Castleman’s Disease In Parotid Region: A Rare Case From Chhattisgarh.

A thirty five year old patient presented with swelling in parotid region. After surgical removal and histopathological examination unicentric lymphoproliferation was observed. Further, immunohistochemical studies of CD 21 tissue marker confirmed Castleman’s Disease. The disease most commonly involves the mediastinum and neck but the involvement of the parotid gland region is very rare, being reported first time from Chhattisgarh State.

The spectrum of perforation peritonitis - central India experience.

Introduction: Peritonitis secondary to gut perforation is one of the most common surgical emergencies in India and is associated with high morbidity and mortality. The aim of this study was to recognize the spectrum of perforation peritonitis as managed at Govt. Chhattisgarh Institute of Medical Sciences hospital Bilaspur Chhattisgarh, in central India. Method: A retrospective analysis of 618 patients was done,in terms of clinical presentation, duration, seasonal variation, operative findings and post operative morbidity and mortality, admitted at Chhattisgarh Institute of Medical Sciences hospital Bilaspur. Chhattisgarh, over a period of 03 years. All the patients had undergone emergency laprotomy and the site of perforation was identified. Results: The most common site of perforation was prepyloric (393 cases. 63.6%).In 22.16% of the cases the perforation was associated with typhoid fever and in 2.7% cases with abdominal Koch’s. Trauma however showed perforation in only 5.6% cases, mainly jejunal. The overall mortality was 12.13%. Conclusion: Non traumatic upper gastrointestinal perforation peritonitis is common in our place. In contrast to the west, where lower gastrointestinal tract perforations predominate, in India upper gastrointestinal tract perforations constitute the majority of cases.

Seminal LDH-C4 isoenzyme and sperm mitochondrial activity: a study in male partners of infertile couples.

Lactate dehydrogenase isoenzyme patterns were obtained in the seman of 93 male partners of infertile couples and 28 proven fertile subjects as a control group. Sperm mitochondrial activity index (SMAI) alongwith the conventional seminal parameters was studied for all the subjects excepting the azoospermic and vasectomised males. Only LDH-C4, a germ cell specific isoenzyme activity varied with the variation in sperm density. LDH-C4 activity varied significantly (p<0.001) within and between different groups. Lactate dehydrogenase-C4 activity was absent in 17 azoospermic samples, confirming its germinal epithelial origin, as well as in 8 samples of vasectomised males. In one azoospermic sample, there were many immature germ cells along with surprisingly high LDH-C4 activity suggesting more activity of germinal epithelium associated with high LDH-C4 activity. LDH-C4 activity was reduced significantly in oligozoospermic samples in proportion to sperm density, thus confirming strong correlation (p<0.001) between LDH-C4 and sperm density. There was statistically significant correlation between LDH-C4 and percentage sperm motility as well as between LDH-C4 and Sperm Mitochondrial Activity Index (SMAI) (probability varying from p<0.05 to p<0.01 in different groups), but no such correlation was found between LDH-C4 and sperm morphology. The data confirms LDH-C4 as a germinal epithelial marker. Its relationship with percentage sperm motility is suggestive of definite role of LDH-C4 in evaluation of the spermatozoal quality, similarly its relationship with Sperm Mitochondrial Activity Index (SMAI score) suggest the role of LDH-C4 in metabolism of the spermatocytes and sperms, though further studies are required for clear and detailed understanding of its metabolic role in semen.

The role of hypo-osmotic swelling test in recurrent abortions.

The role of male factors in abortions has not been studied extensively. We undertook this study to determine if there was any relationship between hypo-osmotic swelling test score and recurrent abortions. This was a cross-sectional case control study conducted at the semen analysis laboratory at a tertiary level referral centre. The male partners of 25 patients who had three or more first trimester abortions of unknown etiology were chosen as cases. Controls were 26 unmarried volunteers with unknown fertility potential to represent the entire population. The conventional seminal parameters were studied according to WHO guidelines. The HOS test score were obtained by the method advocated by Jayendran et al. There were no statistically significant differences in mean sperm count, percentage motility and morphology among the cases and controls. We found a low hypo-osmotic swelling test score among the cases [55.7 +/- 1.197 (SEM)] than the controls [69.3 +/- 1.143 (SEM)] which was statistically significant [P < 0.001]. The normal spermatozoal membrane is the prerequisite for the specialized cell-to-cell communications and cell-to-cell binding. In spite of apparently normal semen analysis, subtle membrane defects in the spermatozoa, which could be the cause of defective membrane functions in the embryo effecting miscarriages, can be elucidated by the hypo-osmotic swelling test.