Background : About 10 to 15 % of the Indian population is known to suffer from major allergic disorders such as Asthma, Rhinitis, Atopic Dermatitis and Urticaria. Aeroallergens play a major role in the pathogenesis of respiratory allergic diseases. Among the aeroallergens, pollens are major causative agents. The predominance of pollen allergens necessitate the need to assess the specific immunotherapy (SIT) in allergic patients. Objective : To evaluate the effect of immunotherapy based on the presence of IgG and its subclass antibodies towards whole pollen antigen of Gynandropsis gynandra (G.gynandra) and its fractions. Material and Methods : A study was conducted in 30 bronchial asthma patients on immunotherapy, by assessing the levels of IgG and its subclasses specific to G. gynandra pollen. Results : There was a significant increase in IgG and its subclass antibodies to whole pollen antigen and its fractions i.e. >90kD, 46­37kD and 36-32kD after the course of IT. Conclusion : The use of peptide fractions may be more appropriate instead of the whole pollen antigen to test the effect of immunotherapy.

Sputum/ bronchial washings of 445 patients with residual tubercular cavitation were subjected to smear and culture examination to isolate fungi. Patients suffering from aspergillosis were put on oral itraconazole daily for 6 months and monitored clinicoradiologically during and after therapy. About half of the patients of aspergilloma and 85% of the patients of chronic necrotizing pulmonary aspergillosis improved by 3 months of therapy. Nausea and headache observed during therapy in 8 and 4 patients respectively were mild and self limiting. Relapses were seen in 8 out of the 37 patients who had completed 6 months therapy and available for follow-up.

Aims: To assess the quality of life in patients with asthma receiving either fluticasone or other inhaled steroids like beclomethasone or budesonide. To assess the effect of equipotent dosage of inhaled steroids at 3 months duration. Methods: Patients were randomised to receive either fluticasone or beclomethasone/budesonide. After spirometry, St. George's Respiratory Questionnaire (SGRQ) was administered at baseline and at 15 ^th , 30 ^th , 45 ^th , 60 ^th and 90 ^th day, to assess improvement in lung function and HRQoL. Results: Out of 96 patients who were enrolled, eighty patients completed three months duration of the study, while sixteen patients dropped out. Forty patients received fluticasone and forty received either beclomethasone or budesonide. No significant difference (p>0.05) was found in the baseline values of St. George's Respiratory Questionnaire (SGRQ) scores and Forced Expiratory Volume at first second (FEV ₁ ) between the two groups. However, significant difference (p<0.05) was noted between the above two groups, in Quality of Life (QoL) but not in pulmonary functions, on 15th day favoring fluticasone. No significant difference (p>0.05) was noted either in QoL or in pulmonary function tests on subsequent follow-ups. Conclusion: Early response in terms of improved QoL was observed in fluticasone treated group in patients with moderate to severe asthma.

Cardiac rhythm disturbances are common concern among patients with neoplastic diseases. Arrhythmias may occur due to the effect of the tumor itself, treatment of the neoplastic process, or metabolic abnormalities. Dysrhythmia in cancer patients is morphologically and functionally identical to dysrhythmia seen in other patients. Atrial fibrillation may occur due to structural diseases of the heart like myxoma and rarely tumors from lung extending to myocardium. We report two cases of metastatic lung cancer, invading atrial cavity and presenting with atrial fibrillation.