A case of primary spontaneous pneumomediastinum in a 13 year male child with none of the recognised risk factors is reported. He presented with classical symptoms and signs of pneumomediastinum. He kept on conservative treatment initially but tracheostomy was done later on in view of respiratory distress and laryngeal stridor and to maintain the patency of airways with prompt relief.

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Two cases with mean age of 66 years were put on antituberculosis drugs containing isoniazid, rifampicin and ethambutol. Both of them exhibited a high grade isoniazid induced pyrexial response. This drug induced fever was thought to be both due to idiosyncratic reaction and the cidal effect of antituberculosis drugs containing isoniazid on the tubercle bacilli contained in the macrophages leading to release of endogenous pyrogens. Impaired immune response in the old age also may have a role to play.

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A Rare Presentation of Metastatic pleural effusion in medullary carcinoma of thyroid gland is reported.

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The study was undertaken to evaluate the presence of pleural involvement in thirty one patients co-infected with HIV and M. tuberculosis. Out of 31 patients, thirteen (41.94%) had pleural involvement, pleural effusion (5), hydropneumothorax (4), pneumothorax (3) and bilateral pyopneumothorax (1). All subjects belonged to young age group with poor educational background and history of multiple sex partners. The patients with pleural lesion along with lung parenchymal involvement or with bilateral pleural involvement had grave prognosis as they were having greater immunocompromised status. The patients having any high risk factor, even if the clinical evidence is not suggestive of, should be investigated for HIV seropositivity for better patient management and to prevent HIV transmission.

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The advent of helical CT (computed tomography) has greatly enhanced the diagnostic armamentarium of the radiologist in both the detection and characterization of thoracic pathology. Introduced into clinical practice in 1989, spiral CT has already altered the basic concepts of routine CT scanning of thorax. The advantages of helical CT are consequent to the nature of the technique, which entails the acquisition of volumetric data during a single breath hold (1,2). This results in elimination of respiratory misregistration which occurs in conventional incremental scanning. Moreover the examination time of the entire chest is dramatically reduced to a single breath hold of 30-35 seconds. The shorter scan time results in reduction of volume of intravenous contrast requirement. These advantages of Spiral CT result in improved detection and characterization of lesions, improved multiplanar and 3-D imaging and excellent evaluation of vascular pathologies (CT angiography).

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