Renal Ganglioneuroma.

Background: Renal ganglioneuroma is an extremely rare benign tumour that affects neural crest cells. Here we report a case of renal ganglioneuroma with nodal metastasis managed by surgical resection. Case report: A 38-year-old female presented with anorexia and early satiety. On examination, she had a palpable mass per abdomen. CT scan revealed a large heterogenous mass in retroperitoneum in right suprarenal region with enlarged retrocrural lymph nodes. She underwent right radical nephrectomy as the mass was inseparable from the right kidney. Postoperative period was uneventful. HPE revealed renal ganglioneuroma. Conclusion: Primary renal ganglioneuroma is difficrult to differentiate from other etroperitoneal lesions. Surgical resection is the most effective treatment.

Visceral leishmaniasis (kala-azar): challenges ahead.

Indian visceral leishmaniasis (VL) is a parasitic disease caused by a haemoflagellete Leishmania donovani and transmitted by the bite of sand fly Phlebotomus argentipes. It affects various age groups. In India about 1,00,000 cases of VL are estimated to occur annually; of these, the State of Bihar accounts for over than 90 per cent of the cases. Diagnosis of VL typically relies on microscopic examination of tissue smears but serology and molecular methods are better alternatives currently. Notwithstanding the growing incidence of resistance, pentavalent antimony complex has been the mainstay for the treatment of VL during the last several decades. The second line drugs such as amphotericin B, lipid formulations of amphotericin B, paromomycin and recently developed miltefosine are the other alternatives. In spite of significant development in various areas of Leishmania research, there is a pressing need for the technological advancement in the understanding of immune response, drug resistance and the pathogenesis of leishmaniasis that could be translated into field applicable and affordable methods for diagnosis, treatment, and control of the disease.

Correlation of serotonin and monoamine oxidase levels with anxiety level in diarrhea-predominant irritable bowel syndrome.

BACKGROUND: Irritable bowel syndrome (IBS) is generally considered to have a psychogenic component in its physiopathology. AIM: To study the role of serotonin (5-hydroxytryptamine; 5-HT), monoamine oxidase (MAO) and anxiety, and to elucidate the relationship between these in patients with diarrhea-predominant IBS. METHODS: 5-HT and MAO activity and anxiety levels were studied in 20 healthy volunteers (aged 18-25 years; all men) and 57 patients with diarrhea-predominant IBS (30-60 years; all men). RESULTS: The concentrations of 5-HT (0.3 [0.04] microg/ mL) and MAO (15.5 [3.2] U/mL), and the anxiety level score (14.4 [2.9]) were significantly higher (p < 0.001) in patients than in healthy volunteers (0.1 [0.02], 6.4 [1.4] and 3.4 [1.2], respectively). These parameters correlated with each other in both patients and volunteers. CONCLUSIONS: Elevated 5-HT and MAO activity and anxiety may play a role in patients with diarrhea-predominant IBS.

A study on physiological changes in certain psychosomatic disorders with reference to cortisol, blood glucose and lipid profile.

Plasma cortisol, blood glucose, serum lipids and lipoproteins were estimated in diseased human subjects and normal control volunteers. Serum triglyceride (Tg) total cholesterol (Tc) and cholesterol content of very low density lipoprotein (VLDLc), low density lipoprotein (LDLc) and high density lipoprotein (HDLc) were assayed under lipid profile. Clinical investigations were carried out on 115 subjects which involved 30 control, 25 irritable bowel syndrome (IBS), 30 bronchial asthma and 30 rheumatoid arthritis patients. The results of this preliminary study showed a significant change in the levels of all the biochemical parameters in diseased subjects in comparison with controls. Increased levels of atherogenic lipids, Tg, VLDLc and LDLc were found in rheumatoid arthritis subjects. This suggests that arthritis subjects are relatively at higher risk of developing coronary heart disease. Furthermore hypercholesterolemia may aggravate the risk condition in arthritis patients by artereosclerosis. The significant elevation in the levels of plasma cortisol reveals the fact that rheumatoid arthritis is a stabilized and chronic psychosomatic disorder, since, homeostatic competence is disrupted following decline in the tendency of stress-response to return to normalcy.

A study on physiological changes in essential hypertension and rheumatoid arthritis with reference to the levels of cortisol, blood glucose, triglycerides and cholesterol.

The levels of plasma cortisol, blood glucose, serum triglycerides (TG) and total cholesterol (TC) were estimated in 175 human subjects (50 normal controls, 65 having essential hypertension and 60 suffering from rheumatoid arthritis. The results showed a significant elevation in the levels of plasma cortisol and blood glucose in both the stressed clinical groups with respect to controls. Increased levels of atherogenic lipids (TG and TC) were also observed in diseased group. However, in rheumatoid arthritis the biochemical changes were comparatively more pronounced than in hypertensives. The findings in vitro reveal that rheumatoid arthritis is a relatively more chronic and late onset disorder, since the functional performance of hypothalamo-pituitary-adrenocortical (HPA) axis declines with chronicity and the efficacy of adrenocortical response to return to normalcy becomes impaired.

Nutrient cycling in an excessively rainfed subtropical grassland at Cherrapunji.

Cycling of six mineral elements (N, P, K, Na, Ca and Mg) was studied in a humid subtropical grassland at Cherrapunji, north-eastern India during 1988-1989. Elemental concentrations in the shoot of four dominant grass species, viz., Arundinella khaseana, Chrysopogon gryllus, Eragrostiella leioptera and Eulalia trispicata were very low, and none of the species appears suitable for fodder use. Among different vegetation compartments, live root was the largest reservoir of all the nutrients (except Ca) followed by live shoot, dead shoot, litter and dead root. For Ca, live shoot was the major storage compartment. The total annual uptake (kg ha-1) was 137·3, 10·4, 51·1, 5·5, 8·7 and 18·2 for N, P, K, Na, Ca and Mg, respectively. In an annual cycle 98% N, 77% P, 49% K, 109% Na, 87% Ca and 65% Mg returned to the soil through litter and belowground detritus. A major portion of Ν, Ρ and Na was recycled through the belowground system, whereas nearly half of K, Ca and Mg was recycled through the shoot system. Precipitation acts as the source of Ν and Ρ input, but at the same time causes loss of cations.

Effects of commonly used NSAID's on gastric mucosa. A clinico-endoscopic and histopathological study.

Non steroidal anti-inflammatory drugs (NSAID's) are one of the most commonly used agents in clinical practice today. All these drugs are known to produce gastro-intestinal lesions. In the present study we found that aspirin, indomethacin and phenylbutazone caused gastric mucosal damage in 90.9%, 100%, respectively while ibuprofen and paracetamol caused gastric mucosal damage in 33.3% and 37.5% respectively. Thus latter two drugs were safer NSAID's. Further more we have demonstrated that endoscopic monitoring of the patients on NSAID's is a sensitive method of early detection of gastric mucosal damage. This monitoring may be particularly valuable in high risk subjects on NSAID's.

Effects of commonly used non steroidal anti-inflammatory drugs on gastric mucosa. A clinical, endoscopic and histopathological study.

Non steroidal anti-inflammatory drugs (NSAIDS) are known to produce gastro-intestinal lesions. In the present work we found that aspirin, indomethacin and oxyphenbutazone caused gastric mucosal damage in 90.9%, 100% and 100% respectively, while ibuprofen and paracetamol caused damage in 33.3% and 37.5% of cases respectively. Thus the latter two drugs were much safer NSAIDs. Furthermore we demonstrated that endoscopic monitoring of patients on NSAIDs is a sensitive method for early detection of gastric mucosal damage. This monitoring may be particularly valuable in high risk subjects on NSAIDs.

Urinary aspartate transaminase (AST) activity and detection of its inhibitors in normal urine.

Urinary aspartate-transaminase activity in the whole urine was found to be mean +/- S.D. = 8.46 +/- 0.69 l.U/l when measured immediately after urine collection. About 50% loss in enzyme activity was observed after 18 hours dialysis. An overall 176% increase in enzyme activity followed by Sephadex G-25 (fine) whole urine fractionation and a highly significant (P less than .001) partial inhibition by earlier Sephadex fractions and maximum inhibition by earlier Sephadex fractions and maximum inhibition of enzyme by fraction 7 have suggested the presence of both high and low molecular weight urinary inhibitors of aspartate-transaminase. Urea and ammonia presence and inhibitor activity in fraction 6 to 8 bear a close parallelism; both the substances produced 31% inhibition of partially purified goat liver GOT at concentrations approximating normal human urine. Therefore, low enzyme activity and its substantial loss in the whole urine and during dialysis may be due to the concomitant inhibitory effects of urea, ammonia and unidentified nature of high molecular weight substance(s). The present method may be effective in separating inhibitors and overcoming the disadvantages of dialysis in determining true urinary aspartate-transaminase activity.