Extensively drug resistance (XDR) tb is not always fatal.

The chance of incidence of XDR TB is on the rise due to improper use of second line anti-tubercular drugs. XDR-TB is very difficult to treat successfully and is often referred to as "virtually untreatable form of TB". We herein report a case of XDR TB confirmed by bacteriological examination in a WHO recognised laboratory who after 12 months of regular treatment improved both clinically and radiologically with sputum smear conversion. To the best of our knowledge, there has been no previous report of any similar case in literature.

Pyrazinamide therapy and severity of haemoptysis.

Background: Pyrazinamide (PZA) has been known to adversely affect the haemostatic mechanisms in our body. Aim: This study aims to find out whether PZA has any influence on the course of haemoptysis. Methods: One hundred and six patients of active pulmonary tuberculosis and haemoptysis, having normal baseline coagulators profile, were included in this prospective study. One half of them were given PZA containing anti-tuberculosis regimens (PZA group) and the other half were prescribed non-PZA containing regimens (non-PZA group). They were managed conservatively and followed up for a period of 7 days. Results: Blood loss during therapy was moderate to massive in amount in majority (56.61%) of patients in the PZA group as compared to non-PZA group (35.84 %). Though the mean duration of haemoptysis was almost similar in both the groups (3.98 days in the PZA group versus 4.12 days in the non-PZA group), but in patients in whom haemoptysis lasted for more than 3 days, in the non-PZA group, majority (62.50 %) had minimal blood loss as compared to the PZA group (48.27 %). Concusion: Although PZA does not alter the mean duration of haemoptysis but omission of PZA can significantly reduce blood loss during therapy.

Airway obstruction in bronchiectasis and its reversibility--a study of 38 patients.

Thirty-eight patients (20 males and 18 females) with bronchiectasis were studied for the evidence of airway obstruction and its reversibility in response to subcutaneous terbutaline. There was an improvement in VC (8.56%), FEV1 (6.36%), PEFR (15%) and PEF 25-75% (18%) respectively. The difference being statistically significant in VC and highly significant in FEV1, PEFR and FEF25-75 as compared to initial values and in 6 patients the improvement in FEV1 was more than 15%. The improvement in airway obstruction was not related to the character of expectoration. It is suggested that all the patients of bronchiectasis should be assessed for the reversibility of airway obstruction and those showing a reversible pattern be treated accordingly.

Bronchogenic carcinoma. A study of 109 cases.

The clinical profile of 109 cases of bronchogenic carcinoma has been studied. Definite histopathological typing of malignancy was possible in 61 patients, squamous cell carcinoma being the commonest tumour in 27 followed by small cell carcinoma in 16, adenocarcinoma in 11 and large cell carcinoma in 7. Another 23 patients showed changes suggestive of malignancy on histological/cytological examination. Definitive diagnosis was obtained in half of the patients by bronchial biopsy, in 16% by bronchial aspiration fluid cytology, in 13% by pleural biopsy, in 11% by lymph node biopsy and in others by pleural fluid cytology, lung biopsy and skin biopsy. Commonest radiological involvement among different cell types was hilar involvement in small cell carcinoma in 62%, evidence of bronchial obstruction (collapse/consolidation) in squamous cell carcinoma in 56%, peripheral mass in adenocarcinoma in 54% and cavitation in a mass in squamous cell carcinoma in 15% cases.