Serum copper estimations were carried out in 44 cases of acute myocardial infarction, 23 cases of angina and 40 age and sex matched healthy controls. A highly significant degree of rise in serum copper levels was observed in patients with acute myocardial infarction as compared to cases of angina and controls. The levels showed a gradual rise with peak on 7th day followed by a gradual decline returning to normal on 28th day. The pattern was the same both in complicated and uncomplicated cases except that values were still higher on the 28th day in complicated cases of acute myocardial infarction. Mean peak serum copper levels were significantly higher (p less than .001) in complicated cases of acute myocardial infarction as compared to uncomplicated cases. Significant correlation was found between serial serum copper changes and creatinine phosphokinase and lactic dehydrogenase levels. The prognostic and diagnostic significance of serum copper has been discussed.

Two hundred cases were selected from medicolegal autopsies for a study of the relationship of serum cholesterol to the amount and severity of atherosclerosis in the aorta and the coronary and cerebral arteries. A preliminary study of cholesterol before and after death in 20 cases showed a close parallel between the two when the sample of blood was taken within 16 hours of death. The mean serum total cholesterol showed a tendency to rise from 122 mg. per cent ±16 in the first decade to 176 mg. per cent ±28 in the fifth decade. A statistically significant correlation was found between serum total cholesterol levels and age up to the fifth decade. No correlation could be observed between the serum cholesterol level and the amount and severity of atherosclerosis in the arteries. When all the cases were divided into arbitrary groups according to the amount of atherosclerosis, a rise in the levels of mean serum total cholesterol was seen in the first six successive groups of aortic atherosclerosis. But when age was excluded from the correlation between atherosclerosis and serum cholesterol, the interrelationship between the two was found to be statistically insignificant.

Striking differences in the extent and severity of atherosclerosis were observed when our results were compared with those reported from the United States, Japan, and Jamaica, and South India by Gore et al. 4 Up to the age of 30 years the mean atherosclerotic indices of aorta from these sources were not significantly different. Subsequently, however, the mean atherosclerotic index in our cases was almost equal to that reported from South India but it was much less than that recorded in the U.S.A. and significantly less than that reported from Japan and Jamaica. It is thus seen that the factors that initiate atherogenesis are different from those that are effective in the formation of the later grades of lesions, since the same amount of streaking does not lead to an equal amount of fibrous plaque formation. It also shows that there are important geographic differences in the prevalence of these latter factors. Similarly, the coronary atherosclerosis was almost equal in our and the South Indian series but in both these places it was less advanced than that obtained in the U.S.A., Japan, and Jamaica.

Thirty cases of viral hepatitis with and without coma and 15 normal healthy age and sex matched controls were studied for disseminated intravascular coagulopathy (DIC). Cases of viral hepatitis with coma showed strong evidence of DIC in the form of increased plasma FDP (240 +/- 190.64 dilution), diminished fibrinogen half life (48.1 +/- 15.3 hours) and increased fractional catabolic rate (46.13 +/- 14.7% per day) with normal Euglobulin clot lysis time and reduced fibrinogen (147.33 +/- 43.5%) and platelet count (1.27 +/- 0.324 lakhs/cm.). The possible role of heparin in the reversal of coagulation abnormalities have been discussed.