An analysis on 1247 (mainly southern) Indian adults (739 Males) is presented. Prediction equations for VC, FVC, FEV1, FEV2, FEV3, PEF, DMBC and MV are given. As predicted values were lower by 20-24 per cent as compared to normal values for white subjects, the factors contributing were analysed. For tobacco smoking, at higher levels, the function was lower, but at lower scores the function was higher than in non-smokers. In general, the standardized (for age and height) values were lower for both sexes for FVC and FEV1. There was a distinct relationship between FVC, FEV1 and socioeconomic status, the values being lower (p<0.05) in the males of lower strata. There was no clear relationship with daily physical activity, the values being lower in those doing strenuous exertion. This is thought to be due to interaction of economic factors. In male smokers and in females, the southern Indians had significantly lower values than the northern Indians. There was no relation of lung function with previous chest illnesses or frequent colds, or skin allergy. Thus, it is concluded that, economic (nutritional) factors may largely account for differences in lung function among Indians and other ethnic groups.

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Seventy five patients with chronic obstructive pulmonary disease were studied in three matching groups, treated with different modes of therapy for 12 weeks, and assessed by periodic pulmonary function tests, analysis of arterial blood gases and questionnaires. Group A received conventional treatment, Group B underwent additional breathing exercises and Group C performed yogasanas, in addition, to treatment given in Group A. Though laboratory values of pulmonary function tests did not achieve significance, patients on yogasanas were seen to have the best maintenance of function. Reduction in the respiratory rate in Group C (p < 0.001) and heart rate (p < 0.01) compared 30 Group A, probably indicated the efficacy of yogasanas. Patients in Group B were intermediate in their response.

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Till 1981, a total of 75 cases of systemic sarcoidosis has been reported in India. The present paper summarises the clinical profile of all these cases grouped into three series: A (34 from Calcutta), B (24 from Delhi) and C (17, other sources). Clinical presentation and course differed somewhat from that recorded in textbooks and described by Western authors. Fever (81%), Cough (81%), with or without dyspnoea (66%) and loss of weight (63%) were the four most frequent symptoms, while hepato-splenomegaly (73%) and transient tenderness in joints (66%) were the two common signs in series A. Dissociation between extensive radiological changes and clinical signs in chest was remarkable (88%) in the same series. Ocular symptoms, cutaneous signs, (especially orythema nodosum), localised or generalised lymphadenopathy, neurological features like cranial nerve palsy or convulsions e and bone cysts were uncommon in this combined Indian series. Spontaneous resolution or asymptomatic regression (even in cases with bilateral hilar adenopathy) was very in frequent. Follow-up reports, whenever available, showed that patients had frequent relapses, which responded well to steroids but not so well to chlorquine/oxyphenbutazone, given for 10-12 weeks. Sarcoidosis, as seen in India, differs in many ways from the disease, reported from western Countries.

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Bronchial sensitivity test was done on a total of 50 allergic rhinitis patients with a view to assess the bronchial reactivity in subjects with allergic rhinitis. It was found that the bronchial tree in 31 (62%) of 50 allergic rhinitis patients was hyper-reactive to the specific allergen though they had not yet developed overt bronchial asthma. Bronchial challenge with histamine produced a positive response more often in patients with allergic rhinitis than in normal healthy individuals. A positive response to bronchial challenge was more likely when history, endermal test and nasal provocation tests were all positive to begin with. Long term follow up of this group of allergic rhinitis patients may indicate whether they are prone to develop bronchial asthma later.

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A trial on 50 tuberculosis patients attending the Government Tuberculosis Sanatorium, Tambaram, who had exhausted all the first line drugs form the subject of this report. The tubercle bacilli cultured from these patients were resistant to standard drugs, viz; streptomycin, isoniazid and para amino salicylic acid (PAS). They were, therefore, treated with a combination of rifampicin and ethambutol given initially for one month on a daily basis followed by twice weekly administration of the same two drugs for the remaining 11 months. By three months, 42 patients (84%) had attained sputum negative status. When followed up for another year, 44 (88%) of the 48 quiescent patients maintained bacteriological quiescence of disease, even a year after stopping all anti-tuberculosis drugs. This intermittent reserve regimen for treatment failure patients works out comparatively cheaper in its cost and was found acceptable to patients attending the mobile treatment centres. Adverse reactions due to these two drugs were not a major problem in this study.

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Out of a total of 4943 patients admitted to various chemotherapy studies at the Tuberculosis Research Centre, Madras, India, over the past two decades. 21 were found to be repeatedly excreting mycobacteria other than the typical human tubercle becilli, thus giving a low detection rate of 0.4%. The persistant isolation of atypical or non-tuberculous or unclassified mycobacteria (UMB) on repeat cultures, supported by laboratory identification tests confirmed the pathogenic nature of the organisms causing pulmonary disease. Chest radiographic appearances were similar to those infections caused by typical tubercle bacilli. Thirteen of 21 patients yielded repeat isolates identified as Photochromogens by special invitro tests, especially those patients who had not previously had tuberculosis. The remaining patients were positive for non-chromogens. This report presents a retrospective analysis on 21 such patients. Occupational exposure to dust was common. Follow up studies indicated radiographic improvement in nine patients and a bacteriological negative status in 11. Ten patients died. The antituberculosis drug regimens were variable, but response was considered unsatisfactory in nearly 50% of patients.

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