Tuberculoma of the brain is an important clinical entity. The main challenge in the management of brain tuberculoma is its diagnosis. Appearance in computed tomography (CT) scan of brain is common and consists of solitary or multiple ring-enhancing lesions with moderate perilesional edema, but these are not specific for tuberculoma as neurocysticercosis (NCC), coccidiomycosis, toxoplasmosis, metastasis and few other diseases may also have similar appearance on CT scan brain. Cerebrospinal fluid examination is often normal and biopsy and tissue culture from the lesion though the diagnosis of choice is technically too demanding and not feasible in most of the times. All these put the clinicians in a great dilemma as regard to a confidant diagnosis of tuberculoma of the brain. With advancement of imaging techniques, magnetic resonance imaging (MRI) of brain with magnetic resonance spectroscopy (MRS) has shown a great hope in this context as MRS shows a specific lipid peak in cases of tuberculoma which is not seen in any other differential diagnoses of tuberculoma. This review article is written to have an overview regarding the current diagnostic approach for brain tuberculoma with special emphasis on the role of MRS. Extensive literature review of the articles published in English was conducted using Google search, Google Scholar, PubMed and Medline using the keywords such as ring-enhancing lesions, etiology, tuberculoma, NCC, CT scan brain, MRI, MRS, images.

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Background: Six-minute walk test (6MWT) is a simple, objective, reproducible test which correlated well with different spirometric indices, and thus able to predict severity of chronic obstructive pulmonary disease (COPD) and can replace spirometry in resource poor set-up. Aims and Objectives: To find out correlation between spirometric indices (forced expiratory volume in 1 s (FEV ₁ ), forced vital capacity (FVC), and peak expiratory flow rate (PEFR)) and 6-minute walk distance (6MWD) in COPD patients, and thus to assess whether 6MWT can replace spirometry. Settings and Design: Institution based cross-sectional observational study. Materials and Methods: Eighty patients of COPD (diagnosis confirmed by Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2010 criteria) were enrolled for the study after applying exclusion criteria. All patients underwent spirometric measurement of FEV ₁ , FVC, PEFR, and ratio of FEV ₁ and FVC and test repeated after bronchodilation by 200-400 μg of salbutamol. 6MWT was performed following American Thoracic Society (ATS) protocol of 6MWT and distance was measured in meters. Results: We found significant linear correlation of 6MWT with post-FEV ₁ (r = 0.478, P < 0.001), post-FVC (r = 0.454, P < 0.001), and post-PEFR (r = 0.408, P < 0.001), but no correlation with FEV ₁ /FVC (r = 0.250, P = 0.025). We also found significant correlation of 6MWT with BODE (body mass index (BMI), airway obstruction, dyspnea, and exercise capacity) index (r = −0.419, P < 0.001). Conclusions: 6MWT can be a useful replacement of spirometry in assessment of severity of COPD.

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Pulmonary parenchymal hydatid cysts are uncommon entities even in endemic areas. Extra-parenchymal intra-pleural hydatid cysts are even rarer. We report a case of a 42-year-old male who developed massive unilateral pleural effusion following rupture of intra-pleural hydatid cyst. The objective of this case report is to highlight upon this not so common cause of pleural effusion and assess the attendant complications and possible modes of management.

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Dermatomyositis (DM) is an uncommon idiopathic inflammatory myopathy with characteristic cutaneous involvement that affects children and adults. Association of lung cancer and interstitial lung disease with DM has been well established, but spontaneous pneumothorax is rare. Recurrent spontaneous pneumothorax as a fatal complication in adult DM has not been described until date. We report a rare case of the patient with adult DM who presented with severe dyspnea. Chest X-rays revealed it to be a case of spontaneous pneumothorax. She had a history of a similar episode 15 days back. In the hospital, she was treated with intercostal drain placement, but succumbed despite vigorous resuscitative effort. Our case attempts to highlights the importance of recognizing recurrent pneumothorax as a potential serious complication of the disease.

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A 61-year-old male admitted in chest clinic with complaints of left-sided chest pain, sudden onset breathlessness, and cough since last 15 days. Patient was anex-smoker with no past history of tuberculosis. He was diagnosed with esophageal cancer and received radiotherapy 1 year back. On chest X-ray, left-sided hydropneumothorax was found and intercostal drainage insertion was done. A week later patient complained of extrusion of food particles into intercostal drainage bag. On evaluation, esophageopleural (EP) fistula was confirmed.

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Although genito-urinary tuberculosis is common, reports of isolated ovarian tubercular abscess are rare. Ovarian tubercular abscess may mimics that of an ovarian tumor, leading to diagnostic difficulties. We reported a case report of 35 years woman presented with chronic pain abdomen, weight loss, low-grade fever and a right ovarian mass on ultrasound, with a significantly elevated CA-125 level. On clinical and radiological evidence, diagnosis of ovarian carcinoma was made, and laparotomy was performed with resection of the ovary. Postoperative specimen sent for histological examination that revealed classic epithelioid granuloma and acid-fast bacilli were present in Ziehl-Neelsen stain. Patient was put on antitubercular regimen from our Dots center. She is improving clinical after taking antitubercular drug and is on regular follow up at our chest outpatient department. Ovarian tubercular abscess is common in young women living in endemic zones, but case report of isolated tubercular abscess is rarely reported. CA-125 can be raised in both ovarian tubercular abscess and ovarian carcinoma, and only imaging is not always conclusive. Laparotomy followed by tissue diagnosis can be helpful in this situation. As the prognosis and treatment outcome of ovarian tubercular abscess and ovarian carcinoma is different, proper diagnosis by laparotomy should be done. Early diagnosis of ovarian tubercular abscess is vital as untreated disease can lead to infertility.

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Oesophageopleural fistula (EPF) is an abnormal communication in between the oesophagous and pleural space such that the contents of oesophagous are drained into the pleural space surrounding the lungs. We describe a case of a middle-aged female who presented with right sided pyothorax secretions of which consisted of food particles. Chest computed tomography and barium swallow confirmed the diagnosis of oesophageopleural fistula, cause of which was found to be an accidental fish bone injury. Conservative management was done by chest tube drainage along with ryles tube feeding. Patient expired following severe sepsis.

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