This 23 year old man with known asthma since infancy arrives in the hospital suffering from cough with yellowish mucus plugs, intermittent fever, increasing shortness of breath and wheezing of four weeks duration. Three months earlier, the patient had consulted another physician for similar complaints. At that time he was diagnosed to have pneumonia and asthma; the treatment was tetracycline, 250mg 4 times a day, oxtriphylline 200mg four times daily, and metaproterenol inhaler, as needed. After two weeks of therapy, the patient felt much better that he decided to discontinue his treatment. Several weeks later, though, the dyspnea, cough and fever reappeared. For the last two months the patient has stayed at home taking oxtriphylline. 200mg four times daily for his asthma.

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Forty cases of spontaneous pneumothorax were studied. Unlike developed countries where subpleural apical bleb is the commonest cause of pneumothorax, tuberculosis was found to be the most important etiological factor, followed by chronic bronchitis with emphysema. Thirty-six patients were males and four females. Peak incidence was in the third decade. Right side was affected little more frequently than left side, while bilateral pneumothorax was quite rare. Majority of patients were smokers. Intercostal drainage with underwater seal was the treatment of choice and response was good in most of the cases.

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One hundred patients with chronic empyema were studied. While active pulmonary tuberculosis was present in 57, a history of chronic alcoholism was seen in 27 cases. Empyema was considered tuberculous in 56, due to mixed infections in 21, and due to pyogenic bacteria alone in 23 cases. In six (three each from the latter two categories) subjects, anaerobic bacteria were isolated; (three-bacteroides melaninogenicus). Initially, collapse of ipsilateral lung was seen in 46 cases and in 79 there was pyopneumothorax. All except 13 cases which needed intercostals tube drainage (including four who later underwent pleurectomy), were controlled by frequent needle aspirations. Pyogenic empyema required shorter time (8 weeks) for control as compared to 13 weeks in those due to other causes. In 74 subjects empyema responded well to treatment (excellent in 46 and good in 28 cases). The response was contributed by anti-tuberculous drugs (77 cases) and antibiotics (41 cases). Of 44 cases given metronidazole 400mg three times daily for 10 days, 21 (48%) showed good or excellent response.

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The present study shows that Phentolamine and Tolazine protects the animals against adrenaline induced pulmonary edema (APE) and lung surfactant activity remains the same as that of control (Saline treated group). This indicates that alpha receptors are involved in APE.

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Tropical Pulmonary Eosinophilia (TPE) is diagnosed on the basis of high peripheral eosinophilia associated with clinical symptoms and signs. Elevated levels of total and antifilarial immunoglobulins is one of the characteristic features of TPE. Ten clinically diagnosed TPE patients and ten controls were compared for their anti-filarial and anti-ascaris antibody levels of classes IgG, IgM and IgA. While, IgG antibodies exhibited considerable cross reactivity between Ascaris and Filarial antigens, IgM antibodies showed nonspecific binding to filarial antigens. However, IgA antibodies were found to discriminate between TPE and control sera better than IgG and IgM antibodies.

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Fifty three Bronchial Provocation tests (BPT) were carried out in 22 carbachol responsive hospitalized patients to determine its correlation to skin tests. All patients had seasonal or irregular asthma with reversible bronchospasm. Bronchial provocation tests (BPT) were carried out with all the allergens, showing two plus (2+) or more skin test (ST) reaction. With four plus (4+) skin tests 80% of BPT were positive. Among three plus (3+) skin tests 40% and among 2+ skin tests only 13% of BPT were positive. It is found that BPT can be directly correlated with skin tests particularly with 3+ and 4+ reactions. Yet, as the correlation is not 100%. the authors believe that before commencing immunotherapy, Bronchial provocation tests should be carried out along with history and skin tests for confirmation of bronchial allergy.

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The incidence of diabetes mellitus in pulmonary tuberculosis is not as high as has been previously reported. With the current standards of classification, 6.9% of pulmonary tuberculosis patients were found to have diabetes mellitus, an incidence not much higher than that in general population. Further, there was no specific radiological picture diagnostic of "diabetic tuberculosis", except a predominance of exudative lesions in upper and mid zones. Parahilar and lower zone involvement reported as typical feature of diabetic tuberculosis was not observed and there was no appreciable difference among diabetics and non-diabetics in extent of lesions and presence or absence of cavitation.

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A case of amoebiasis with multi-organ involvement is reported, who, in addition to intestinal and hepatic pathology, had left-sided pleuropulmonary involvement and an extremely unusual splenic enlargement as well. The diagnosis was supported by dramatic response to specific anti-amoebic therapy. The possible pathogenesis of this extremely rare clinical presentation is discussed and the need to keep in mind the possibility of amoebiasis in differential diagnosis is stressed.

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A total of 200 Chittar Stone Mine Workers of Western Rajasthan were studied clinically, radiographically and expirographically to detect respiratory disability in them. Equal number of non-smoking healthy individuals were taken as control subjects. Clinical symptoms in the form of cough (53%). dyspnoea (21%) and pain chest (22.5%) were present in 53 per cent of stone mine workers. Radiological evidence of pneumoconiosis was evident in 106 (53%) subjects, obstructive (43%), restrictive (2%) and mixed (13%) ventilatory disorders were seen in 58 percent of the workers. Duration of exposure was the most important factor in prediction of disability in them. However, complete assessment of disability requires a multifactorial approach.

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