A 46-year-old female, was admitted for wheezing and dyspnea. She had been diagnosed with asthma 10 years previously and was well controlled using budesonide at 160 μg + formoterol at 4.5 μg b.i.d. combination therapy until 5 months before when she had a severe asthma attack at that time, during which her wheezing was not well correlated with physical exercise and had persisted for several months. She was treated unsuccessfully with budesonide at 320 μg + formoterol at 9 μg b.i.d. combination, montelukast at 10 mg/day, and oral steroids. Her medical history was significant for appendectomy and hemorrhoidectomy. She was taking thyroid hormone for Hashimoto's thyroiditis and calcium tablets for osteoporosis. What is your opinion on the case?

44-year-old male, stigmata of HIV, presented with shortness and respiratory distress. Patient was intimated and sedated. The patient is a known MDR-TB patient, on further investigation found to have completed treatment in 2015. Other history was not obtained. On arrival patient x/ray reviewed (attached - Image 1) and bilateral infiltrates noted as well as ? right lung mass. The patient sent for urgent non-contrast CTB (NAD) and chest. CT findings: ‘Basal infiltrates bilaterally, no cavities, faint effusions with no gross adenopathy. Active TB is very unlikely. Cardiomegaly with PAH. Paraseptal emphysema - mild degree only. Right pericardiac mass (mediastinal).” Patient management is ongoing. What are your valuable suggestions?

A 60-year-old male presented with cough and dyspnea. He is a known Sarcoidosis patient. He is on cortisol treatment for 6 months. New Chest CT shows multiple mediastinal lymph nodes, interstitial sarcoidosis findings, and Pleural thickening. Newly presented Chest CT is almost same. Additionally bilateral ground-glass densities. The question: Is it alveolar Sarcoidosis or COVID 19?

Dear Actor Vijay sir, Silambarasan sir and the respected Govt. of TamilNadu, I am tired. We are all tired. Thousands of doctors like me are tired. Health care workers are tired. Police officials are tired. Sanitary workers are tired. We have worked so hard at the ground level to make sure the damage done is kept to as low as possible amidst an unprecedented pandemic. I am not glorifying our work for I know there is nothing so great about it to the onlooker’s eyes. We don’t have cameras in front of us. We don’t do stunt sequences. We aren’t heroes. But we deserve some time to breath. We don’t want to fall prey to someone’s selfishness and greed. The pandemic isn’t over and we have people dying till today to the disease. A hundred percent theatre occupancy is a suicide attempt. Rather homicide , for none of the policy makers or the so called heroes are going to put themselves under the pump, to watch the movie amidst the crowd. This is a blatant barter system, trading lives for money. Can we please slowly try and concentrate on our lives and make sure we tide through this pandemic peacefully and not reignite the slowly burning out flame, that is still not completely put out? I wanted to make this post scientific and explain why we are still in danger. But that’s when I asked myself, “what’s the point?” Yours tiredly A poor, tired resident doctor https://www.facebook.com/aravinth.srinivas/posts/3937347876284519

What is the most likely diagnosis? A) Acromegaly B) Cystic fibrosis C) Eisenmenger's syndrome D) Squamous-cell lung cancer E) Ulcerative colitis