Clinical Profile of Pediatric Oncology Patients Treated by External Beam Radiotherapy: An Institutional Experience

Introduction:

Pediatric tumors are a heterogeneous group of malignant conditions requiring multimodal treatment, and management of such cases is at time challenging. We present the clinical profile of pediatric cancer patients who received radiation, either alone or as adjuvant to surgery and chemotherapy; in prophylactic, radical or palliative clinical setting.

Aim:

This study was envisaged to review our experience of pediatric oncology cases, their clinical and morphological profile, dosage schedule of radiotherapy, and the therapy induced complications.

Settings and Design:

This was a retrospective, observational study carried out in an apex tertiary care cancer institute of government set-up in a developing country.

Materials and Methods:

The treatment charts and clinical summary of patients who had received radiation over the last 5 years period were retrieved and perused. Various clinical and pathological parameters were studied and inferences drawn.

Results:

A total of 50 patients got radiation over 5 year study-period, including 37 male and 13 female patients. The commonest age group of presentation was 8-12 years followed by 13-16 years. The mean age of presentation was 9.3 years. The most common diagnosis was hematological malignancies followed by CNS tumors with 21 and 13 patients respectively. Overall the most common indication of RT was in adjuvant setting after surgery as the definitive management, where 24 patients were irradiated; and the next common indication was prophylactic cranial irradiation in 14 patients of childhood leukemias. 10 patients tolerated treatment with Grade 1 site-specific or systemic toxicities while 7 patients developed Grade 2 and more systemic toxicities. 9 patients received craniospinal irradiation, common indications being medulloblastoma and Atypical teratoma rhabdoid tumor (ATRT). 3 patients received concurrent chemotherapy with weekly Inj Vincristine. 17 patients required sedation or short general anaesthesia for radiation planning and execution.

Conclusion:

External beam Radiotherapy constitutes an important component of management of pediatric cancers. One should be judicious in Radiotherapy planning, execution and monitoring acute and delayed toxicities.

Consensus on Insulin Dose and Titration Algorithms in Ambulatory Care of Type 2 Diabetes in India

INSTRUCTION

Insulin is the oldest of the currently available treatment options in Type 2 diabetes mellitus (T2DM) and is considered as the most effective glucose lowering agent. Despite this, decision on starting insulin therapy is often delayed in India as well as worldwide due to various barriers at both patient and physician levels. Appropriate insulin dosing and titration is also critical to the successful achievement of tight glycaemic control.

OBJECTIVE

To provide simple and easily implementable guidelines to primary care physicians on appropriate insulin dosing and titration of various insulin regimens for both initiation and intensification.

METHODOLOGY

Each insulin regimen (once daily [OD] basal, OD, twice daily and thrice daily premixed, basal-plus and basal-bolus) was presented and evaluated for dosing and titration based on established guidelines, data from approved pack inserts, and published scientific literature. These evaluations were then factored into the national context based on the expert committee representatives patient-physician experience in their clinical practice and common therapeutic practices followed in India.

RESULTS

Recommendations for dosing and titration of basal, basal-plus, premixed and basal-bolus insulins were developed. The key recommendations are that insulin doses can be adjusted once or twice weekly; adjustment can be based on lowest/mean of three recent self-monitoring of plasma glucose pre-meal/fasting plasma glucose (FPG) values. The titration should be based on FPG or pre-meal value of 80-130 mg/dL and the dose should be reduced by 10-20% for patients reporting hypoglycaemia(<70mg/dL).

CONCLUSIONS

The consensus based recommendations mentioned in this paper will be a useful reference tool for health care practitioners, to initiate, optimise and intensify insulin therapy and to successfully achieve optimal glucose control.

IL-15 regulates IL-23 production and murine IBD-like disease

Group 3 innate lymphoid cells (ILC3) have been recently implicated in various autoimmune conditions including inflammatory bowel diseases (IBD). The mechanisms by which ILC3s contibute to IBD pathogenesis remain elusive. In this study, using genetic deleletions that impact ILC3s to varying degrees we sought to determine their contribution to murine IBD development. We show that IL-23-dependent T cell-induced colitis develops independently of ILC3s. Host IL-2 receptor common γ chain (IL-2Rγc) is needed for both innate and adaptive cell-driven colitis, since its deficiency impairs colitogenic T cell proliferation, expansion and recruitment to intestines. We also provide evidence that resistance to colitis in IL-2Rγc Rag2−/− mice may occur as a result of defective IL-15R signaling, and that IL–15−/− Rag1−/− mice recapitulates the murine IBD phenotype of IL-2Rγc Rag2−/− mice. Data we presented herein demonstrates that IL-15 plays an important role in IBD pathogenesis and may contribute to gut inflammation by regulating IL-23 production of antigen presenting cells.

Metabolomics approach discriminates toxicity index of pyrazinamide and its metabolic products, pyrazinoic acid and 5-hydroxy pyrazinoic acid

Pyrazinamide (PYZ)-an essential component of primary drug regimen used for the treatment and management of multidrug resistant or latent tuberculosis-is well known for its hepatoxicity. However, the mechanism of PYZ-induced hepatotoxicity is still unknown to researchers. Studies have shown that the drug is metabolized in the liver to pyrazinoic acid (PA) and 5-hydroxy pyrazinoic acid (5-OHPA) which individually may cause different degrees of hepatotoxicity. To evaluate this hypothesis, PYZ, PA, and 5-OHPA were administered to albino Wistar rats orally (respectively, at 250, 125, and 125 mg kg^-1 for 28 days). Compared to normal rats, PYZ and its metabolic products decreased the weights of dosed rats and induced liver injury and a status of oxidative stress as assessed by combined histopathological and biochemical analysis. Compared to normal controls, the biochemical and morphological changes were more aberrant in PA- and 5-OHPA-dosed rats with respect to those dosed with PYZ. Finally, the serum metabolic profiles of rats dosed with PYZ, PA, and 5-OHPA were measured and compared with those of normal control rats. With respect to normal control rats, the rats dosed with PYZ and 5-OHPA showed most aberrant metabolic perturbations in their sera as compared to those dosed with PA. Altogether, the study suggests that PYZ-induced hepatotoxicity might be associated with its metabolized products, where 5-OHPA contributes to a higher degree in its overall toxicity than PA.

Effect of developed acidity and neutralization of milk on sensory, microstructural and textural changes in khoa prepared from cow and buffalo milk

Khoa is a heat desiccated milk product which serves as base material for traditional dairy based Indian sweets. Sensory, textural and microstructural changes in khoa were studied to assess the effect of developed acidity and neutralization of milk. Noticeable changes were observed in sensory, textural and micro structural quality of khoa as affected by quality of milk. Lower hardness, springiness, cohesiveness and accordingly, gumminess and chewiness were observed in khoa manufactured using neutralized milk due to higher moisture retention as compared to control and acidic milk khoa. It was also evident from the Scanning Electron Microscopy that higher moisture retention in neutralized milk khoa resulted in elongation of native microstructure of khoa by suppressing the grain formation leading to smooth and plain surface while, developed acidity in milk resulted in greater granule formation in the resulting khoa causing shrinkage of native microstructure and acidic flavour in khoa. Similarly, acidification and subsequent neutralization of milk adversely affected sensory attributes of resulting khoa.

Hysteretic photochromic switching of Eu-Mg defects in GaN links the shallow transient and deep ground states of the Mg acceptor

Although p-type activation of GaN by Mg underpins a mature commercial technology, the nature of the Mg acceptor in GaN is still controversial. Here, we use implanted Eu as a ‘spectator ion’ to probe the lattice location of Mg in doubly doped GaN(Mg):Eu. Photoluminescence spectroscopy of this material exemplifies hysteretic photochromic switching (HPS) between two configurations, Eu0 and Eu1(Mg), of the same Eu-Mg defect, with a hyperbolic time dependence on ‘switchdown’ from Eu0 to Eu1(Mg). The sample temperature and the incident light intensity at 355 nm tune the characteristic switching time over several orders of magnitude, from less than a second at 12.5 K, ~100 mW/cm² to (an estimated) several hours at 50 K, 1 mW/cm². Linking the distinct Eu-Mg defect configurations with the shallow transient and deep ground states of the Mg acceptor in the Lany-Zunger model, we determine the energy barrier between the states to be 27.7(4) meV, in good agreement with the predictions of theory. The experimental results further suggest that at low temperatures holes in deep ground states are localized on N atoms axially bonded to Mg acceptors.

Comparison of Guy’s vs S.T.O.N.E. nephrolithometry scoring systems in predicting the success rate of PCNL

Introduction and objective:

The aim of the present study was to compare the accuracy of the Guy’s and S.T.O.N.E. scoring systems in predicting percutaneous nephrolithotomy (PCNL) outcomes.

Methods:

This prospective study was carried out in the Department of Urology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, between August 2013 and September 2015 in collaboration with the Department of Radiodiagnosis and Imaging. A total of 100 cases of renal calculi operated on with PCNL were considered in the study on the basis of CT morphodensitometry. The study was approved by the institute’s ethical committee. Guy’s and S.T.O.N.E. scoring systems were calculated. Regression analysis and ROC curves were performed.

Results:

A total of 100 PCNLs were operated on. The overall stone-free rate was 90% with a complication rate of 17%. When compared to patients with residual fragments, stone-free patients had significantly lower Guy’s grade (3.5 vs 2; p < 0.001) and S.T.O.N.E. score (9.1 vs 7.5; p = 0.023). Logistic regression analysis showed that both Guy’s and S.T.O.N.E. systems were significantly associated with stone-free status, OR 0.96 ( p < 0.001) and OR 0.94 ( p < 0.001), respectively. Furthermore, both scoring systems were significantly associated with estimated blood loss ( p = 0.02 and p = 0.004). There was good correlation between both scoring systems and operative time ( r = 0.2, p < 0.002 and r = 0.3, p < 0.002) and length of hospital stay ( r = 0.1, p = 0.002 and r = 0.2, p < 0.002). There were significant associations between both scoring systems and complications ( p < 0.001 and p = 0.004). There was no significant difference in the areas under the curves for the Guy’s and S.T.O.N.E. scoring systems (0.96 (95% CI 0.92–0.99) vs 0.94 (95% CI 0.89–1.001); p < 0.001).

Conclusion:

Both Guy’s and S.T.O.N.E scoring systems have comparable accuracies in predicting post-PCNL stone-free status. Other factors not included in either scoring system may need to be incorporated in the future to increase their accuracy.

Supplementation of corn seed with regular diet modulates immune function and antioxidant status in Capra hircus

Melatonin modulates the functional activation of antioxidative enzymes to maintain the oxidant-antioxidant balance in the physiological system. Melatonin administration via subcutaneous injection increases endogenous melatonin concentration that has been used to modulate the immune function in rodents and reproductive activity in small ruminant like goats. However, to date, no report exist which could suggest the effect of corn seed supplementation on the endogenous melatonin concentration and its impact on cellular-immune function and antioxidative enzymes activity in any small ruminant like goats. Therefore, in this study, Zea mays (corn seeds), as source of melatonin, were supplemented with regular diet to explore its impact on endogenous melatonin concentration in goat, Capra hircus. Zea mays supplementation with regular diet for 40 days significantly elevated the endogenous melatonin concentration, proliferative response of peripheral blood mononuclear cells and antioxidative enzymes activity along with total antioxidant capacity of the plasma. An increase in circulatory IL-2 and IL-6 level along with declined TNF-α, malondialdehyde and nitric oxide was noted with elevated endogenous melatonin concentration. In conclusion, it might be suggested that corn seed could be used as supplement to modulate endogenous melatonin concentration that may improve cellular-immune function and antioxidant status. The corn seed might also be included as nutraceutical in regular diet to maintain immune-antioxidant homoeostasis in other species.

A quantitative assessment of the functional recovery of flexion of the elbow after nerve transfer in patients with a brachial plexus injury

AIMS

Improvements in the evaluation of outcome after nerve transfers are required. The assessment of force using the Medical Research Council (MRC) grades (0 to 5) is not suitable for this purpose. A ceiling effect is encountered within MRC grade 4/5 rendering this tool insensitive. Our aim was to show how the strength of flexion of the elbow could be assessed in patients who have undergone a re-innervation procedure using a continuous measurement scale.

METHODS

A total of 26 patients, 23 men and three women, with a mean age of 37.3 years (16 to 66), at the time of presentation, attended for review from a cohort of 52 patients who had undergone surgery to restore flexion of the elbow after a brachial plexus injury and were included in this retrospective study. The mean follow-up after nerve transfer was 56 months (28 to 101, standard deviation (sd) 20.79). The strength of flexion of the elbow was measured in a standard outpatient environment with a static dynamometer.

RESULTS

In total, 21 patients (81%) gained MRC grade 4 strength of flexion of the elbow. The mean force of flexion was 7.2 kgf (3 to 15.5, sd 3.3).

CONCLUSION

This study establishes that the dynamometer may be used for assessing the strength of flexion of the elbow in the outpatient department after nerve reconstructive surgery. Cite this article: Bone Joint J 2016;98-B:1517-20.

Free radicals hasten head and neck cancer risk: A study of total oxidant, total antioxidant, DNA damage, and histological grade

Background:

Free radicals such as reactive oxygen species (ROS), which induce oxidative stress, are the main contributors to head and neck carcinogenesis (HNC). The present study was conducted with the aim to assess the oxidant/antioxidant status and DNA damage analysis in head and neck cancer/control patients.

Materials and Methods:

This prospective study was conducted on 60 patients with biopsy-proven HNC and 17 patients of head and neck disease (HND). The total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) were determined by novel automatic colorimetric methods from tissue homogenate. DNA damage analysis was determined by single cell gel electrophoresis (SCGE).

Results:

The mean age of the study cohort was 46.65 ± 14.84 years for HNC patients, while it was 49.41 ± 13.00 years for HND patients. There were no significant differences found between the two groups with respect to demographic presentation except tobacco addiction. The association between oxidative stress parameters and DNA damage analysis with study group revealed the following. (A) DNA damage - tissue homogenate TOS and OSI were significantly higher in HNC subjects than in HND (16.06 ± 1.78 AU vs 7.86 ± 5.97 AU, P < 0.001; 53.00 ± 40.61 vs 19.67 ± 21.90, P < 0.01; 7.221 ± 5.80 vs 2.40 ± 2.54, P < 0.01, respectively), while TAS was significantly decreased. (B) Aggressive histological features were identified, more commonly with higher TOS and lower TAS [probability (P) = 0.002, relative risk (RR) = 11.838, 95% confidence interval CI = 2.514-55.730 and P = 0.043, RR = 0.271, 95% CI = 0.077-0.960, respectively].

Conclusion:

The increase in free radicals may be the event that led to the reduction of antioxidant status in HNC, thus explaining the oxidative damage of DNA and the severity of disease. Increased OSI represents a general mechanism in its pathogenesis.

Histogenesis of Human Fetal Spleen

Background and Aims: Spleen is the largest secondary lymphatic organ. It acts as a graveyard for RBCs, is essential for immune responses, performs lymphopoiesis in adults and haemopoiesis in fetuses. The present study was conducted to assess the histogenesis of spleen in human fetuses in view of existing literature. Material and Methods: The study was carried out on 34 formalin preserved human fetuses procured from Dr Sushila Tiwari Government Hospital, Haldwani with due clearance from ethical committee. The 6 pm sections of the spleen were stained with Haematoxylin and Eosin and observed under light microscope. Results: At 14 tol5 weeks, spleen had extensive sinusoids filled with RBCs and few lymphocytes. At 16-18 weeks, trabecular arteries were noticed more towards centre along with extensive haemopoietic cells in the venous sinusoids. By 20th week lymphocytic aggregation had started around arterioles. By 24 weeks periarteriolar lymphatic sheath was clearly observed. At term (37-40 weeks), classical primary lymphoid follicle was present but germinal centers were not observed. Conclusion: During earlier differentiation, spleen symbolizes the function of haemopoietic activities and gradually during subsequent gestation; it establishes its identity as a principle lymphoid tissue.

Comparative efficacy of deltamethrin and chlorpyriphos in bovine ticks in and around Jabalpur

Efficacy of chlorpyriphos (Classic*20, 20% EC) and deltamethrin (Butox^®, 1.25% EC) was assessed by spraying these drugs on cattle and buffaloes which were naturally infested with ticks at the concentration of 2.5 and 2 ml/l, respectively. Results of the study demonstrated the prolonged effect of chlorpyriphos when compared with deltamethrin. Moreover, residual effect of chlorpyriphos remained even after 14 days of treatment with 28.57% animals showing reinfestation, while in deltamethrin treated animals; the tick number started increasing after 14th day of treatment with 50% animals showing reinfestation on 14th day post-treatment.

Histomorphological changes in digestive tract of golden mahseer (Tor putitora) during different developmental stages

Histomorphological changes in digestive tract of golden mahseer (Tor putitora) were examined in larvae [starting from hatching to 45 days post-hatching (dph)], fry, fingerling, and adult. Digestive tract appeared during hatching, on the dorsal side of yolk sac, as a straight tube with a narrow lumen. Mouth opening and appearance of liver and pancreas were observed at 2 dph, and subsequently anal opening, appearance of goblet cells in esophagus, and posterior intestine were evident at 3 dph. The remodeling of oral cavity in terms of epithelial stratification, appearance of taste buds, and goblet cells were observed in a window of 4-5 dph. Intestinal folding was found to be initiated at 8 dph. From 12 to 45 dph, thickening of oral and esophageal mucosal/extramucosal layers, increase in intestinal folding, increases in the density of goblet cells in entire gut were observed. Within the same time window, other histological changes such as disappearance of vacuoles in liver, and abundance of zymogen granules in pancreas were also observed. Supranuclear vesicles in mid-to-posterior intestine were found to be prominent from first feeding to 45 dph; however, this phenomenon was no longer evident in fry and fingerling. Overall, the increase in intestinal folding and complexity of extramucosal layer were found to be continuous from the first appearance to adult, and this inferred the fact that the nutritional physiology, in terms of digestion and assimilation, progressively changes throughout the life stages of golden mahseer. Findings of this study will, therefore, help in preparing diets for different life stages of this fish, and in addition, the present information widens the understanding of digestive physiology of golden mahseer.

Effect of testicular tissue lysate on developmental competence of porcine oocytes matured and fertilized in vitro

The objective of the present study was to investigate the effect of testicular tissue lysate (TTL) on developmental competence of germinal vesicle (GV) stage porcine oocytes. Two types of TTL were prepared through repeated freeze-thaw in liquid nitrogen, one from whole testicular tissue (wTTL) and other from either of four different sections of testes, namely just beneath the tunica albuginea (TA), from the transitional area between the seminiferous cord/tubules and the mediastinum testis (TR) and from the intermediate area (parenchymal tissue origin) and CE (cauda epididymis origin). The whole or section-wise TTL treatments were given for 44 hr during in vitro maturation (IVM). Oocyte maturation was done in either of the two media, namely defined (high-performance basic medium for porcine oocyte maturation, commercially available) and serum containing (TCM199). After maturation, oocytes were co-incubated with fresh spermatozoa for 6 hr and then transferred to embryo culture media. Treatment of GV stage oocytes with wTTL (1 mg/ml) increased the cleavage and morula percentage rate (69.23 ± 6.23 and 48.15 ± 6.77, respectively) than that of their control (58.33 ± 8.08 and 32.54 ± 5.53, respectively) in defined media, and in serum-containing media, cleavage and morula percentage rate were almost equal in both treatment (54.56 ± 7.79 and 34.70 ± 6.78, respectively) and control (59.52 ± 8.21 and 38.52 ± 6.54, respectively). However, effect of wTTL was not significant. In case of section-wise TTL supplements, TR section significantly (p < .01) improved cleavage and morula rate (58.43 ± 7.98 and 36.14 ± 6.89, respectively) followed by TA. In conclusion, present study indicates that IVM, in vitro fertilization and in vitro culture of embryo are improved in the presence of TTL, particularly its TR section. Further study is expected to reveal the principal components of TTL which may prove useful for IVM.

BenzoDODA grafted polymeric resin-Plutonium selective solid sorbent

A new ligand grafted polymeric resin (BenzoDODA SDVB) was synthesized by covalently attaching plutonium selective ligand (BenzoDODA) on to styrene divinyl benzene (SDVB) polymer matrix. BenzoDODA SDVB resin was evaluated for separation and recovery of plutonium(IV) from nitric acid medium. Sorption of Pu(IV) was found to decrease with the increase in nitric acid concentration, with very small sorption above 7.0M HNO3. Sorption kinetics was fast enough to achieve the equilibrium within 60min of contact where the kinetic data fitted well to pseudo-second-order model. Sorption isotherm data fitted well to Langmuir model suggesting chemical interaction between the BenzoDODA moiety and plutonium(IV) ions. Sorption studies with some of representative radionuclides of high level waste showed that BenzoDODA SDVB is selective and therefore could be a promising solid sorbent for separation and recovery of plutonium. Further, the theoretical calculations done on BenzoDODA SDVB resin suggested Pu(NO3)4·BenzoDODA (1:1) sorbed complex conformed to generally observed square antiprism geometry of the plutonium complexes, with contributions from oxygen atoms of four nitrate ions as well as from four oxygen atoms present in BenzoDODA (two phenolic ether oxygen atoms and two carbonyl oxygen atoms of amidic moiety).

Morpho-histological and ultra architectural changes during early development of endangered golden mahseer Tor putitora

Ultrastructural and histological changes in the embryonic and larval surface during ontogenesis of the endangered golden mahseer Tor putitora is studied here for the first time. Embryonic development was completed 91-92 h after fertilization at an ambient temperature of 23° ± 1° C (mean ± s.d.). The gastrula stage was characterized by presence of the Kupffer's vesicle, notochord, ectoderm and endoderm cells. Primordial germ cells were clearly identifiable from c. 55 h post-fertilization at the organogenesis stage. Mean total length of newly hatched larvae was 7·0 ± 0·5 mm. Scanning electron microscopy of newly hatched larvae demonstrated vitelline arteries, microridged epithelial cells and mucous gland openings over much of the body surface. Eye, oral cavity, pharyngeal arches, heart, intestinal loop, prosencephalon, cephalic vesicle and nasal epithelium were clearly distinguished in 3 day old hatched individuals. In 6 day old individuals, caudal-fin rays and internal organs were evident. The dorsal fin became prominent at this stage and larvae began swimming at the surface. The reserved yolk material was totally absorbed 8-11 days after hatching and larvae began feeding exogenously. Tor putitora exhibited a longer early developmental period than other cyprinids reared at similar temperatures.

Prediction of entropy stabilized incommensurate phases in the system MoS2 -MoTe2

A first principles phase diagram calculation, that included van der Waals interactions, was performed for the 3D bulk system (1 - X) · MoS2 - (X) · MoTe2. Surprisingly, the predicted phase diagram has at least two ordered phases, at X ≈ 0:46, even though all calculated formation energies are positive; in a ground-state analysis that examined all configurations with 16 or fewer anion sites. The lower-temperature I-phase is predicted to transform to a higher-temperature I'-phase at T ≈ 500 K, and I' disorders at T ≈ 730 K. Both these transitions are predicted to be first-order, and there are broad two-phase fields on both sides of the ordered regions. Both the I- and I'-phases are predicted to be incommensurate, i.e., aperiodic: I-phase in three dimensions; and I'-phase in two dimensions.

Prenatal glomerular changes during development of human foetal kidney

Background and aims: The cortical glomerulus shows many developmental changes during fetogenesis. Nonnalhistologyofthe fetal glomerulus at various stages of development was studied to get insight into the morphology of fetal glomerulus. Fetal glomerular study is a necessity for correlation with increase in gestational age and pathological changes which may affect the normal functioning of kidneys in fetal life. Method: Dissection of 70 normal human fetuses was carried out and histological findings of glomerulus were noted with respect to the age of fetus. The histology of fetal kidney was studied using H & E stain. Important developmental stages of glomerulus were observed. Results: Fetal kidney glomerulus histology is different from adult. Unlike in adult kidney, foetal kidney glomerulus shows many developmental stages as v, c, s, cresentric in starting phase. Multiple rows arrangement in between mednllary rays with well developed mature glomeruli at juxtamednllary junction. Capillary invagination with developed Juxta glomerular apparatus was appreciated. Nephrogenic zone which was found as hroad band in early gestational weeks disappeared near term. Conclusion: The present study will be helpful in understanding the normal histological architecture of foetal kidney glomerulus and add to the existing knowledge regarding development of foetal kidney, its relation with gestational age and pathogenesis.

Rasmussen Aneurysm

Angiographic findings in tuberculosis patients presenting with hemoptysis include hypervascularity, hypertrophy of systemic arteries, aneurysm, systemic to pulmonary anastomosis, and rarely, contrast extravasation. Bronchial arteries are the source of hemorrhage in majority of cases with non-bronchial systemic or pulmonary arteries being less common as the source. Rasmussen's Aneurysm is a very rare sequalae of Pulmonary Tuberculosis. We present one such case of Rasmussen's aneurysm and review of the relevant literature.