Background: To study the profile of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) in tertiary care hospital setting, representing almost the whole affected population in Kashmir valley of India. Methodology: A total of 910 cases of pulmonary tuberculosis were enrolled over four years. Among these, cases of MDR-TB and XDR-TB were meticulously studied for drug susceptibility, treatment, adverse effects profile and overall survival. Results: Fifty-two (5.7%) cases of MDR-TB were identified, among which eight (15.3%) were diagnosed as XDR-TB on the basis of drug susceptibility testing, using the prescribed definition. The cases were sensitive to 2, 3, 4, 5 and more than 5 drugs in almost equal proportions. Thirty-seven (71.1%) cases were successfully cured; eleven (21.1%) patients died; and only four (7.6%) cases defaulted, indicating overall satisfactory adherence to treatment. Conclusion: For effective treatment of MDR-TB and XDR-TB, early case detection, improved laboratory facilities, availability of appropriate treatment regimens, and financial assistance in resource-limited settings through effective political intervention are necessary for better patient adherence and overall cure.

Background:Medical thoracoscopy or pleuroscopy, in recent past has received lot of interest for diagnostic as well as therapeutic purposes. In the evaluation of undiagnosed pleural effusion, it has become a key diagnostic modality as it is a cost effective and safe procedure. The aim of present study was to assess the diagnostic yield of medical thoracoscopy in patients with undiagnosed exudative pleural effusion. Methods: This prospective study was conducted at government chest diseases hospital Srinagar between December 2016 to June 2018. One hundred and twenty-five (125) patients who fulfilled inclusion criteria were included in this study. Thoracoscopy was done using rigid thoracoscope under local anesthesia. Thoracoscopic and histopathological data of enrolled patients was collected prospectively and analysed. Results: Patients enrolled in the study were in the age range of 17 to 82 years and consisted of 80 males and 45 females. Most common thoracoscopic finding was multiple variable sized nodules (53.6%) followed by sago grain infiltration (15.2%). Malignancy was the most common histopathological diagnosis (60.8%) with metastatic adenocarcinoma being the most common histopathological diagnosis (50%). The overall diagnostic yield of thoracoscopy was 90.4%. Conclusions: Medical thoracoscopy is a safe procedure with excellent diagnostic yield for evaluation of undiagnosed pleural effusion with minimal complication rates.

Background: Conventional TBNA has been used in the evaluation of intrathoracic lymphadenopathy with varied success rates depending upon size, site and aetiology of the node. Although mediastinoscopy has higher successes but it comes at the cost of general anaesthesia, more complications and limited access to the inferior and posterior mediastinum. Endobronchial ultrasound guided transbronchial needle aspiration has the advantage of real time nodal sampling with good success rates and minimal complications. The aim of our study was to assess the diagnostic yield and safety of EBUS TBNA in the evaluation of intrathoracic lymphadenopathy.Methods: This prospective observational study was conducted at government chest diseases hospital Srinagar over a period of two years from January 2016-December 2018 on 100 consecutive patients who underwent EBUS TBNA procedure for evaluation mediastinal and hilar lymphadenopathy. The data was collected and analysed for diagnostic yield and safety profile.Results: Out of the 100 subjects included in the study 52% were males and 48% were females. Mean age of the study population was 48.5±16.65 years. Most of the nodes sampled were subcarinal in location followed by paratracheal and hilar group. Granulomatous pathology (tuberculosis and sarcoidosis) was present in 41 patients followed by malignancy in 39 patients. Anthracosis was the cause of lymphadenopathy in 4 of the patients. There were no major complications in our study.Conclusions: EBUS TBNA is an effective and safe procedure for evaluation of mediastinal and hilar lymphadenopathy.

BACKGROUND: The World Health Organization declared vaccine hesitancy as one of the planet's top 10 global health threats in 2019. With the rollout of the coronavirus disease-19 (COVID-19) vaccines, a survey was conducted to find out the hesitancy and the apprehensions that come along with taking COVID-19 vaccines among health-care workers (HCWs). MATERIALS AND METHODS: This was an online cross-sectional survey which was developed and shared through social media platforms among the HCWs of Kashmir. The survey captured demographic data and used a validated hesitancy measurement tool from January 2021 to February 2021. The data were analyzed by descriptive statistics and multivariable logistic regression using Stata 15 (Stata Corp. 2017. Stata Statistical Software: Release 15. College Station, TX: Stata Corp LLC). RESULTS: Willingness to take the COVID-19 vaccine when available was seen in 67.7% of the HCWs. Overall, 9.59% of respondents reported unwillingness to receive a vaccine for COVID-19, while 22.7% were unsure. The most commonly cited reason for willingness to get vaccinated was an understanding of the disease and vaccination, as reported by 81.5%. Being single was significantly related to an increased risk of vaccine hesitancy (adjusted odds ratio = 5.27, 95% confidence interval: 2.07–13.40). Among vaccine attitudes, concerns about the safety of the vaccine, unforeseen problems in children, and possible unknown future adverse effects of the vaccine were the most important determinants of unwillingness. CONCLUSIONS: A significant proportion of the HCWs showed vaccine hesitancy to the COVID-19 vaccine. Hesitancy attitudes were almost always driven by concern around the vaccine safety. States and health-care authorities need to recognize the massive trust deficit around the Covid-19 vaccine and use the popular media used by people to share credible and reliable information.

Background: Ultrasound (USG) guided fine needle aspiration cytology (FNAC) is a simple and cost-effective method for the diagnosis of various peripheral lung lesions. Being radiation free and easily available in most of centres, it has become an important diagnostic modality for early diagnosis of peripheral lung lesions. Besides procedure is simple and complications if occur, can be managed by a pulmonologist effectively. This study was aimed to evaluate the role of Transthoracic ultrasound guided FNAC in diagnosis of peripheral lung lesion.Methods: This prospective observational study was conducted at Government Chest Diseases Hospital Srinagar over a period of one year from January 2018-December 2018. 61 patients who fulfilled inclusion criteria were included in this study. After properly explaining the procedure and taking informed consent, USG guided FNAC was done in patients with peripheral lung lesions under local anaesthesia. Radiological and cytological data of enrolled patients was collected prospectively and analysed.Result: About 61 patients were included in this study comprising of 39 males and 22 females in age range of 17- 90 years. Malignancy was the most common cytological diagnosis (78.57%). while as benign diagnosis was reached in 21.43%. In 8.19% of patients, FNAC was inconclusive. Among the malignant group, adenocarcinoma (47.72%) was most common cytological diagnosis. The overall diagnostic yield of USG guided FNAC in this study was 91.8%.Conclusion: USG guided FNAC of peripheral lung lesions is a simple procedure with high accuracy and less complication rate which can be performed by a pulmonologist for diagnosis.