Hepatitis A associated with myoglobinuria.

We report a patient with hepatitis A who had myoglobinuria. Creatine phosphokinase levels and electromyography and muscle biopsy findings were consistent with polymyositis.

Granulomatous hepatitis: a retrospective study.

51 cases of granulomatous hepatitis were seen among 1234 liver biopsies over a 10 year period. Tuberculosis was the commonest cause seen in 55 percent of cases. Other causes included leprosy, sarcoidosis, histoplasmosis, brucellosis, amoebic liver abscess, lymphoma and malignant granuloma. 12 percent of cases remained undiagnosed. Clinically these patients presented with pyrexia and hepatosplenomegaly. Jaundice was uncommon. Many showed elevated alkaline phosphatase levels, anaemia and raised ESR Granulomatous hepatitis of unknown aetiology with FUO was seen in 6 percent cases only.

Indolent gastric carcinoma.

A 55 year old woman presenting with epigastric pain and dyspeptic symptoms was diagnosed to have gastric carcinoma on endoscopic biopsy independently on two occasions. She was subsequently asymptomatic without any specific therapy till she developed gastric outlet obstruction and weight loss four years later. Histology of the resected specimen revealed an adenocarcinoma infiltrating the serosa without any evidence of metastasis.

Comparative evaluation of bone marrow aspirate particle smears, imprints and biopsy sections.

Comparative evaluation of bone marrow aspirate particle smears, imprints and biopsy sections was done on 30 haematological problems. Core needle biopsy of the bone marrow is a safe and useful procedure. It is a valuable diagnostic aid for measurement of marrow cellularity, metastatic tumours and fibrosis. It should not be taken as a substitute for examination of the marrow by aspiration smear but is a complementary procedure which affords several advantages. Bone marrow biopsy was of maximum utility in myelofibrosis which was diagnosed on biopsy alone. There were three additional cases with normal bone marrow aspiration in which specific diagnosis could only be made from bone marrow biopsy sections. New methodologies i.e. plastic embedding and semi thin sections of undecalcified bone marrow, can be expected to improve the cytological details of tissue obtained by biopsy. Imprint preparations obtained from biopsy can be useful in patients of malignancy but we have found them to be of limited value except in cases of dry tap.

Endoscopic and histopathological study of duodenitis.

Fifty patients who presented with symptoms suggestive of disease related to peptic acidity having endoscopic evidence of duodenitis were analysed. Endoscopic duodenal biopsy was done in all these patients. Histologically duodenitis was labelled if there was infiltration of epithelial layer. Male to female ratio was found to be 3:2. Duration of symptoms in the patients ranged from less than one month to more than 5 years. Possible aetiological factors like drugs, alcohol and smoking were established in 26 patients (52%), drugs being the commonest (26%). Stool examination showed cyst or ova of parasites in 8 patients (16%). Endoscopically multiple hyperaemic patches were seen in 15 (30%), erosions in 19 (38%), coarse mucosal folds in 5 (10%), nodules in 2 (4%) and multiple lesions in 9 (18%) patients. Histological and endoscopical correlationship was established in 40 (80%) cases.

Jaundice in Plasmodium falciparum.

Thirty-two patients of smear positive Plasmodium falciparum malaria having jaundice were analysed retrospectively. Majority of the cases were in the age group of 31-40 years. Serum bilirubin levels ranged from 2 mg to 40 mg%. Fourteen (42.6%) had serum bilirubin above 10 mg%. Conjugated bilirubinaemia was found in twenty one patients (65.5%), unconjugated in 4 (12.5%) while 7 patients (21.8%) had a mixed pattern. Serum transaminases were high in 21.8% patients. Twenty five patients (78%) had associated azotaemia, 11(34.3%) had intravascular haemolysis and 3(9.3%) had possible cerebral malaria. Hepatosplenomegaly was seen in all the 32 patients. Mortality was 21% but none died of hepatic encephalopathy. Histologically the most consistent finding in liver biopsies was reticulo-endothelial cell hyperplasia. Pigmentation in kupffer cells, fatty change, sinusoidal and portal infiltration and cholestasis were the other features seen.

Ossifying fibroma of the maxilla. Case report.

A rare case of ossifying fibroma presenting as a rapidly growing tumour of the maxillary antrum and causing destruction of its walls is described with a brief review of literature.