Aims: To study the prevalence of tuberculosis infection among children in household contact with adults having pulmonary tuberculosis, and identify the possible risk factors. Methods: Children under the age of 5 years who were in household contact with 200 consecutive adults with pulmonary tuberculosis underwent tuberculin skin testing. Transverse induration of greater than 10 mm was defined as positive tuberculin test suggestive of tubercular infection. Infected children underwent chest radiography and analysis of gastric lavage fluid or induced sputum for detection of acid fast bacilli. Results: Tuberculin test was positive in 95 of 281 contacts (33.8%), of which 65 were contacts of sputum positive patients, while 30 were contacts of sputum negative patients. Nine of these children were diagnosed as having tuberculosis based on clinical features and/or recovery of acid fast bacilli; seven were in contact with sputum positive adults. The important risk factors for transmission of infection were younger age, severe malnutrition, absence of BCG vaccination, contact with an adult who was sputum positive, and exposure to environmental tobacco smoke. Conclusion: The prevalence of tuberculosis infection and clinical disease among children in household contact with adult patients is higher than in the general population, and risk is significantly increased by contact with sputum positive adults.

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The first case of fatal pulmonary sporotrichosis caused by Sporothrix schenckii var. luriei in a patient from the northwestern region of India is described. In the absence of cultures, the diagnosis was suspected by notation, in lung tissue, of large, thick-walled, hyaline fungal cells that divided internally by septation or a budding process. The thick-walled, internally septated cells often became muriform. The presence of an "eyeglass" configuration of incompletely separated cells characteristic of S. schenckii var. Iuriei in large numbers aided the diagnosis. The identity of the etiologic agent was confirmed by application of a fluorescent-antibody reagent specific for S. schenckii.

Background: Ultrasound-Guided Continuous Interscalene Block (USGCISB) decreases postoperative morbidity following arthroscopic shoulder surgery. Both dexamethasone and clonidine have been shown to prolong the duration of analgesia when added with ropivacaine in peripheral nerve blocks. However, there is no head-to-head comparison between dexamethasone and clonidine as an adjuvant using USG-CISB. Methods: In this randomized double-blinded controlled trial, 60 ASA grade 1-2 patients, 18-65 years, scheduled for arthroscopic shoulder surgery under general Anaesthesia following USG-CISB with perineural catheter using 30 ml of 0.5% ropivacaine were randomly allocated to Group 1 (adjunct dexamethasone 8 mg) or Group 2 (adjunct clonidine 150 μg). Primary outcome was duration of postoperative analgesia, as measured (in min) from the achievement of adequate sensory block till the first bolus of 0.2% ropivacaine by patient controlled regional analgesia. Secondary outcomes were measures of the pain ratings, total postoperative analgesic consumption, patient satisfaction, and adverse effects over 48h postoperatively. Results: The median duration of analgesia in Group 1 was significantly longer than Group 2 (1432 min vs. 751 min; P < 0.001). Median total postoperative analgesic consumption in Group 1 was significantly less than Group 2 (84 ml vs. 120 ml; P < 0.001). Median patient satisfaction score in Group 1 was significantly more than Group 2 (90 vs. 84; P = 0.001). Postoperative adverse effects were few and comparable. Conclusion: Compared to clonidine, dexamethasone significantly prolonged the duration of analgesia, decreased postoperative analgesic consumption, and increased patient satisfaction following USG-CISB when used as an adjunct to ropivacaine for arthroscopic shoulder surgery.

Pulmonary artery aneurysm (PAA) secondary to Behçet’s disease (BD) is a rare condition. The commonest presentation is hemoptysis, which can be fatal. Though the classical triad of recurrent oral and genital ulcers and relapsing iritis is present in most patients of BD, isolated pulmonary artery involvement termed as incomplete BD has been reported. Prompt diagnosis and immunosuppressive therapy can cause regression of aneurysm and prevent fatal hemoptysis. We report a case of PAA due to BD who presented with hemoptysis and responded to steroid therapy.

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