Objective: The aim of present study is to evaluate the role of decortication in management of chronic pleural empyema. Methods: From Jan 2003 to Jun 2004, 25 patients of chronic empyema who were subjected to decortication at our tertiary care hospital were evaluated prospectively. Patients were subjected to detailed clinical, radiological and other diagnostic evaluation for etiology, duration of treatment and response. Decision for decortication was taken on the basis of long duration of treatment, poor response to antibiotics, intercostal tube drainage, thrombolytic therapy and thickness of pleural peel. All the patients were followed up for six months. Results: Out of 25 patients, who were subjected to decortication, 24 patients were male and one was female with average age 33 years (range 19-50 years). The mean duration of symptoms was 6.4 months (range 1-24 months). The mean duration of preoperative antitubercular treatment (ATT) was 5 months (range 2 weeks to 12 months). Preoperative spirometry showed moderate restriction (FVC -53%, FEV ₁ -61.7%). Postoperatively all patients showed good recovery. Spirometry after decortication showed satisfactory improvement (FVC-68%, FEV ₁ -72.8%). Only one patient had complication in the form of left subclavian artery injury. Conclusion: Decortication is the safe and effective treatment for chronic organized empyema, enabling complete expansion of the lung.

50 patients with sputum smear positive pulmonary tuberculosis were evaluated for initial drug resistance to 4 first line anti-tuberculous drugs using Lowenstein Jenson method.17.7% of patients showed initial drug resistance out of which 2 were resistant to INH alone and 4 having multidrug resistant tuberculosis.

Over 5 years from 2000 to 2004 a consecutive series of 420 cases of obstructive airway disease were studied with full history, spirometry, chest radiograph, and other relevant investigations. Several were followed and reassessed: 58.1 % were males - of these 42.1 % were smokers. Sixty percent (252) belonged to age above 40 years; 200 cases revealed clinical history of upto 5 years:

1. 9.3% had a family history of asthma.
2. 55.5% showed some changes in chest radiograph
3. 52.6% had a daily chest symptoms
4. Chronic cough was seen in 59.5% and paroxysmal dyspnoea in 38.9%
5. Clinically asthma was labelled in 43.8% and COPD in 56.2%
6. On follow up 45.6% showed an improvement while 34.1 % deteriorated.
7. Mainly management was oral theophyllin (93.1 %), beta stimulant inhalers (81.2%). During exacerbations 94.1 % were given antibiotics and 24-29 % had steroids.
8. A history of hospitalization was seen in 51.9%: 4 died, 4 had IPPR and 8 had malignancies mainly in Lung.
9. 50.2% had hypertension, 26.1% ischemia and 10.8% a prior lung tuberculosis
10. 11.2% Showed diabetes.
11. FVC, FEV ₁ , AND VE50 could assess the degree of functinol disability: asthmatics showed a larger bronchoreversibility.
12. In many, distinction from asthma to COPD was not easy and mainly clinical.

Turner's syndrome is a form of gonadal dysgenesis, which occurs due to abnormalities in the X chromosome during gametogenesis. The diagnosis may be made at birth due to various associated abnormalities or at puberty due to primary ammenarrhoea and delayed sexual development Abnormalities of the skeleton and connective tissue in Turner's syndrome has been frequently reported. We present a case of bilateral bronchiectasis in a patient with Turner's syndrome, of which only 2 cases have been reported so far in literature. Further studies are required to know the true incidence and the etiology of this association.

Primary ciliary dyskinesia, with Kartagener's syndrome as one of the subsets, is an autosomal recessive disorder with significant genetic heterogeneity. A 26-year old male with this syndrome, presenting with recurrent upper and lower respiratory tract infection, was found to be fertile. The case is being reported for uncommon occurrence of this syndrome with male fertility.