Background: Paragangliomas are neoplasms arising from extraadrenal chromaffin cells. In the trachea, these tumors are exceedingly rare and only a few cases have been reported in the medical literature. Tracheal paragangliomas usually present with hemoptysis.

Case report: This report describes a 32 year old Moroccan man suffering from progressive dyspnea and hemoptysis due to tracheal tumor. Histopathology of tumor after surgery showed paraganglioma. A circular resection of the trachea carrying the first 4 rings allowed for resecting the entire tumor. No recurrence of tumor was detected at bronchoscopy six months later and it demonstrated good healing of the anastomosis.

Conclusion: Paraganglioma is an unusual histology for tracheal neoplasms. The originality of this case lies in the rarity of this type of tumor, tracheal location that is even more rare and differential diagnostic problem which arises. Clinical features, histological appearance and differential diagnosis as well as treatment are discussed

Lactose Intolerance (LI) is a natural process where production of lactase, an intestinal disaccharide, decreases during the aging due to lack of consumption. There are several sub-types of lactose tolerance: Lactose Tolerant (LT), Lactose Intolerant (LI) and Lactose Mal-absorber (LM). Osteoporosis (OP) is a degenerative endocrinal bone disorder affecting over 200 million people worldwide whereas LI affects up to 70% of the world’s population and approximately 15% of the UK population. OP develops predominantly with age and affects mainly women due to hormonal imbalance post-menopause which when coupled with lack of dairy intake, a key source of lactase and calcium required for bone ossification, leads to the increased bone loss. Understanding the association between LI and OP can lead to better prognosis, prevention technique and treatment.

A young Asian woman was treated for metastasized adenocarcinoma of the lung. Diagnostic evaluation identified a mutation in the Epidermal Growth Factor Receptor (EGFR) gene as well as a mutation in breast cancer 2 (BRCA2). Response to treatment was seen using radiographic imaging and in plasma Circulating Tumor DNA (ctDNA) levels of the BRCA2 and EGFR mutations.

Background: Malignant pleural effusion is a common problem in patients with advanced malignancies and compromised the short-lived survival of these patients. These effusions can be resistant to the treatment such as systemic chemotherapy, pleurodesis with sclerosantagents and recurrent drainage. Therefore, new therapeutic options are needed. The purpose of this study was to evaluate the effectiveness of intrapleural chemotherapy with Cisplatin for the management of MPE in lung, breast and mesothelioma cancers.

Materials and methods: Twenty-one cancer patients with MPE were enrolled in this study. Cisplatin was injected through a catheter at a dose of 30mg /m2, and this procedure was performed 3 times at intervals of two weeks. Patients were evaluated for side effects and responses to the treatment every two weeks and one month after the last treatment.

Results: Among the assessable 18 patients, complete response and partial response were 9 (50%) and 4 (22.2%) patients, respectively (overall response rate 72.2%). Dyspnea was improved in 13 (72.2%) patients and had no change in 5 (27.8%) patients. One patient did not refer after the first intrapleural injection. Also two patients died during the study. None of the patients had side effects of grade 3 and 4.

Conclusion: The results of this trial study showed that using of Intrapleural Chemotherapy with cisplatin in the management of patients with MPE in lung, breast and mesothelioma cancers is effective and safe.

Non-Tuberculous Mycobacteria (NTM) are not obligate pathogens and generally do not cause disease or get transmitted from person to person they are opportunistic organisms that cause disease in immunocompromised individuals. They most commonly cause skin and soft tissue infections, lymphadenitis and lung infections.

Background: CAT and SGRQ are two health related quality of life questioners validated for application in patients with COPD. Our purpose is to study the correlation of these questioners in COPD patients considering separate features of disease including symptom, activity, impact and total score.

Material and Method: Between December 2014 and December 2015 validated Farsi translation of CAT and SGRQ were administered to patients with clinically proven COPD in referral center of Masih Daneshvari hospital, Tehran-Iran. The components of SGRQ score including symptom, activity, impact and total scores were calculated using excel based SGRQ calculator. Informed consent was obtained from patients. CAT questions similar to SGRQ were categorized into symptom (question number 1 to 3), activity (question number 4 and 5), and impact (question number 6 to 8), based on the meaning and concept of the questions. All data was processed by spearman correlation coefficient analysis using SPSS software version 22.

Results: Ninety nine patients [73 male (73.7%) and 26 female (26.3%)] with COPD were studied. Mean age was 57.46 ± 12.17 years old (31-87). The correlation between CAT and SGRQ in all components of questioners including symptom (0.792), activity (r=0.657), impact (r=0.467) and total score (r=0.673) was significant (p< 0.001).

Conclusion: Total scores of Farsi translation of CAT and SGRQ correlated significantly as well as the subdivided questions including symptom, activity and impact. Despite less number of questions, CAT questionnaire is able to reliably assess the different aspects of COPD patients.

Pleural effusion associated with bacterial pneumonia, lung abscess, or bronchiectasis is a parapneumonic effusion. An empyema is pus in the pleural space. The morbidity and mortality in patients with parapneumonic effusion are higher than in patients with pneumonia alone.

It is a cross-sectional observational study of 50 cases with parapneumonic effusion and empyema coming to tertiary care center, previously diagnosed outside or diagnosed on arrival over a period of 2 years (August 2014 - September 2016) with the aim to study their clinical profile.

In the present study, we found that patients have varied clinical symptoms mimicking pneumonia. Among cases from all age group studied, 66% (n-33) had CAP, 30% (n-15) had HAP and 4% (n-2) had VAP. Patients with comorbidities, tobacco and alcohol intake were more prone for developing the disease. 42% (n-21) had complicated parapneumonic effusion and 10% (n-5) had empyema. The overall cure rate was 80% (n-40); surgery was required in 4% (n-2) of patients while 12% (n-6) succumbed during the disease course. We found that 9.1% deaths incurred in patients of CAP whereas death amongst HAP were up to 13.3%. Mortality was highest amongst patients of VAP with parapneumonic effusion. Culture positive pleural fluid grew the following microorganisms- Acinetobacter baumannii (2%), Escherichia coli (2%), Methicillin-resistant Staphylococcus aureus (4%), Pseudomonas aeruginosa (4%), Peptostreptococcus (2%) with multidrug resistance pattern.

The important factors related to poor outcome amongst complicated pleural effusions were mixed bacterial infection with multidrug resistance, poor response to higher antibiotics, presence of bacteraemia and septic shock.

TB and HIV (Human Immunodeficiency Virus) co-infection is one of the public health issues. TB is one of the main life-threatening infection for HIV-infected people whether the status of enrollment to the anti-retroviral (ARV) treatment, and a cause of death among these people. The risk of getting TB of HIV-not infected people is 5-10%, but of HIV-infected people it increases up to 50%.

Even Mongolia is the low HIV prevalent country, the HIV, AIDS and drug-resistant TB (DR-TB) has increasing trend. By 2017, totally 52 cases of HIV co-infections have been registered of which 6 were DR-TB cases. Out of these cases 50% (3) were aged 45-54 years old, 33% (2) were 25-44 aged people, 17% (1) were 25-34 years old people. But in terms of sex, all were males. Out of registered 6 cases 66% (4) were cases received the first-line TB drugs treatment prior to enrollment in ?? DR-TB treatment. According to DR-TB treatment results, 67% (4) were died, 16.5% (1) were cured, and 16.5% (1) were relapse cases. The mortality among HIV-infected cases that getting DR-TB is high, thus the clinical observation made among cases with the specific clinical manifestations, weak treatment results in order to provide information on the treatment follow-up monitoring and diagnosis for clinical doctors.