impairment in function occurs early in the course of the diseases and even without symptoms, affecting the quality of life. Thus, clinicians should encourage patients for an earlier visit to a respiratory clinic for follow-up and further management if needed. Guidelines for the management of cured tuberculous patients are urgently needed. Trial registration ClinicalTrials.gov, NCT05097638. Registered on October 28, 2021—retrospectively registered

Background Regarding risk stratification of intermediate-risk pulmonary embolism, data are still not sufficient. Transthoracic echocardiography parameters may be useful in risk evaluation in those patients. Some novel echocardiographic indices mainly tricuspid regurgitation peak gradient (TRPG), pulmonary artery acceleration time, and tricuspid annulus plane systolic excursion (TAPSE) were evaluated showing that they may be used for risk stratification of normotensive cases with acute pulmonary embolism (APE). Results The studied cases were subdivided into two classes: Class I with intermediate-low-risk pulmonary embolism included 32 patients (53.3%) and class II with intermediate high-risk pulmonary embolism involved 28 cases (46.7%). Dyspnea, tachypnea, troponin level, RVD, RVD/LVD, TR velocity, and TRPG/TAPSE were statistically higher in cases of class II than that of class I (p < 0.001). On the other hand, TAPSE and PA acceleration time were markedly lower in the case of class II than that of class I (p < 0.001). Ten cases (35.7%) of group II required thrombolytic agents with a significant difference (p<0.001). Conclusions RVD/LVD ratio, TAPSE, TRPG/TAPSE ratio, and PA acceleration time are echocardiographic parameters that might be helpful for risk stratification of cases with moderate-risk pulmonary embolism. The addition of elevated levels of cardiac troponins to imaging and clinical findings can improve PE-related risk identification. Trial registration NCT04020250. Registered on 16 July 2019.

Background Weaning-induced pulmonary edema (WIPO) is one of the commonest causes of weaning failure in critical care. As ultrasound machine is an easy and available tool in critical care units that help to diagnose interstitial lung syndrome by detecting B lines, it can be a handy method for diagnosis of WIPO. Aim We aimed to detect the threshold of increase in B lines (ΔB lines) that can accurately diagnose WIPO. Methods This is a prospective observational study carried on 52 mechanically ventilated patients who were eligible for weaning. Lung ultrasound was done before and after spontaneous breathing trial (SBT) to detect the increase in B lines (ΔB lines). Results Among the first 52 SBT, 25 trials were failed. Twelve patients developed WIPO (23% of all SBT and 48% of failing SBT). The best diagnostic accuracy for WIPO was a ΔB lines ≥ 6. In these cases, a ΔB line ≥ 6 has a sensitivity of 83.3%, a specificity of 82.5%, a positive predictive value of 58.8%, and a negative predictive value of 94.3% (area under the curve = 0.824, p < 0.001). Low body mass index (BMI) and increased number of ΔB lines were independent predictors of WIPO. Conclusion A ΔB lines ≥ 6 has the best diagnostic accuracy for diagnosis of WIPO during SBT. Trial registration NCT04463303.