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A 45-year-old male presented with massive hemoptysis, clubbing in all limbs, disproportionate hypoxia and persistent ill-defined shadow in left lower zone in chest radiograph since his childhood. The patient received empirical anti-tuberculosis treatment and the chest X-ray finding was misinterpreted as tuberculoma. Subsequently, CT pulmonary angiography proved it to be a case of a simple type solitary pulmonary arteriovenous malformation with a saccular aneurysm in left lower lobe.

A 60-year-old female presented with pneumonitis of right lower zone. CT scan revealed mass like lesion with multiple air pockets. FNAC and ultrasound confirmed the diagnosis as isolated active pulmonary hydatid cyst, which is not common finding in adult population.

Background: Drug resistant tuberculosis is a major public health threat that hinders progress in tuberculosis control worldwide. In 2019, India contributed highest cases of TB (27%) Worldwide. In 2019, 3.3% of new TB cases and 18% of previously treated cases had MDR/RRTB worldwide and India (27%) had the largest share of the global burden. This study was done to find out the sociodemographic and clinical profile of drug resistant TB patients. Methodology: It is an observational descriptive study with cross-sectional design, conducted at the drug resistant tuberculosis centre of R. G. Kar Medical College of Kolkata, West Bengal. Study Population consisted of the patients who were registered for the DR-TB regimen. Study duration was July 2016-March 2017. Pre-tested, semi-structured schedule was designed to capture their sociodemographic profile, treatment history, clinical findings and available medical records. Data were compiled in MS Excel and analyzed in IBM SPSS 23.0. Results: Out of 159 cases, 27% patients were between 21-30 years. Males were predominant (68.6%). Most patients (56.6%) were underweight (BMI<18.5kg/m2). HIV seropositivity was found in 4 (2.5%) cases. Among all cases, 81.1% had history of taking ATD and 34.4% was cured in previous episode of treatment. The commonest associated comorbidity was DM (15.7%). Rifampicin resistance (93.1%) was most common followed by Isoniazid (8.2%). Pallor was found among 94.3% patients. Most patients had bilateral (62.3%) and moderately extensive (57.2%) lesions in chest x-ray. Conclusion: DR-TB control should focus adequately on younger age group as numbers of resistance is increasing among them. Relapse in previously cured cases was found to be major contributor of DR-TB suspect cases. Though, Rifampicin resistance was so common but prevalence of resistance to 2nd line drugs is still low. Focus should be given on early detection of drug resistance in all TB cases and improvement of nutritional status of the TB patient. [ABSTRACT FROM AUTHOR]

Introduction: There has been a new challenge to the already existing threat of tuberculosis (TB) and that is drug resistance TB (DR-TB). The causal relationships between mental disorders and TB are complicated and relatively unexplored. For this reason a qualitative study was done on DR-TB patients attending R G Kar Medical College. Materials and Methods: The study population consisted of the patients who are registered for the DR-TB regimen are followed up four times with General Health Questionnaire (GHQ). Those scoring poorly were sent for expert evaluation by psychologist, who counselled them, and followed them up after in-depth interviews. These records of in-depth interview were analysed as qualitative research inputs. Results: In our study out of 165 patients, (4.8%) needed interventions. The domains emerging from the study are worried about future and as well as family, disbelief about the diagnosis, embarrassment regarding the diagnosis, fear of death, blaming fate for the disease, stigma, suicidal ideation. Conclusion: This study finds out the important domains of psychogical problems among the patients and also advocates a psychologist to remain at DR-TB centres. [ABSTRACT FROM AUTHOR]

Background: The wide availability of Computed tomography (CT) imaging facility in recent years, even in district or sub-district level, has demanded proper evaluation of the trend of its utilisation and assessment of benefit in diagnosis of different diseases. Material & methods: It is a retrospective analytic study of CT thorax images along with its medical records in a tertiary care hospital in sub-urban locality of a metropolitan city over a period of one year. Minitab software (version 15.1.0.0) used for statistical analysis. Result: 226 CT thorax images reviewed; 71% referred from pulmonary Medicine department and mostly from Pulmonary Medicine out-patient department (60.6%). Overall, the final diagnosis obtained with CT imaging remained unaltered in 62.8% of cases. However, among those with discordant radiological diagnosis, normal CT images were the most common finding (29.8%); infective aetiology was the most common pretest provisional diagnosis among these patients. Conclusion: CT imaging is immensely helpful for critical decision making regarding management. However, it should be utilised more judiciously specially when dealing with suspected pulmonary infections, especially in resource constrained set-up. [ABSTRACT FROM AUTHOR]

A 28-year-old male presented with fever with right-sided chest pain for 2 weeks. Clinicoradiological picture was suggestive of right-sided pleural effusion. He had history of polytrauma following a road traffic accident and had to undergo emergency laparotomy a month ago. Microscopic and culture examination of the pleural fluid showed neutrophilia, high bilirubin content and presence of gram-negative bacilli. Ultrasound of the abdomen showed the presence of biloma in the liver and right subdiaphragmatic space with fistulous communication into the right thoracic cavity. The patient was managed successfully with complete recovery. [ABSTRACT FROM AUTHOR]

Schwannomas arising from vagus nerve sheath are rare mediastinal neurogenic tumours. Schwannomas usually arise from left hemithorax. Unlike a hamartoma, radiologically, calcification is rarely seen in schwannomas. We present the rare case of an ancient schwannoma arising from vagus nerve sheath from the right hemithorax presenting with gross calcification.

To find out the clinicoradiomycopathological profile of allergic bronchopulmonary Aspergillosis (ABPA) and incidences of aspergillus hypersensitivity (AH) among asthma patients, 215 consecutive extrinsic asthma patients were screened with aspergillus intradermal test and those found positive for AH were investigated further for ABPA. Out of 215 asthma patients (124 males and 91 females), 54 were hypersensitive to AH and 15 of them fulfilled criteria for ABPA. On repeated culture of sputum and/or broncho-alveolar lavage fluid, A flavuswas the most common isolate (40%), followed by A fumigatus (26.67%). No species was isolated in 4 cases (26.6%). AH/ABPA is not very uncommon in this part of the country. Diseases similar to ABPA caused by other fungus might be diagnosed if allergen tests for other fungal antigens are made widely available. A strong clinical suspicion and proper laboratory backup is essential for diagnosing ABPA and related diseases.