The prevalence of airway obstruction as judged by FEV1 percentage value in different categories of silicosis in slate pencil industry, Mandasaur was determined and related to smoking habits and respiratory symptoms. The overall prevalence of airway obstruction was seen in 18.8 percent workers and a liner relationship with category of silicosis noted. In all categories of silicosis, smokers demonstrated significantly higher obstruction than non-smokers. Obstruction was worse in category two and three with symptoms. This prevalence of airway obstruction is attributable to the very high concentration of total and respirable dust containing high percentage of free silica to which the workers are exposed.

Tuberculin skin testing with 1 T.U. of P.P.D. - R.T. 23 is being extensively practised in our country to determine the possible tuberculous infection. The distribution of tuberculin reactions among 1000 newly diagnosed and bacteriologically confirmed untreated pulmonary tuberculosis patients was studied. Severity of tuberculosis was found to affect the immuno-responsiveness of the tuberculin. Tuberculin sensitivity was found to be 39% in patients with far advanced pulmonary tuberculosis in comparison with 76% In patients with minimal disease (p<.001).

A 42 year old male presented with sicca syndrome and arthralgia. One year later cervical lymphadenopathy developed, which was diagnosed and treated as tuberculous lymphadenitis. After three months, skin nodules appeared but were mistaken for erythema nodosum secondary to tuberculosis. Inspite of eighteen months of antituberculous therapy patient progressed to develop dyspnoea and cough. At this stage examination revealed mucosal dryness, salivary and lacrymal gland enlargement, multiple non-tender, matted cervical nodes and numerous erythematous, indurated, non-tender, skin nodules and plaques. Chest skiagram showed hilar lymphadenopathy. Repeat skin and lymph node biopsies revealed scarcoid granulomas. Lung function tests showed moderate airflow obstruction. Cystic changes were noted on skiagram of hands. Dramatic improvement resulted on institution of steroid therapy. Xerosis, parotid enlargement and lymphadenopathy resolved whereas skin lesions healed with deep atrophic scarring.

Between 1979 to 1990, 1586 patients (age range – six to 84 years, Male : Female – 1.8 : 1) were subjected to therapeutic fiberoptic bronchoscopy (FOB) under local anaesthesia. The patients included cases involving retained secretions (1162), atelectasis (244), uncontrolled haemoptysis (39) and foreign body removal (four). One hundred and thirteen patients underwent FOB aided endotracheal intubation. Lung abscesses (24) were drained by internal pulmonary puncture and drainage. The FOB was carried out predominantly by trans-nasal route (65.59%) once or repeatedly. Of these patients 6.05% were on mechanical ventilation. The high-risk complications observed were cardiac arrhythmias (0.76%), hypotension (2.65%) and cardio-respiratory arrest (0.26%); mortality being 0.13%.

One hundred and ten episodes of airway obstruction in 86 bronchial asthmatics were treated by a special eight stepped yoga chair breathing procedure consisting of very simple neck muscle relaxation movements and asanas with breathing exercises. Seventy percent of the episodes have been successfully relieved within a mean time of 30mts. The patients gained great confidence and tried this technique before resorting to drugs. The reduction in panic anxiety elements, cutting the vicious circle of aggravating bronchial obstruction appear to work in relieving the acute episodes.

Based on current literature, an aetiological classification of pulmonary eosinophilia due to helminthes including tropical eosinophilia is proposed.

Bronchial washings of 42 consecutive patients with endoscopically non-visualised lesions were analysed. They underwent fiberoptic bronchoscopy as they had respiratory symptoms with suspicious radiological shadows which needed exclusion or further confirmation of a diagnosis between bronchogenic carcinoma, pulmonary tuberculosis or pyogenic suppurative lesions. Because of non-visualisation of lesions no biopsies were taken. Analysis of bronchial washings alone made useful contribution towards diagnosis in over 20% of the cases.

A case of proven primary skin tuberculosis in an infant born to a mother with sputum positive pulmonary tuberculosis is reported. Both were treated successfully with short-course chemotherapy.

Ectopic herniation of a pulmonary cavity is a very rare entity. A relapsing cavitary tuberculosis patient is reported, whose cavity herniated through the chest wall and formed a caverno-cutaneous fistula.