Pulmonary tuberculosis is one disease that has created, nurtured & modified thoracic surgery.With the invention of effective antitubercular drugs, role of surgery in pulmonary TB declined over decades, but with appearance of MDR/XDR TB – role of surgery is again becoming important.

Elderly immunocomptetent female presented with cough and breathlessness of 3 weeks duration. Physical examination revealed absence of breath sound in both upper lobe areas. Sputum examination was negative for acid fast bacilli (AFB). Chest radiograpgh showed bilateral upper lobe homogenous opaqcity. Contrast enhanced CT (CECT) chest showed complete cut off of right upper lobe bronchus with collapse of both right and left upper lobe.

With early diagnosis of pulmonary tuberculosis and availability of effective antituberculosis chemotherapy, prevalence of laryngeal tuberculosis had decreased significantly. Because of similar clinical presentation and risk factors, laryngeal tuberculosis is often confused with laryngeal carcinoma and diagnosis was usually made while work-up for malignancy. Here we are presenting one such case of 55 years old male, initially suspected as laryngeal carcinoma was diagnosed to have secondary laryngeal tuberculosis.

Bronchiectasis in Chronic obstructive pulmonary disease (COPD) has been recognized as a potential new phenotype of COPD in recent years due to different clinical presentation, prognosis and treatment response. Broad application of CT scan significantly increased identification of bronchiectasis in COPDpatients. Although the exact mechanism of bronchiectasis development in COPD is lacking, the chronic airway inflammation, colonization of particular bacteria strain such as P. aeruginosa and continuous airway reconstruction may proceed to airway damage and following bronchiectasis. The significance of identifying bronchiectasis in COPD patients is to improve patients’ management through more individualized treatment regimen. Given the poor prognosis in COPD patients with bronchiectasis and limited evidenced based clinical experience, it is therefore essential to have high quality clinical trials conducted in this group of patients.

A middle aged female presented with symptoms of chronic cough, breathlessness, fatigue and weight loss of 4 months duration. Chest Xray (CXR) was suggestive of bilateral upper lobe mass lesion with a differential diagnosis in favour of malignancy. Contrast enhanced computed tomography (CECT) chest showed collapse of right upper lobe and left upper lobe. Bronchoscopy showed thick gelatinous globular plugs occluding both upper lobes and guided biopsy showed granular necrotic debris and dense eosinophilic infiltrates. Her serum immunoglobulin-E (IgE) levels were very high (18,887 IU/ml) and Gomori Methenamine Silver staining was suggestive of Aspergillussps. She was diagnosed to have Primary pulmonary aspergillosis and treated with itraconazole for 2 months. She responded very well and lung lesions cleared drastically on follow up.

Nasal congestion is the fourth most common minor ailment presented in primary care and as such, a method to quantify the meaning of nasal congestion in order to enable evaluation of medicines catered to specific congestion levels can prove important. The Airflow Perturbation Device (APD) is a noninvasive respiratory diagnostic device that evaluates the respiratory resistance in humans. It measures the total respiratory resistance under normal breathing in less than one minute. This study involved using the APD to determine the influence of nasal congestion on respiratory resistance in a laboratory setting. A total of 25 volunteers volunteered for this study and it employed a standard subjective categorical scale for nasal congestion (i.e. No Congestion, Mild Congestion, Moderate Congestion, and Severe Congestion). The results show that resistance values increased with increased congestion levels. However, resistance values of the groups of volunteers for the various congestion categories overlapped, and there were no statistically significant values differentiating no congestion and mild congestion or moderate congestion and severe congestion