Volume-4, Issue-4

In Asthma, COPD & ACOS

Salmeterol ( as Xinafoate) BP & Fluticasone Propionate BP

HFA Inhaler 25/125, 25/250

Rotacap 50/100, 50/250, 50/500

Montelukast USP 4 mg, 5 mg & 10 mg

2-4

5-6

7-8

9-12

13-16

1. An unusual presentation of primary myelo�brosis

2. Xanthogranulomatous pyelonephritis presenting as a left-sided pleural e�usion

3. Recurrent respiratory papillomatosis: the role of cidofovir

4. Shisha smoking as a possible cause of bilateral granulomatous lung lesions

5. Pulmonary hernia: Case report and review of the literature

Extramedullary hematopoisis (EMH) normally occurs in fetal life, but it is pathological in later life and most of the time because of underlying marrow diseases. Sometimes EMH tissue can present with large masses which can cause compressive and constitutional symptoms. They can be wrongly diagnosed as malignancy and pulmo-nary tuberculosis. Here in this case report we are reporting a case with mediastinal EMH because of underlying mylofibrosis.

Keywords:Extramedullary hematopoiesis, Mediastinal mass, Myelofibrosis, Pulmonary TB

EMH is formation of blood cells outside the medullary spaces of the BM and can be microscopic or can present as a mass lesion, as noted in our case.3

Xanthogranulomatous pyelonephritis (XGP) is a rare chronic granuloma- tous process that affects the kidneys. It is usually associated

with longstanding urinary tract infections and obstruction. Patients suffering from XGP typically present with undifferentiated

symptoms, including abdominal pain, weight loss, and intermittent fevers. For this reason, diagnosis is often delayed until patients are

acutely unwell with sepsis.

Recurrent respiratory papillomatosis (RRP) is a rare condition that affects the respiratory system. It is caused by human papilloma virus

(HPV) infection. Usually infection and papilloma growth is limited to 6–12 months duration; however, some patients have persistent

disease, resulting in longterm symptoms and the need for recurrent intervention. Predominant symptoms include shortness of breath,

reduced exercise tolerance and voice deterioration during flares. Current gold-standard management is through resection via microde-

brider, CO laser, cryotherapy, electrocoagulation, Nd: YAG laser or pulse-dye laser. However, despite these therapies, approximately 20%

of patients require adjuvant therapy. We discuss the use of intralesional cidofovir in the management of tracheal papillomatosis.

Cidofovir’s mechanism of action involves incorporating into the virus DNA chain and therefore, inhibiting the viral DNA polymerization

process and hence replication.

Keywords

Cidofovir, chronic condition, human papilloma virus,

A 19-year-old male who regularly smoked tobacco shisha pipes presented with pleuritic chest pain, dyspnoea, and cough. He was found to have multiple bilateral lung nodules on computed tomography. A biopsy of the lung revealed necrotizing granulomatous inflammation but without evidence of infection, foreign body, vasculitis, or malignancy. There was sponta-neous and complete clinical and radiographic resolution over the next 12 weeks following cessation of shisha use.

Pulmonary hernia (PH) is an uncommon condition. We report a case of PH secondary to thoracic surgical intervention. In addition to the rarity, the peculiarity of the case is given by the clinical course as it is characterized by a clinical latency before the onset. The patient showed risk factors such as obesity and poliomyelitis infection sequelae. We also reviewed the literature about this topic.