Background: Although COPD is traditionally associated with polycythemia, the systemic inflammation that is now recognized as a feature of COPD makes it a possible cause of Anemia of Chronic Disease (ACD). Preliminary evidences suggest that anemia in COPD may be more prevalent than expected occurring in 10% -15% of patients. While in states like chronic heart failure and renal insufficiency, anemia has been extensively studied; little attention has been given to it in COPD. Objectives: To see the prevalence of anemia in patients with COPD and its potential impact on morbidity of COPD patients. Design and Setting: A university hospital-based cross-sectional study in Kashmir, India. Methods: Two hundred patients (119 males and 81 females) with spirometery documented COPD were evaluated for frequency of anemia. In addition to routine investigations, erythropoietin levels were done in a subgroup of patients. Results: A total of 36 cases (20 males and 16 females) of anemia were detected giving a frequency of 18%. Normocytic normochromic type of anemia was present in 32 (88.89%) patients while the rest had normocytic hypochromic type of anemia. Majority of patients were in GOLD stage 11 and had decreased serum iron, transferrin saturation and TIBC. Erythropoietin levels were significantly raised in anemic COPD patients compared to non-anemic COPD patients. The various factors significantly associated with anemia were: No. of exacerbations of COPD, No. of hospital admissions, BMI and erythropoietin levels. Conclusion: Anemia occurs frequently in patients of COPD and is associated with increased morbidity in the form of No. of exacerbations and hospital admissions. Correcting anemia in these patients may improve their clinical outcome.

Primary adrenal Non-Hodgkin's lymphoma is rare. The symptoms of the disease and response to treatment are variable depending on the type of lymphoma, tumor size, and presence of adrenal insufficiency. We report two cases of primary adrenal lymphoma who had varied presentations. One presenting with abdominal pain and weight loss was documented to have unilateral disease without any adrenal insufficiency and showed a good response to combination chemotherapy, while the second one had bilateral adrenal involvement with adrenal insufficiency and died after second chemotherapy. Functional adrenal involvement in lymphoma depends on the extent of involvement; patients with bilateral involvement almost always have adrenal insufficiency.

Central venous catheters (CVCs) are used in intensive care units (and, increasingly, in other locations) to administer intravenous fluids and blood products, drugs, parenteral nutrition, and to monitor haemodynamic status. The risk of complication during the insertion or exchange of central venous catheters has been well documented. The majority of complications involve mechanical problems, although rarely it may induce arrhythmias as well [1]. Herein we present a case of peripheral central venous catheter induced supraventricular tachycardia in a young patient of acute lymphoblastic leukemia.

Extrarenal Wilms' tumour (ERWT) is extremely rare with a scant mention in the literature. We described a 7 yearold girl who presented with abdominal pain, vomiting and constipation. Diagnostic investigation and exploratory laparotomy provided evidence of a huge retroperitoneal mass in the lumbosacral area with normal kidneys. Histology and immunophenotyping confirmed the diagnosis of Wilms' tumour. Bone marrow revealed infiltration with non-hematogenous cells and patient was started on chemoradiotherapy. Presently patient is on our follow up and asymptomatic for her disease.

Tuberculosis has varied clinical and radiological presentations, ranging from constitutional symptoms with segmental involvement to severe forms with multiple lobar consolidation and high mortality. Though uncommon, respiratory failure can be a presenting feature of tuberculous consolidation of lungs, rarely requiring mechanical ventilation. We report a 27 year female diagnosed as having total left lung consolidation and respiratory failure who showed marked clinical and radiological improvement after taking anti-tubercular drugs. Knowledge of radiological presentations of the pulmonary tuberculosis such as patchy, poorly defined consolidation with/without cavitation, fibrosis, calcification, lung destruction, pleural effusion or miliary lesions can help in timely diagnosis and proper management of these cases. JMS 2016; 19(1):29-31