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Introduction: The presence of Mycobacterium tuberculosis in a respiratory specimen is diagnostic in patients with pleural effusion. It is difficult to obtain sputum even after induction in these patients. An alternative method of acquiring respiratory specimens is via bronchial lavage. This study was undertaken to evaluate the diagnostic yield of acid-fast bacilli (AFB) smear, AFB culture, and Xpert assay of bronchial lavage fluid in the workup of pleural tuberculosis patients. Material and methods: All patients who met the inclusion criteria of the study underwent thoracentesis, pleural biopsy, and bronchial lavage. Specimens of pleural fluid, pleural biopsy, and bronchial lavage fluid were sent for acid fast bacilli smear, culture, and Xpert assay. Result: Bronchial lavage AFB smear, culture, and Xpert assay was positive in 9.5%, 17.9%, and 26.2% of patients, respectively. It gave an immediate diagnosis in 22 (26.2%) patients. Conclusion: Bronchial lavage, though not a surrogate to pleural biopsy, offers an additional approach to the early diagnosis of pleural tuberculosis in patients not producing sputum. Besides being diagnostic, this method also has epidemiologic significance in containing the tuberculosis epidemic because detecting Mycobacterium in bronchial lavage confirms that the patient is infectious.

Aim: To evaluate the frequency of gall bladder wall thickness in patients suffering from liver cirrhosis. Study design: Cross-sectional study Place and duration of study: Department of Internal Medicine, Bolan Medical Complex Hospital, Quetta from 01-01-2020 to 31-012-2020. Methodology: Sixty eight diagnosed patients of liver cirrhosis, age ranging between 20 to 60 years, were randomly selected from indoor patient department and they were further evaluated for gall bladder wall thickness.The diagnosis of liver cirrhosis and portal venous hypertension was made by ultrasonography of abdomen, especially hepatobiliary system. The gall bladder wall thickness is also evaluated by ultrasonography. Results: Mean age of the patients was 41.22±8.93 years. There were 35(51.5%) males while female patients were 33(48.5%). The mean duration of symptoms was 6.32±0.57 weeks. The duration of symptoms was ≤6 weeks in 45(66.2%) of patients, while 23(33.8%) of patients were having duration of symptoms >6 weeks. Twenty 20(29.4%) cases of liver cirrhosis patients were presented with gall bladder wall thickness, while rest 48(70.6%) were presented with normal gall bladder wall thickness on USG. Conclusion: The gall‐bladder wall thickness is very common finding associated with liver cirrhosis. It requires no surgical intervention or any other specific medical therapy. Keywords: Gall‐bladder wall thickness; liver cirrhosis; portal venous hypertension; hypoalbuminemia.

Aim: Effects of oral anabolic steroids on BMI, functional capacity and pulmonary functions of under nourished patients of COPD Methodology: All COPD patients outside pulmonary rehabilitation program, who met the inclusion criteria, were included. Subjects were given methandienone 5mg BD for six months. Weight, BMI, paO2, peak expiratory flow rate, FEV1 was measured for all subjects initially and six months after treatment. Results: There was significant improvement in weight (p <0.01), BMI (p <0.01), paO2 (p 0.04), peak expiratory flow (p <0.01), six minutes walk distance (p <0.01), CAT (p <0.01) and mMRC scores (p <0.01) after 6 months therapy with anabolic steroid. Conclusion: Treatment with Oral anabolic steroids has a significant effect on BMI and functional capacity of patients with COPD. Keywords: BMI, COPD, oral steroid