Pulmonary artery aneurysm is a rare but important entity in the spectrum of pulmonary vascular diseases. The etiologies can be varied and patients can present with non-specific symptoms with the diagnosis being incidental. There is limited consensus regarding the diagnostic criteria and follow-up imaging for patients diagnosed with this entity. Further the management strategies can be variable depending upon underlying disease, etiology, center dependent expertise, and resources available. We review the etiologies, epidemiology, classification, clinical manifestations, and imaging features of pulmonary artery aneurysm. We also review the current management strategies and suggest an algorithmic approach to these patients.

This article reviews the current understanding of the oral and dental aspects of chronic renal disease (CRD). A PubMed literature search was performed and all relevant studies were assessed. As the number of people suffering from CRD increases worldwide, dentists are expected to encounter more patients with CRD who need oral care. In children, CRD can elicit a wide spectrum of oral manifestations in the hard and soft tissues. Bleeding, altered drug metabolism, impaired immune function, and an increased risk of dentally induced bacterial endocarditis are some important features that require attention. Dental management of patients with CRD requires that clinicians appreciate that multiple systems can be affected by the disease. Dentists should consult with nephrologists regarding the specific precautions required for each patient. Medical treatments in these patients may need to be postponed due to an unfavorable oral health status or potential risk of life-threatening infection after surgery. Improving oral hygiene and performing necessary dental and oral treatment before hemodialysis or transplantation may prevent endocarditis and septicemia in these patients. Hence, treatment plans should be formulated to restore the patient's dentition and protect them from potentially severe infections of dental origin.

Objectives:Primary objective was to assess the prevalence of tuberculosis (TB) among household contacts of newly diagnosed sputum smear (SS) positive TB index cases. Secondary objectives were the evaluation of risk factors in household contacts for acquiring TB disease; and the evaluation of various characteristics of index cases which influence the transmission of disease to household contacts.Settings and Design:This exploratory cohort study included 521 household contacts of 133 newly diagnosed SS positive TB patients who were registered under the Revised National Tuberculosis Control Program at the Directly Observed Treatment-Short Course Centres of District Tuberculosis Centre, Kolhapur, Maharashtra from July 1, 2013 to February 28, 2014 (8 months).Subjects and Methods:Household contacts with symptoms suggestive to TB were subjected to SS examination of two samples for acid fast bacilli by Ziehl-Neelsen staining and for X-ray chest postero-anterior view. Presence of risk factors in symptomatic contacts was also recorded.Results:Eighteen contacts out of 521 (3.45%) had symptoms suggestive of TB. Of these, 6 contacts were diagnosed to have TB; 5 being sputum positive cases and one with X-ray suggestive of TB; giving a prevalence of 1.15 %. The study achieved a yield of 4.51% secondary cases.Conclusions:Household contact screening of newly diagnosed TB index cases provides modest yield of cases. Relatively fewer secondary symptomatic persons need to be investigated by this method for achieving additional yield proving it to be a practical and feasible approach.

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Rectus sheath hematoma (RSH) is a rare complication that usually occurs in patients receiving anticoagulation therapy. It can mimic an acute abdomen and be life-threatening. RSH can develop even with prophylactic dose of heparin. Early recognition is necessary to decrease morbidity and mortality. RSH should be considered in anticoagulated patients who develop sudden onset of abdominal pain. RSH is usually managed conservatively, but sometimes requires surgery. Patients who are taking antiplatelet require careful monitoring with the use of anticoagulation (AC). It is important to identify them early. This is a case of 69-year-old female who presented with epigastric pain secondary to rectus sheath hematoma. She was receiving subcutaneous injections of heparin for left lower quadrant pain and swelling for venous thromboembolism prophylaxis. Ultrasound of abdomen revealed large rectus sheath hematoma.

Lemierre's syndrome is a rare disease associated with significant morbidity and mortality. It begins with an oropharyngeal infection, which spreads locally to involve the internal jugular vein causing thrombophlebitis, followed by distant spread and metastatic infections. Affected individuals are commonly young adults. Causative organisms are usually oropharyngeal flora, most commonly being the anaerobe Fusobacterium necrophorum. Porphyromonas asaccharolytica is a rare etiological agent with only three cases being reported in the literature. This case report describes a previously healthy 22-year-old man who initially presented with acute tonsillitis and was later found to have left internal jugular vein thrombophlebitis along with bilateral septic emboli to the lungs. The patient was treated with a five-week course of ampicillin-sulbactam and metronidazole. Subsequent imaging also showed progression of internal jugular vein thrombus, for which warfarin was given for three months for anticoagulation.

We describe an adolescent patient presenting with hemoptysis. Detailed clinical work up of the patient showed right ventricular thrombus and bilateral pulmonary artery aneurysms along with the prescribed criteria for the diagnosis of Behcet's disease. Younger age of the patient was another distinctive feature of this case. Six months of therapy with cyclophosphamide and prednisolone resulted in near complete clinicoradiological response.

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