Lung is the second most common site of hydatid disease, after liver. Pleural involvement of hydatiddisease can occur, and usually follows the rupture of a pulmonary or hepatic hydatid cyst into thepleural space. When a patient presents with tension pneumothorax, zoonotic infections, especiallyhydatid disease of the lung, also has to be considered especially in areas with high burden of thedisease. We report a 31 years male patient presenting with tension pneumothorax due to rupture ofhydatid cyst of lung.

Key message It is unusual to be able to visualize an entire cavity with such clarity.

Hepatitis A virus infection is the commonest form of hepatitis in pediatric age group and common health problem in developing countries due to poor sanitation. The clinical spectrum of hepatitis A virus infection ranges from asymptomatic infection to fulminant hepatitis and the symptoms are primarily hepatobiliary or constitutional. Here, we present a case of 16 years old male who presented with complains of fever, vomiting, anorexia, right sided abdominal pain, shortness of breath and cough. On clinical examination, patient has hepatomegaly and decreased breath sounds on right sided mammary, infra- mammary and infra scapular region. Blood investigations showed aminotransferases while pleural effusion and ascites with thickened gall bladder were found in chest x-ray and abdominal ultrasonography respectively. In absence of others causes, pleural effusion can be a rare complication of hepatitis A. Thus, this complication should be kept in mind in endemic countries in clinically matching scenarios.Keywords: Acalculous cholecystitis; ascites; hepatitis A; pleural effusion

Many centres around the world are at the stage of expanding endobronchial ultrasound (EBUS) services. Our centre was one of the earlier centres to start the services in Nepal, a country in South Asian region which falls under low-and middle-income countries. Our experience will likely resonate with centres which have similar background.The field of respiratory medicine in Nepal is at a budding and exciting stage. In 2018, our centre decided to procure EBUS. At that time, we were the second centre to bring in convex probe-EBUS (CP-EBUS) in the country. However, no one in the country had formalized, structured, certified training in EBUS. In this background, the corresponding author applied for European Respiratory Society (ERS) EBUS training and received part 1 (June 2018) and part 2 (January 2019) of EBUS training in Amsterdam, Netherlands. It is one of the first open certified EBUS training programs. This training focuses on CP-EBUS with simulation-based training in part 2 followed by supervised procedures in part 3 leading to certification. Simulationbased training has been shown to be more effective than traditional apprenticeship training. 1 Successful completion of

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