Brain abscess caused by Cladophialophora Bantiana in an immunocompetent host: need for a novel cost-effective antifungal agent.

We report a 53-year-old male who presented with headache, tremor and memory disturbance. Radiological evaluation was suggestive of brain abscess. He underwent gross total excision of the cerebral abscess. The histopathological examination and pus culture was suggestive of brain abscess caused by Cladophialophora bantiana. Authors report a rare case of biopsy and culture proven Cladophialophora bantiana brain abscess in an immunocompetent host. The authors review the relevant literature and current treatment options while emphasizing the need for a cost-effective novel antifungal drug to salvage a subset of patients suffering from this rare but increasingly frequent condition.

Clinical efficacy of clonidine as an adjunct to anaesthesia for coronary artery bypass graft surgery.

Clonidine, a preferential alpha 2 adrenergic agonist has been reported to have perioperative effects including reduction of anaesthetic requirements, improving haemodynamic stability and providing analgesia, however its clinical usefulness in cardiac surgery is not widely studied. Thirty-four consecutive patients undergoing coronary artery bypass graft surgery (CABG) were preoperatively administered clonidine and studied for its possible desirable effects. Seventeen patients (Gr B) received 2 microg/kg clonidine orally the previous night and again one hour prior to surgery. Seventeen patients did not receive the drug and served as control (Gr A). Heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), requirement of isoflurane, requirement of nitroglycerin, sedation score, extubation score and urine output were studied throughout the perioperative period. HR was observed to be lower at all time points in the clonidine group though the difference between groups was not statistically significant (p > 0.1). MAP was higher at all time points and significantly so after intubaton in the control group (P < 0.01). Patients receiving clonidine required significantly less isoflurane and nitroglycerin (P < 0.05). sedation score was significantly higher in the clonidine group. Other aspects studied were comparable in both groups. At the doses described in this study, clonidine seems to be a safe useful adjunct to anaesthesia for CABG surgery.

Acute accidental exposure to chlorine fumes--a study of 82 cases.

Eighty-two patients were hospitalized following an accidental exposure to chlorine. All patients presented with dyspnoea and cough. The other symptoms included irritation of throat (53.6%), irritation of eyes (42.3%), headache (29.2%), abdominal pain (26.8%), vomiting (24.3%) and giddiness (9.7%). All of them had bronchospasm and 5 (6%) had cyanosis at the onset. An x-ray of the chest revealed patchy infiltrates in 3 (3.85%) and hilar congestion in 2 (2.44%). Pulmonary function tests showed an obstructive pattern in 27.4%, restrictive in 3.25% and mixed in 53.2%. Pulmonary functions were normal in 16.1% of the patients. Bronchoscopy revealed tracheobronchial mucosal congestion in all cases, hemorrhagic spots in 35.7%, erosions and ulcers in 12.5%. All patients were treated with oxygen, aminophylline, hydrocortisone and antibiotics. Haematemesis (n = 1) and pulmonary oedema (n = 2) developed 12 hours after the admission. Two other patients developed pneumonia 48 hours later. All patients recovered satisfactorily. On follow-up 16 patients had no sequelae after one year. Pulmonary functions were normal in 5 patients after 3 years of follow-up.