Current literature suggests the potential benefits of nebulized corticosteroids (NCs), particularly budesonide and fluticasone, in the treatment of various respiratory conditions beyond their conventional application. This review aimed to comprehensively summarize the available evidence regarding the use of NCs for medical conditions beyond their conventional role in asthma and chronic obstructive pulmonary disease (COPD) management. This scoping review included all studies evaluating the use of NCs in children and adults for indications other than asthma and COPD. The search was limited to human studies published in English. Data were collected from the PubMed and Cochrane databases through December 2025. A narrative approach was employed to synthesize the extracted data, which are summarized and presented in tables and graphs. As this was a scoping review, formal risk of bias assessment and certainty of evidence evaluation were not performed. A predefined methodological approach was followed; however, no formal protocol registration was undertaken. A total of 302 articles were identified from various databases, of which 36 met the inclusion criteria. The included studies enrolled a total of 3,415 patients (range: 20-525) and primarily comprised randomized controlled trials, including double-blind placebo-controlled studies, prospective randomized studies, multicenter trials, pilot studies, and comparative interventional studies. Several indications beyond the conventional use of NCs in asthma/COPD were identified, including bronchiolitis, transient tachypnea of the newborn, respiratory complications after endotracheal intubation, croup, meconium aspiration syndrome, chronic rhinosinusitis, and viral wheezing. Overall, the available literature suggests that NCs may have therapeutic applications beyond asthma and COPD; however, the available evidence was heterogeneous with respect to indications, patient populations, study designs, and outcome measures. Further research is needed to clarify the effectiveness and safety of NCs, enabling evidence-based decision-making and improving patient-related outcomes.

Food allergies are a critical health issue that increases susceptibility to a range of allergic disorders. However, there is limited understanding of the burden of food allergies in Bangladeshi schoolchildren. This study aimed to determine the prevalence of food allergies and their risk factors among schoolchildren in Bangladesh and to examine the relationship between food allergies and the coexistence and severity of asthma. A cross-sectional study was conducted among schoolchildren aged 12-18 years, with 828 participants (54.5% girls and 45.5% boys) enrolled in schools across all divisions of Bangladesh. Food allergies and current asthma status were determined based on patients' clinical histories. Associations were examined using Poisson regression with robust variance estimation, yielding adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs). Among schoolchildren, the 12-month prevalence of study-defined food allergies was 29.3% and the prevalence of current asthma was 15.9%. The most commonly reported locally significant offending food allergens were vegetables (76.1%), beef (61.3%), and shellfish (58.0%). Food allergies were more common among girls, older adolescents, lower-income families, and children residing in Barisal, Sylhet, or Rajshahi. Asthma and food allergies frequently coexist (8.1%), with asthma cases being twice as likely to report food allergies. Food allergies were also associated with higher asthma severity, particularly wheezing and sleep-disturbing symptoms. GIS mapping revealed marked regional variation, with the greatest coexistence observed in the Barisal and Sylhet divisions. This study demonstrated the significant burden of food allergies and their frequent coexistence with asthma among Bangladeshi school children. Targeted awareness campaigns, early diagnosis, and region-specific interventions are critical for reducing the dual burden of food allergies and asthma, particularly in high-prevalence areas, such as Barisal and Sylhet.

A 68-year-old woman was hospitalized for hypoxemia during an asthma exacerbation with cough, highly tenacious sputum and exertional dyspnoea. Chest computed tomography revealed lower lobe-dominant mucus plugs. Irpex lacteus was identified from both sputum culture and environmental sampling from the patient's bedroom, although diagnostic criteria for allergic bronchopulmonary mycosis were not fulfilled. Wheezing improved after standard therapy; however highly tenacious sputum persisted. Following administration of inhaled N-acetylcysteine (NAC), sputum tenacity improved, followed by improvements in respiratory symptoms, pulmonary function test values and flow-volume curves and the resolution of mucus plugs. This case suggests that highly tenacious sputum may represent a treatable trait in mucus plug-forming asthma and that inhaled NAC may serve as a useful adjunctive therapy in selected patients. Further accumulation of cases is needed to clarify the clinical significance of Irpex lacteus colonisation.

Pneumonia and pulmonary embolism (PE) share similar clinical presentations, posing a significant diagnostic challenge. We investigated whether available diagnostic modalities could identify distinct characteristics in patients suspected of pneumonia later diagnosed with PE. Patients who underwent a CT pulmonary angiography (CTPA) scan on admission were retrospectively screened for suspected pneumonia, defined as a chest X-ray infiltrate accompanied by clinical or laboratory evidence of infection. Patients with COVID-19, pregnancy, and thrombophilia were excluded. Comorbidities, clinical presentation, electrocardiograms, laboratory tests, and outcomes were compared between patients with and without PE. Among 5,522 CTPA scans, 846 patients had suspected pneumonia. 106 (12.5%) had PE. Patients with PE had a higher rate of prior venous thromboembolism (14.2% vs. 7.7%, P = 0.03). However, other risk factors and baseline anticoagulation therapy were comparable between groups. Most clinical and laboratory parameters, including CRP and D-dimer levels, were similar, as were the Wells criteria and Geneva scores. New-onset atrial fibrillation was more frequent in PE patients (11.1% vs. 5.4%, P = 0.009). Prolonged expiration and wheezing were more common in those without PE (17.9% vs. 5.7%, P = 0.0015) and remained the only discriminative parameter in a multivariate analysis (OR = 0.29, 95%CI: 0.09-0.74, P = 0.021). Notably, the presence of PE did not impact mortality rates. PE is prevalent in patients with suspected pneumonia undergoing CTPA. Clinical presentation, laboratory findings, and commonly used diagnostic tools, including the Wells criteria and the Geneva score, perform poorly in this setting. These findings underscore the need for new diagnostic approaches.