Introduction: Thrombocytopenia (TP) is associated with poor outcome in patients who are critically ill with pneumonia, burns, and H1N1 influenza. To our knowledge, no similar study in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has been conducted to date. The aim of this study was to determine the impact of platelet count on the outcome of patients with AECOPD. Material and methods: Patients admitted to our teaching hospital for AECOPD were divided into two cohorts, those with and without TP. The outcome of all patients was followed. Results: Of the 200 patients with AECOPD, 55 (27.5%) had TP. Of these, 14 (25.5%) died in the hospital, whereas of the 145 non-TP patents, 11 (7.5%) died (p-value = 0.001). There was a significantly higher transfer rate to the ICU and mechanical ventilation in TP patients. The mean platelet count was significantly lower in patients who died than those who were discharged (161,672 vs. 203,005 cell/µL; p-value = 0.017). There was negative correlation between duration of hospitalization and platelet count. Conclusion: TP was associated with poor outcome in AECOPD. TP could be considered as a marker for the assessment of inflammation and prognosis in AECOPD patients based on its cost-effective features.

The main assay tool of COVID-19, as a pandemic, still has significant faults. To ameliorate the current situation, all facilities and tools in this realm should be implemented to encounter this epidemic. The current study has endeavored to propose a self-assessment decision support system (DSS) for distinguishing the severity of the COVID-19 between confirmed cases to optimize the patient care process. For this purpose, a DSS has been developed by the combination of the data-driven Bayesian network (BN) and the Fuzzy Cognitive Map (FCM). First, all of the data are utilized to extract the evidence-based paired (EBP) relationships between symptoms and symptoms’ impact probability. Then, the results are evaluated in both independent and combined scenarios. After categorizing data in the triple severity levels by self-organizing map, the EBP relationships between symptoms are extracted by BN, and their significance is achieved and ranked by FCM. The results show that the most common symptoms necessarily do not have the key role in distinguishing the severity of the COVID-19, and extracting the EBP relationships could have better insight into the severity of the disease.

No abstract

Introduction: Asthma is one of the most common chronic diseases in adults characterized by variable airway obstruction. Asthma is diagnosed with wheezing and shortness of breath, however it sometimes manifests as a chronic cough that is difficult to diagnose and requires spirometry stimulation tests. Objectives: This study aimed to investigate the relationship between methacholine test results and respiratory symptoms in patients with chronic unexplained cough. Patients and Methods: In this cross-sectional study, 102 patients with chronic cough and normal basal spirometry were included. All patients underwent a methacholine challenge test, and their airway irritabilities were assessed. Then, the relationship between methacholine test results and clinical symptoms and also demographic characteristics were investigated. Results: Of 102 patients, 69 (67.6 %) and 33 (32.4%) were female and male, respectively. Most of patients were non-smoker (90.2%). Around 25 (24.5%) patients had a positive methacholine test. Rhinitis had a statistically significant difference between patients with positive and negative tests (positive test group: 48%, negative test group: 23.4%; P = 0.01). Postnasal discharge was reported in 60% of positive methacholine test patients, which was significant compared to the negative group (36.4%; P = 0.03). Most patients who had positive tests were housewives (76%). Logistic regression showed that female gender (OR: 7.75, 95% CI: 1.7-35.2), postnasal discharge (OR: 3.19, 95% CI: 1.25-8.2), rhinitis (OR: 3.02, 95% CI: 1.17-7.79), and allergy symptoms OR: 3.51, 95% CI: 1.35-9.18) were directly associated with a positive methacholine test. Conclusion: The presence of airway hypersensitivity, postnasal discharge, allergic rhinitis, female gender and the housewife’s job were strongly associated with a positive methacholine test.

Background: The prevalence of both obesity and asthma has risen in recent years. We sought to investigate whether obesity may be related to asthma. Materials and methods: In this analytical study, 177 patients with asthma were enrolled. Obesity was defined as a body mass index (BMI) greater than 30. Asthma severity was defined by using the National Heart Lung and Blood Institute 1997 guidelines. Results: Of the 177 patients, there were 80 males and 97 females. 38.4 percent of the sample was obese. There is no significant relationship between BMI and asthma severity (P=0.76) but as established by Pearsons correlation coefficient a positive and significant correlation is present between BMI and FEV1/FVC values (r=0.32 P=0.0001). Females with asthma were significantly more overweight than males (p = 0.001). Conclusions: In our study, there was a significant correlation between body mass index and sex of patients with asthma. Women had the highest percentages of asthma compared to men, and had a higher body mass index than men.