Not All Primary Osteolytic Mandibular Swelling Is Malignant.

Tubercular infection of the oral tissues can be primary or secondary. Primary lesions develop when tuberculosis bacilli are directly inoculated into the oral tissues of a person who has not acquired immunity to the disease. Here we present a case of 66yrs old non-smoker male presenting with a swelling in the left mandibular region (Lumpy jaw) over a period of last 1yr now presenting with weight loss, pain and trismus for 6month. No past history of tuberculosis or dental extraction. On examination there was a 6x5cm firm to hard nonfluctuant mildly tender swelling with trismus and no palpable cervical lymph nodes. Investigations revealed leucocytosis, ESR 45mm and Mantoux 24mm after 48hrs.PNG radiograph showed osteolytic lesion in angle & body of left mandible with CECT showing retro mandibular trigon extension. USG guided FNAC was consistent with tubercular osteomyelitis with Ziehl Neelsen stain positive for acid fast bacilli. He was started on antitubercular therapy for 9 month showing reduction in size and symptom.

Acute Onset Dyspnea Due To Foreign Body (Pill) Aspiration In Left Main Bronchus.

Abstracts: Aspiration of tracheobronchial foreign commonly affects young children and it is uncommon in adults. Bronchoscopy both flexible and rigid is recommended to reveal the aetiology and therapeutic removal of foreign body aspiration. Here we report a case of pill aspiration presenting with acute onset breathlessness in emergency. Investigation of a case revealed left lung atelectasis on chest X-ray. Further workup by bronchoscopy showed an endobronchial mass lesion in left main bronchus causing left lung atelectasis. The obstruction was removed and patient improved promptly.

A Biodiversity Hub: Sandi Bird Sanctuary, Hardoi, Uttar Pradesh, India.

Diversity refers variety in nature i.e. the variety of life on Earth and its biological diversity is commonly referred to as biodiversity. Sandi Bird sanctuary was developed and conserved in the year 1990 as natural biodiversity hub for aquatic vegetation as well as local residents and migratory birds. This Sanctuary has an area of 309 hectares. A study of faunal diversity in Sandi Bird Sanctuary was done during January 2013 to March 2014. Sandi Bird Sanctuary is well known as popular tourist destination because of the diverse assemblage of avifauna especially migratory water birds that congregate at the Sandi Bird Sanctuary in winter. The result includes 3 species of annelids belonging to 3 orders, 10 orders of insects with 61 species, 4 species of mollusks belonging to 3 orders, 11 species of fishes belonging to 5 families, 3 species of amphibians and 15 species of reptiles belonging to 13 families, 157 species of birds, and 12 species of mammals belonging to 09 families from Sandi Bird Sanctuary. The sanctuary is an envoy area of the Indo-gangetic eco-system. Wetland vegetation is also found in the sanctuary.

Diagnosis of interstitial pulmonary fibrosis-an update.

The most common and most lethal type of idiopathic interstitial pneumonia (IIP) is idiopathic pulmonary fibrosis (IPF), which accounts for 55% of lung diseases classified as IIPs. Diagnosis of IPF requires precision and a multidisciplinary approach .Indeed, an early and accurate diagnosis of IPF is critical for a better outcome, especially with the advent of new specific treatments for this disease. The previous guidelines using major and minor criteria for the clinical (i.e. non-pathological) diagnosis of IPF have been discarded, as it is now clear that, in an appropriate clinical setting, the presence of a classical UIP pattern on the HRCT scan is sufficient for a diagnosis of IPF to be made. In the presence of the four classical features, that together accurately identify a Usual interstitial pneumonia (UIP) pattern, a definitive diagnosis of IPF can be made. Guidelines emphasizes the importance of multidisciplinary discussion between clinicians, radiologists and pathologists to improve diagnostic confidence. The course of disease in IPF is unpredictable, but the importance of an early diagnosis is clear, as individuals with less severe lung function abnormalities have a better prognosis.

Role of flexible fiberoptic bronchoscopy in suspected sputum smear negative pulmonary tuberculosis cases at microscopy centre under RNTCP.

Background: Microbiological diagnosis is the main stay for the effective treatment of pulmonary tuberculosis. About 31%of the new cases may be smear-negative for AFB. Difficulties arise when a patient who is suspected of active tuberculosis, both clinically and radiologically, does not produce sputum or when it is available AFB may be negative. Fiberoptic bronchoscopy offers a mean of investigation whereby bronchial secretion and washing can be collected from the most likely abnormal site under direct vision. Aims & Objective: To study the role of flexible fiberoptic bronchoscopy in suspected sputum smear negative pulmonary tuberculosis cases at microscopy centre under RNTCP. Material and Methods: Thirty three patients aged Above 18 years old who were suspected of having pulmonary tuberculosis based on clinical and radiological appearances were prospectively studied. All subjects had at least 2 sputum smear examination which were negative for acid fast bacilli according to the revised national tuberculosis control program (RNTCP). The bronchoscopy was performed transnasally using fujinon bronchoscope by 2 bronchoscopists under local anaesthesia. A thorough examination of bronchial tree was carried out and bronchial aspirate (BA) bronchoalveolar lavage (BAL) bronchial brushing, transbronchial lung biopsy (TBLB) and post bronchoscopy sputum (PBS) were collected. The specimen obtained was placed on slides for Ziehl-Nielsen stain. Bronchial biopsy was performed on abnormal looking mucosa and stained with Eiosin-hematoxylin and Ziehl- Nielsen stains. Results: In total 33 sputum smear negative suspected pulmonary tuberculosis cases, at microscopy centre under RNTCP, early diagnosis of pulmonary tuberculosis was established in 10 (30.30%) cases and in 3 (9.09%) cases diagnosis of malignancy was established. Conclusion: Fiberoptic Bronchoscopy is a useful procedure to establish the diagnosis of pulmonary tuberculosis when sputum smear examination does not show acid fast bacilli. This allows appropriate treatment to be started with confidence.