Mediastinal germ cell tumour masquerading as loculated pleural effusion

Benign mediastinal teratomas often discovered while patients are still asymptomatic. Almost all arise in the anterosuperior mediastinal compartment. Most symptoms result from compression of adjacent structures. We report a case of a large teratoma arising from the anterior mediastinum that presented a confusing clinical picture of loculated pleural effusion which was successfully diagnosed and treated by surgical excisio

Knowledge, anxiety and the use of hydroxychloroquine prophylaxis among health care students and professionals regarding COVID-19 pandemic

Introduction:  Data regarding knowledge and attitude about COVID-19, the prevalence of acceptance of hydroxychloroquine prophylaxis and anxiety amidst COVID-19 pandemic among health care students/professionals in India is scarce.Material and methods: A cross-sectional study was conducted during May 2020, using an online survey via Google forms. A self-administered validated structured questionnaire was applied, which comprised 28 questions among health care students/professionals at a tertiary care centrein North India.Results: A total of 956 respondents were included (10.2% nurses, 45.2% medical students, 24.3% paramedical students, 11.7% resident doctors and 8.6% consultant doctors). Overall knowledge score was 9.3/15; the highest for preventive practices (4/5), followed by clinical knowledge (2.7/5) and the use of personal protective equipment (PPE) (2.6/5). The overall score was the highest in consultant doctors (10.8) while the lowest in nurses (8.5) and paramedical students (8.4) (p < 0.001). Less than half of the respondents had knowledge about the correct sequence of doffing PPE and the use of N95 mask. About 21.8% of the participants experienced moderate to severe anxiety; higher among nurses (38%), followed by paramedical students (29.3%); and anxiety was higher when knowledge score was low (27.6% vs 14.7%); both factors were independent predictors on multivariate analysis (p < 0.001). Only 18.1% of the respondents applied HCQ prophylaxis — the highest proportion constituted consultants (42.7%), and the least — paramedical students (5.2%); (p < 0.001) and HCQ use was more frequently used if they had a family member of extreme age group at home (23.3% vs 12.2%; p < 0.001). Conclusions: The knowledge about correct PPE usage is low among all groups of HCWs and students, and there is a high prevalence of anxiety due to COVID-19. The lower COVID-19 knowledge scores were significantly associated with a higher likelihood of anxiety and inadequate use of HCQ prophylaxis. The appliance of HCQ prophylaxis had no significant association with anxiety levels of the respondents

A Young Female with Polycythemia: Pearls in the Lung

A 35 year-old female presented to the Pulmonary Medicine OPD with a history of progressive dyspnea, malaise, weakness and easy fatigability for the last 5–6 month [...

Mediastinal Germ Cell Tumour Masquerading as Loculated Pleural Effusion

We report a case of a large teratoma arising from the anterior mediastinum that presented as a confusing clinical picture of loculated pleural effusion which was successfully diagnosed and treated by surgical excision [...

Designing of type-I polymeric superlattices using genetic and ant algorithms: A comparative study

1652-1656Genetic and ant algorithms, a class of metaheuristic algorithms, have been applied in combination with the negative factor counting method to the designing of copolymers to find the optimum concentrations of the constituent homopolymers which would give the most conducting copolymer (with minimum band-gap and maximum delocalization). Quasi-one dimensional model ternary polymeric superlattices belonging to type-I have been investigated using both genetic and ant algorithms and a comparative study of the results has been made. Further the dependence of the optimized results on factors like the random sequence generated (depending on the seed used) has been investigated. It has been found that the band gap, of the copolymers studied, lies close to that of the constituent lowest band gap homopolymer. The optimized solutions are nearly seed independent. Also, the results obtained from both the algorithms are found to be more or less the same

Not just skin deep: Multiple cutaneous nodules as first presenting sign of small cell cancer

A 65 years old male, chronic smoker (30 pack years), presented with complaints of dyspnea (mMRC grade2), cough (dry in nature), loss of appetite, loss of weight ( > 5 kgs), weakness, bony pains, feverish feeling and easy fatigability for last 2–3 months.Contrast enhanced CT chest showed bilateral extensive paraseptal and centriacinar emphysematous changes, right upper lobe spiculated heterogeneously enhancing soft tissue lesion and significant conglomerate mediastinal lymphadenopathy encasing lower trachea and great vessels.As patient was high risk for development of pneumothorax related to image guided sampling of right upper lobe lesion in view of extensive emphysema; patient was referred to us for EBUS-TBNA (endobronchial ultrasound guided transbronchial needle aspiration) guided mediastinal lymph nodes sampling. But on head to toe examination revealed round, firm, non-tender, skin coloured, 2–3 cm size skin nodules (2 on left lateral chest wall, 1 on right lateral chest wall and 1 in proximity to umbilicus).Fine needle aspiration cytology (FNAC) was attempted from two of skin nodules which was suggestive of small cell lung cancerSkin metastasis as initial presentation is reported rarely in small cell lung cancer.The index case emphasize on importance of detailed physical examination in cases of lung cancer to look for any skin manifestation of the disease, although encountered rarely.Moreover detection of skin nodules helps in staging and prognosis of diseases