Backgrounds & Objective: Mycoplasmas pneumoniae is responsible for more than 20% of community acquired pneumonia cases and also implicated in acute respiratory infections, such as sore throat, pharyngitis, rhinitis, and tracheobronchitis. Conventional assays for the detection of M. pneumoniae have their limitations, resulting in the need for more accurate diagnostic methods. Molecular methods, for example Polymerase Chain Reaction (PCR), have the potential to produce rapid, sensitive, and specific results, allowing early appropriate antibiotic therapy. In this study, we aimed to compare PCR and culture results and to develop a rapid and more practical PCR technique for detection of M. pneumoniae.
Materials & Methods: Clinical samples from 100 patients with respiratory complaints were subjected to culture and PCR. A highly sensitive, PCR protocol using P4A and P4B primers targeting the P1 cytadhesin gene was designed and applied to nasopharyngeal swab samples collected from patients. Amplicon (345 bp) cloned by PCR-cloning and then sequenced by dideoxy chain termination.
Results: The results of positive cultures (10 out of 100) well correlated with the results of PCR. Samples from 33 additional patients which showed a negative result in culture, were positive by PCR. The detection limit for this assay was found to be 10 M. pneumoniae organisms in clinical samples. There was no amplification of DNA from 11 other species of human and animal mycoplasmas and 17 other bacterial species.
Conclusion: This study indicates that PCR is a sensitive, specific and reliable method for rapid diagnosis of M pneumoniae in respiratory tract samples.

Background and Objective: Exact recognition of the needs of patients with leukemia and move to solve them will promote the health standards in the country. The aim of this study was to evaluate the needs and to assess the process of diagnosis and treatment of leukemia and their shortcomings according to experts’ views in this field. Materials and Methods: This study was a descriptive study and the population under study consisted of 101 specialists in Hemato-oncology and pathology across the country, who were selected by random cluster sampling. Data was collected by valid peer reviewed questionnaires with Cronbach's alpha coefficient of 0.80. The collected data were evaluated and analyzed using SPSS, and chi-square test. Results: According to specialists, lack of diagnostic facilities in small cities, timely diagnosis, especially in cases of chronic leukemia and inadequate attention to the mental state of patients during the treatment process was considered as the most important problems of health system in the diagnosis and treatment of leukemias. Conclusion: Shifting the health policies towards greater attention to equip the health care centers and reviewing the policies resulting in concentration of services in large cities, providing health care plans acceptable for the patient's mental state by counseling centers during the process of treatment and finally financial support of patients with leukemia (particularly low-income patients) by governmental and non-governmental organizations will certainly pave the way to achieve modern standards.

Hemophagocytic lymphohistiocytosis (HLH) is the result of excessive cytokine release, leading to over-response by immune cells, such as macrophages and T lymphocytes. Here, we report a lethal case of HLH with a complete clinical course. The patient was a 45-year-old man with fever and chills since two months ago plus splenomegaly, hepatomegaly, and pancytopenia. The Anti-HBc IgM was positive, but the HBS antigen, anti-HCV, and HBS antibody were negative. Assessment for cirrhosis was carried out by FibroScan, which showed F4 grade.
 The biopsy sampling was impossible due to the low platelet count. During admission, generalized bleeding was developed and led to alveolar hemorrhage, which subsequently resulted in the patient's death. Liver necropsy certified the diagnosis of hemophagocytic syndrome. Overall, according to the reported case in this paper, it should be remembered that secondary HLH is an inflammatory phenomenon due to different conditions, such as latent newly-developed infections.

The Coronavirus infectious disease 2019 (COVID-19) has recently emerged as a pandemic and has endangered the lives of thousands of people worldwide. No specific treatment has been identified so far. However, the identification of diagnostic and prognostic factors in patients can be valuable for the application of preventive strategies. Increased platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), prothrombin time (PT), and D-dimer indices have been found in patients with increased inflammation and thrombosis and can lead to heart disease. Also, an increase in these indices is accompanied by worsening of the disease and impairment of the respiratory tract, which necessitates ventilation for the patients eventually. The evaluation of NLR, PLR, and coagulation parameters can be useful for identifying high-risk individuals who need to be intubated. Patient survival will improve by the timely identification and the use of appropriate treatment strategies.

Tietze’s syndrome is an inflammatory disorder, which frequently misdiagnosed as the severe life-threating problem. Herein, we reported a case of a 23-year-old male, who complained about the acute chest pain after pneumonia complication. After full examination, he diagnosed as Tietze’s syndrome. Since the precise diagnosis of Tietze’s syndrome has a great importance, our report may raise consciousness to manage this condition.

Background and Objective: Due to the importance of the rapid diagnosis of SARS-COV-2, many studies have been performed on various diagnostic methods. In this vein, the aim of this study is to compare the diagnostic value of chest CT with RT-PCR in patients with suspected COVID-19.
Materials and Methods: This cross-sectional research was conducted at Shahid Sadoughi Hospital in Yazd. A total of 531 patients were randomly referred to the CT scan department for chest imaging (spiral or HRCT).Based on the PCR findings, they were divided into: positive and negative PCR groups. The CT scan findings were then recorded in a data collection form. Finally, the CT scan results of the two groups were compared.
Results: In this study, 531 patients (306 males and 225 females with the mean age of 55.14 ± 19.7) were examined. The findings of reverse hallo (P = 0.000) and strict consolidation (P= 0.001) in CT scan were significantly different for the positive and negative PCR groups. Through the comparative analysis of the results, the sensitivity of CT scan and PCR findings emerged to be 97.42 and 55.75, respectively. However, the specificity of both diagnostic methods was 100%.
Conclusion: The results of this study show that, owing to the higher sensitivity of chest CT for the diagnosis of COVID-19 pneumonia, performing CT scan for quick diagnosis is recommended for COVID suspected people with negative RT-PCR test results.

Background and Objective: Chronic inflammation, dyspnea and activity limitation are common phenomena in patients with chronic obstructive lung disease.  Clinical studies suggest that Ubiquinone has anti-inflammatory and energetic properties. Here the beneficial effect of CoQ10 in patients with COPD will be studied.
Materials and Methods: Baesd on the census method, 90 patients with moderate to severe COPD were divided into two identical placebo and CoQ10 groups. High sensitive-C-reactive protein (hs-CRP), Forced Expiratory Volume in 1 second, numerical rating breathlessness scale and "the time to get exhausted" were evaluated and recorded at baseline and the end of the study. The CoQ10 group received 120 mg of CoQ10 supplement per day versus the placebo group who also received a placebo (identical in look, size and taste to pharmaceutical sample) and were followed for 6 weeks. Data were analyzed using t-test, and nonparametric statistical tests. Qualitative variables were assessed by chi-square or Fisher exact tests. 
Results: The study included 49(53.6%) women and 41(46.4%) men, collectively 90 patients with moderate to severe COPD. The mean age was 66.97±12.59 years in the placebo and 64.21±11.78 years in the CoQ10 group (p=0.30). Breathlessness scale was improved in CoQ10 group (p<0.001). hs-CRP significantly declined after intervention in the CoQ10 compared to  the placebo group (p<0.001).No serious side effects were observed as a result of CoQ10 consumption.
Conclusion: Daily administration of CoQ10 in COPD patients increases hs-CRP and improves dyspnea and "the time to get exhausted” without side effect.