Morphological study of chordae tendinae in human cadaveric hearts

The chordae tendinae [CT] are strong, fibrous connections between the valve leaflets and the papillary muscles. Dysfunction of the papillary muscles and chordae is frequent. Mitral valve replacement with preservation of CT and papillary muscles may preserve postoperative left ventricular function better than conventional mitral valve replacement in patients with chronic mitral regurgitation. The study was carried out on 116 human cadaveric hearts. The heart was opened through the atrioventricular valve to view the constituents of the complex. Origin, attachments, insertions, distribution, branching pattern and gross structure of CT were observed and studied in detail. In the present study more than 21 terminologies of CT were defined by classifying it into six different types. Classification is done according to the origin, attachments, insertion, distribution, branching pattern and gross structure. Terminologies defined are as follows. Apical pillar chordae, Basal pillar chordae, True chordae, False chordae, Interpillar chordae, Pillar wall chordae, Cusp chordae, Cleft chordae, Commissural chordae, First order chordae, Second order chordae, Free zone chordae, Marginal chordae, Rough zone chordae, Straight chordae, Branched-fan shaped chordae, Spiral chordae, Irregular-web chordae, Tendinous chordae, Muscular chordae, Membranous chordae. Basal pillar chordae are found in 9.48%. Mean number of chordae taking origin from apical half of a single papillary muscle or single head of papillary muscle was 9.09 with the range of 3-18. Mean number of the marginal chordae attached to a single cusp was 22.63 ranging from 11 to 35. Strut chordae showed interesting insertion with broad aponeurosis in 38.79% and large muscular flaps in 13.79%. Chordae muscularis were found in 14% and membranous chordae were found in 6%. This knowledge may prove useful for cardiologists and cardiac surgeons

Evaluation of C-reactiveprotein as early indicator of blook culture positivity in veonates

To determine the Sensitivity, Specificity and Predict values of C - reactive protein as an early indicator of Neonatal Sepsis. Design: It was an observational study of newborns suspected sepsis. Place and Duration of study: The study was carried out in the Department of Paediatrics, Karachi Medical Et Dental College and Abbasi Shaheed Hospital, Karachi over a period of eight months [March 1, 2001 to October 31, 2001]. Patient and Neonates admitted to intensive care nursery of the Abbasi Shaheed Hospital Karachi were evaluated for Neonatal Sepsis. C-reactive protein as screening test was performed along with blood culture from peripheral venepuncture. The gold standard for the Diagnosis of Sepsis was positive blood culture. Result: The positive C- reactive protein found in 14 of 21 episodes associated with the positive blood culture, but in 15 of 29 negative cases it was also found positive. The sensitivity and specificity are equal to negative predict value and positive predict value respectively i.e. 66.66% and 48.27%. CRP estimation have some value in early diagnosis of Neonatal sepsis but the frequent occurrence of raised CRP in sera of uninfected neonates eliminates it as a useful indicator of infection but may suggest an active tissue damaging process. We do not advocate to rely on the result of single test, even with the combination of test, we still stress the importance of correlating the clinical and laboratory data. We recommend that a scoring system should be designed for our setup, using those test that are easy to perform, economical, reliable, should have high predictive value and should ideally identify all infected infants [high sensitivity]

study of 30 cases of renal amyloidosis

To determine the clinicopathological features of renal amyloidosis. Patients And A total number of thirty cases were included in two year study. Diagnosis was based on renal biopsy and Congo red staining. There was 18 [60%] male and 12 [40%] female patients. Age range was 20 - 70 years and maximum number was found between 40 - 50 years. Out of 30 cases tuberculosis was present in 10 [33.3%], leprosy in 6 [20%], bronchiectasis and rheumatoid arthritis in 4 [13.3%], chronic osteomyelitis in 3 [10%], ankylosing spondylitis in 2 [6.7%] and multiple myeloma in 1 [3.3%] case. Proteinuria was present in all cases. Generalised edems found in 26 [86.6%], hypertension in 17 [56.6%], hematuria in 10 [33.3%], hepatosplemngely in 5 [16.6%] patients. Tuberculosis was the commonest cause of secondary renal amyloidosis

Effects of short and long-term neuroleptic administration on brain bioamines

Effects of short and long term administration of Chlorpromazine and Fluphenazine on the levels of certain bioamines have been investigated in rabbit. Brain levels of 5-hydroxytryptamine, 5-hydroxyindole acetic acid and tryptophan remain unchanged after short term [90 mins.] administration of Chlorpromazine [10 mg/kg] and fluphenazine [2.5 mg/kg]. Although long term administration [21 days] of Chlorpromazine and Fluphenazine resulted in an increase in 5-HT and 5-HIAA level of mid-brain hypothalamus and other regions examined, these findings suggest that neuroleptics enhance the synthesis and utilization of brain serotonin