Incidence of Genital Organ Abnormalities in Female Genitalia of Marwari Goats

The present study was conducted to record various gross genital abnormalities of female genital organs in Marwari goats. A total of 115 genital organs were collected from municipal and local abattoir of Bikaner city, randomly. Slaughtered genital organs were segregated in 3 groups viz. healthy non pregnant, pregnant and abnormal groups based on their visual observations. The incidences of various gross genital abnormalities were recorded. Out of total 115 genitalia collected, 80 were found to be grossly normal (69.56%).The percentage of pregnancy wastage was 11.30% (13 out of 115). Over all 22 (19.13%) genitalia had abnormalities. The common genital abnormalities found were uterine infections (18), ovarian cyst (3) and parovarian cyst (1), respectively. All these genital disorders are causes a big damage to reproductive health of goat and if they are not diagnosed or treated early then they cause infertility.

Wilson's disease presenting as isolated obsessive-compulsive disorder.

Wilson's disease (WD) is a genetic neurodegenerative disorder; it exhibits wide heterogeneity in symptoms and usually presents with liver disease and/ or neuropsychiatric manifestations. The common neurological manifestations observed are dysarthria, gait disturbance, dystonia, rigidity, tremor, dysphagia and chorea. The frequent psychiatric manifestations reported are personality and mood changes, depression, phobias, cognitive impairment, psychosis, anxiety, compulsive and impulsive behavior. Isolated obsessive-compulsive disorder (OCD) is a rare presentation of WD. Reported herein is a case of a 17-year-old boy with isolated OCD. He presented to the psychiatrist with symptoms of contamination obsessions and washing compulsions, along with compulsion of repeated feet tapping and was treated with adequate doses of fluoxetine for 6 months but did not improve. Later on, he was diagnosed as a case of WD and showed improvement with chelating and behavior therapy. This implies the importance of the occurrence of isolated psychological symptoms in WD.

Cerebral malaria in Indian adults: a prospective study of 441 patients from Bikaner, north-west India.

AIMS OF THE STUDY: As per WHO (1993) the assessment and analysis of local problems and an appropriate epidemiological information system is an essential part of a control programme before embarking any control activity. METHODOLOGY: Four hundred and fourty one (441) adults of strictly defined admitted cerebral malaria patients were studied. Detailed clinical/neurological examination was done at the time of admission, daily thereafter, at the time of regaining consciousness, at the time of discharge and at weekly intervals in those having neurological sequelae. All patients were treated by i.v./oral quinine and specific syndromes were managed according to WHO guidelines. RESULTS: Apart from fever and unconsciousness in all the patients, other features were convulsion (21.31%), neck rigidity (19%), psychosis (5.21%), conjugate deviation of eyes (2.26%), extrapyramidal rigidity (2.25%), trismus (1.31%), decorticate rigidity (1.13%) and decerebrate rigidity (0.90%). One hundred forty five (32.87%) patients expired and mortality was highest in pregnant ladies (39.28%). The important neurological sequelae in survivors were psychosis in 15 (5.06%), cerebellar ataxia in 14 (4.72%), hemiplegia in five (1.68%), extrapyramidal rigidity (EPR) in four (1.35%), peripheral neuropathy in three (1.01%), EPR with trismus in one (0.33%) and isolated sixth nerve palsy in one (0.33%) patients and all showed complete recovery in further follow up. CONCLUSION: The important observations of this study were stormy presentation, increased incidence of haemoglobinuria and jaundice, presence of neck rigidity, no prognostic relation to fundus abnormalities and high incidence of cerebellar ataxia and psychosis as neurological sequelae in survivors. Knowledge of self-limiting course of neurological sequelae may be helpful in reducing economic strain of expensive investigations and treatment.

Meningoencephalitis in brucellosis.

Human brucellosis, more specifically neurobrucellosis, is a less commonly reported disease in India; although, animal brucellosis and seroprevalence in specific areas is well reported. We are reporting 4 cases of neurobrucellosis presenting as meningoencephalitis. Diagnosis was confirmed by serological test and agglutination titre was > 1:320 in all the patients. All these patients had close contact with animals and history of raw milk ingestion was present in 3 cases. The aim of presenting these cases is to create awareness among physicians while treating meningitis in persons, engaged in occupations related to brucellosis or having a history of ingestion of raw milk or milk product.

Prognostic significance of eye changes in cerebral malaria.

AIMS: Eye in Plasmodium falciparum malaria are described by various workers all over the world but its prognostic significance is not clear because of conflicting observation by different authors from different regions. No such study is available on Indian adult patients of cerebral malaria. So we want to describe our observations on various eye abnormalities in these patients and study its prognostic significance. METHODOLOGY: Two hundred and fourteen adult (> 14 years) patients of strictly defined cerebral malaria admitted in classified malaria ward in this tertiary level health care station were studies. Detailed ophthalmoscopic examination was done through dilated pupils at the time of admission, daily thereafter, at the time of discharge and at weekly intervals in those with persistent changes at the time of discharge. RESULT: Retinal haemorrhage was found in 25 (11.68%) patients, papilloedema in 17 (7.94%), blurring of disc margins in 25 (11.68%), retinal oedema in six (2.8%), disc pallor in five (2.33%), vitreous haemorrhage and hard exudate in one (0.46%) each and subconjunctival haemorrhage in six (2.8%) patients. The mortality associated with individual finding was not statistically significant except disc pallor. CONCLUSION: None of the above finding except disc pallor (p < 0.05) was associated with statistically significant mortality (p > 0.05); whereas any of the fundus findings as a whole was related to statistically significant mortality (p < 0.05).

Brainstem auditory evoked potentials and somatosensory evoked potentials in cerebral malaria--a prognostic significance.

OBJECTIVE: To study the changes in brainstem auditory evoked potentials (BAEPs) and somatosensory evoked potentials (SSEPs) in cerebral malaria and to see their prognostic significance. METHODS: BAEPs and right median nerve SSEPs were performed in 25 adult patients of strictly defined cerebral malaria in acute stage in a semi-dark, sound proof chamber on four channel computerized multi-basis OTE-Biomedica machine in department of neurology, SP Medical College, Bikaner. RESULTS: The abnormalities of BAEPs were delayed peak latency of wave III in 13/25 (52%) and wave V in 20/25 (80%) patients and delayed interpeak latencies (IPLs) of wave I-III in 9/25 (36%), wave I-V in 15/25 (60%) and wave III-V in 12/25 (48%) patients. In SSEPs delayed N20 was seen in 11/25 (44%); delayed IPLs of N13-N20 (central conduction time; CCT) in 12/25 (48%) patients. Distorted N20 was recorded in 12/25 (48%) patients. Both N13-N20 IPLs in SSEPs and wave III-V IPLs in BAEPs were delayed in five patients and all of them expired. Delayed N13-N20 with normal III-V IPLs was present in seven patients and two of them died, whereas delayed III-V IPLs with normal N13-N20 was present in seven patients, and one of them expired. In remaining six patients both the parameters were normal and one of them died. CONCLUSIONS: The values of BAEPs and SSEPs were abnormal in patients of cerebral malaria and it was observed that BAEPs/SSEPs alone was not useful for predicting the outcome of coma, whereas abnormalities in both was predictive of worst prognosis. The changes in evoked potentials (BAEPs and SSEPs) could be due to either interruption of conduction in central pathways because of structural changes due to petechial hemorrhages and malarial granuloma at multiple levels in the brain including brainstem or due to metabolic abnormalities.

Importance of blood glucose level at the time of admission in severe and complicated malaria.

A prospective study of blood glucose level at the time of admission was done on 532 cases of severe and complicated malaria admitted in classified malaria ward at PBM Hospital, Bikaner. Eleven patients had blood glucose level < 40 mg% (< 2.2 mmol/L) and all were unconscious with diagnosis of cerebral malaria. Four patients became conscious with i.v. infusion of 25% dextrose only without receiving any specific antimalarial treatment. Recognition of these patients of "falciparum malaria with hypoglycaemia" by blood glucose estimation at the time of admission can significantly affect the ultimate outcome. The mortality trend was more in patients having blood glucose level < 40 mg% (< 2.2 mmol/L) in comparison to group of patients having blood glucose level between 41 to 60 mg% (2.2 to 3.3 mmol/L) and was least in those having blood glucose level > 60 mg% (> 3.3 mmol/L).

Herpes zoster and post-herpetic neuralgia--a clinical trial of aspirin in chloroform for anodyne.

Pain associated with Herpes Zoster (HZ) and Post-herpetic Neuralgia (PHN) has been a challenging task to manage with ease. Topical aspirin dissolved in chloroform is an effective means of reducing pain due to HZ and PHN in most patients. The locus of pain origin and analgesia induced by topical aspirin is supposed to be at cutaneous free nerve ending pain receptors. The present study was conduced in fifty two patients of HZ and PHN. Pain intensity before and after the application of drug was measured with help of Sort Form McGill Pain Questionnaire (SE-MPQ). Most of the patients experienced relief of pain within 1-5 minutes after the aspirin-chloroform application. Maximum relief was achieved in about 30-40 minutes and persisted for 5-6 hrs. In the beginning 3-4 applications were required but frequency decreased gradually as the pain abated.

Severe and complicated malaria in Bikaner (Rajasthan), western India.

Severe and complicated malaria is an important cause of mortality in Plasmodium falciparum infection. We describe in this study the details of 532 cases of such syndromes admitted to hospital during an outbreak of malaria between September-December 1994. Increase in the annual rain fall, collection of water around Indra Gandhi Canal, forestation of shrubs around it and migration of labor, adaptation of Anopheles stephensi to desert climate and favorable breeding of An. culicifacies in the areas under impact of irrigation were presumptive causes of the outbreak in this region. Cerebral malaria (25.75%), hepatic involvement (11.47%), spontaneous bleeding (9.58%), hemoglobinuria (7.89%), severe anemia (5.83%), algid malaria (5.26%), ARDS (3%) and renal failure (2.07%) were the important manifestations. The overall mortality was 11.09%, which was high because of infection in the non-immune population of this area. Ignorance about the severity of this disease and lack of transportation facility was another important factor. Morality was highest in ARDS (81.25%) followed by severe anemia (70.97%), algid malaria (46.43%), renal failure (45.45%), jaundice (36.06%) and cerebral malaria (33.57%). Pregnancy was an important determinant increasing the mortality in female patients. Mortality was very high (82.35%) in those persons who presented with more than 3 syndromes together.

Delayed cerebellar ataxia--a complication of Plasmodium falciparum malaria.

Cerebellar ataxia is an unusual post malarial complication. We encountered 10 patients of this disease (3 in 1992 and 7 in 1994) during the malaria epidemic period in Bikaner, Rajasthan. All patients were permanent residents to malaria endemic areas. The ataxic symptoms appeared after an afebrile period of 2-7 days. The neurological examination revealed no other abnormality except a cerebellar syndrome interfering with normal gait and speech. Lower limbs were affected more than the upper limbs and the mean delay between onset of fever and onset of cerebellar ataxia was 13 days. Peripheral blood film of all cases showed gametocytes of Plasmodium falciparum and in two cases schizonts of the same. All the patients improved within one month without any residual deficit. Further follow up for next 4 weeks revealed no abnormality.