Profile of bone marrow examination in HIV/AIDS patients to detect opportunistic infections, especially tuberculosis.

Morphological evaluation of 140 bone marrow aspirations received in haematopathology laboratory with serologically established HIV infection, along with other relevant special haematological tests, was done during 1st Jan 1999 - 31st Dec 2002 at state government run tertiary care General Hospital in Maharashtra state, India. Out of 140 cases: 118 (84.28%) patients had anaemia, 25 (17.86%) had leukopenia, while 13 (9.28%) were thrombocytopenic. Dyserythropoiesis was present in 18 (12.86%) cases, dysmyelopoiesis 37 (26.43%) and micromegakaryocytes were noted in 44 (31.43%) cases. Haemophagocytosis was evident in 8 (5.71%) cases. Plasmacytosis encountered in 120 (85.71%) cases was a common feature. Based on clinical profile and results of other investigations 56 (40%) patients were clinically diagnosed to be of Mycobacterium tuberculosis (TB). Of these, 18 (12.86%) bone marrow aspirates were positive for AFB, Mycobacterium tuberculosis. In 4 cases cryptococci were demonstrated (Mucicarmine stain). There was one case each of Histoplasma capsulatum and leishmaniasis. One patient showed dense parasitemia with Plasmodium falciparum. One patient had immunoblastic lymphoma and showed bone marrow infiltration. Findings in this study strongly indicate that in HIV/AIDS, AFB stain should be done on each marrow aspirate to rule out tuberculosis in countries like India; where TB and AIDS are marching together.

Primary thyroid lymphoma: a report of two cases.

Primary thyroid lymphomas (PTLs) are rare neoplasms which in the past have been classified by various schemes. Clinicopathological findings of two cases which were diagnosed in the past one year in our institute are presented using the Revised European and American classification (REAL) for lymphomas. Both cases presented as enlarging neck masses in elderly female patients, in association with lymphocytic thyroiditis. One case was diagnosed as a MALT (mucosa associated lymphoid tissue) lymphoma while the other was a diffuse large cell lymphoma (DLCL).

Malaria still a threat to life--a postmortem study.

This study is of 25 cases of acute malaria encountered at autopsy. Cause of death was malaria in all the cases. The study covers a period of 6 years i.e. from January 1994 to December 1999. There was an upward trend in deaths due to malaria. P. falciparum malaria with its complications accounted for majority of deaths and cerebral malaria (CM) topped the list. Other complications observed were adult respiratory distress syndrome (ARDS), acute septicemic malaria, acute renal failure (ARF) and disseminated intravascular coagulation (DIC). The commonest presenting symptoms were fever with chills associated with central nervous system (CNS) complaints like altered sensorium and unconsciousness.

Amyloid (spheroid) deposits in pituitary adenoma presenting as Cushing disease--a case report.

A rare case of pituitary adenoma with spheroid amyloid deposits encountered in a 40 year old male is presented.

Niemann Pick disease--a case report.

Niemann Pick disease is a rare disorder occuring in paediatric age group. The clinical features, hematological characteristics and autopsy findings in an one year old male diagnosed to have Niemann Pick disease are presented.

Hypomagnesaemia in paediatric population in an intensive care unit.

AIMS: To determine incidence and risk factors for hypomagnesaemia in children admitted in Paediatric Intensive Care Unit, (PICU). SUBJECTS AND METHODS: Prospective study was carried out on 80 children admitted in PICU. The patients were clinically assessed for nutritional status, neurological status on Glasgow coma scale, congestive cardiac failure, etc. and relevant biochemical parameters including serum and red cell magnesium levels were done. 25 patients of the same age group admitted in general ward who were not in critical state were included as a control group. RESULTS: 70% of PICU patients had hypomagnesaemia, which was more common in patients on aminoglycosides and diuretics. CONCLUSION: In view of complications of magnesium depletion and benign nature of appropriate magnesium therapy critically ill children should have their magnesium level monitored.

Percutaneous pigtail catheter drainage of pancreatic pseudocysts.

AIM: To evaluate the efficacy of percutaneous pigtail catheter drainage (PCD) in the management of pancreatic pseudocysts otherwise meriting surgical intervention. METHODS: Fourteen consecutive patients with pancreatic pseudocysts (five following acute pancreatitis and nine with chronic pancreatitis) were subjected to PCD. For uncomplicated chronic pseudocysts, an algorithm using endoscopic retrograde pancreaticography to demonstrate ductal communication with obstruction was followed. Five patients had complicated pseudocysts and nine uncomplicated cysts persisting > 6 weeks and > 6 cm in size. RESULTS: All uncomplicated and two complicated pseudocysts resolved in 6-58 days (mean 19.7). No recurrences were seen. Three patients with complicated cysts had pancreatic fistulae; two of these were treated by surgery and one by pancreatic stenting. Sepsis required sump drainage in two patients. Four patients required early surgery: two for pancreatic fistula and one each for hemorrhage and residual cyst. Two patients were subjected later to pancreatico-jejunostomy for pain of chronic pancreatitis. CONCLUSIONS: Patients with acute pseudocysts and uncomplicated noncommunicating chronic pseudocysts respond to PCD. In complicated chronic pseudocysts, sepsis may be controlled by PCD.

Micro-determination of fluoride by means of metallic sodium fusion and using fluoride-sensitive electrode.

A simple and accurate method to determine the content of fluoride in non-volatile organofluoro compounds or in biological samples has been developed. The method includes the metallic sodium fusion followed by quantitative estimation of fluoride using fluoride-sensitive electrode.