Decreased TRPM7 alleviates high glucose-induced renal tubular epithelial cell injury by inhibiting the HMGB1/TLR4 signaling pathway

Objective:To explore the regulatory mechanism of transient receptor potential melastatin-7(TRPM7)in high glucose-induced renal tubular epithelial cell injury.Methods:The expression of TRPM7 in the serum of diabetic nephropathy patients and high glucose-induced HK-2 cells was detected by RT-qPCR.Then,the TRPM7 interference vector was constructed,and the downstream high mobility group box 1(HMGB1)/Toll-like receptor 4(TLR4)signaling pathway proteins were detected.Next,in addition to interference with TRPM7 expression,overexpression of HMGB1 in high glucose-induced HK-2 cells was performed.Cell activity,apoptosis,oxidative stress levels,and inflammation levels were determined by CCK8,TUNEL,Western blotting,immunofluorescence and related kits.Results:TRPM7 expression was upregulated in the serum of diabetic nephropathy patients and high glucose-induced HK-2 cells.Interference with TRPM7 reduced cell damage,epithelial-mesenchymal transition,oxidative stress,and inflammatory response in high glucose-induced HK-2 cells via inhibiting the HMGB1/TLR4 signaling pathway.However,the effects induced by TRPM7 silencing were abrogated by HMGB1 overexpression.Conclusions:Decreased TRPM7 alleviates high glucose-induced renal tubular epithelial cell injury by inhibiting the HMGB1/TLR4 signaling pathway.Further animal experiments and clinical trials are warranted to verify its effect.

用4.7特斯拉磁共振成像活体内观测豚鼠实验性内淋巴积水

目的探讨用4.7特斯拉试验用磁共振成像系统能否在豚鼠中检测内淋巴积水。方法20只白色或者杂色豚鼠用于该研究。5只正常豚鼠作为对照组,15只豚鼠用于制作内淋巴积水模型。9只内淋巴囊破坏组中的5只和6只内淋巴囊完整组(与乙状窦游离)动物采用gadolinium(Gd)-DTPA-BMA增强MRI检测内淋巴积水。结果由于Gd-DTPA-BMA主要进入鼓阶和前庭阶,耳蜗的三个阶可在所有动物中由MRI清晰显示。在内淋巴囊完整组,内淋巴囊手术后6天MRI即可检测到内淋巴积水,并且由组织学证实。在内淋巴囊破坏组中的1只动物,因内耳屏障的严重破坏而使Gd-DTPA-BMA快速漏入中阶,MRI可检测到该变化,其听力损失为60dB。结论用Gd-DTPA-BMA增强的高分辨MRI可检测出内淋巴积水,有可能对积水程度进行定量测试。在Gd-DTPA-BMA的帮助下,内耳屏障损伤或可能的膜破裂可以被检出。

Biofeedback-guided pelvic floor exercise therapy for obstructive defecation: An effective alternative

AIM: To compare biofeedback-guided pelvic floor exercise therapy (BFT) with the use of oral polyethylene glycol (PEG) for the treatment of obstructive defecation.

认知行为治疗和症状特异性药物治疗伴焦虑和抑郁的喉切除术后咽喉癌患者的回顾性比较(英文)

背景:喉切除术是一种常见的治疗喉癌损伤性手术作,可导致巨大的压力,但如何能减轻手术带来的心理影响知道甚少。目标:比较认知行为治疗(CBT)与药物治疗对喉切除术后咽喉癌患者焦虑和抑郁症状的治疗效果。方法:回顾湖州市第三人民医院2009年3月至2013年5月心理门诊中喉切除术后患有抑郁症或焦虑症患者的病历,确定63例患者曾接受过8周一对一的CBT治疗(其中无法说话的患者以书面形式作出回应),以及56例患者曾接受过8周的盐酸丁螺环酮治疗(n=11)、舍曲林治疗(n=9)或两种药物联合治疗(n=36)。治疗的选择(CBT或药物)是根据病人的陈述偏好而定的。采用焦虑自评量表(SAS)和抑郁自评量表(SDS)分别评估治疗前后的焦虑和抑郁症状。结果:治疗8周后,两组的SAS平均分和SDS平均分都明显下降,(根据焦虑自评量表和抑郁自评量表评分标准)伴有有焦虑或者抑郁症状患者的百分比也显著下降了。但是,两种治疗方法之间没有显著差异。药物治疗组32%的参患者在治疗过程出现一个或多个不良反应,但这些都没有严重到需要停药治疗。讨论:CBT是一种有效的、短期的治疗手段,可用于减少一个人被诊断患有癌症或接受癌症治疗后往往产生的焦虑和抑郁症状。众多证据表明,这些心理症状的治疗可以提高癌症患者的生活质量和减短疾病的病程,所以肿瘤学家和其他临床医生需要定期筛查癌症患者和其他危及生命的慢性病患者的抑郁和焦虑症状,如果存在的话,就需要积极对这些症状进行治疗。这项研究表明,CBT对于即使无法说话的癌症患者来说也是有效的。

Photoselective green-light laser vaporisation vs. TURP for BPH. meta-analysis

This study sought to evaluate the efficacy and safety of photoselective vaporisation （PVP） vs. transurethral resection of the prostate （TURP） for patients with benign prostatic hyperplasia （BPH）. Eligible studies were identified from electronic databases （Cochrane Library, PubMed and EMBASE）. The database search, quality assessment and data extraction were performed independently by two reviewers. Efficacy （primary outcomes： maximum urinary flow rate （Qmax）, international prostate symptom score （IPSS）, postvoid residual urine （PVR） and quality of life （QoL）; secondary outcomes： operative time, hospital time and catheter removal time） and safety （complications, such as transfusion and capsular perforation） were explored by using Review Manager 5.0. Six randomized controlled trials （RCTs） and five case-controlled studies of 1398 patients met the inclusion criteria. A meta-analysis of the extractable data showed that there were no differences in I PSS, Qmax, QoL or PVR between PVP and TU RP （mean difference （MD）： prostate sizes 〈 70 ml, Qmax at 24 months, MD=0.01, P=0.97; IPSS at 12 months, MD=0.18, P=0.64; QoL at 12 months, MD=-0.00, P=0.96; PVR at 12 months, MD=0.52, P=0.43; prostate sizes 〉70 ml, Qmax at 6 months, MD=-3.46, P=0.33; IPSS at 6 months, MD=3.11, P=0o36; PVR at 6 months, MD=25.50,P=-0.39）. PVP was associated with a shorter hospital time and catheter removal time than TURP, whereas PVP resulted in a longer operative time than TURP. For prostate sizes 〈70 ml, there were fewer transfusions, capsular perforations, incidences of TUR syndrome and clot retentions following PVP compared with TURP. These results indicate that PVP is as effective and safe as TURP for BPH at the mid-term patient follow-up, in particular for prostate sizes 〈70 ml. Due to the different energy settings available for green-light laser sources and the higher efficiency and performance of higher-quality lasers, large-sample, long-term RCTs are required to verify whether different energy settings affect outcomes.

Adenoviral-mediated Hath1-EGFP gene transfer into guinea pig cochlea through intact round window membrane

Objective To study expression of adenoviral-mediated Hath1-EGFP gene in the guinea pig cochlea after transfer through intact round window membrane(RWM), and to assess its effects on hearing. Methods Twenty adult guinea pigs were used, of which: 12 were surgically inoculated with Ad-Hath1-EGFP in the bony groove of round window niche, and 8 with artificial perilymph. Auditory brainstem response(ABR) thresholds were determined in all animals before and 5 days after surgery. On post-surgery day 5 and day 14, animals were sacrificed and whole mounts of cochlea and frozen sections were examined. Results ABR tests showed no significant change of hearing after the surgery. Strong fluorescence staining in the cochleae was seen in Ad-Hath1-EGFP groups. The highest levels of gene expression were seen in the post-surgery day 5 group with little decrease on post-surgery day 14.The contralateral cochlea and those in the control groups were free of fluorescence staining. Conclusion The transgenic Hath1-EGFP can be effectively delivered into the inner ear through intact RWM, in an atraumatic manner.

Postoperation of preauricular fistula cellulitis caused by methicillin-resistant staphylococcus aureus infection

A one-year-old baby girl with one-month history of recurrent pus fluid exuding from her left preauricular sinus orifice, who failed multiple courses of surgical drainage of the abscess and persistent debridement for the wound, presented with MRSA infection. The patient was treated with linezolid for three days. Her pain and paresthesia resolved, and C-reactive protein decreased to normal.

Hearing evaluation after successful myringoplasty

Objectives: To assess postoperative hearing level, and factors that may have influence hearing improvement after myringoplasty.Methods: Twenty six cases of successful myringoplasty were included in this prospective study. Patient parameters including age, gender, size and site of the perforation, mastoid status, and etiology were evaluated. Hearing levels were assessed as the mean air conduction(AC), and airbone gap(ABG) at 500, 1000, and 2000 Hz, and their relation with aforementioned parameters were analyzed.Results: The mean AC hearing gain was 22.373 dB and mean ABG reduction was 20.733 dB. The maximum AC hearing gain was 25.93 dB for subtotal perforation and 26.24 dB for big central perforation, and the maximum ABG reduction was 25.63 dB for subtotal perforation and 24.20 for big central perforation. Mean AC hearing gain was 23.01 dB, 22.72 dB, and 21.39 dB for 500, 1000, and 2000 Hz, respectively, and mean ABG reduction was 21.52 dB, 20.79 dB, and 19.86 dB for 500, 1000, and 2000 Hz, respectively. Patient age, gender, mastoid status and etiology did not seem to have any bearing on postoperative hearing improvement.Conclusion: While patient parameters do not seem to correlate with hearing improvement following myringoplasty, the size and location of perforation appear to have an impact on postoperative hearing outcomes. Most hearing improvement appears to occur at 500 Hz.

Saturated hydrogen saline protects against noise-induced hearing loss

Objective To study effects of saturated hydrogen saline in preventing noise-induced hearing loss. Methods Fifteen guinea pigs were randomly divided into 3 groups （5 each）, group one was for control, group two was treated with normal saline and group three was treated with saturated hydrogen saline, which was given intraperitoneally at 1 hour before noise exposure at 1 ml/100 g. One hundred rounds of impulse noise （ 157 dB SPL peak） were delivered as noise exposure. Immediately after exposure to impulse noise and on Days 1, 2, 4 and 8 following exposure, auditory brainstem response （ABR） thresholds were measured. Outer hair cell morphological changes and sueeinate dehydrogenase （SDH） activity were examined on Day 8 post-exposure. Results Immediately after noise exposure, ABR thresholds in saturated hydrogen saline treated animals were lower than the non-treated animals （P 〈 0.05 ）. Microscopy showed little SDH staining, cell swelling and irregular cell arrangement in the non-treated or normal saline treated animals. Whereas in the saturated hydrogen saline treated animals, there was deep SDH staining with significantly reduced cell loss and more regular cellular arrangement compared to the other two groups. The surviving cells counts was 45.17 ±12.15 for non-treated animals, 44.50 ±10.02 for normal saline treated animals and,116.50±2.38 for animals treated with saturated hydrogen saline. While the count was similar between non-treated and normal saline treated animals, it was significantly higher in saturated sions Intraperitoneal injection of saturated hydrogen saline damage. hydrogen saline treated animals （P 〈 0.05）. Concluappears to protect the cochlea against noise-induced damage.

Retraction pocket excision with cartilage grafting as a preventive surgery for cholesteatoma

Aims: The goal of the present study is to summarize our experience on surgical management of retraction pockets(RP) as a preventive tool against cholesteatomas.Methods:Twenty-five ears have been followed up for a mean period of 6.16 ± 4.35 years(from 1 to 17 years). The sample presented a mean age of 47.56 + 19.11 years(from 16 to 73 years). All patients underwent cartilage graft surgery. Furthermore 10(40%) underwent tympanoplasty(TPL) type Ⅰ, 14(56%) TPL type Ⅱ and 1(4%) TPL type Ⅴ.Results: Eleven ears(44%) showed cholesteatoma: all these cases were stage Ⅲ according to Charachon staging, and stage Ⅳ or Ⅴ according to Gersdorff classification. Twelve patients(48%) showed erosion of the ossicular chain. Of these, five were associated with cholesteatoma and seven only with retraction. The recurrence rate of cholesteatoma was 12%. None of the patients with a stage Ⅱ or Ⅲ RP(according to Gersdorff classification) developed cholesteatoma. The recurrence of RP was 0%.In regards to literature review, seven references were selected. These studies showed a success rate ranging from 79.1% to 88%, while recurrences of RP varied from 6.4% to 13%. Only one study specified a recurrence rate of cholesteatoma of 28%.Conclusions: Surgical treatment of stages Ⅱ and Ⅲ RP is an effective tool to prevent cholesteatoma formation. The presence of keratin accumulation and cholesteatoma at the RP(stages Ⅳ and Ⅴ, according to Gersdorff) are the real predictors of poor prognosis.

Synchronous Chemoradiotherapy in Patients with Stage III and IV Head and Neck Cancer: Comparing Cisplatin with Capecitabine

Purpose: To evaluate the efficacy of concurrent intravenous cisplatin versus oral capecitabine with radical radiotherapy in locally advanced squamous cell carcinoma of the head and neck. Materials and methods: Between January 2007 and December 2009, 60 patients with stage III/IV head and neck squamous cell carcinoma (0 to 1 performance status) were enrolled into this study. Thirty cases are given cisplatin 30 mg/m2 IV infusion weekly for 6 weeks with conventional radiotherapy. The remaining thirty cases are given oral capecitabine 500 mg/m2 twice daily, continuously for 28 - 35 days with conventional radiotherapy also. The radiotherapy dose was 4600 cGy in 20 fractions over 4 weeks to primary and neck nodes followed by boost to primary site and any residual disease 1500 - 2000 cGy in 6 to 8 fractions. Results: The median age was 53 (range 25 - 71) years;10 cases had stage III disease, 36 cases IVa disease and 14 cases IVb disease. Seventy-three percent of patients completed the course of capecitabine and 80% completed prescribed cisplatin. There were no treatment-related deaths, grade 4 haematological toxicity or grade 3 renal toxicity in either arm. The complete response rate at 3 months was 77% (23/30 patients) in the capecitabine group and 60% (18/30) in the cisplatin group. Relapse occurred in 10/30 (33%) patients by 2 years in the capecitabine group and in 12/30 (40%) in the cisplatin group. On analysis of survival data, the median follow-up period was 35 ± 15 months for overall survival and 33 ± 10 months for disease free survival. The overall survival, and disease-free survival rates at 2 years were 67%, and 85%, respectively for the capecitabine group versus 60% and 73% for the cisplatin group. Conclusion: Synchronous chemo-radiotherapy with capecitabine was found to be very effective, with excellent response, local control and 3-year cancer-specific survival rates.

A Unified Management for Spontaneous CSF Leak

Background: Spontaneous CSF leak represents less frequent cause of CSF leak, but cases are more difficult to control, with the highest failure rate and recurrence despite adequate repair. The problems in these cases might be related to an underlying undiagnosed associated intracranial hyper-tension. Recognition and long-term treatment of elevated ICP is therefore critical to the successful management of these patients. Objective: To evaluate the CSF pressure in cases of spontaneous CSF rhinorrhea and to describe our same setting combined protocol to the repair of the leak, measurement and management of CSF pressure. Patients and Methods: All patients presenting to Ain Shams University Hospitals, Cairo, Egypt, with spontaneous CSF leak were included prospectively in the study. Clinical and radiologic data were collected to suspect elevated intracranial pressure. After CSF repair, CSF pressure was measured and if found to be more than 20 cmH2O, a lumboperitoneal shunt was used. Results: Twenty-seven cases, 23 women and 4 men, presented with spontaneous CSF leak. 23 patients had BMI above 30. All patients had empty sella syndrome (100%), and a meningoencephalocele was found in 13 cases (48%). CSF pressure ranged from 5 to 39 cmH2O (mean = 28.7). A pressure above 21 cmH2O was found in19 patients (70%) and subsequently had lumboperitoneal shunt in the same setting. No recurrence occurred in this subset of patients with 6 - 60 months follow-up period. Conclusion: A selective and specific same setting protocol can result in a better diagnosis and control of the accompanying elevated ICP in cases of spontaneous CSF leak. It avoids a second operative intervention, and shortens the hospital stay, with an increase in the success rate. In the same time, the smaller number of patients with normal ICP can avoid further drainage.

Two‑Dimensional Platinum Diselenide:Synthesis,Emerging Applications,and Future Challenges

In recent years,emerging two-dimensional(2D)platinum diselenide(PtSe2)has quickly attracted the attention of the research community due to its novel physical and chemical properties.For the past few years,increasing research achievements on 2D PtSe2 have been reported toward the fundamental science and various potential applications of PtSe2.In this review,the properties and structure characteristics of 2D PtSe2 are discussed at first.Then,the recent advances in synthesis of PtSe2 as well as their applications are reviewed.At last,potential perspectives in exploring the application of 2D PtSe2 are reviewed.

Research on clinical observation of RFTVR adjuvant treatment of CRS

Objective:To discuss the curative effect of radio frequency tuiss volumetric reduction (RFTVR) adjuvant treatment of Chronic rhinosinusitis (CRS).Methods:A total of 112 cases of CRS patients who were treated in our hospital between June 2013 and March 2016, were selected and retrospective analysis was performed for their surgical methods, and these patients were divided into control group (n=58) with simple nasal endoscopic surgery treatment and study group (n=54) with nasal endoscopic surgery combined with RFTVR treatment. Curative effects after operation in both groups were evaluated and nasal resistance and serum inflammatory mediator content were compared in both groups before and after operation.Results: Before operation, nasal airway state and serum inflammatory mediator content difference in both groups had no statistical significance;one week after operation, the clinical treatment effective rate in study group was significantly higher than that in the control group;the left nasal resistance, the right nasal resistance and the total resistance levels in study group were lower than that in the control group;serum inflammatory mediator (IL-5, IL-17, IL-22, TNF-α) content in study group was lower than that in the control group.Conclusions:RFTVR adjuvant treatment contributes to the improvement of the curative effect of CRS patients, which could effectively optimize the nasal airway state and reduce the systemic inflammatory responses.

Aesthetic and Functional Outcomes of Open versus Closed Septorhinoplasty in Deviated Nose Deformity

Background: Over the years, an optimal surgical method for septorhinoplasty in deviated nose as a challenging problem was the one of common interest of plastic surgeon;the purpose of this study is to compare outcomes of open and closed methods of septorhinoplasty in patients with deviated noses. Methods: Through a prospective study, we selected seventy patients with deviated nose. Based on their deviation severity, they underwent open or closed septorhinoplasty. Patients were evaluated for deviation angles of nasal bony and cartilage components, nasal projection, nasolabial angle, nasofacial angle, and nasofrontal angle;for which three standard photos were captured pre and postoperatively. Finally the outcomes were analyzed according to their surgical methods. Results: Closed septorhinoplasty could grant a mean 11 degrees correction to nasal bony component and a mean 8.6 degrees correction to cartilage component. That’s while open septorhinoplasty could bring a mean 19.5 degrees deviation correction to the bony component and a mean 12.5 degrees deviation correction to the cartilage component. Cosmetic angles were not improved significantly after the surgery, maybe because of complicated deformities our series of patients had. Conclusion: Open septorhinoplasty resulted in better cosmetic and functional outcomes than the closed method.

Effects of dermatophagoides farinae drops combined with pidotimod on inflammatory response and immune response in children with allergic rhinitis combined with asthma

Objective: To investigate the effects of dermatophagoides farinae drops combined with pidotimod on inflammatory response and immune response in children with allergic rhinitis combined with asthma. Methods: A total of 118 children with allergic rhinitis combined with asthma who were treated in our hospital between December 2014 and May 2017 were selected as the research subjects and divided into the control group (n=59) and the dermatophagoides farinae drops group (n=59) by random number table method. Control group received both conventional therapy and pidotimod therapy, and dermatophagoides farinae drops group received both conventional therapy and dermatophagoides farinae drops combined with pidotimod therapy. The differences in inflammatory factor, cellular immunity index and humoral immunity index levels were compared between the two groups before treatment (T0), after 3 months of treatment (T1), after 6 months of treatment (T2) and after 12 months of treatment (T3). Results: At T0, inflammatory factor, cellular immunity index and humoral immunity index levels were not significantly different between the two groups. At T1, T2 and T3, serum inflammatory factor IL-2 contents of dermatophagoides farinae drops group were higher than those of control group at the corresponding time points whereas IL-4, IL-5, IL-9 and IL-18 contents were lower than those of control group at the corresponding time points;peripheral blood cellular immunity indexes CD3+, CD4+, CD8+ and CD4+/CD8+levels were higher than those of control group at the corresponding time points;serum humoral immunity indexes IgA, IgM and IgG contents were higher than those of control group at the corresponding time points whereas IgE contents were lower than those of control group at the corresponding time points. Conclusion: Dermatophagoides farinae drops combined with pidotimod therapy can effectively reduce the inflammatory response degree and optimize the cellular and humoral immune function of the children with allergic rhinitis combined with asthma.

Prevalence of Ear Disorders at Rabak City, White Nile Province, Sudan, 2017

Background: Residence to industrial areas was associated with increased risk of health problems. Lacks of epidemiological data of ear disorders were noticed among Sudanese. Objectives: This study was set out to determine the prevalence of preventable ear disorders in Rabak city, White Nile province in Sudan. Methods: A well-structured open-ended (pro forma) questionnaire was used to screen 300 participants who suffered of ear, nose and throat (ENT) complaints in the industrial area of Rabak city. Ear examinations for participants complaining of ear disorders were conducted using illuminated and pneumatic otoscope, tuning fork and pure tone audiometry. Diagnosis, risk factors and therapeutic outcomes were evaluated. Data were analyzed statistically and manipulated in a suitable manner. Results: Of total (n = 300), only (n = 186) fit the study criteria. About 85 (28.6%) of participants aged 20 - 40 years old, whilst most 99 (33%) lived at urban-industrial part of the city. The participants who were not working 131 (43.6%) and those with basic level of education were 134 (44.6%). Otitis externa was prevalent in 50 (26.9%) of our participants. Around 44 (23.6%) were suffering of chronic otitis media and 40 (21.4%) were suffering of otitis media with effusion. Acute otitis media was detected in 27 (14.3%). Ear wax was detected in 13 (7.1%), and foreign bodies were found in 12 (6.6%) of the study population. Smoking was commonest amongst participants with otitis externa. Our results revealed that the preferred treatment modality was medical treatment and follow-up the participants which resulted in good outcome. Conclusion: Preventable ear diseases represent a significant health problem among participants of Rabak city. Amongst the ear problems, the incidence of otitis media and otitis externa due to industrial pollution was reported to be high. Creating comprehensive health education about the common ear disorders in this community can help reduce the prevalence of these conditions and is highly recommended.

Magnet Attract Shell during Head and Neck Surgery

Objective: New method to use magnet for localization and extraction of shell during head and neck surgery. Method: Series of 3 cases study all are boy’s 17_15_5 years old respectively. All are with penetrating shell injuries to head and neck in Salahaden General Hospital-Tikrit city-Iraq from 25-Oct.-2016 to 30 March 2017. This hospital is a central general governmental hospital that receives referral cases from region distal to the center of Salahaden province at north of Baghdad city (capital of Iraq) and plays a major rule in management of injured patient during war. The cases are selected after explanation of this new method to the patients, it is expected result, risk, possible complication, and unexpected sequelae that may happen after surgery. Prior consent from patients and their families about this sort of surgery has been got. These patients are from families of low socio economic group except the last one he is medium class. All are undergoing surgical management with the aid of magnet. Result: we have 3 cases of shell injuries to head and neck magnet is used successfully for identification of shells and helps in their extraction. Our trial is limited for metallic objects and limited depth. Conclusion: These results suggest that magnet aid removal of shell during head and neck surgery, is less invasive technique, minimal trauma to the surrounding tissues and reducing time of surgery.

New low-cost magnifying device for temporal bone laboratory

Temporal bone dissection has important role in educating and training oto and skull base surgeons.Mounting of a temporal bone laboratory is expensive.A dedicated magnifying system,such as a surgical microscope or an endoscopic equipment,represents one of the most significant costs.The aim of this study is to test and demonstrate the utility of a commercial USB as a low-cost solution to equip the laboratory with a good magnifying system and illumination.

Laryngotracheal Stenosis Following Intubation for COVID-19 Pneumonia: A Report of Two Cases

Benign laryngotracheal stenosis (LTS) is a debilitating and potentially life-threatening condition that is commonly caused by iatrogenic events as a result of endotracheal intubation or tracheostomy. Numerous cases are being published for patients with coronavirus disease 2019 (COVID-19) who end up with severe LTS after prolonged intubation or tracheostomy. Here, we presented two cases of LTS due to prolonged intubation after severe COVID-19 pneumonia. The characteristic of these two cases is that both of them needed second time intubation and were readmitted because of severe dyspnoea and all the workup for post-COVID-19 complications were investigated except the LTS which was later diagnosed after one month of suffering of these patients.