Morphology of Ulnar Nerve and its Variation in North Indian Population

Introduction: The ulnar nerve is formed from medial cord of the brachial plexus. It lies medial to axillary and brachial artery as far as middle of humerus, and then pierces the medial inter muscular septum to descend on the anterior face of triceps. Lesions of the associated structures often occur. There is anatomical variations in course of ulnar nerve amongst the races. Aim: This study was conducted to analyse the anatomical variation of ulnar nerve in north Indian population.Subjects and Methods: The study was done on 30 human cadavers at Departments of Anatomy, Darbhanga Medical College and Hospital, Laheriasarai. Results: The observations showed that- Ulnar nerve was present in all specimens, and in 97% cases originated from the medial cord of the brachial plexus, at the level of tip of the acromion processes and showed the normal course. Conclusion: The awareness of these variations along the normal pattern are helpful for the interventional radiologists, orthopaedicians and neurologists in preventing untoward iatrogenic injury to the ulnar nerve during radiological procedures or operating on fractured patients or diagnostic therapy

Morphometric Analysis of the Human Second Cervical Vertebrae of North Indian Population

Introduction: The Aim of the study was to provide the morphometric measurement of the axis vertebrae in North Indian popuulation. Which could be used as clinical tool to determine the feasibility of safe translaminar screw placement. Subjects and Methods: 50 dry human axis vertebrae from adult North Indian population were subjected to morphometric measurement using venier caliper. The various dimensions of the axis vertebrae were observed. Results: There is high variability in the thickness of the C2 lamina. As compared to western population, the axis bones used in the present study had smaller profiles. Conclusion: The current study showed safety margin for translaminar screw insertion is low.

Complete pathological response in rectal cancer after neoadjuvant therapy - case report

A fifty-four year old woman underwent colonoscopy due to symptoms of altered bowel habit and weight loss. There was a malignant looking lesion at her rectosigmoid junction [Fig. 1a] which was confirmed histologically to be a moderately differentiated adenocarcinoma. Although the blood results were normal, her CT scan and MRI [Fig 2a] showed an apple core lesion at rectosigmoid junction which was deemed to be Stage IIIC (T4aN2aM0)

Emergence of sporotrichosis in Manipur.

A retrospective analysis of all cases of sporotrichosis was conducted to examine the pattern and frequency of sporotrichosis cases in Manipur over a period of six year from July 1999 to June 2005. Seventy-three (73) cases of sporotrichosis were detected of which 30 were confirmed by culture and 43 were diagnosed by aspiration cytology only. Most of the patients belonged to the age group of 21 to 40 years (n = 23; 31.5%). There were 39 females (53.4%) and 34 males (46.5%). Commonest site of infection was upper limbs (n = 39; 53.4%) followed by lower limbs (n = 17; 23.2%). Commonest type of infection was lymphocutaneous form (n = 46; 63.1%) followed by fixed cutaneous form (n = 27; 36.9%). Among these 73 cases, 2 male patients (2.7%) were found to be HIV positive. In our experience, collection of material by aspiration of pus or infected tissue was found to be a better method compared to scraping or exudate. This study revealed Manipur as a new endemic area for sporotrichosis.

STD trends in regional institute of medical sciences, Manipur.

A study carried out among the 2230 STD patients during 1996-2000 shows the types, distribution and trends of the various STDs seen in our hospital. STDs contribute 3.30% of the total skin OPD cases. Males dominate with 89.3% of STD cases. Bolanoposthitis (22%) was the commonest STD, followed by gonorrhoea (11.8%) and nongonococcal urethritis (NGU) being 11.2%. Syphilis was seen in 6.2% of the cases. The prevalence of VDRL reactivity and HIV reactivity remains almost the some being 8.49% and 8.21% respectively. There is increased occurrence of various psychosexual disorders among the affected patients.

Artemether vs quinine therapy in Plasmodium falciparum malaria in Manipur--a preliminary report.

Qinghaosu and its derivatives are rapidly effective antimalarial drugs derived from a Chinese plant (sweet worm wood). Preliminary studies suggest that these drugs may be more effective than quinine in the treatment of Plasmodium falciparum malaria. A randomised double blind trial was conducted in 52 cases of Plasmodium falciparum malaria cases. In all 26 cases were given artemether and another 26 were given quinine. There were 2 (7.5%) deaths in artemether group and 4 (15%) deaths in quinine group. The parasites were cleared more quickly from the blood in artemether group when compared to quinine group (mean-72 hrs vs 96 hrs). Resolution of fever was comparable in both artemether and quinine group (mean-84 hrs vs 78 hrs) and also the average time of recovery from coma was more earlier in artemether group (mean-60 hrs vs 72 hrs). The only side effect noticed with artemether therapy was gastrointestinal (GI) intolerance while quinine therapy was associated with myocarditis, hypotension, hypoglycemia and GI intolerance.

HIV-1 subtypes in injecting drug users & their non-injecting wives in Manipur, India.

The presence of HIV-1 antibodies was determined among the injecting drug users (IDUs) and their non-injecting wives. A total of 233 (72%) were found to be HIV-1 seropositive among the 322 subjects recruited in this study between August, 1996 and September, 1997. The distribution of HIV-1 subtypes among the injecting drug users (IDUs) and their wives was determined using peptide enzyme immunoassay (EIA). Sexual transmission of HIV-1 occurred frequently (45%) from HIV-1 infected IDUs to their spouses. The majority of the subjects (167/233) were infected with subtype C followed by subtype Thai B (29/233). Subtype C was the most common among both IDUs (78%) and their wives (57%), followed by subtype Thai B (12% and 13% respectively). The distribution of subtypes was significantly different between IDUs and their wives with a lower percentage of subtype C and higher percentage of subtype D in the infected wives (P < 0.03). Discordance for subtypes transmitted from IDUs to their wives suggests the occurrence of dual and/or recombinant infection in the IDUs.

Cryptosporidium and HIV.

To study the importance of cryptosporidium as a diarrhoea causing pathogen (using stool samples), a cohort study was conducted from 14-9-1994 to 14-3-1995 on injecting drug users in Imphal. Stool samples were also collected from close contacts of the patients of human immunodeficiency virus (HIV) infected cryptosporidium diarrhoea cases and patients of paediatric medicine ward of Regional Institute of Medical Sciences (RIMS), Imphal. A total of 9 cases of cryptosporidium diagnosed out of 11 HIV infected diarrhoea cases and 2 out of 11 personal contacts were found to be positive. Two cases with history of close contacts with HIV infected cryptosporidium diarrhoea cases were not suffering from diarrhoea. One out of 7 paediatric diarrhoea cases was found to be positive. Five out of 9 HIV infected cryptosporidial cases died within one month of diagnosis of cryptosporidium. The remaining 4 had improved and diarrhoea was controlled. One of the 4 did not show cryptosporidium any more in the stool sample.

Multiple tubercular ulcer perforation of ileum in an AIDS patient: case report.

Intestinal perforation is an extremely uncommon complication of Mycobacterium tuberculosis (MTB) infection. We report a case of HIV infection in a male injecting drug user (IDU) with intestinal tuberculosis complicated with multiple ileal perforations at the Regional Institute of Medical Sciences Hospital, Imphal, Manipur. The emergency surgical therapy supported by antitubercular drugs (ATT) and parenteral nutrition saved the life of this patient who presented in a critical state of shock. The patient manifested with extrapulmonary tuberculosis, which is one of the criteria of AIDS. The authors stress the possibility that in future, tubercular complication till now considered atypical, may become more frequent.

Changes in the virulence of Mycobacterium bovis (BCG Phipps) in carbon tetrachloride treated mice.

Mild grade of liver damage was produced in mice by repeated subcutaneous injection of carbon tetrachloride. These mice along with saline treated mice were challenged with an avirulent vaccine strain of BCG (Phipps), intravenously. The CCl4 treated, BCG challenged mice developed disease and died much earlier than the controls, indicating an increased susceptibility to the avirulent strain in mice with mild hepatitis.

Evaluation of diversified antigens for detection of Mycobacterium leprae antibodies from leprosy patients and contacts.

A comparative evaluation of diversified antigens in ELISA has been made for detection of M. leprae antibodies in the sera of leprosy patients and their contacts. Out of the four antigens, namely M. leprae sonicate (ML), phenolic glycolipid I (PGL-1), M. habana sonicate (MH) and its arabinomannan (AM), the cross reactive antigens (MH,AM) have comparatively detected more number of leprosy cases. Homologous antigens (ML, PGL-1) have lower detection level. Use of MH and AM for detection of mycobacterial antibodies have been discussed and advocated for epidemiological studies of leprosy/tuberculosis.

Angiotensin converting enzyme activity in female reproductive tract of domestic fowl (Gallus domesticus) and its interactions with semen.

Presence of angiotensin converting enzyme (ACE, EC 3.4.15.1) in female reproductive tract and its interaction with semen has been investigated in domestic fowl. Higher activity of ACE was detected in homogenates of infundibulum region followed by magnum and relatively low level was noticed in rest of the parts of the oviduct (i.e. isthmus, uterus, uterovaginal-junction and vagina). This decreasing order in ACE activity was, however, reversed when these segments were incubated with semen. ACE in the ovarian follicular wall increased with corresponding increase in the follicle size. Presence of some stimulatory or inhibitory substances for ACE in the oviduct of fowl is suggested.

Pulmonary paragonimiasis in childhood--a cause of recurrent haemoptysis and pneumonia.

A 2-year-old Manipuri girl had haemoptysis and a chest roentgenogram disclosed diffuse-infiltrates in the right lung. Microscopic examination of sputum and morning gastric aspirate showed numerous golden-brown, operculated ova, and microscopic examination of stool specimens confirmed these ova to be those of the lung fluke, Paragonimus westermani. She responded favourably to bithionol therapy and was asymptomatic and growing normally during follow up for one and half years.

Use of non-conventional antigen: M. habana in detecting M. leprae antibodies from leprosy patients and contacts in FLA-ABS test.

An indirect immunofluorescent (FLA-ABS) test has been developed to detect M. leprae specific antibodies in the active and subclinical cases of leprosy. An antigenically related mycobacterium, M. habana, was used as an antigen to detect M. leprae specific antibodies in the sera samples of leprosy patients. A comparison was made with M. leprae antigen using same set of sera samples. M. habana is capable of detecting anti-M. leprae antibodies in the serum samples of leprosy patients, previously absorbed with various mycobacterial antigens, cardiolipin and lecithin, almost to the same percentage as M. leprae. Possible use of M. habana antigen as an alternative to M. leprae, in the serodiagnosis of leprosy, has been discussed.

Detection of leprosy antigenuria through DOT-ELISA.

Fifty-five samples of urine from different grades of leprosy patients and normal persons were processed for detection of PGL-1 antigen through DOT-ELISA on nitrocellulose paper strips using anti-human IgG horse raddish peroxidaseconjugate. About 66.6% of the paucibacillary and 100% of the multibacillary leprosy cases were detectable through this technique on the basis of differential colour development on the strips. Possibility of its use in the field conditions has been discussed.

Relative cross reactivity of habanin, lepromin and tuberculin in guinea pigs sensitized with homologous and heterologous mycobacteria.

An atypical strain Mycobacterium habana has been studied for its antigenic cross reactivity with delayed type of hypersensitivity responses in guinea pigs. Guinea pigs sensitized with M. habana, M. leprae and M. tuberculosis when challenged with habanin, lepromin and tuberculin in criss-cross fashion have demonstrated strong cross reactivity with each other. Possibilities of developing M. habana as a vaccine against tuberculosis and/or leprosy has been discussed.