Essential hypertension: antecedents in children.

A prospective study was conducted to determine the incidence of essential hypertension (EH) and identify markers, if any, in children of essential hypertension families. The study group included 90 children (2-18 years) with a parent or grandparent with EH while the control group had 25 age matched children from non-hypertensive families. Around 30% children (n=27) from these families had a diastolic blood pressure of >95th centile and an additional 27% (n=24) had borderline hypertension. The serum cholesterol, serum triglycerides and 24 hour urinary sodium excretion were significantly higher in the study group (p < 0.05) as compared to controls. The children from the study group also had a significant high salt (p < 0.001) and fat intake (P < 0.05).

Effect of inhaled terbutaline on platelet activity in bronchial asthma.

Thirty five young subjects with long standing bronchial asthma were studied for the effects of terbutaline misthaler (500 micrograms) during acute asthma. Bronchodilators were omitted for a day before the test. Ten matched controls were also studied. In all subjects, basal IgE level (ELISA), pulmonary parameters (FVC, FEV, PEFR, FEF 25-75 and FEF 75-85) and platelet activity, (platelet clumping/150 WBC on smear, platelet adhesiveness, blood recalcification time and kaolin clotting time for platelet factor3) were compared. During acute asthma, the subjects displayed IgE levels > or = 500 IU/ml (n = 33), activation of clotting (n = 30) and eosinophilia > or = 450/cmm (n = 28). These changes were not seen in normal controls. Terbutaline resulted in a reversal of airway obstruction, mainly of small airways, while the platelet hyperactivity and blood hypercoagulability were rectified (P < 0.001). It is concluded that platelet activity increases in acute asthma and is corrected by inhaled terbutaline concomittant with the relief of bronchospasm.

Gemfibrozil in familial and type V hyperlipidaemias. Report of 3 cases.

Gemfibrozil, a lipid lowering agent, was administered to two patients with familial hyperlipidaemia and one patient with insulin dependent diabetes mellitus. It was partially effective in familial hyperlipidaemia. It dramatically reduced triglyceride and cholesterol levels in the patient with Type V hyperlipidaemia and insulin dependent diabetes mellitus. Patients with familial and Type V hyperlipidaemias should be given a trial of gemfibrozil therapy.

Immunoglobulins and allergy mediators in bronchial asthma.

Seventy four young asthmatics were evaluated to establish the role of immunoglobulins and allergy mediators in clinical asthma. They were categorized into Group I (n = 38) or Group II (n = 36) when having mild or severe bronchospasm respectively. In some patients, reversibility of bronchospasm (n = 35), exercise challenge (n = 24) and intradermal allergy testing (n = 24) were also studied. Seventy subjects had raised IgE levels (greater than 100 KU/L) but these did not correlate with the severity of clinical or exercise induced asthma or with reversibility of bronchospasm. An IgE level greater than 1000 KU/L was associated with more number of positive skin tests. Group II subjects had a shorter blood recalcification time (p less than 0.01) and higher levels of IgG, histamine and serotonin (p less than 0.001). It appears that severe asthma is associated with activation of blood coagulation, and release of allergy mediators contributes to the evolution of bronchospasm. Total IgE predicts the utility of skin testing in asthma.

Gemfibrozil in hyperlipidaemia: an open, single blind trial.

The efficacy of Gemfibrozil on S. lipid levels was studied in 36 middle aged subjects with type IIA, IIB, IV hyperlipidemia. Gemfibrozil was well tolerated in the dose of 1200 mg/day and no dropouts were attributable to its use. An overall reduction in total cholesterol (39.91%), total triglycerides (71.10%), VLDL triglycerides (62.97%). LDL cholesterol (45.57%) and apolipoprotein B levels (26.83%) were observed at 24 weeks. At the same time HDL cholesterol, and apolipoprotein A levels showed increases by 26.23% and 53.67% respectively. It is concluded that Gemfibrozil is an effective lipid lowering agent. Further long term studies are necessary to determine its optimal dosage and its long term safety in Indian subjects.

Cryoglobulin studies in systemic lupus erythematosus.

Twenty-two patients with systemic lupus erythematosus (SLE) were investigated to study the incidence and immunochemical nature of circulating immune complexes. In 68.18% of patients, the immune complexes were detected as cryoglobulins. A significantly high value of serum IgG and IgA (1980.64 +/- 1031.53 and 283.81 +/- 131.02 mg% respectively) were observed in these patients compared to those in normal (1097.04 +/- 298.10 and 200.93 +/- 89.96 mg% respectively). The patients also had significantly low levels of serum complement fraction C3 (61.35 +/- 22.64 mg%). Correlation of these parameters could help in understanding of the role of immunochemical factors in the pathogenesis of the disease.