We present a patient with sarcoidosis who presented with diffuse military shadows in both the lungs without any hilar and mediastinal lymph node enlargement on chest roentgenogram. Such a presentation is distinctly rare and difficult to differentiate from military tuberculosis.

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A study to evaluate the clinical profile of bronchial asthma in eastern India was undertaken at Calcutta Medical Research Institute during a period of 25 years (1970-1994). Of the 26826 bronchial asthma patients attended the institute during the period, 7208 patients were studied in detail childhood (3-15 years) asthma was seen in 678 children (9.4%). In young children (3-5 years), boys with asthma outnumbered girls (3:1), while in teenagers (13-15 years) girls had preponderance (2.5:1) over boys. Of the 6530 adult asthmatics, 54.5% were males and 45.5% were females. Clinically extrinsic asthma was seen in 80.5% and intrinsic variety in 12.8%, 34% of adult asthmatics had evidence of recurrent nasal allergy with or without infection by 10th year of the life and this proportion increased to 67.3% by the age of 15 years. Familial atopy was present in 82.1%. Allergy (91.3%) heredity (82.1%), infection with or without preceding nasal allergy (78.3%), sudden temperature change (17.3%) heavy meals at night (15.6%), smoking (11%), psychosomatic factors (7.1%) and household work in women were found to have significant influence on asthma. House dust mite (82.3%) and house dust (77.3%) were the two most common allergens. Food allergy was fairly frequent (70.1%). Allergic bronchopulmonary aspergillosis and nasal polyp – aspirin allergy syndrome were rare. Classical nocturnal asthma (4-6a.m) was seen in 11% while early night attacks (12 midnight – 2 a.m.) were frequent (38.1%). Temporary remission at puberty was seen in 32%, but nasal problems persisted in them. Under diagnosis and under treatment of childhood asthma were common.

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Systemic lupus erythematosus (SLE) is a multisystem connective tissue disorder with a wide spectrum of clinical manifestations. A case of SLE presenting with laryngitis is reported.

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A case control study of deceased quarry workers and controls comparing their age at the time of death was carried out. It showed that the mean age at death was 49.3 ± 12.1 years in quarry workers and 60.0 ± 14.4 years in non-worker controls. In another prospective study, a sample of 314 quarry workers and 40 ex-workers was followed up for a period of 17.4 ± 7.2 months to study their mortality rate. This study demonstrated that there was excess mortality in quarry works (Stanardised Mortality Ratio (SMR) = 1.84, 95% confidence interval 0.79 to 2.90). Mortality was higher in those with opacities suggestive of silicosis in chest skiagrams (age adjusted death rate 66.3 per thousand per year and SMR = 6.95), than in non-silicotics (age adjusted death rate 19.97 per 1000 per year and SMR = 1.63). Workers with pulmonary tuberculosis had significantly higher mortality than other quarry workers. Even in the absence of tuberculosis, mortality was more in silicotics (age adjusted death rate 24.9 per thousand per year, SMR 2.8)

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Serum levels of circulating immune complexes (CIC) were estimated by polyethylene glycol precipitation method in 20 newly diagnosed sputum positive cases pulmonary tuberculosis to evaluate the CIC levels before and after treatment with short course chemotherapy. Twenty healthy persons were studied as controls. Serum CIC levels were estimated in each patient before treatment and at three and six months after treatment. The mean serum CIC levels was significantly higher in patients (314.2 ± 106.5 vs 97.9 ± 64.8, p < 0.001) compared to control subjects. Eighteen patients (90%) had elevated levels before treatment. At the end of treatment, mean CIC levels was significantly lower (106.0 ± 156.6, P<0.001) compared to pretreatment values. Elevated levels persisted in two patients (10%) at the end of treatment. The mean serum CIC levels before treatment was significantly lower in patients who become smear negative at first month compared to those who become smear negative at second month (266.8 ± 98.0 vs 385.3 ± 72.8, P<0.01). The mean serum CIC levels had shown a tendency to increase as the severity of radiological abnormalities increased.

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Three male patients with chronic respiratory disorder and infertility are reported.

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