Scrub typhus presenting without fever

Scrub typhus may be a very a familiar reason for an acute undifferentiated fever. Although there has been an improvement in the diagnostics as well as an increased awareness regarding this disease, it still remains belatedly diagnosed and eventually turns fatal. We present a male patient who was brought to us with jaundice, tender hepatomegaly and distinctly no history fever who turned out to have a Scrub typhus infection and was salvaged owing to a diverse empirical antibiotic coverage. This represents an atypical clinical presentation of a very familiar infection: Tropical rickettsioses infection presenting with afebrile jaundice in an immunocompetent patient. It also brings into perspective the wavered nature of its disease presentation, the significant merit of procuring a good patient history and a change in empirical antibiotic policies especially in areas endemic for scrub typhus

Multiple constitutional aetiological factors in bone marrow failure syndrome (BMFS) patients from north India.

BACKGROUND AND OBJECTIVES: A large number of patients diagnosed with bone marrow failure syndromes (BMFS), comprising aplastic anaemia (AA) and myelodysplastic syndromes (MDS), remain aetiologically uncharacterized worldover, especially in resource constrained set up. We carried out this study to identify a few constitutional causes in BMFS patients attending a tertiary care hospital in north India. METHODS: Peripheral blood lymphocyte cultures were performed (with and without clastogens) in a cohort of 135 consecutive BMFS patients, in order to detect Fanconi anaemia (FA), Down's syndrome (+21), trisomy 8 (+8) and monosomy 7 (-7). RESULTS: Constitutional factors were detected in 17 (12.6%) patients. FA defect was observed in 24.07 percent (13/54), 16.66 percent (1/6) and 2.85 percent (1/35) paediatric aplastic anaemia, paediatric MDS and adult MDS patients respectively. Down's syndrome was detected in 5.00 percent (2/40) adult aplastic anaemia patients. None of the patients revealed trisomy 8 or monosomy 7. INTERPRETATION AND CONCLUSION: Presence of an underlying factor determines appropriate management, prognostication, family screening and genetic counselling of BMFS patients. Special tests required to confirm or exclude constitutional aetiological factors are not available to majority of the patients in our country. Diepoxybutane (DEB) test yielded better results than mitomycin C (MMC) test in our experience.

Biochemical effects of some organophosphorus pesticides on the ovaries of albino rats.

An evaluation of the toxic effects of three organophosphates; monocrotophos, dimethoate and methyl parathion on female reproduction was made by biochemical estimations of cytoplasmic and membrance bound proteins, lipids, phospholipids and cholesterol in the rat ovaries after treatment with their low residual level doses (LD50 1/8-1/5) to three groups of six rats each for 90 days. All the three pesticides caused degenerative changes in the ovaries as evidenced by a significant decrease in the concentration of cytoplasmic as well as membrane bound proteins, total lipids, phospholipids and cholesterol. The observations are thus indicative of the reproductive toxicity caused by organophosphates at cellular and molecular level in the ovaries of rats.

Enzymatic changes induced by some organophosphorus pesticides in female rats.

An evaluation of toxic effects of three organophosphorus pesticides viz. monocrotophos, methyl parathion and dimethoate given orally daily for 90 days was done in terms of enzymatic changes in plasma and liver of female albino rats. A significant decrease was observed in the level of esterases in plasma with all the three pesticides. The activity of acid and alkaline phosphatases and aminotransferases increased significantly in plasma and significantly or marginally in liver with these pesticides. The results are thus indicative of the cellular toxicity of these organophosphates even after their subchronic administration in low doses for a long period.