A rare case of benign fibrous histiocytoma of the cornea

Fibrous histiocytoma (FH) commonly occurs in the superficial layers of the skin. Orbit and limbus are documented ophthalmic sites of involvement but isolated corneal FH has never been reported in literature. We present the first case of FH exclusively involving the cornea where a 10-year-old male child presented with a 3-month history of a painless growth on the superior cornea of the right eye with deterioration of vision. Tumor excision with therapeutic penetrating keratoplasty was done and the histopathological examination confirmed the diagnosis. There was no recurrence and the corneal graft was clear at 1 year.

Testosterone and DHEA Levels in Osteoporosis in Males Above The Age Of 60 Years

Background: A cross sectional study in which 100 male patients of 60 years and above were evaluated for Osteoporosis. Methods: Out of enrolled 100 men above 60 years suspected of Osteoporosis, 46 % is diagnosed as Osteoporosis, 32% as Osteopenia and 22% were observed to be normal based on BMD T-Score value. Results: The average level of Total Testosterone and DHEA in entire suspected osteoporosis patients were 2.74 ± 1.04 ng/ml and 1.45 ± 1.08 μg/ml respectively. The level across Osteoporotic cases (n=46), the average Total Testosterone and DHEA were 2.20 ± 0.77 ng/ml and 1.55 ± 0.91 μg/ml respectively. Abnormally low serum testosterone ( <2.0 ng/ml as per society of andrology) were found in 19 (41%) cases out of 46 osteoporotic men compared with normaltestosterone level men. Testosterone deficiency was seen in 39 (84%) cases of osteoporosis. This study has shown that the men with low testosterone levels had decreased BMD T-scores across entire cases (p<0.001). The men with decreased DHEA level also had decreased BMD T-scores BMI was inversely associated with testosterone and DHEA levels. It was found that decreased plasma testosterone had a 14 fold higher risk for decreased BMD compared with their peer with normal testosterone level. Age and BMD has shown significant association with testosterone levels (p<0.001).In this study, the incidence of osteoporosis increases with advancing age. Conclusion: There was significant decline in Testosterone and DHEA with advancing age and more over decrease in BMD value indicates the pathogenesis of osteoporosis in the patients. But still further study with large sample size is needed to clearly identify the role of testosterone in osteoporosis.

A Study of Prognostic Value of Hs-CRP and Fibrinogen in Patients of Unstable Angina

Background: Unstable angina constitutes a clinical syndrome that is usually caused by atherosclerotic coronary artery disease and is associated with an increased risk of cardiac death and myocardial infarction. Material and Methods: An open, prospective, observational, comparative study was conducted. The study included 50 cases in age group 20-80 years admitted in Government Medical College, Amritsar diagnosed as unstable angina ruled out by Trop T and CPK-MB at admission. Hs-CRP and Fibrinogen levels were estimated at time of admission and repeated after 48 hours. Results: There was significant difference in the mean value of Hs-CRP between favourable and unfavourable group at the time of admission (0.807±0.37mg/l v/s 3.57±1.70mg/l, p<0.001). A significant difference in the mean value of Hs-CRP was found between favourable and unfavourable group after 48 hours (0.51±0.22mg/l v/s 4.03±1.84mg/l, p<0.001) There was significant difference in the mean value of fibrinogen between favourable and unfavourable group at the time of admission (356.94±72.50mg/dl v/s 588.60±94.89mg/dl, p<0.001). A significant difference in the mean value of fibrinogen was found between favourable and unfavourable group after 48 hours (309.11±75.25mg/dl v/s 622.60±133.42mg/dl, p<0.001). Conclusion: It is concluded that in patients with unstable angina, elevated levels of Hs-CRP and Fibrinogen at admission indicate an adverse hospital outcome.

Methylenetetrahydrofolate reductase gene polymorphism in Indian stroke patients.

BACKGROUND AND AIMS: In view of the prevailing controversy about the role of Methylenetetrahydrofolate reductase (MTHFR) C677T mutation in stroke and paucity of studies from India, this study has been undertaken to evaluate MTHFR C677T gene polymorphism in consecutive ischemic stroke patients and correlate these with folic acid, homocysteine (Hcy) and conventional risk factors. SETTINGS AND DESIGN: Ischemic stroke patients prospectively evaluated in a tertiary care teaching hospital. MATERIALS AND METHODS: Computerized tomography proven ischemic stroke patients were prospectively evaluated including clinical, family history of stroke, dietary habits and addictions. Their fasting and postprandial blood sugar, lipid profile, vitamin B12, folic acid and MTHFR gene analysis were done. STATISTICAL ANALYSIS: MTHFR gene polymorphism was correlated with serum folic acid, Vitamin B12 and Hcy levels; family history of stroke in first-degree relatives; and dietary habits; employing Chi-square test. RESULTS: There were 58 patients with ischemic stroke, whose mean age was 50 (4-79) years; among them, 10 were females. MTHFR gene polymorphism was present in 19 (32.8%) patients, 3 were homozygous and 16 were heterozygous. Both serum folate and B12 levels were low in 29 (50%) patients and Hcy in 48 (83%). Hypertension was present in 28 (48%) patients, diabetes in 12 (21%), hyperlipidemia in 52 (90%), smoking in 17 (29%), obesity in 1 (1.7%) and family history of stroke in first-degree relatives in 13 (22.4%). There was no significant relationship of MTHFR gene polymorphism with folic acid, B12, Hcy levels, dietary habits and number of risk factors. Vitamin B12 level was low in vegetarians (P<0.003). In 3 patients with MTHFR TT alleles, Hcy was elevated in all 3, low folic acid in 2 and family history of stroke in 1 patient. CONCLUSION: MTHFR gene polymorphism was found in one-third of patients with ischemic stroke and was insignificantly associated with higher frequency of elevated Hcy.

Honey--a remedy rediscovered and its therapeutic utility.

Honey is a common household product with many medicinal uses described in traditional medicine. Modern system of medicine is also finding the honey efficacious in various medical and surgical conditions. Antimicrobial, antioxidant and wound healing properties of honey are being evaluated with successful outcome. Prevention and treatment of various infections due to a wide variety of organisms and promoting surgical wound healing are some of the areas where honey is making its mark.

The first successful simultaneous pancreas-kidney transplant in India.

Insulin-dependent diabetes mellitus is associated with renal failure, diabetic retinopathy, neuropathy and vasculopathy. We report the first successful simultaneous pancreas-kidney transplant in India in a young diabetic with renal failure. The dual transplant has cured his diabetes and renal failure and has had a beneficial effect on his neuropathy, retinopathy and quality of life. Obstacles to dual transplant in India include a lack of suitable recipients and a cadaver donor programme that is still in its infancy.

Adult respiratory distress syndrome following non-thoracic skeletal trauma.

Thirty adult patients with severe non-thoracic skeletal trauma were monitored over the first five days for evidence of adult respiratory distress syndrome (ARDS). Three of the patients developed progressive respiratory distress, refractory hypoxaemia and pulmonary infiltrates suggestive of ARDS. Two patients died while one recovered completely. Close monitoring is suggested for early recognition of the disease and institution of therapy.

Role of allogenic vesical mucosa in inducing neo-osteogenesis in guineapigs.

Fresh allogenic mucosa lining the urinary bladder was transplanted into a 1 cm gap of right ulna bone in 24 guineapigs. The 1 cm, bone gap in the left ulna served as control. At regular intervals, the implanted and control sites were studied grossly with naked eye, radiologically and histopathologically to ascertain the role of allogenic vesical mucosa in inducing neo-osteogenesis. The bone gaps were uniformly bridged by bone in 10-12 wk at the implanted sites and fibrous tissue at control sites. There was no evidence of graft rejection. The study thus suggests the potential of the use of stored allogenic vesical mucosal grafts for neo-osteogenesis in clinical practice.

Interaction of human alpha fetoprotein with bilirubin.

Human alpha fetoprotein (AFP) binds bilirubin with an affinity somewhat lower than albumin. Free bilirubin was found to have an extinction maximum at 440 nm with an extinction coefficient of 4.97 x 10(4) M-1cm-1. AFP binding with the bile pigment elicits a blue shift while albumin interaction produced red spectral shift.

Development of an inexpensive and rapid two site microenzyme linked immunosorbent assay kit for human alpha fetoprotein.

Laboratory scale development of a two site micro enzyme linked immuno assay kit is described. The kit comprises rabbit anti human alphafetoprotein (AFP), anti human AFP IgG peroxidase conjugate and standard AFP. All the above reagents were prepared in the laboratory. The kit is eminently suitable for early screening of blood sample of pregnant women for neural tube defects of their fetuses and for the quantitation of AFP as a tumor marker. The assay kit was used to determine AFP in 76 sera from women at different stages of pregnancy. During 1st trimester AFP level was 18 to 119 ng/ml, during 2nd trimester the concentration varied from 85 to 302 ng/ml and during 3rd from 103 to 580 ng/ml. No evidence for maternal antibody to AFP was found. The above data agree with AFP level in pregnant women reported by earlier workers, using RIA or ELISA. The present ELISA kit would hopefully be much cheaper than internationally available ELISA kits for human AFP.

Alpha fetoprotein levels in newborn infants with reference to sex, gestational age and birth weight.

Alpha fetoprotein (AFP) concentration was higher in the mature full term male infants than age matched females. An inverse correlation, at birth, between cord serum AFP level and duration of pregnancy was observed. In contrast no correlation between body weight and AFP levels exists in babies of either sex at identical gestational age.