Study objective : To study the value of adenosine deaminase level in tuber­cular pleural effusion. Design: A hospital based observational study. Setting : Out and In patients service of department of Tuberculosis & Chest Diseases, MLN Medical College Allahabad. Patients : 50 consecutive patients of pleural effusion, who were above the age of 12 years, were studied. RESULTS: Pleural fluid adenosine deaminase was more than 36 IU/L (36 to 229.7 IU/L) in tubercular pleural effusion (34 patients). In case of malignancy no. of patients was 08 and pleural fluid adenosine deaminase was more than 18.5 IU/L (18.5 to 87.6 IU/L). While in one case of hypoprotenemiea pleural fluid adenosine deaminase was 8.21 IU/L. If 36 IU/L is taken as cut of limit the sensitiv­ity and specificity of ADA for tuberculosis is 100 % and 77.7 %. More than 100 IU/L was exclusively seen in tubercular pleural effusion. Conclusion: ADA > 100IU/L was observed in TB only.

Aims and Objectives : To determine sputum conversion rate at monthly intervals of 1st, 2nd and 3rd month in new smear positive cases (cat-1) under treatment under RNTCP. Material and Methods : The study was conducted at DOTS Center, Gauhati Medical College and Hospital; Guwahati between July 2005 to June 2006.The study is a prospec­tive study and consists of 100 cases of new smear positive pulmonary tuberculosis cases (category 1) irrespective of age and sex. Results and Observations : The age & sex distribution of 100 patients showed that majority of the patients (74%) belonged to 2nd, 3rd and 4th decades & 75% were males and 25% were female with male to female ratio 3:1 respectively. The chest x-ray of 100 Smear Positive patients shows that only 60 (60%) patients had x-ray evidence of pulmonary Koch. In the present study, sputum conversion i.e. from smear positive to smear negative at the end of the 1st month is 71%, at the end of 2nd month is 84% and at the end of 3rd month is 92%. Summary & Conclusion : In conclusion, the overall sputum conversion rate under Directly Observed Treatment, Short Course (DOTS) chemotherapy in 100 sputum smear positive Pulmonary Tuberculosis in DOTS centre, Gauhati Medical College & Hospital was 92%.The chest x-ray evidence of pulmonary Koch in 100 patients is 60%.The sputum conversion at the end of 1st month is 71%, at the end of 2nd month it is 84% and at the end of 3rd month the same is 92%. In the present study, the infectivity decreases from the baseline with significant P value for sputum conversion of 3+, 2+ and 1+ sputum positivity. Directly Observed Treatment is an effective intervention for improving adherence to tuberculosis treatment programme in a resource-poor country. A significant decrease in conversion rate was observed with the initial high grade smear positive cases.

A 24-year old male developed left sided pleural effusion 10 days after the start of anti tubercular chemotherapy for right-sided pleural effusion and parenchymal lesion. This effusion seemed to be a paradoxical response as it resolved on follow up.

The case of a 35-year old man who presented with massive left sided haemothorax as a complication of an asymtomatic pancreatic pseudocyst is descibed. The diagnosis was confirmed by very high amylase content of the pleural fluid. The complications of pancreatitis and pancreatic pseudocyst are also briefly discussed. Haemothorax represents an unusual pulmonary complication of pseudocyst pancreas and should be considered in the differential diagnosis of pleural fluid collection in pancreatitis.

Pulmonary Mucormycosis is an uncommon disease caused by fungi of class Zygomycetes. It occurs predminantly in an immunodeficient host most common risk factor being diabetes mellitus. The lesions are localized in the lungs or the mediastinum. We are reporting a case of 70 years old male, having cough, haemoptysis, fever and chest pain. He was on antituberculosis treatment (RHEZ) for last 10 days and was later found to have Pulmonary Mucormycosis on further evaluation.

Combined type of small cell lung carcinoma (SCLC) is a rare malignancy of the lung that is usually peripheral and diagnosed after resection. We report an unusual case of centrally located combined SCLC with squamous cell component that was diagnosed on endobronchial lung biopsy.

Skeletal tuberculosis is usually seen in association with primary pulmonary form. Pulmonary tuberculosis of the chest wall is a rare entity. We herein report a case of tuberculosis of the chest wall without pulmonary involvement that presented with big ulcer in the anterior chest wall and responded completely to the antituberculosis therapy without any surgical intervention.