Autonomic and peripheral neuropathy in insulin dependent diabetics.

Twenty five diabetics (all insulin dependent) and 20 age and sex matched controls were studied to assess peripheral nerve functions and autonomic (cardiovascular and urinary bladder) nerve functions. Impotence was the commonest symptom followed by postural dizziness, atonic bladder, shooting pains in the limbs and gustatory sweating. Cardiac autonomic neuropathy was found in 60% of the diabetics while 68% of them had diabetic cystopathy. Peripheral nerve dysfunction was present in 80% of the patients. Forty percent of the diabetics had all the three forms of neuropathies (cardiac, urinary bladder and peripheral), while another 40% of the patients had at least two forms of neuropathy.

Prediction of airway responsiveness to allergen from skin sensitivity to allergen, airway responsiveness to histamine and serum IgE levels.

Immediate allergic reaction of the skin, non allergic airway responsiveness of the bronchi, and serum IgE levels were estimated in 25 atopic non asthmatic subjects and 15 controls. A good correlation was observed between these three parameters i.e. patients with positive skin response to allergen had increased airway responsiveness and significantly increased levels of serum IgE. However, the serum levels of IgE provided a significantly better indication of the likely presence of bronchial allergic reactivity than did the skin reactivity. The results indicate that knowledge of the airway responsiveness to histamine, skin sensitivity to allergen and serum IgE levels can predict the presence of airways responsiveness to an allergen. In all atopic non asthmatic individuals with a significant correlation between these parameters, the relevant allergen could stand identified as having the potential to provoke attacks of clinical asthma.

Histamine bronchoprovocation tests in subjects with gastro-oesophageal reflux disease.

The relationship of gastro oesophageal reflux (GER) with bronchial asthma has already been well documented in asthmatic subjects and it has been postulated that their asthma might have been caused by GER disease. Thus, it was planned to establish an association, if any, between GER and increased bronchial reactivity by histamine broncho provocation. The study was done in 25 GER disease patients and 15 controls. The difference in bronchial reactivity between the two groups was found to be significant (p less than 0.01). It was concluded that GER subjects expressed greater bronchial reactivity and it has been discussed that at a later stage of life they may be more prone to develop asthma.

Cerebrospinal fluid free N-acetyl neuraminic acid levels--a diagnostic and prognostic test in meningitis.

Cerebrospinal fluid (CSF) free N-acetyl neuraminic acid (NANA) levels were estimated in 20 cases each of pyogenic and tubercular meningitis (TBM) and 10 controls. The levels of free NANA were significantly high (P less than 0.001) in pyogenic and partially treated pyogenic meningitis when compared to TBM. The CSF free NANA levels had direct correlation with severity of the disease, CSF sugar and protein levels in pyogenic meningitis. The CSF free NANA can even be a prognostic criterion in management of pyogenic meningitis. Higher the levels, poorer the prognosis.