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Performance of composites can be improved by adding a suitable fiber to the polymer matrix. Many natural fibers available are cost-effective and can be used as reinforcement. Mudar fiber is one among the natural fiber obtained from bark of Crown flower (Calotropis Gigantea) plant. The natural fiber, Mudar, is available in the southern parts of India. The Mudar fiber is primed in a sodium hydroxide solution and diced into 4 mm length. The fiber-reinforced composite is obtained by mixing the epoxy resin with Mudar fiber, and the roller is repeatedly used to reduce the inherent porosities. The mechanical behaviors like flexural, compression, tensile, and impact behaviors of untreated and NaOH-treated Mudar fiber composites are analyzed. The maximum tensile strength was accounted for 20% treated fiber composite,s which was 90% more than the untreated composites. The compressive strength and flexural strength of 30% treated composites was 31% and 83% more than that of the untreated composites, respectively. Similarly, the maximum flexural strength of 40% treated composites was 2.6 times higher than the untreated composites. The morphological characteristics of specimens after tensile and compressive tests for treated and untreated conditions are also investigated. Consequently, it is found that the structural characteristics of polymer composites reinforced with alkali-treated fiber are more superior than those of the untreated fiber.

INTRODUCTION: Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. Various triggers, lack of knowledge about the disease, and unawareness about the correct inhalation techniques lead to poor control of the disease. This study aimed to study the factors responsible for uncontrolled asthma using the asthma control test (ACT) and explore other ways to improve asthma control. MATERIALS AND METHODS: One hundred and eighty diagnosed cases of bronchial asthma according to Global Initiative for Asthma (GINA) guidelines, >18 years were enrolled for the study in an outpatient setting. The level of asthma control was assessed using the self-administered ACT. Factors responsible for uncontrolled asthma were evaluated using a questionnaire based on GINA guidelines. RESULTS: Our study noted that in the majority (66.11%) of patients, asthma was poorly controlled followed by well-controlled (24.44%). Asthma was perfectly controlled in only 9.44% of patients. The mean value of the ACT score of study subjects was 17.5 ± 4.16 with a median (25th–75th percentile) of 17 (15–20) within the range of 7–25. Smoking (P < 0.0001), poor education about asthma (P < 0.0001), social stigma regarding inhaler use (P < 0.0001), wrong inhalation techniques (P < 0.0001), environmental triggers (P < 0.0001), associated comorbidities (P = 0.005), poor adherence to treatment (P < 0.0001), inappropriate therapy (P < 0.0001), and frequent hospitalizations (P = 0.006) were the factors responsible for uncontrolled asthma. CONCLUSION: The present study identified various factors responsible for the high prevalence of asthma in an outpatient clinical setting. Common risk factors that contribute to poor asthma control were assessed in a comprehensive manner.

Aims and Objectives: The aim of the study is to detect the pattern of genetic mutation, i.e., Inh A or Kat G or both (Inh A and kat G) in isoniazid (INH) monoresistant mycobacteria and to correlate with the pattern in multidrug-resistant (MDR) isolates. Materials and Methods: In this study, a quantitative research approach was used. The research design was descriptive observational study. The study was conducted at the Department of Respiratory Medicine, JLN Medical College, Ajmer, Rajasthan, and Intermediate Referral Laboratory, State TB Demonstration Centre, Ajmer. A total of 298 samples found to have resistant strains of Mycobacterium tuberculosis were enrolled with purposive sampling. Results: The mean age of patients was 40.27 ± 13.82 years. There were 250 (83.9%) males, while 48 (16.1%) were females. One hundred ninety-two (64.4%) were resistant for INH only, while the rest were resistant to both INH as well as rifampicin (MDR-tuberculosis). The most common mutation in INH monoresistance was kat G (125; 65.1%) as compared to inh A (54; 28.1%) and both inh A and kat G (13; 6.7%). Among kat G mutations, the most common gene pattern was the absence of WT (S315T) and the presence of MUT1 (S315T1). Conclusion: Knowledge about mutation patterns of different INH resistant strains is important in the present era where there is a provision of separate regimens for INH monoresistant TB. Since these mutations are very closely related to high- or low-degree resistance to INH, the therapeutic regimens cannot be generalized.

Unilateral absent pulmonary artery is an uncommon condition and may be associated with other congenital cardiac defect. Patients without associated cardiac abnormality usually present in adulthood with symptoms of dyspnea, hemoptysis, etc. We encountered two adults with absent right pulmonary artery who presented with hemoptysis and on investigations found to have absent right pulmonary artery. Considering the rarity of this entity, we found it worthy of reporting.

Malignant pleural effusion (MPE) denotes an advanced malignant disease process. Most of the MPE are metastatic involvement of the pleura from primary malignancy at lung, breast, and other body sites apart from lymphomas. The diagnosis of MPE has been traditionally made on cytological examination of pleural fluid and/or histological examination of pleural biopsy tissue that still remains the initial approach in these cases. There has been tremendous advancement in the diagnosis of MPE now a day with techniques i.e. characteristic Ultrasound and computed tomography features, image guided biopsies, fluorodeoxyglucose-positron emission tomography imaging, thoracoscopy with direct biopsy under vision, tumor marker studies and immunocytochemical analysis etc., that have made possible an early diagnosis of MPE. The management of MPE still remains a challenge to pulmonologist and oncologist. Despite having various modalities with better tolerance such as pleurodesis and indwelling pleural catheters etc., for long-term control, all the management approaches remain palliative to improve the quality of life and reduce symptoms. While choosing an appropriate management intervention, one should consider the clinical status of the patient, life expectancy, overall cost, availability and comparative institutional outcomes, etc.

Introduction: Acute exacerbation of COPD is one of the leading causes of death worldwide. Aim: This study was aimed to study the role of clinical tools and biochemical markers which have significant impact on short-term mortality in COPD patients presenting with acute exacerbation. Material and Methods: A total of 50 patients were studied. Patients of age >40 years having COPD exacerbation and presenting with two of the three cardinal features of exacerbation: increase in amount of cough, increase in purulence of cough, increase in baseline dyspnoea which were severe enough to necessitate a hospital admission, were evaluated after admission. A thorough history taking and clinical examination was performed. Along with this, all necessary laboratory parameters were studied. Study population was followed for 30 days. Data were analysed using Chi-square test and multivariate regression analysis using SPSS version 16.0. Results: Out of 50 patients, 30% (15/50) did not survive despite treatment. Parameters such as, history of mechanical ventilation in past one year, low GCS (Glasgow Coma Scale), raised JVP (Juglar Venous Pressure), low pH and raised IL-6 levels were significantly associated with mortality in multivariate analysis (p-value

Introduction: Tuberculosis (TB) is one of the leading causes of death and disease worldwide. Tobacco smoking has been linked as a risk factor for TB. This study was aimed to affirm the strength of association between smoking and pulmonary TB. Materials and Methods: Pulmonary TB patients aged between 18 and 65 years were enrolled and followed-up until treatment completion. Two consecutive sputum smears were examined from each patient for the presence of acid-fast bacilli (AFB) using Ziehl-Neelsen technique. Radiological severity of disease was assessed using guidelines of National TB Association of USA. Sputum smears for AFB were graded for positivity as per WHO Revised National TB Control Programme criteria. Response was determined in terms of sputum conversion at the end of intensive phase and final treatment outcomes. Results: Sputum smear grading of 3+ increased from 12.5% to 68.18% and 66.66% as smoking index increased from 300 (P < 0.05). In nonsmokers, 79.2% patients had minimal disease while only 4.2% had advanced disease as compared to smokers where 52.4% had moderate disease, 26.2% advanced disease, and 21.4% minimal disease (P < 0.01). Smokers had significantly lower treatment success rate (69%) as against nonsmokers and former smokers (93.8% and 90.9%, respectively, P = 0.001) owing to a higher default rate among smokers (28.5%) than nonsmokers (6.3%) and former smokers (9.1%). Conclusion: Smokers during initial presentation, as well as at end of the treatment demonstrate more radiological findings, cavitary disease, and worse sputum AFB smear grading. Smokers also have a poorer treatment success rate largely due to high percentage of default rate thus suggesting noncompliance as a main confounder to treatment success. Focus needs to be made to reduce defaulters which are more common among smokers.

Chest wall swelling with underlying lung involvement is a rare phenomenon and it poses certain diagnostic challenges as well. It has to be differentiated from other swellings with different underlying etiology. We present a case where a 60-year-old man presented with a progressive chest wall swelling over right sterno-clavicular joint abutting the manubrium sterni. The origin of the swelling resulted from a leak of air from a tense tubercular cavity in the lung parenchyma that was diagnosed with the help of a contrast-enhanced computerized tomography thorax. The case was managed conservatively with antitubercular therapy and evacuation of air from the chest wall swelling by a nasogastric tube.

Osteosarcoma (OS) is a malignant connective tissue tumor originating from bone and is the most common primary bone malignancy of long bones but seldom arises in jaw bones. Osteosarcoma of jaws is frequently seen arising in the second and third decade as compared to earlier occurrences in other bones and show a slight predilection for body of mandible. It is a highly malignant tumor with varied radiographic features. We present a case with detailed radiographic assessment using intraoral radiograph, computed tomography (CT), 3-D CT, CT angiography techniques and histological evaluation.

Botryoid odontogenic cyst (BOC) is considered to be a polycystic variant of the lateral periodontal cyst (LPC) as the specimen resembled a cluster of grapes. It is a non-inflammatory odontogenic cyst. The BOCs can be unicystic or multicystic. These cysts have potential to extend in the bone and become multilocular and they have a high recurrence rate. Till now, only 73 cases of BOC have been reported. The pathogenesis of BOC is still debatable. We review different pathogenesis proposed for BOC and discuss a rare case of BOC developing from lining of an abnormally large LPC which showed aggressive behaviour in terms of growth and size.

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