Ten patients of chronic obstructive pulmonary disease were studied for changes in ultrastructure of the glomeruli, serum immunoglobulin and complement levels. The glomeruli showed proliferation in the mesangium in 90% patients and electron dense deposits in the mesangium in 30% patients. IgA and IgG were usually elevated whereas complements were usually depressed in most of these patients. It is suggested that repeated respiratory infections in these subjects may be responsible for mesangioproliferative type of glomerulonephritis, high IgA and IgG levels. The complements are activated and they take part in immune complex formation getting deposited in mesangium.

Electrocardiograms of 984 healthy subjects residing in village Kalpa at the height of 9000 feet above sea level were studied. Right ventricular hypertrophy (RVH) was observed in 9 (0.914%) subjects. Electrocardiographic evidence of ischaemic heart disease was found in 6 (0.609%) subjects.

A herbal powder consisting of Guargum, Methi, Tundika and Meshasringi was administered to thirty control and thirty NIDDM patients twice daily before principal meals for four weeks. Oral GTT showed improvement in both control and patient groups. Serum total and LDL cholesterol also fell significantly in both the groups after the trial period. Test meal of the herbal powder with D-Xylose excretion was otherwise normal. Follow up for upto two years did not reveal any long term side effect of the powder. This powder, therefore, can be effectively used to reduce postprandial blood glucose and LDL cholesterol in NIDDM patients as a long term measure.

A herbal powder containing guar gum, methi, tundika and meshasringi was administered to 30 control and 30 type 2 (non-insulin dependent) diabetes mellitus patients for a month. Total serum cholesterol and its fractions eg, high density lipoprotein, low density lipoproteins, very low density lipoproteins and serum triglyceride were determined before and after the trial period. Total and low density lipoprotein (LDL) cholesterols were reduced significantly after the therapy. There were no significant changes in high density lipoproteins (HDL), very low density lipoproteins (VLDL) or triglyceride levels. Side-effects eg, mild flatulence and looseness of bowel were noticed in less than 40% cases.

Electrocardiographic (ECG) changes were studied in 120 consecutive subjects during and after upper GI endoscopy done in ambient hypoxia (PO2-120 mmHg) at Shimla (2200 m). No premedication was given to any of the subjects. There were 75 men and 44 women. Fifty three subjects were aged 40 years or below (Group I) and 67 subjects were above 40 (Group II). There were 29 subjects with and 91 subjects without cardiac diseases. Increase in heart rate was seen in 96.6% of subjects. Maximum rise in heart rate was found in cardiac patients. ST depression was seen in 14.2%, T wave inversion in 13.3%, supraventricular tachycardia in 5.8% and ventricular ectopics in 1.6%. ST depression was more frequent in cardiac than in non cardiac patients (P less than 0.001) and T wave inversion was more frequent in women than in men (P less than 0.001). All the changes reverted to normal within 10 minutes. ECG changes notwithstanding, upper GI endoscopy without premedication in the presence of ambient hypoxia is a safe procedure.

Thirty patients of chronic obstructive pulmonary disease (COPD; all smokers) and an equal number of controls (15 smokers) were studied. The COPD patients were further divided into group A (predominantly emphysema) and group B (predominantly bronchitis) of 15 patients each. Serum and sputum IgG, IgA and IgM and serum C3 and C4 were estimated. IgG, IgA, IgM and C3 and C4 were similar in smoker and non-smoker controls. Mean (+/- SD) serum IgG (IU/ml) was significantly higher in COPD patients (207.78 +/- 62.73) than in control (177.25 +/- 43.5; P less than 0.05), serum IgA (IU/ml) was also significantly higher in COPD (205.04 +/- 46.56) than in control (108.21 +/- 33.3; P less than 0.01). IgM was similar in the 2 groups. Sputum IgA (IU/ml) was higher in COPD (4.68 +/- 3.51) than in control (2.25 +/- 1.03; P less than 0.05). IgG and IgM were similar in the 2 groups. Both serum C3 (IU) and C4 (IU) were lower in COPD patients (C3 = 95.9 +/- 33.11, C4 = 113.6 +/- 62.4) than in control (C3 = 167.3 +/- 25.42, C4 = 205 +/- 76.5; P less than 0.05). Serum IgA in type B COPD (212.25 +/- 50.06) was higher than in type A (197.52 +/- 43.3; P less than 0.05) IgG and IgM were similar in these 2 groups. In COPD patients, immunoglobulins were either normal or higher indicating that deficiency of immunoglobulin is not a predisposing factor in development of COPD. Similar immunoglobulin values in smoker and nonsmoker controls indicated that smoking was not the cause of rise of immunoglobulins in COPD.(ABSTRACT TRUNCATED AT 250 WORDS)

A 45 year old male who developed eosinophilic pleural effusion after administration of metoprolol is described. This type of reaction with metoprolol has not been reported so far and hence this report.

The 366 patients attending a special clinic for help with sexual health problems at the H.P. Medical College Hospital in Simla India were analyzed during the 1976 through December 1979 period. During its 1st year the clinic registered an attendance of only 30 patients but in the subsequent years an average attendance of about 112 patients/year were recorded. A majority of patients who attended the clinic were young (82.1%) indicating that the sexually active group was more anxious to obtain help. The patients belonged to various socioeconomic strata. Only male patients came to the clinic on their own accord. Women only accompanied their husbands and did this only when the clinic authorities required the absolute cooperation of both spouses for dealing with the problem. It is not uncommon for men to feel insecure and threatened when women strive for sexual equality or make sexual demands upon men. A growing need exists to remove this disparity. Almost a third of the patients (104 or 28.4%) complained of a whitish emission before or after urination which they ascribed to as loss of seminal fluid leading consequently to loss of vigor and manhood. This comprised the largest group of patients who were both married and unmarried. No hormones or medicines were prescribed to this group. They were given sex education along with a schedule of relaxing exercises for the perineal muscles. Over 76.8% of these patients reported relief from their symptoms after this treatment. 66 patients complained of wet dreams. Of these 80.9% were unmarried. Proper sex counseling along with purely symptomatic treatment is all that was required to help this group of patients. 15.6% of the total patients complained of premature ejaculation despite a firm erection. No physical abnormality was detected in all but 8 cases. This group of patients was taught genital hygiene and exercises to recondition the emission reflex. Almost equal numbers of patients (12.2%) were worried about their masturbating habits (12.2%) or problems concerned with contraceptive usage (12.8%). Individual and group discussions were held for this group. 6.81% of the patients complained of no or very weak errections. Of the 20 married patients 3 were known diabetics and 1 had a spinal injury. The patients were managed according to the underlying cause of the problem. Those patients without evidence of any organic disease were treated with sex counseling. On the basis of the experience at this clinic it is believed that the majority of sex problems can be managed with proper and timely sex education and guidance.