Benign esophageal stricture following aluminium phosphide poisoning.

Aluminium phosphide is often implicated in accidental and suicidal poisoning in India. Ingestion of even half a fresh tablet invariably results in death, whereas exposed tablets are usually considered harmless. We report two cases of short-segment esophageal strictures that occurred following ingestion of exposed tablet of aluminium phosphide. Both cases could be successfully managed by endoscopic dilatation.

Autoimmune thyroiditis perdating the presentation of systemic lupus erythematosus: two cases and a review of literature.

Autoimmune diseases are commonly encountered in dermatology practice. While the association of two autoimmune diseases in the same individual is not unknown, it is relatively rare for the second disease to be suspected based on cutaneous manifestations. We present two such cases wherein cutaneous manifestations were the first clue to the development of lupus erythematosus in a setting of autoimmune thyroiditis. Further, we have reviewed literature on this uncommon occurrence and discuss various aspects of this association.

Glucoregulatory hormones in hepatic cirrhosis.

In the present study hormonal responses to 75 gm oral glucose were studied in 34 biopsy proven cases of hepatic cirrhosis and 15 normal subjects. Though fasting blood glucose was similar in both controls and cirrhotics the latter showed higher glucose values throughout the study. The peak of glucose level in cirrhotics was delayed to 60 minutes. Two of 34 (5.8%) cirrhotics showed marginal fasting hyperglycaemia and 44% had (impaired glucose tolerance (IGT). There was no significant difference (P > 0.05) in blood glucose levels in patients with and without varices. The fasting serum insulin was significantly raised in cirrhotics (24.9 +/- 2.2 vs 8.4 +/- 1.2 mu/ml, p > 0.05). Hyperinsulinaemia was significantly marked in cirrhotics with abnormal Oral glucose tolerance test (OGTT) as compared to those who had normal OGTT. The mean fasting serum insulin concentration in patients with and without varices was similar showing thereby that portasystemic shunt in cirrhotics is not the cause for peripheral hyper-insulinaemia. Basal cortisol was similar in cirrhotics and controls though expected fall in cirrhotics like control was absent. Twelve percent cirrhotics had basal human growth hormone (hGH) more than 10 ng/ml. Forty four percent showed paradoxical rise of hGH. hGH has significantly high (p < 0.01) in cirrhotics with abnormal OGTT as compared to those with normal OGTT.

Pulmonary functions in ulcerative colitis.

The lung functions were evaluated in eighteen patients of ulcerative colitis, in a controlled study. There was statistically significant (p less than 0.01) reduction in maximum voluntary ventilation (MVV). Diffusing capacity (DLCo) was also reduced. Though the reduction in DLCo was not statistically significant, the importance of this finding as compared to the controls has been discussed. The findings are suggestive of subclinical restrictive ventilatory abnormality.