Chest Computed Tomography (CT) Severity Score Assessment to Explore Association between Tuberculosis and COVID-19 Pneumonia for Assessing the TB Bulwark against Moderate to Severe COVID-19 Infection.

Importance Objective: First case of Covid-19 pneumonia was reported in Wuhan and soon it became pandemic.1 Pulmonary tuberculosis (TB) is mainly a disease of tropical and poor countries like India.9 Initially, it wasn't clear how these two diseases will interact with each other. We tried to determine if TB has any impact on course and prognosis of Covid-19 pneumonia. DESIGN SETTING: In this retrospective analytical study, data of 7774 patients were collected from various state government owned hospitals of India. Chest CT scans were reviewed for present or past stigmata of pulmonary TB, CORADS and CT severity score. Statistical analysis was done for class wise frequency distribution and association of attributes were calculated. RESULTS: 95.01% Patients with Covid-19 pneumonia didn't have CT signs of history of active or old healed pulmonary TB, while 4.99% had it. In first group 44.85 % mild, 36.17 % moderate and 13.98 % had severe disease, while in second group figure is 3.39 % 1.21 % and 0.40 % respectively. Probability of TB providing immunity against developing moderate or severe form of Covid-19 pneumonia is 0.6778. CONCLUSIONS: Patients with active or past history of TB are less prone to develop moderate or severe form of Covid-19 pneumonia. It may be the reason for less mortality in health resource poor India as compared to Europe or America.

Evaluation of spinopelvic parameters in lumbar prolapsed intervertebral disc.

BACKGROUND: Sacro-pelvic morphology and orientation are usually described in terms of pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). Orientation and morphology of pelvis can affect degenerative changes in the lumbar spine. Thus, here we investigated the relationships between various sagittal spinopelvic parameters and the degree of disc degeneration in young adults. MATERIAL AND METHODS: A hospital-based cross-sectional study with a total of 60 cases was done. Patients presenting with back or leg pain having prolapsed disc on magnetic resonance imaging (MRI) were included in the study. A standing X-ray of LS spine from dorso-lumbar junction to mid-thigh was taken. Various spinopelvic parameters were assessed from the scannogram using the software. RESULTS: The mean age was 39.27 years. L5S1 was the most common level. Mean SS, PT, PI, and LL were 37.78°, 13.52°, 51.33°, and 41.01°. Disc pathologies at L1L2, L2L3, and L4L5 level showed a positive correlation with PT, PI, and LL. Disc pathology at the L5S1 level shows a positive correlation with PT and LL. A statistically significant correlation between SS and degenerative spondylolisthesis at L4L5 was found from data with P = 0.023. DISCUSSION: An increase in SS statistically significantly increases the chance of development of degenerative spondylolisthesis at L4L5. An increase in PT, PI, and LL will cause an increase in disc pathology at L1L2. An increase in SS, PT, PI, and LL will cause an increase in disc pathology at L2L3. An increase in SS, PT, PI, and LL will cause an increase in disc pathology at L4L5. An increase in PT and LL will cause an increase in disc pathology at L5S1. CONCLUSION: Standing lateral view radiograph from dorso-lumbar junction to the mid-thigh is as good as standing whole spine radiograph for measurement of spinopelvic parameters. Degenerative spondylolisthesis at L4L5 has a statistically significant correlation with an increase in SS.

Unicentric Castleman's disease of abdomen.

Castleman's disease (CD) is a rare lymphoproliferative disease of uncertain etiology that affects lymph nodes. CD can be classified as a) unicentric vs. multicentric, based on clinical and radiological findings, b) hyaline vascular (80-90%) vs. plasmacytic (10-20%) vs. mixed cellularity variety based on histopathology. Unicentric disease is more common in the 3rd and 4th decade, whereas the multicentric form is more common in the 5th and 6th decade with no sex predilection. HIV seropositive individuals appear to be at an increased risk for multicentric castleman's disease (MCD) at a younger age due to the increased incidence of HHV- 8 infection. Diagnosis is usually based on histopathology features as imaging features show considerable overlap, thus posing diagnostic difficulties. Overall prognosis is good, particularly in the unicentric variety of disease. We have presented a case of the unicentric CD in a 40 year old male patient having abdominal pain and hematuria as chief complaints.

Uncommon presentation of a common cancer papillary thyroid cancer in paediatric population.

Carcinoma of thyroid gland is rare in the paediatric age group before the age of 15 years. A 12-year-old girl presented with a swelling in the midline of neck, with no exposure of radiation in the past. On ultrasonography and fine needle aspiration cytology, the findings were suggestive of papillary carcinoma of thyroid. The case is being reported on account of its rarity.

Paraspinal sinuses? Do remember renal tuberculosis.

Approximately 4%-8% of patients with pulmonary tuberculosis develop clinically significant genitourinary infection. In the case being reported, a 30-year-old female, admitted with right-sided back swelling, local pain and low-grade fever. The swelling gradually increased in size over a period of 6 months and had burst spontaneously forming a pus discharging with associated localised pain and fever bringing the patient to the hospital. X-ray lumbar spine, chest and kidney ureter bladder showed no abnormalities. Ultrasound findings were suggestive of pyonephrosis with a posterior paraspinal abscess with a sinus tract within the posterior paraspinal region. CT findings were more conclusive in suggesting the sinus tract origin. Finding of tuberculous kidney and upper ureteric stricture with sinus tract opening in the posterior paraspinal region was made on CT. Right nephrectomy was done. Histopathologically proved it to be tuberculous kidney.