Lupus enteritis is a rare clinical entity with a global incidence of 0.2%-14.2%. Signs and symptoms of lupus enteritis are nonspecific, and incidence is very low; it is often misdiagnosed as tuberculosis (TB) in endemic countries like India. Also, enteritis as initial presentation is quite uncommon in systemic lupus erythematosus. We are reporting a case of a 15-year-old woman of lupus enteritis who was misdiagnosed as intestinal TB.

Interstitial lung disease (ILD) comprises a heterogeneous group of chronic pulmonary disorders. ILD is associated with impaired gas exchange and progressive respiratory dysfunction. Due to improved survival and delayed childbearing, healthcare providers increasingly encounter pregnancy in women with ILD, but the evidence on management remains limited. Pregnancy in ILD poses a high risk and necessitates early preconception evaluation, risk stratification and a multidisciplinary management approach. This review aims to summarise current knowledge regarding diagnostic evaluation, treatment strategies, obstetric management and maternal-fetal outcomes in women with ILD. Understanding these aspects is essential for optimising care for women with ILD who are planning to conceive or are already pregnant.

With the help of modern medical technology, various neoplastic and nonneoplastic lesions are getting diagnosed in the subclinical stage. Also, by lowering the threshold of disease definition, a large number of at-risk individuals get reclassified to the disease category. Quite often, these conditions remain harmless throughout a lifetime. Overzealous management in these settings becomes therefore unnecessary and results in various treatment-related adverse effects.

Kikuchi-Fujimoto disease (KFD) is a rare and benign condition characterized by regional necrotizing lymphadenopathy. Acute or subacute painful cervical lymphadenopathy is the most common clinical presentation. The characteristic morphology in histopathologic examination of the lymph node specimen is diagnostic of KFD. Fine needle aspiration cytology (FNAC), often employed as the initial diagnostic method, gives inconclusive results due to inadequate specimens. Our patient was a 36-year-old woman who presented with cervical lymphadenopathy for six weeks. Despite an inconclusive FNAC result, she was treated with empirical antituberculosis therapy (ATT). Later, she was diagnosed with KFD in our facility on excisional lung biopsy in view of non-improvement with ATT. Ambiguous cytological findings may usually lead to the initiation of empirical ATT since tuberculosis (TB) is a major cause of cervical lymphadenitis, particularly in TB-endemic areas. As a result, there is not only a delay in the management of the actual disease, but also a chance of developing adverse reactions to ATT.

Tuberculosis (TB) is a great mimicker due to its various unusual and atypical presentations. Mass-like lesions in thoracic radiology may raise the suspicion of lung malignancy. A man in his early 50s complained of cough, low-grade fever and dyspnoea. Chest radiograph was suggestive of a right hilar mass. Contrast-enhanced CT of the thorax revealed right perihilar consolidation and mediastinal lymphadenopathy. The lesion was encasing the major vessels, causing luminal narrowing. Flexible bronchoscopy showed multiple mucosal nodules in the right lobar bronchi. Histopathology of the endobronchial biopsy showed chronic inflammatory cell infiltrate, while endobronchial ultrasound-guided fine needle aspiration cytology from mediastinal lymph nodes showed numerous caseating epithelioid cell granulomas. Cartridge-based nucleic acid amplification test of lymph node aspirate detectedMycobacterium tuberculosisthat was not resistant to rifampicin. So, the final diagnosis was pulmonary TB. The man improved with 6 months of standard antituberculosis therapy. This case represents an uncommon radiological presentation of pulmonary TB.

ABSTRACT:Skeletal tuberculosis (TB) accounts for only 10% of extrapulmonary TB and predominantly involves the spine and joints. Sternal involvement in TB is a rare clinical occurrence. The clinical presentation is indolent with localized swelling and pain over the sternum. Other less common manifestations are discharging sinuses, ulcers, and bone deformities. Magnetic resonance imaging can delineate the extent of bone and soft tissue involvement well. The diagnosis is established by cytopathological or histopathological examination along with microbiological evidence of Mycobacterium tuberculosis . Treatment with a standard anti-TB regimen provides excellent outcomes. Here, we report a case of primary tubercular osteomyelitis of the sternum that presented as a chronic ulcer over the suprasternal notch.

This narrative review explores parental knowledge, attitudes, and practices (KAP) toward childhood asthma in India, covering aspects of disease etiology, stigma, trigger avoidance, and management, and their overall impact on asthma control and outcomes. A total of 17 studies from 2014 to 2024 focusing on parental KAP were analyzed, excluding those centered on healthcare providers or lacking KAP-compliance correlation. This review reveals widespread parental misconceptions, stigma, and poor knowledge about childhood asthma in India, influenced by regional and socioeconomic factors. Fear of inhalers, use of alternative therapies, and cost barriers to treatment are common. Improved, culturally tailored education and policy efforts are needed to enhance asthma care and outcomes. Parental KAP significantly influences asthma control, with gaps caused by misconceptions, cultural beliefs, and poor practices. Regional disparities highlight the need for context-specific strategies. Despite various global and national asthma guidelines, parental knowledge and practices in India remain poor. Culturally tailored education, community engagement, and policy support are essential to improve parental compliance and childhood asthma outcomes, particularly in underserved regions.

Mediastinal lipomatosis is a benign condition characterized by excessive deposition of unencapsulated mature adipose tissue in the mediastinum.1 The exact prevalence is not known. The available literature mainly consists of some case series and a bunch of case reports.

The coexistence of carcinoma of the colon and tuberculosis (TB) represents a rare and intricate clinical scenario. It poses significant challenges in both diagnosis and management. Clinical prediction of this coexistence is challenging since the clinical features of these two conditions are often similar. Likewise, the radiology is not decisive because of the significant overlap in the image findings of carcinoma and TB. A conclusive diagnosis relies on histopathological evidence of both malignancy and TB. Here, we report a case of a 58-year-old female who presented with chronic abdominal pain. Computed tomography showed the presence of a mass in the cecum. Histopathology of tissue retrieved through colonoscopy was indicative of features of both TB and adenocarcinoma of the cecum. Mycobacterium tuberculosis was detected in the tissue by cartridge-based nucleic acid amplification test. The patient was initiated on antitubercular treatment. She underwent surgical resection of the mass and is planned for adjuvant chemotherapy.

The antitubercular drugs are associated with different cutaneous adverse drug reactions. Toxic epidermal necrolysis (TEN) is a severe form of cutaneous reaction. Although it is rare, it carries a high mortality rate. We report a case of a 75-year-old man with abdominal tuberculosis, who developed pyrazinamide-induced TEN.

Background Artificial intelligence chatbots have demonstrated potential to enhance clinical decision-making and streamline health care workflows, potentially alleviating administrative burdens. However, the contribution of AI chatbots to radiologic decision-making for clinical scenarios remains insufficiently explored. This study evaluates the accuracy and reliability of four prominent Large Language Models (LLMs)-Microsoft Bing, Claude, ChatGPT 3.5, and Perplexity-in offering clinical decision support for initial imaging for suspected pulmonary embolism (PE). Methods Open-ended (OE) and select-all-that-apply (SATA) questions were crafted, covering four variants of case scenarios of PE in-line with the American College of Radiology Appropriateness Criteria. These questions were presented to the LLMs by three radiologists from diverse geographical regions and setups. The responses were evaluated based on established scoring criteria, with a maximum achievable score of 2 points for OE responses and 1 point for each correct answer in SATA questions. To enable comparative analysis, scores were normalized (score divided by the maximum achievable score). Result In OE questions, Perplexity achieved the highest accuracy (0.83), while Claude had the lowest (0.58), with Bing and ChatGPT each scoring 0.75. For SATA questions, Bing led with an accuracy of 0.96, Perplexity was the lowest at 0.56, and both Claude and ChatGPT scored 0.6. Overall, OE questions saw higher scores (0.73) compared to SATA (0.68). There is poor agreement among radiologists' scores for OE (Intraclass Correlation Coefficient [ICC] = -0.067, p = 0.54), while there is strong agreement for SATA (ICC = 0.875, p< 0.001). Conclusion The study revealed variations in accuracy across LLMs for both OE and SATA questions. Perplexity showed superior performance in OE questions, while Bing excelled in SATA questions. OE queries yielded better overall results. The current inconsistencies in LLM accuracy highlight the importance of further refinement before these tools can be reliably integrated into clinical practice, with a need for additional LLM fine-tuning and judicious selection by radiologists to achieve consistent and reliable support for decision-making.

Extramedullary involvement in multiple myeloma is uncommon. It can present as a plasma cell mass in the soft tissue surrounding the bony structures through direct extension or in various other organs via hematogenous spread. Here, we report a case of paraskeletal plasmacytoma that manifested as a chest wall mass in a 60-year-old man.

There are reported 7.5 million cases of extra pulmonary tuberculosis (TB) (EPTB) worldwide and 19% in the South-East Asia region. Anal TB represents an exceedingly uncommon extra pulmonary manifestation of TB), occurring in fewer than 1% of individuals who acquire TB. The occurrence of perianal illness is extremely rare, accounting for 1% of the gastrointestinal (GI) tract, while GI TB makes up less than 1% of all TB cases. The most prevalent manifestation is the development of a fistula in the anus, while the presentation as a perianal abscess is uncommon. We present a case of isolated perianal TB with no associated GI or pulmonary dissemination in the immunocompetent.

Tropical pulmonary eosinophilia (TPE) is a specific pulmonary manifestation of lymphatic filariasis. There is overwhelming infiltration of eosinophils in the lung parenchyma in response to microfilaria. The characteristic features include paroxysmal respiratory symptoms, strikingly high blood eosinophil count, elevated level of immunoglobulin (Ig) E along with high titer of anti-filarial antibody. Treatment with diethylcarbamazine (DEC) has an excellent favorable response. However, recovery may often be incomplete. We present a case of a 36-year-old man with TPE who had complete symptomatic improvement after a three-week course of DEC, but only a partial response in radiological and pulmonary function abnormalities.

Thoracic musculoskeletal disorders are important differential diagnoses in patients presenting to the emergency department with acute-onset chest pain. Although fractures of the ribs usually occur due to trauma, non-traumatic fractures can be seen in the setting of vigorous as well as repetitive coughing. Usually, ribs with malignant or osteoporotic involvement are susceptible to breaking. Uncommonly, cough-induced fractures have been reported in healthy young individuals. Here, we present a case of a 32-year-old healthy man who suffered a fracture of the left seventh rib following a bout of violent coughing.

Cough is invariably encountered during flexible bronchoscopy despite sedation and topical anaesthetics. The ideal cough suppressant during flexible bronchoscopy is not known. We assessed the role of dextromethorphan premedication in relieving the cough during flexible bronchoscopy in adults.

CASE PRESENTATION: A 54-year-old Indian woman presented with low-grade fever and cough with expectoration for 1 month. Fever was not associated with any chills or night sweats. Expectoration was minimal in amount and mucoid in nature. Her appetite was decreased, without any significant weight loss. She denied any history of dyspnea or hemoptysis. The patient was diagnosed with rheumatoid arthritis 1 year previously and was initially started on metho-trexate and short-term glucocorticoids. At the time of presentation, she was taking methotrexate 15 mg weekly and hydroxychloroquine 200 mg daily. Her joint disease was controlled on im-munomodulators. She had no other comorbid condition, and she was a never smoker. She neither traveled within or outside India in the past nor came in contact with patients with pulmonary TB. A chest radiograph was done because a prior workup showed an ill-defined solitary nodular lesion in the right lower zone. She took a course of amoxicillin-clavulanate, but that was of no benefit.