A study of correlation of the extent and severity of atherosclerosis in the coronary and cerebral arteries and between their individual branches has been undertaken in 200 consecutive medicolegal autopsies. The coronary atherosclerosis developing first in the second decade appears about 20 years earlier than the cerebral atherosclerosis. There is, however, a significant correlation between the coronary and cerebral arterial beds. There is a significant interbranch relationship within the coronary system. The atherosclerotic process starts earliest in the left anterior descending branch of the coronary arteries. The extent of correlation is more marked between the two branches of the left coronary artery than that of either of them with the right coronary artery. The interbranch relationship in the cerebral arterial bed also shows a significant correlation. Basilar artery shows the maximum atherosclerosis, next in order being middle cerebral artery; the postcerebral artery shows much less affliction to the atheroma and the anterior cerebral artery exhibits a high degree of freedom.

Metformin is widely used in type 2 diabetes mellitus patients. Lowered levels of vitamin B12 and folate due to impaired gastrointestinal absorption have been documented with long-term metformin therapy,1 but clinically these effects are insignificant and do not cause anaemia. We report a patient with haemolytic anaemia caused by metformin.

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The case of an elderly woman is reported in whom alendronate, given for osteoporosis, led to severe hypocalcaemia a few days after starting the drug treatment. This was caused by the unmasking of previously unrecognised hypoparathyroidism. (Postgrad Med J 2000;76:417-419)

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