Streptomyces belongs to the Actinomycetes group of bacteria which are gram-positive non acid-fast bacilli, widely recognised for their potential to produce antimicrobials active against bacterial, mycobacterial, parasitic and fungal infections. They commonly cause cutaneous infections following traumatic inoculation. Visceral infections are relatively rare and limited to immunocompro-mised hosts. We describe a case of Streptomyces pneumonia in a healthy immunocompetent female, who when investigated for voluntary kidney donation, resulted in the isolation of Streptomyces species from bronchial wash cultures. Streptomyces, a potential pathogen in immunocompetent hosts is frequently underdiagnosed. Once isolated, both physicians and microbiologists should pay attention to differentiate true infection from contamination.

Schwannomas are the most common tumor of peripheral nerves. It comprises 1 to 2% of total thoracic tumor. Posterior mediastinum is the most common site in thorax. Hereby we are reporting two cases of schwannoma with different sites of origin. The classical presentation of schwannoma is an asymptomatic mass found on chest radiograph. This tumor is usually benign and slow growing. Imaging followed by histopathological examination is key to the diagnosis of this neoplasm. Resection of tumor cures the disease.

Background: The term interstitial lung diseases (ILD) refer to a broad category of lung diseases rather than a specific disease entity. True prevalence of ILD is difficult to estimate and it may vary according to the geography, environment, occupation etc. Aim and objectives were to find out the distribution of interstitial lung disease (ILD) subtypes in a tertiary care centre.  Methods: A descriptive study was conducted between August 2016 and November 2018 in a tertiary care centre in Puducherry, South India. Baseline demographic details, clinical symptoms, signs, radiological findings (chest radiograph and HRCT), pathological findings, and physiological findings were taken into consideration and diagnosis of type of interstitial lung disease was made using multidisciplinary discussion. Statistical analysis was done using SPSS 19.0 version.Results: A total of 150 patients were recruited of which 70.5% were females. Most common ILD subtype in our study was connective tissue disease associated ILD – 97 patients (65%) followed by idiopathic pulmonary fibrosis (IPF)–31 patients (22%). Most common type of CTD ILD observed in our study was progressive systemic sclerosis (46%) followed by mixed connective tissue disease (24%). The most common HRCT finding was NSIP pattern and most commonly observed physiological abnormality was moderate restriction and moderate diffusion impairment.  Conclusions: Connective tissue disease-associated ILD was the most common ILD found in our study amongst south Indian population. This suggests that the distribution of ILD would vary depending on the geographical area and the environmental exposure which was in contrast with the Indian ILD registry.

Objectives: Chronic Obstructive Pulmonary Disease (COPD) is heterogeneous in nature. Acute exacerbation of COPD (AECOPD) is diagnosed clinically which is subjective and clinical judgment may vary from clinician to clinician. Since chronic inflammation underlies the pathogenesis of COPD, markers of inflammation have generated lot of interest for their potential to be used as biomarkers of COPD. This study aimed to assess the variation in levels of neutrophil lymphocyte ratio (NLR) and platelet indices in patients with stable COPD and acute exacerbation of COPD patients and its association with GOLD stages. Methods: This prospective analytical study was carried out in our tertiary care hospital from December 2018 to July 2020. About 64 subjects (32- stable COPD, 32- AECOPD) who satisfied study criteria were included. Blood sample was taken from stable and AECOPD patients and were compared. Results: It was observed that Neutrophil Lymphocyte Ratio, Platelet Distribution Width, Erythrocyte Sedimentation Rate and C-Reactive Protein were increased in AECOPD patients when compared with stable COPD patients which was statistically significant with p value of <0.001. A positive correlation was observed between Neutrophil Lymphocyte Ratio, Platelet Distribution Width and Erythrocyte Sedimentation Rate, C-Reactive Protein which was statistically significant with p value of <0.001. Conclusion: We found that neutrophil lymphocyte ratio and platelet distribution width values increased significantly in AECOPD patients when compared to stable COPD patients. Keywords: AECOPD; COPD; Neutrophil Lymphocyte Ratio; Platelet Distribution Width.

Background: Health care workers (HCWs) are at risk of acquiring tuberculosis (TB) infection and disease due to occupational exposure. But there are no national guidelines on routine screening for TB (active case finding (ACF)) among HCWs and understand its implementation and feasibility. Methods: This study was conducted among HCWs in a teaching hospital in India. We used symptom screening to identify those with presumptive TB and were further evaluated for diagnosis of TB. Results: A total of 1,001 HCWs were screened over a period of 18 months. In our study, 51 (5.1%) HCWs were found to have presumptive TB and on further evaluation, 5 (0.5%) of these patients were diagnosed with active TB. The number needed to screen (NNS) for one active TB among the HCWs was 200. Alcohol use was significantly associated with both presumptive TB ( P = 0.037) and active TB ( P = 0.035) among HCWs, and exposure to active TB patients ( P = 0.014) in the family and workplace and increased frequency of exposures ( P = <0.001) were associated with presumptive TB. Conclusion: ACF for TB among HCWs had a good yield in our study. ACF utilizing routine national TB program guidelines is feasible to be implemented among HCWs to aid in the early diagnosis and treatment of TB in this high-risk group.