One hundred five patients with advanced pulmonary tuberculosis were studied; randomly 59 were given metronidazole (400 mg t.i.d.) and 46 given identical placebo for four weeks. Except for more drug sensitive strains in placebo group there were no differences between two groups. In 31 patients (30%) anaerobes (esp. Bacteroides) were isolated; in 7 of 18 patients who died anaerobes had a significant role. There was greater reduction in sputum production with metronidazole but overall clinical (65-68%) and radiographic (53-60%) improvements were similar in both groups. The post drug sensitivity pattern of tubercle bacilli became more favourable in metronidazole as compared to placebo group (P<0.05). This finding needs to be further studied.

The response of forced expiratory volume to inhaled isoprenaline was studied in 21 patients during the primary episode of tropical pulmonary eosinophilia (TPE), in 13 patients during a relapse of the disease and in 9 patients before and after a course of Diethyl Carbamazine (DEC). Patients with primary presentation were on the whole unresponsive to inhaled isoprenaline whereas the patients with relapse showed significant response; (P<0.02). Pre and Post DEC groups did not reveal any significant differences. Possible reasons for differing airways response in different stages of illness in TPE are discussed.

The radioallergosorbent technique (RAST) was used to measure the levels of Aspergillus specific IgE in 25 normal controls, 25 cases of extrinsic bronchial asthma and 25 cases of allergic broncho-pulmonary aspergillosis with a view to study the clinical role and its correlation with sputum culture, skin sensitivity and severity of airways obstruction. The test was performed using Pharmacia diagnostic kits with antigen derived from Aspergillus fumigatus. Abnormal levels of Aspergillus specific IgE were observed in 84% cases of bronchial asthma but none of the controls. 86.7% of all cases with positive skin test had positive radioallergosorbent test and there was no false positive reaction. There was a positive correlation of Aspergillus specific IgE with skin test positivity and with FEV1 / FVC%.

Spontaneous pneumomediastinum as a complication of status asthmaticus is extremely rare. History, careful physical examination and radiography play an important role in diagnosis. Though potentially life threatening, majority of cases of pneumomediastinum respond to conservative medical management and surgical intervention is rarely required. In this report, clinical history and background of spontaneous pneumomediastinum in a 21 year old patient who had status asthmaticus is presented. The underlying mechanism and management of this rare complication are discussed.

A case of pseudomonas pneumonia in a four year old child is reported. The patient also had prolymphocytic leukaemia which was revealed during follow-up.

A patient of bronchiectasis who developed chloramphenicol induced thrombocytopsenia manifesting clinically as massive haemoptysis is reported. There is some suggestive evidence that chloramphenicol may have been responsible for the haemoptysis.