Introduction : C-reactive protein being an acute phase protein rises in pneumonia and may be helpful in differentiating patients with lung parenchymal infection from patients with infection sequestered to the bronchial tree. Methods : A prospective study was undertaken where 48 pneumonia patients and 35 patients of COPD with acute exacerbation were included. Serum CRP levels and other traditional markers of infection and chest x-ray were done on presentation. Results : The mean CRP was found to be 75.87±17.1mg/L in patients with pneumonia and 16.71±20.76mg/L in patients with COPD in acute exacerbation. A highly significant (p=0.0012) difference was found in the CRP values between the two groups using the 't' test. More than 70% of pneumonia patients had CRP value >50mg/L with less than 3% of COPD patients having the same. Conclusion : Serum CRP may be a useful adjunctive test in pneumonia patients in distinguishing endobronchial versus parenchymal infection. A CRP value of more than in 50mg/L favours pneumonia.

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To evaluate the occurrence of electrocardiographic abnormalities during fiberoptic bronchoscopy, in relation to specific stages of the procedures, patients' age, sex, smoking, pre-existing lung disease, premedication and oxygen saturation, a prospective study was conducted on 56 patients aged 35 to 75 (mean 62) years without pre­existing cardiovascular disease. Patients were connected to a 12-lead computerized electrocardiographic recorder and pulse oximeter. Fall of oxygen saturation from mean of 95.12% before the procedure to below 80% was observed in 12 (21.4%) patients and below 75% in 5 (8.9%) patients, at various stages. Statistically highly significant (p < 0.001) fall of oxygen saturation was observed during the procedures while bronchoscope was introduced into the airways and tracheobronchial tree examined. Major disturbances of cardiac rhythm (i.e. atrial, ventricular or both) developed in 23 (41.07%) patients. Out of these, sinus tachycardia was noted in 16 (69.5%), ventricular premature complexes in 5 (21.7%) and paroxysmal supraventricular tachycardia in 2 (8.6%) patients. Arrhythmias were most frequent in association with periods of maximum oxygen desaturation in 18 (78.2%) of these 23 patients. Oxygen desaturation persisted for more than half an hour in 38 (67.8%) of the 56 patients. However, no correlation was observed between the frequency of arrhythmias during bronchoscopy and patients' age, sex pre-medication or pre-existing pulmonary disease.

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Young's syndrome is a well known disease since its first authentic description by Young who described in group of 52 infertile men. The basic etiology of Young's syndrome justified ultrastructurally in modern science a decreased cilliary motility, obstruction of secretions due to common defect of ciliated columnar epethelium. Disease includes chronic bronchitis, sinusitis and azoospermia. We present a case of 30 year old make who presented with recurrent sinopulmonary infection, with oligospermia and 100% immotile sperm and diagnosed as a Young's syndrome.

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Background : Mycoplasma pneumoniae is implicated in acute exacerbations of bronchial asthma and is also a factor in the chronicity of asthma. This study was conducted to determine the significance of this association and to estimate the incidence of M.pneumoniae in the airways of asthmatics by isolation of the organism in sputum by culture method. Methods: In our study we have tried to isolate M.pneumoniae in sputum specimen samples by culture technique in one hundred asthmatic patients and fifty non-asthmatics who served as controls. Results : In our study we were able to isolate M.pneumoniae by sputum culture in 18% of the asthmatics. Among the culture positive patients, 16% had acute exacerbation of asthma. Conclusions : Our study compares favorably with the earlier studies done using serology and PCR in the diagnosis of M.pneumoniae infections in asthma emphasizing the usefulness of sputum cluture as a reliable investigative tool for isolation of M.pneumoniae in asthmatics. It also suggests a role for broader therapeutic implications in treatment of asthma. Lung India 2005; 22 : 50-53

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Exposure to various types of farming occupation is associated with a number of respiratory problems which are both immunologic and non-immunologic in orgin. This study was undertaken to determine the prevalence of various respiratory symptoms and assess pulmonary function among farmers around the city of Chandigarh. An attempt was also made to identify the types of farming that may be associated with these symptoms. A house-to-house survey was carried out in seven villages around Chandigarh with the help of a questionnaire that was used in our earlier surveys. Lung function tests were carried out using a portable spirometer. Out of the 486 farmers included in the study, 106(21.8%) were symptomatic: chronic bronchitis (n=34), cough (n=38), bronchial asthma (n=13), post nasal drip (n=9), chest tightness (n=8) and dyspnea (n=4). The respiratory symptoms were more common among non-smokers (55.6%) than smokers (44.3%). Combined type of farming work was associated most often with respiratory symptoms followed by grain cutting. Pulmonary function parameters had lower values in smokers than in non-smokers and in symptomatic than in asymptomatic sybjects.

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We describe a case of acquired broncho-esophageal fistula (BOF) with hydropneumothorax due to pulmonary tuberculosis treated effictively with antituberculous therapy and intercostal drainage. The fistulous connections appeared to be secondary to mycobacterial mediastinal adenopathy and it healed with medical line of management; surgical intervention was not necessary.

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