Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation and tissue destruction of lung. It is associated with structural changes due to chronic inflammation due to prolonged exposure to particles or gases most commonly cigarette smoke. Purpose: the purpose of this study is to demonstrate how to improve oxigenation in patients with COPD and also demonstrate that they have energies deficiencies in the chakras’ energy centers. The treatment of this deficiency is very important to treat the root of the problem, and not just the symptomMethods; thought one case report of a 66 years-old-women with history of smoking during the last 50 years, 20 cigarettes per day. Since December 2020, she began to feel very fatigue and shortness of breath, mainly when she took out the oxygen that she needs to use since then. Radiesthesia procedure were done to measure her chakras’ energies centers and all her chakras were in the lowest level of energy, rated one out of eight. Treatment using homeopathies according to the theory Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine were used to treat her condition. Results: she improved a lot after take the homeopathic medications in a daily sequence and have more energy to her daily life, that was very compromised before the treatment. Her oxygenation improved a lot and the necessity of oxygen reduced allowing her to stay without oxygen more time. Conclusion; patients with COPD can improbe their oxygenation using homeoipthy medications replenishing the chakras’ energy centers. The importance of measurement of these chakras’ energy centers during their COPD treatment and treatment of this energies deficiencies is very important to the improvement of the patient´s oxigenation and all clinical condition. The use of homeopathy medications were choosen because the patient were in the lowest level of energy and the use of highly concentrated medications could worse even more the vital energy, leading to worsening of the patients condition. 

Methotrexate (MTX) is an anti-folate drug which is used in the treatment of various inflammatory and malignant conditions due to its efficacy and safe therapeutic utilization. However, it has the potential to cause serious, life threatening complications. [1] 
A 50-year-old female presented to the ER with a history of fever for the past five days and bruises, blisters and oral bleeding for the past three days. She also had difficulty in breathing for the past day. On arrival, the carotid pulsation was absent and the cardiac monitor showed pulseless electrical activity (PEA) or cardiac arrest. As per the ACLS protocol, cardio-pulmonary resuscitation (CPR) was initiated and the patient was subsequently revived after 5 cycles of CPR. On examination, ecchymosis, blisters and bullae were noted on the extremities along with high colored urine and hematuria. Further history revealed that the patient was a known case of rheumatoid arthritis and was on MTX therapy for the past four years.
The patient was started on inotropes due to persistent hypotension as a result of delayed return of spontaneous circulation (ROSC). Investigations revealed a low Hb level, pancytopenia and elevated serum MTX levels. Fluid therapy, blood transfusion, anti-fibrinolytics were started in due course. Antidote, folinic acid was administered and the patient was shifted to the ICU for further evaluation and management. Due to the extensive complications, the patient deteriorated and was declared dead after a day.
Acute methotrexate toxicity manifests itself in several forms including hepatotoxicity, pulmonary toxicity, acute renal failure, stomatitis, ulceration/erosion of the GI and pancytopenia. [2]
The authors would like to emphasize that MTX-induced pancytopenia (myelosuppression) is rarely reported but potentially fatal side effect of methotrexate therapy, even at low doses. It is a dose and duration-dependent complication with a female preponderance (62.51%) and should be recognized and treated promptly. [3]
MTX is one of the most widely used drug for dermatology, rheumatology and oncological diseases, however, careful monitoring of therapeutic dose and avoidance of self-administration is crucial to prevent such adverse outcomes. [4]

Trycho phyton usually causes a superficial skin infection affecting outer most layer of epidermis, stratum corneum .In immune compromised patient’s deeper invasion to the dermis with systemic infection and multi organ failure may occur.
Case report:
We report a case of 32 yr. old male who presented to our ER with one week history of circumscribed lesions all over the body complicated with super imposed secondary bacterial infection, left upper limb cellulitis and abscess leading to septic shock and multi organ failure. He had a history of similar lesions over the body on and off for the last 6 years for which he took local treatment. He had a history of steroid abuse mainly through IV and IM route. Direct microscopy with 10% KOH showed Long Branch like tubular structures called hyphae confirmed fungal infection (Dermatophytosis). This patient was treated with empirical antibiotics, oral Itraconazole and other supportive medications. Patient responded well to the treatment.
Conclusion:
Disseminated Dermatophytosis should be considered as a differential diagnosis whenever an immune compromised individual presents with a diffuse skin lesions and superimposed bacterial infection and abscess. Literature reviews and similar case reports will be discussed in detail.