Rheumatoid arthritis-associated interstitial lung disease seen in two generation of females in an Indian family

Interstitial lung diseases (ILDs) or diffuse parenchymal lung diseases (DPLDs) are a group of lung diseases that is distinguished by subacute or chronic inflammation and/or fibrosis. Family history is currently being considered one of the biggest risk factors for ILD. Rheumatoid arthritis (RA) a systemic autoimmune disease has lungs as its most common extraarticular organ involved. Interstitial lung disease associated with it is one of the major causes of mortality along with severe disability. Lung involvement in RA might appear as ILD, pleural effusion, or pulmonary vasculitis. In this case report a 42-year-old female presented with complain of progressive breathlessness, dry cough, chest pain, joint pain since past 10 years. HRCT Thorax of patient suggested it to be ILD of UIP pattern with raised RF, anti CCP and positivity in ANA profile. Patient had a family history with mother being diagnosed with ILD-NSIP pattern. She was suspicioned for RA as she had complained of small joint pains and swellings and was responding well to steroids and HCQ

A Case of Intralobar Pulmonary Sequestration Diagnosed Incidentally in a Geriatric Male

Pulmonary sequestration is a rare congenital malformation of lung in which a part of the lung is supplied by an anomalous systemic blood supply from thoracic or abdominal aorta. This is a nonfunctioning lung tissue and lacks normal communication with tracheobronchial tree. It develops from accessory lung bud. If developed before pleura formation, it results in intralobar sequestration, and extralobar, if it develops after pleura formation. Usually Intralobar type of pulmonary sequestration presents in late childhood or adolescence with recurrent pulmonary infections. It is less commonly associated with foregut communication or associated anomalies, unlike the latter. Extra lobar type usually presents with respiratory distress while recurrent infections are less common. In the present case report a 76-year-old male patient was diagnosed with intralobar pulmonary sequestration. This patient was presented with recurrent respiratory infections with complaints of fever and cough with expectoration for one week. Previously the patient was misdiagnosed with recurrent pneumonia. Despite the age of patient, consideration of pulmonary sequestration as a differential diagnosis lead to investigations in that direction. This helped in prompt diagnosis and further plan of management. Misdiagnosis of this condition may have lead to development of complications like recurrent infections and abscess. These complications can be avoided by prompt surgical excisions which are curative. This case report was unique because it diagnosed pulmonary sequestration in a 76 years old patient who presented with recurrent pneumoni

Half-metallic magnetism in Ti3Co5-xFexB2

Bulk alloys and thin films of Fe-substituted Ti3Co5B2 have been investigated by first-principle density-functional calculations. The series, which is of interest in the context of alnico magnetism and spin electronics, has been experimentally realized in nanostructures but not in the bulk. Our bulk calculations predict paramagnetism for Ti3Co5B2, Ti3Co4FeB2 and Ti3CoFe4B2, whereas Ti3Fe5B2 is predicted to be ferromagnetic. The thin films are all ferromagnetic, indicating that moment formation may be facilitated at nanostructural grain boundaries. One member of the thin-film series, namely Ti3CoFe4B2, is half-metallic and exhibits perpendicular easy-axis magnetic anisotropy. The half-metallicity reflects the hybridization of the Ti, Fe and Co 3d orbitals, which causes a band gap in minority spin channel, and the limited equilibrium solubility of Fe in bulk Ti3Co5B2 may be linked to the emerging half metallicity due to Fe substitution

Bronchiectasis in India:results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry

BACKGROUND: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India. METHODS: The Indian bronchiectasis registry is a multicentre, prospective, observational cohort study. Adult patients ( 6518 years) with CT-confirmed bronchiectasis were enrolled from 31 centres across India. Patients with bronchiectasis due to cystic fibrosis or traction bronchiectasis associated with another respiratory disorder were excluded. Data were collected at baseline (recruitment) with follow-up visits taking place once per year. Comprehensive clinical data were collected through the European Multicentre Bronchiectasis Audit and Research Collaboration registry platform. Underlying aetiology of bronchiectasis, as well as treatment and risk factors for bronchiectasis were analysed in the Indian bronchiectasis registry. Comparisons of demographics were made with published European and US registries, and quality of care was benchmarked against the 2017 European Respiratory Society guidelines. FINDINGS: From June 1, 2015, to Sept 1, 2017, 2195 patients were enrolled. Marked differences were observed between India, Europe, and the USA. Patients in India were younger (median age 56 years [IQR 41-66] vs the European and US registries; p<0\ub70001]) and more likely to be men (1249 [56\ub79%] of 2195). Previous tuberculosis (780 [35\ub75%] of 2195) was the most frequent underlying cause of bronchiectasis and Pseudomonas aeruginosa was the most common organism in sputum culture (301 [13\ub77%]) in India. Risk factors for exacerbations included being of the male sex (adjusted incidence rate ratio 1\ub717, 95% CI 1\ub703-1\ub732; p=0\ub7015), P aeruginosa infection (1\ub729, 1\ub710-1\ub750; p=0\ub7001), a history of pulmonary tuberculosis (1\ub720, 1\ub707-1\ub734; p=0\ub7002), modified Medical Research Council Dyspnoea score (1\ub732, 1\ub725-1\ub739; p<0\ub70001), daily sputum production (1\ub716, 1\ub703-1\ub730; p=0\ub7013), and radiological severity of disease (1\ub703, 1\ub701-1\ub704; p<0\ub70001). Low adherence to guideline-recommended care was observed; only 388 patients were tested for allergic bronchopulmonary aspergillosis and 82 patients had been tested for immunoglobulins. INTERPRETATION: Patients with bronchiectasis in India have more severe disease and have distinct characteristics from those reported in other countries. This study provides a benchmark to improve quality of care for patients with bronchiectasis in India. FUNDING: EU/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative inhaled Antibiotics in Bronchiectasis and Cystic Fibrosis Consortium, European Respiratory Society, and the British Lung Foundation

Pulmonary Nocardiosis in Immunocompetent Patient: A Rare Case Report

Pulmonary nocardiosis is a rare bacterial infection that may lead to severe disease in immunodeficient patients and usually not so common in immunocompetent patients. The report is about a 57-year-old male with Norcardiosis. His sputum and Bronchial Alveolar Lavage (BAL) were negative for acid-fast bacilli. Nocardia species was isolated in BAL culture. He was started on Trimethoprim/ Sulfamethoxazole and Clarithromycin, which was later continued for six months