Eighty contact lens wearing eyes and 20 non-contact lens wearing eyes are investigated for biomicroscopic changes and impression cytology. Symptomatic contact lens wearing eyes demonstrate significantly more prevalent and severe papillary conjunctival changes than in asymptomatic contact lens wearing eyes. Impression cytological changes demonstrate squamous metaplasia and goblet cell loss which is seen to increase with increasing duration of lens wear.

We report an unusual occurrence of involuntary movement involving the tongue in a patient with confirmed Wilson's disease (WD). She manifested with slow, hypophonic speech and dysphagia of 4 months duration, associated with pseudobulbar affect, apathy, drooling and dystonia of upper extremities of 1 month duration. Our patient had an uncommon tongue movement which was arrhythmic. There was no feature to suggest tremor, chorea or dystonia. It might be described as athetoid as there was a writhing quality, but of lesser amplitude. Thus, the phenomenology was uncommon in clinical practice and the surface of the tongue was seen to “ripple” like a liquid surface agitated by an object or breeze. Isolated lingual dyskinesias are rare in WD. It is important to evaluate them for WD, a potentially treatable disorder.

Male erectile dysfunction is common and frustrating after the age of forty years. Erectile dysfunction is a cause of misery, relationship difficulties, and significantly reduced quality of life. Sildenafil citrate (Viagra) has shown promising results in recently published clinical trials. Slldenafil is a potent and competitive inhibitor of cGMp specific phosphodiesterase-S, predominant isoenzyme in the human corpus cavernosum, It is effective in erectile dysfunction of diverse origin, however it requires a patent vascular system to be effective. It is not effective in patients with endocrinal impotence, loss of libido, premature ejaculation or infertility. Its main adverse effects are headache, flushing, dyspepsia, diarrhoea, nasal congestion, indigestion, visua1 disturbances, dizziness and rash. Ventricular tachycardia and acute myocardial infraction have been reported in patients of ischaemic heart disease after consumption of siidenafil. Six deaths have been reported in patients taking nitrates. In India it is likely to be prescribed by a primary care physician without complete evaluation of patient on complaint of impotence. Hence the ethical question of who should prescribe this drug should be addressed by medical fraternity and proper guidelines formulated to avoid misuse of sildenafil. Phosphodiesterase is distributed in nerve, central nervous system, and systemic vasculature, hence long-term effects of drug on these tissues has to be ascertained. It should be made mandatory to report all adverse drug reactions to ADR monitoring centres. It is a wonder for those who require it, but has potentially dangerous adverse effects and drug interactions and hence is and not a wonder pill for all kinds of impotence. MJAFI 2001; 57 : 44·46

The prevalence IIf microalbumlnurla was assessed in 50 patients of non-insulin dependent diabetes mellitus. The mean age of patients was 52.1 ± 11.6 years and the duration of diabetes was 8.3 ± 6.8 years. Twenty (40%) patients had microalbuminuria. Microafbuminuria was more common in patients with a longer duration of diabetes (more than 5 years), a poor glycaemic control, and higher systolic blood pressure. MJAFI 1996; 52: 153-156

A prospective study of 82 patients with acute renal failure was carried out over the last 2 years. Mean age of the patients was 35.6 years (8-82 years). Male to female ratio was 3.5:1. The etiological factors were septicaemia in 18 patients (21.95%), aminoglycoside toxicity in 16 patients (19.51%), open heart surgery in 8 patients (9.76%), volume depletion and blood loss in 12 patients (14.63%), glomerulonephritis in 4 patients (4.88%), renal allograft dysfunction in 4 patients (4.88%), and miscellaneous causes in 20 patients (24.39%). Non-oliguric renal failure was observed in 39.02 per cent cases. Dialysis support was required in 65.8 per cent of the cases; with average 5.6 (4 to 11) dialysis sessions. Four patients of acute renal failure following open heart surgery were given continuous arterio-venous haemofiltration. Overall mortality was 32.5 per cent, septicaemia accounting for 60 per cent of the deaths.