We read with great interest the scientific review by Nahshon et al., titled 'Hazardous Postoperative Outcomes of Unexpected COVID-19 Infected Patients: A Call for Global Consideration of Sampling all Asymptomatic Patients Before Surgical Treatment' [1]. Universal testing for patients undergoing surgery promises to weed out those who slip through the diagnostic criteria in the pre-operative period. It would further allow the physicians to strike a balance between the urgency of surgery, allowing recover by deferring surgery, thus reducing mortality.The article points to an inordinately high fatality in postoperative patients (14/64 or 21.8%) in comparison with the 2-5% in the general population, indicating the need for increased vigilance among those undergoing surgical procedures in these testing times.The authors conclude that patients must test for COVID-19 before they undergo surgery using RT-PCR, the gold standard for testing for . What must be considered is that RT-PCR has its own shortcomings as a testing modality. Depending on the site of sampling, the rate of swab positivity could range between 53.3 and 71% and that too, somewhere between 2 and 8 days after exposure [3]. This attests to the fact that merely testing negative for COVID-19, would not rule out the possibility of the patient being an asymptomatic carrier. It also remains vital that patients that do not have the disease, do not contract it, during the course of their stay in the

Bronchoscopy is an extremely useful diagnostic and therapeutic procedure that finds an invaluable place in Pulmonology practice. Due to aerosol generation, bronchoscopy carries a high risk of infection transmission to health care workers and other patients. This fact is even more important in the present times of COVID-19 pandemic owing to its droplet- (and possibly aerosol-) mediated spread. With this background, a working group extracted literature through electronic search of PubMed and Google Scholar databases. All relevant documents were comprehensively reviewed and consensus recommendations formulated based on the level of available evidence. Where evidence was insufficient, Usual Practice Points were formulated based on expert opinion. This resultant document attempts to present clinical recommendations for performing flexible bronchoscopy in COVID-19 suspect/confirmed patients. It outlines important general considerations for bronchoscopy in these cases, provides an algorithmic approach to patient selection for bronchoscopy during these extraordinary times, and enlists critical do's and don'ts that should be followed before, during, and after the procedure. To conclude, flexible bronchoscopy must be cautiously performed amid the COVID-19 crisis. Judicious case selection and meticulous contact and airborne precautions are important to minimise infection transmission.

Undifferentiated Pleomorphic Sarcoma (UPS) is a common soft tissue sarcoma that can develop in various organs, but lung involvement is usually due to metastasis. UPS originating primarily in the lungs is called primary pulmonary undifferentiated pleomorphic Sarcoma (PPUPS) and is exceptionally rare. It is a high-grade pleomorphic neoplasm with no identifiable lines of differentiation. Thus, it is essentially a diagnosis of exclusion that requires extensive clinical, radiographic and histopathological evaluation. Herein we report the case of a 49-year-old gentleman who presented with anemia and weight loss and was found to have a large right lung mass. The lesion was diagnosed as PPUPS after detailed histopathological, immunohistochemical and molecular analysis and exclusion of a possible extrapulmonary origin.

Background: COVID-19 is primarily transmitted by droplets, aerosols and fomites. While adequate hand hygiene (HH) practice has already been proven to reduce transmission of pathogens and prevent infection, its role in checking cross-contamination with SARS-CoV-2 appears paramount. Aim: To assess the impact COVID 19 has had on individual HH practices among health care workers (HCW) at a tertiary health care center. Patients and Methods: A cross-sectional survey was conducted among HCWs for a period of 15 days from May to June 2020. The survey was distributed online via Google Forms after acquiring permission from Institutional Ethics Committee. Results: Two hundred and three completed survey questionnaires were received, primarily from nursing officers (42.4%) and residents (38.9%). Comparison of pre- and post-COVID-19 habits revealed a significant change in awareness regarding hand washing steps (87%–100%), practicing all steps of hand washing (66%–99%), washing hand before and after touching patient (55%–92% and 77%–100%, respectively), washing hands before going home (30%–91%), washing hands despite wearing gloves (21%–80%) and after touching patient's surroundings (46%–92%). Another significant finding observed was that almost 72% of the respondents took time to educate someone close by in HH and washing steps. Conclusion: The pandemic has seen an improvement in practices of HH. This change will not only impact the transmission of SARS-CoV-2, but every infectious disease spread similarly. Moreover, educating the general public would help in curbing the spread of COVID-19.