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Background: The coronavirus disease 2019 [COVID-19] pandemic has created an environment in which many determinants of mental health are affected. Our objective was to determine the prevalence of depression, stress, and anxiety symptoms in adult patients discharged and recovering after hospitalization for COVID -19 pneumonia, at Almoosa Hospital. Materials and Methods: In a cross-sectional study, the Depression Anxiety Stress Scale 21 [DASS21] assessment instrument was used to measure distress along the three axes of depression, anxiety, and stress and distributed one month after discharge and recovery. Medical records were reviewed to collect information on medical details.Results: Of the 466 respondents, 53.2% were female, with an average age of 54.20 years. Mental health problems were noted in 130 [27.9%] patients with anxiety symptoms, 79 [17%] with stress symptoms, and 63 [13.5%] with depression symptoms. Patients with mental health problems [depression, anxiety, and stress symptoms] were found to have significantly higher D-dimer levels than patients without these symptoms. The severity of depressive symptoms was found to be significantly associated with decreased oxygen saturation and increased length of stay in the intensive care unit [ICU]. Conclusion: Patients recovering from COVID-19 pneumonia have high rates of mental health problems. Significantly higher D-dimer levels were found in patients with mental health problems. The severity of depressive symptoms was associated with decreased oxygen saturation and increased ICU length of stay. Early recognition and appropriate management of mental health problems are needed.

Background: A diaphragmatic hernia is a defect or hole in the diaphragm through which abdominal contents can enter the chest cavity. Diaphragmatic hernias may be congenital (Morgagni hernia, Bochdalek hernia), a hiatal hernia, or acquired (iatrogenic and traumatic). Bochdalek's hernia typically occurs on the left side and rarely occurs in adults. Less than 100 cases of left Bochdalek's hernia in adults have been described in the literature. Most of them are asymptomatic. Case report: We report a complicated left Bochdalek hernia in a 43-year-old adult male who is a smoker. He came to the pulmonary clinic with symptoms and signs of pneumonia of the left lower lobe with persistent dyspeptic symptoms. Chest radiography revealed evidence of a left diaphragmatic hernia, which was confirmed by computed tomography of the chest and abdomen, and subsequently treated by left diaphragmatic repair via limited left thoracotomy. Conclusion: We report a rare case of a left Bochdalek hernia in an adult who underwent an appropriate left thoracotomy. Bochdalek hernias in adults are rare and usually asymptomatic, but when they become symptomatic, surgical intervention is required to avoid complications. BH should be considered in the differential diagnosis when radiographs suggest pneumothorax and should be treated early to avoid complications.

Background: Shrinking lung syndrome (SLS) is an uncommon complication of systemic lupus erythematosus (SLE) that has also been seen in other autoimmune diseases and is linked with a high risk of acute or chronic respiratory failure. Alveolar hypoventilation in the presence of obesity-hypoventilation syndrome, systemic lupus erythematosus (SLE), and myasthenia gravis (MG) is uncommon and poses a diagnostic and therapeutic challenge. Case report: We reported a 33-year-old female patient from Saudi Arabia who suffered from obesity, bronchial asthma, newly diagnosed essential hypertension, type 2 diabetes mellitus, with recurrent acute alveolar hypoventilation, secondary to obesity hypoventilation syndrome and mixed autoimmune disease (systemic lupus erythematosus and myasthenia gravis), based on the correct constellation of clinical findings and laboratory evidence. Conclusion: The interesting aspect of this case report: is the presentation of the overlap of obesity hypoventilation syndrome and shrinking lung syndrome due to systemic lupus erythematosus with generalized and respiratory muscle dysfunction due to myasthenia gravis with good outcomes after therapy.