揂ir Bubble Sign� and Fibreoptic Bronchoscopy in Complicated Pulmonary Hydatid Cysts: Steps in the Right Direction

Intact pulmonary hydatid cysts are often discovered incidentally on chest X-rays (CXRs) as rounded opaque lesions with smooth borders. Cyst rupture and infection (complicated hydatid cyst) often change the radiologic appearance delaying diagnosis. Air bubble sign on computed tomography is recognized as a sign of high sensitivity and specificity in the diagnosis of complicated hydatid cysts when compared to other classical radiologic signs. Bronchoscopy is not a preferred investigation in patients with intact hydatid cysts but may have a major role in patients with complicated hydatid cysts with atypical presentation. In the present case series, we attempt to highlight the importance of the 揳ir bubble sign� and the identification of a whitish membrane at bronchoscopy in the diagnosis of complicated hydatid cysts.

A Rare Case of Blood & Sweat: Hematohidrosis

Hematohidrosis is an uncommon pathophysiological condition of sweating blood. A young lady with abrupt bleeding from the skin (since January 2017) was brought to the emergency. The bleeding was vanished after mopping with no site of injury, but it reappeared soon enough confirming its nature. Bleeding time (BT), clotting time (CT), and the prothrombin time (PT) was within normal limit. This patient is confirmed as a case of hematohidrosis by the method of exclusion and the presence of blood was finalized by benzidine test as well as biochemical and microscopic examination of it. Now, no treatment is available as per the latest pieces of evidence. Also, the cause of it is not known till date. Psychological anxiety is a predisposing cause for hematohidrosis.

Fecundity Studies Of Andrographis Paniculata On Drosophila Melanogaster

Objective: Andrographis paniculata is widely used in Asia for various medicinal purposes. The plant has a major bioactive chemical constituent Andrographolide, which exhibits various essential pharmacological properties. Recently, to enhance immunity against viral fevers especially dengue viral fever during monsoon season, Tamil Nadu state government has advised rural health centres to provide a tea or kashayam made from a mixture containing this plant leaf along with selected plant roots and leaves. However, there is concern among the general public population that this plant extract may have a negative impact on potency. This study is being done to investigate the toxic effects of Andrographis paniculata on fecundity and physiological properties of Drosophila melanogaster. Methods: The flies were treated and mated in pure and mixed form of Andrographis paniculata separately. Results: The results were obtained in the form of egg count, which was compared to control and the conclusion was obtained that Andrographis paniculata might affect the fecundity and at the same time, it was observed that the developmental span from an egg to an adult fly increased upon treatment in successive generations. More importantly, the effect of pure form plant on the fecundity was found to be significant, while that of the mixed form was not. On mating a treated male with an untreated female and an untreated male with a treated female when the treatment is being discontinued, it can be very well seen that there is no effect on the fecundity of the flies. Conclusion: Since the continuity of the treatment played a major role on the effect of fecundity, highlighting the importance of the period of treatment and the exposure time of the compound on the fly system, therefore this research suggests that the conception of tea or kashayam extracted from mixed plant content could not have the same effect as the similar concentration of pure Andrographis paniculata and it does not have any acute effect on the fecundity when being consumed over a short period of time in Drosophila melanogaster model.

Diagnostic value of serum adenosine deaminase in Type 2 diabetic patients

Background: Adenosine deaminase (ADA) is suggested to modulate the bioactivity of insulin, but its clinical significance in Type 2 diabetes mellitus (DM) is not yet established. The present study was undertaken to evaluate serum ADA activity and serum uric acid levels in patients of Type 2 DM. Aim: To evaluate the serum ADA level and to correlate ADA levels with Blood Glucose, Glycated Hemoglobin (HbA1c) levels in Type-2 DM patients. Material and Method: It is a case control study. The subjects in this study were divided into 3 groups. Group I consisted of 50 normal healthy individuals who served as controls with no history of DM. Group II consisted of 50 patients of Type 2 DM both males & females in the age group of 40-65 years on oral hypoglycemic drugs with HbA1c <7%. Group III consisted of 50 patients of Type 2 DM both males & females in the age group of 40-65 years on oral hypoglycemic drugs with HbA1c >7 %. Serum levels of fasting blood sugar, HbA1c, ADA and uric acid were estimated in all the subjects. Results: FBS, HbA1c, ADA and serum uric acid levels were found to be increased in the patients of Type 2 DM as compared with controls. Conclusion: It is concluded that there is an increase in serum ADA levels with increase in HbA1c levels. Serum uric acid levels increased with moderately increasing levels of HbA1c <7% and then decreased with further increasing levels of HbA1c >7% (a bell-shaped relation).

Solitary staphylococcal liver abcess in a neonate.

28 days old neonate presented with high fever, abdominal distension, poor feeding and lethargy. Sepsis screen was positive; ultrasound and computed tomography of the abdomen demonstrated a multiloculated hepatic abcess in the right lobe of the liver. The baby was treated with intravenous antibiotics for 6 weeks and percutaneous aspiration of the abcess, resulting in excellent recovery.

Interface between drug use and sex work in Manipur.

BACKGROUND: In India, drug use is seen predominantly as a problem among men. This study attempts to address the interface between drug use and sex work among women drug users in Manipur and the prevalence of HIV, hepatitis B and other sexually transmitted infections in them. METHODS: This cross-sectional survey was conducted between April and October 1997 at the time of an ethnic clash in imphal, the capital of Manipur. Sixty-nine women drug users were interviewed through street-based outreach workers; 38 women (55%) were injecting drug users. Data were generated with the help of a semi-structured questionnaire on sociodemography, drug use practice and health issues after obtaining informed consent from the participants. Subsequently, consent was also obtained from 60 respondents for collecting blood for unlinked anonymous tests for HIV and hepatitis B surface antigen. Clinical examination for reproductive tract infections, offered to all the study participants, generated data on sexually transmitted diseases. RESULTS: The prevalence of HIV infection in injecting drug users was 57% (20/35) compared to 20% (5/25) among non-injecting drug users (p = 0.001), although the prevalence of hepatitis B surface antigen was similar in the two groups, 48% v. 56%, respectively. Eighty per cent of the respondents, many of whom migrated following the ethnic clash, reported having sex with non-regular partners, two-thirds reported sex in exchange for money or drugs. Eighty-one per cent (29/36) of women who agreed to have a clinical examination had abnormal vaginal discharge, of which 10 had endocervical discharge. The presence of infection was confirmed in only 24% of those with vaginal discharge--4 had bacterial vaginosis and 3 trichomoniasis. CONCLUSION: Environmental interventions to reduce civil unrest and forced migration have an important role to play in HIV containment. The high rate of HIV infection, and the probability of a high rate of sexually transmitted infections in women drug users suggests that a targeted intervention in this population group is a public health need. An innovative outreach strategy should be designed for effective implementation of interventions among women injecting drug users and non-injecting drug users who operate from the streets as sex workers to support their drug habit as well as livelihood.

Trichosporon beigelii peritonitis in a HIV-positive patient on continuous ambulatory peritoneal dialysis.

Peritonitis, the commonest complication of peritoneal dialysis, is usually bacterial in origin. Fungal peritonitis is rarely encountered. We are reporting a rare case of fungal peritonitis caused by Trichosporon beigelii in a patient on continuous ambulatory peritoned dialysis (CAPD), who was HIV positive.

HIV-1 subtypes in injecting drug users & their non-injecting wives in Manipur, India.

The presence of HIV-1 antibodies was determined among the injecting drug users (IDUs) and their non-injecting wives. A total of 233 (72%) were found to be HIV-1 seropositive among the 322 subjects recruited in this study between August, 1996 and September, 1997. The distribution of HIV-1 subtypes among the injecting drug users (IDUs) and their wives was determined using peptide enzyme immunoassay (EIA). Sexual transmission of HIV-1 occurred frequently (45%) from HIV-1 infected IDUs to their spouses. The majority of the subjects (167/233) were infected with subtype C followed by subtype Thai B (29/233). Subtype C was the most common among both IDUs (78%) and their wives (57%), followed by subtype Thai B (12% and 13% respectively). The distribution of subtypes was significantly different between IDUs and their wives with a lower percentage of subtype C and higher percentage of subtype D in the infected wives (P < 0.03). Discordance for subtypes transmitted from IDUs to their wives suggests the occurrence of dual and/or recombinant infection in the IDUs.

Pre-clinical toxicity evaluation of leaf-stalk extractive of Piper betle Linn. in rodents.

Studies on pre-clinical toxicity were undertaken to determine the haematological and biochemical changes after administration of alcoholic extract of leaf-stalk of P. betle in rats and mice. Acute and chronic toxicity experiments were performed on mice and rats according to WHO protocol. Different doses of plant extractive were administered for toxicity studies on short and long term basis. Haematological, biochemical profiles and enzymatic studies (transaminases and phosphatases) indicated that the drug (plant extractive) was devoid of toxicity.

Prevalence of HCV & HBV infection amongst HIV seropositive intravenous drug users & their non-injecting wives in Manipur, India.

Hepatitis C virus (HCV) and hepatitis B virus (HBV) infections were evaluated among 77 Manipuri couples of whom all husbands were both intravenous drug users (IDUs) and human immunodeficiency virus (HIV) positive. This study showed for the first time a high prevalence of HCV (92%) and HBV (100%) infection amongst the IDUs in Manipur. Stringent control measures to prevent the transmission of hepatitis viruses (B and C) are urgently required in Manipur.

Antioxidant activity of active tannoid principles of Emblica officinalis (amla).

The antioxidant activity of tannoid active principles of E. officinalis consisting of emblicanin A (37%), emblicanin B (33%), punigluconin (12%) and pedunculagin (14%), was investigated on the basis of their effects on rat brain frontal cortical and striatal concentrations of the oxidative free radical scavenging enzymes, superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX), and lipid peroxidation, in terms of thiobarbituric acid-reactive products. The results were compared with effects induced by deprenyl, a selective monoamine oxidase (MAO) B inhibitor with well documented antioxidant activity. The active tannoids of E. officinalis (EOT), administered in the doses of 5 and 10 mg/kg, i.p., and deprenyl (2 mg/kg, i.p.), induced an increase in both frontal cortical and striatal SOD, CAT and GPX activity, with concomitant decrease in lipid peroxidation in these brain areas when administered once daily for 7 days. Acute single administration of EOT and deprenyl had insignificant effects. The results also indicate that the antioxidant activity of E. officinalis may reside in the tannoids of the fruits of the plant, which have vitamin C-like properties, rather than vitamin C itself.

Hypertension in the young in eastern India.

Three hundred and forty-one young hypertensives in the age group of 18-30 years were evaluated over a 7-year period. Essential hypertension constituted the single largest group (35.8%). Renal pathology was the most common cause of secondary hypertension (26.4%). Congenital coarctation of the aorta and endocrine causes accounted for 14.1 percent and 3.2 percent cases of secondary hypertension, respectively. A strikingly high incidence of nonspecific aortoarteritis (20.1%) was a distinguishing feature amongst secondary causes. Aortoarteritis was the commonest cause of renal artery stenosis. Renal angioplasty was performed in 11 patients with refractory hypertension. Forty percent of the patients achieved post-angioplasty control of blood pressure without drugs; in 25 percent, the blood pressure became easier to control. Restenosis was detected in 4 cases over 18-24 months of follow-up.

Reuse of pacemaker.

Implantation of a permanent pacemaker is an expensive proposition for the poor patients of our country. Many patients on permanent pacemaker die prematurely due to diseases or conditions not related to pacemaker function. The purpose of this study was to reuse these pacemakers after thorough cleansing and proper sterilisation in other suitable patients and compare the efficiency of the reused pacemakers with that of newly implanted ones. Between April 1979 and April 1992, 642 patients implanted with reused pacemakers were studied. The study population consisted of patients ranging in age from 15-85 years and included patients of both sexes (M:F = 4:1). The mean period of follow-up was 7.5 +/- 5.6 years. Removal and reimplantation of the pulse generators was carried out after obtaining the State Government's approval, informed consent of the donors, relatives and recipients. The functional status of the pulse generators was tested by a "pacing system analyser". The clinical indications for reuse were chronic complete heart block, symptomatic bifascicular heart block, sick sinus syndrome and chronic complete heart block with congestive heart failure, in decreasing order of frequency. In terms of morbidity and mortality, the efficacy of reused pacemakers was highly comparable with that of newly implanted ones. The infection rate in cases of reuse from dead patients was comparable to that in cases of new implantation. However, pacemakers reused in the same patient showed a high rate of infection. With the aid of newer generations of antimicrobials, infection when matched with efficacy and economy (of reuse) does not seem to be a major factor against pacemaker reuse.

Cardiac tumours: an observational study.

We studied 38 patients with cardiac tumours. Of these, 30 had primary cardiac tumours while the rest had secondary tumours. The commonest manifestations in patients with primary tumours were exertional breathlessness (23), fever (9), mitral diastolic murmur (15), loud pulmonary component of the second heart sound (16), and mitral systolic murmur (21). Left atrial myxoma was the commonest diagnosis (24) followed by left ventricular leiomyoma (2), right atrial myxoma (2, one with RA and RV both), RV myxoma (1), and left ventricular haemangioma (1). The commonest modes of presentation of secondary cardiac tumours were atrial extrasystoles (5) and pericardial friction rub (4). Histopathological reports revealed bronchogenic carcinoma (4), breast carcinoma (2), seminoma of the testis (1) and lymphoma (1). The unexpectedly low number of secondary cardiac tumours in this series is attributed to the lack of routine autopsy studies in our institute.

Bioactive forms of gonadotropin releasing hormone in the brain of an Indian major carp, Catla catla (Ham.).

Two forms of biologically active gonadotropin releasing hormones were isolated from the hypothalami of Catla catla. Gonadotropin releasing hormone activity was studied in vitro using enzymatically dispersed carp pituitary cell incubation system. Gonadotropin released into the medium was measured by carp gonadotropin-radio immuno assay. Acetic acid extracted hypothalamic material was subjected to acetone fractionation. Among the three protein pellets obtained at different time periods (AC I, AC II and AC III), AC II exhibited the gonadotropin releasing hormone activity. Gel filtration of AC II through Sephadex G-25 column showed three protein peaks (SG I, SG II SG III) and only SG II demonstrated strong gonadotropin releasing hormone activity. Elution of SG II through FPLC Mono Q column (an anion exchanger) in NaCl gradient programme showed one unadsorbed (MQ I) and three adsorbed (MQ II, MQ III and MQ IV) protein peaks. MQ III, which was eluted with 51% NaCl, exhibited gonadotropin releasing hormone activity. Surprisingly, unadsorbed fractions, MQ I, also showed gonadotropin releasing hormone activity. MQ 1 was therefore subjected to FPLC Mono S (a cation exchanger) column chromatography where a highly active gonadotropin releasing hormone enriched peak, i.e., MS III, could be eluted with 45% NaCl. These findings show that Catla catla hypothalamus has two forms of gonadotropin releasing hormones one anionic (carp gonadotropin releasing hormone I) and another cationic (carp gonadotropin releasing hormone II). These two forms of gonadotropin releasing hormones were also active in heterologous carp species, rohu (Labeo rohita), mrigal (Cirrhinus mrigala) and an exotic common carp (Cyprinus carpio). Combined activity of two forms of gonadotropin releasing hormones was significantly greater as compared to any of the single form.