Antifibrotics were exuberantly used to treat post covid lung complications. Lung is the primary target organ in COVID-19 disease with diverse clinical and radiological presentations and outcome. It has caused minimal to moderate lung disease in some patients and in some cases caused deadly acute respiratory distress syndrome (ARDS). COVID-19 disease caused lung damage by direct virus induced alveolar damage, cytokine induced alveolar and vascular damage and microvascular thrombosis resulting into acute hypoxic respiratory failure. COVID-19 pneumonia evolved over period of three weeks in cases with ARDS as natural course of illness. Usually, ARDS resolves by fibrosis or resolution as final outcome. Similarly, in COVID-19 recovered cases of advanced disease or those suffering from ARDS are having post covid lung disease. Lung fibrosis is final radiological outcome of COVID-19 pneumonia documented in proportionately majority of cases. Post COVID lung fibrosis is considered as worrisome radiological complication observed during early phase of pandemic. Antifibrotics such as Nintedanib and Pirfenidone were used to treat post covid lung complications such as fibrosis. Both drugs were shown good antifibrotic property in clinical trials for fibrotic lung disease and observed positive outcome in restoring lung parenchyma. Time trends of final radiological outcome has evolved over months with or without treatment with antifibrotics and steroids. Importantly, Post covid lung fibrosis resolved more than fifty percent cases in six months and nearly in all cases after one year. Thus, antifibrotics were used irrationally in fibrosing lung condition of reversible type. Actually, we have overestimated post covid lung fibrosis and overtreated with antifibrotics.

Coronary catheterization is a minimally invasive procedure to access the coronary circulation and blood-filled chambers of the heart using a catheter to recognize occlusion, stenosis, and thrombosis. This procedure is commonly performed through the femoral artery, which may induce possible complications such as bleeding or hematoma. Restricting patient movement was adopted to avoid these complications. The patient has to lie in bed in a supine position for at least 6 hours after angiography. This is an experimental case-control study, conducted to evaluate the effect of early mobilization on back pain. A sample of 300 adult patients was selected by a random sample technique. They were randomly allocated to 100 patients in the experimental group and 200 patients in the control group. The study was conducted from March 2017 to March 2019 at Ahmed Gasim Cardiac Surgery and Renal Transplantation Hospital in Khartoum State, Sudan. The experimental group was mobilized early after 4 hours and the control group had routine bed rest for 6 hours post-sheath removal. Both groups received the usual care. A structured questionnaire and checklist were used to collect data. Data were analyzed by using Statistical Packages for Social Sciences (SPSS).The results revealed that the two groups feel pain varying between no pain and mild (85%) in the cases and in the controls (89.0%) from one hour up to four hours but significant back pain increased clearly at five hours and six hours for the controls group (5th hours severe (6%) very severe (0.5%). P. value 0.000 significant and 6th hours severe (27.5%) very severe (6%). This study concluded that back pain reduction was statistically significant among the experimental group compared to the control group.

Pulmonary Tuberculosis is most common diseases in India with significant mortality and morbidity. Tuberculosis can cause diverse thoracic presentations ranging from nodules, consolidations & cavitation, mediastinal adenopathy, pleural effusion to diffuse endobronchial disease presenting like bronchial asthma. In this case report, 29- year male, presented with constitutional symptoms for 4 months duration with partial response to medical treatment received according to their knowledge and experience towards bronchial asthma, enteric fever and jaundice. Radiological investigations documented only prominent hilum left side of thorax which was underestimated due to presence of wheeze. Recurrent, progressive and partially responding constitutional symptoms was the reason for referral to our center. We have also noted prominent hilum with inhomogeneous infiltrates left lung field and localized wheeze and crepitations on left side of thoracic cavity in mammary and interscapular region. We have further evaluated with HRCT thorax and observed thick-walled cavities in left upper lobe posterior segment. ‘Stepladder Lung Cavities’ in HRCT is defined as multiple cavities adjacent with each other partially communicating to noncommunicating of variable size and shape unilaterally or bilaterally in stepladder fashion. ‘Starry sky pattern’ in HRCT Thorax is defined as randomly placed nodular opacities presenting as discrete or conglomerated, interstitial and acinonodular opacities unilateral or bilateral adjacent to pulmonary cavities usually reported as satellite nodules. Satellite nodules are defined as nodular opacities adjacent to pulmonary primary caviatary lung disease and indicator lymphatic local spread and active pulmonary tuberculosis. We have done sputum examination and documented acid-fast bacilli in sputum smear and MTB genome with rifampicin sensitivity in cartridge based nucleic acid amplification test. Treatment initiated with anti-tuberculosis (ATT) and recorded near complete radiological resolution, bacteriological cure after six months with good compliance. High index of suspicion is must while managing these cases with constitutional symptoms with typical ‘Stepladder Lung Cavities’ with ‘starry sky pattern’ in HRCT Thorax to have successful treatment outcome.

Because of its curative properties, Syzygiumaromaticum has long been used in conventional, holistic medicine. It has anti-inflammatory, antibacterial, antioxidant, and cancer-fighting properties. Clove oil, also known as the essential oil of the Syzygiumaromaticum tree, contains a wide variety of compounds, including the methyl salicylate, tannins like bicorningallotannic acid, acetyl eugenol, beta-caryophyllene, vanillin, catholic acid, and the flavonoids eugenin and hesperetin., kaempferol, and rhamnetin are some of the bioactive compounds found in eucalyptus., and eugenic Using the MTT assay, we were able to determine the cytotoxicity of the stable oil and found that it inhibited the growth of cancer cells, suggesting that this formulation may be helpful as a complementary therapy for cancer. Also tested was the oil's efficacy against Staphylococcus aureus bacteria. According to membrane permeability studies, it is highly effective in passing through cell membranes and themes, increasing the leakage of cytoplasmic contents.

Tuberculosis is a more prevalent disease and the leading cause of death from an infectious agent in India. Tuberculosis in India accounts for the highest number of cases and deaths annually in the world. In spite of an efficient National tuberculosis control program for five decades, Tuberculosis is still the number one cause of death due to infectious agents in India and one third of total global deaths occurs in India due to this disease. Burden of drug sensitive and drug resistant cases is highest in the south east Asian region with maximum cases in India and China. India has launched a National strategic plan to end TB in 2017 with a target to eliminate TB by 2025. Main theme of the national strategic plan is ‘TB Free India’ with the vision of zero TB disease, zero deaths due to TB and decreasing poverty due to TB. Tuberculosis is an ancient disease and history traced before the evolution of mankind on this planet. Tuberculosis primarily affects the lung and is classified pathologically as primary, post-primary and progressive primary tuberculosis. In this case report, a 62-year male, presented with constitutional symptoms for six-month duration with partial response to medical treatment. He was having low grade fever, cough, shortness of breath, weight loss and anorexia for 6 months. His symptoms were progressive and empirically treated as enteric or typhoid fever for four to five occasions with oral and intravenous antibiotics with steroids with general physicians and family physicians. Additionally, he received empirical treatment as jaundice, viral fever, bronchitis, asthma, and generalised debilitating disease. Relatives brought to our center worsened general health with increased shortness of breath. Clinically he was having bilateral crepitations with decreased breath sounds right lower axillary and infrascapular area. Chest x-ray showed right pleural effusion with miliary opacities bilateral lung field. HRCT thorax showed typical miliary opacities with conglomerated pattern and pleural effusion on the right side of thorax. Pleural fluid analysis revealed exudative effusion with raised ADA level. He was unable to produce sputum, we have done bronchoscopy and BAL evaluation confirmed pulmonary tuberculosis and sensitivity pattern. BAL cytology documented acid-fast bacilli in smear and MTB genome with rifampicin sensitivity in cartridge based nucleic acid amplification test. Treatment initiated with anti-tuberculosis (ATT). We have recorded near complete radiological resolution, bacteriological cure after eight months of ATT with good compliance. More awareness is required regarding symptoms, diagnosis and treatment of tuberculosis to family physicians and general practitioners as the majority of the rural population receives treatment from these health professionals.