Myocarditis and multiple cerebral and cerebellar infarction following scorpion sting.

An unusual case of scorpion sting followed by multiple cerebral and cerebellar watershed infarctions is being reported. Myocarditis, hypotension and hypoperfusion infarction is being considered as the possible explanation for this pathology. Hypoperfusion leading to parieto-occipital infarction has been reported earlier, however cerebellar infarction in this context is extremely rare.

Gabapentin in the management of pentazocine dependence: a potent analgesic--anticraving agent.

OBJECTIVES: To evaluate the role of Gabapentin in the management of Pentazocine dependence for suppressing muscle aching and craving during its withdrawal. MATERIAL AND METHODS: Patients of Pentazocine dependence were divided in two groups GpA and GpB (n = 10 in each) and were administered Clonidine (P.O.) in first seven days (acute detoxification phase) and later Naltrexone (P.O.) from seventh day onwards (stabilisation-maintenance phase). Gabapentin (1200 mg/day) was additionally added in group B. Muscle pain and craving were rated on 100 mm visual-analogue scale. Psychological dependence was assessed on four step categorical scale. RESULTS: Group B (Gabapentin group) scored significantly lower (p < 0.001) than group A on both the parameters. Psychological dependence was significantly low (p < 0.01) in Gabapentin group. CONCLUSION: Gabapentin is an important adjuvant to the management of opiate dependence both in acute detoxification as well as stabilisation phase.

Sacral chordoma--a case report.

Chordoma, a rare malignant tumour of early adulthood, rarely presents in children. We report such a case of rare malignant tumour which was diagnosed in the first decade of life.

Three sibs with mild variety of osteopetrosis.

We report three sibs with mild autosomal recessive variety of osteopetrosis. The prominent clinical features were short stature, malocclusion of teeth, hepatosplenomegaly and a typical facial appearance. The only atypical features were microcephaly, a normal upper segment to lower segment ratio and a normal arm span.

Embolic stroke in a child with idiopathic dilated cardiomyopathy.

An eleven year old boy presented with sudden onset right-sided hemiplegia and ipsilateral lower facial weakness. Two-dimensional echo revealed the diagnosis of idiopathic dilated cardiomyopathy with multiple intracardiac clots. MRI scan of head showed infarctions in the area of caudate nuclei, putamen, brain stem and cerebellum. On anticoagulation therapy, all thrombi, except one, disappeared. The child died 2.5 months later due to resistant cardiac failure.

Typhoid fever in a 7 month old infant.

The clinical profile of typhoid fever in an infant is variable and non-specific. A rare case of typhoid fever in a 7 month old infant is reported. The child presented with only a day's history of fever and loose motions which resulted in severe dehydration, acute tubular necrosis and death. The diagnosis of typhoid fever was made only on post-mortem study. The problem in diagnosing typhoid fever in a young infant is highlighted with a brief literature review on the subject.

Impaired pancreatic bicarbonate secretion in chronic malnutrition.

Twenty three children with recurrent episodes of diarrhea and chronic malnutrition were studied for pancreatic duct function. Those children were subjected to pancreatic stimulation with pancreozymin and secretin. Grade I malnourished children, as per Gomez classification, formed the control group. The water output from pancreas increased in malnourished children (p < 0.05). It correlated significantly to cationic transport (p < 0.01). Sodium and potassium together accounted for significant proportion of water output in pancreatic fluid. Potassium transport increased with increasing severity of malnutrition and may be responsible for the hypokalemia observed in malnourished children. Pancreatic secretion of bicarbonate decreased in severe malnutrition inspite of increased flow rate of pancreatic secretion. This is probably due to defective bicarbonate secretion likely to be located at pancreatic duct epithelial cell membrane.

Jejunal disaccharidases in protein energy malnutrition and recovery.

The jejunal disaccharidases, sucrase, maltase and lactase, were determined in jejunal biopsies obtained from 43 malnourished children and 10 controls. In the study group, 63% were girls and 93% had severe malnutrition. Lactase activity was significantly reduced in third and fourth degree malnutrition (p < 0.05 and p < 0.005, respectively), but maltase activity was significantly reduced only in the fourth degree malnutrition (p < 0.01). After recovery, maltase and sucrase activities showed a marginally significant increase (p = 0.06), where lactase showed no significant increase (p > 0.05). We conclude that jejunal disaccharidase activity decreases significantly with increasing severity of malnutrition, lactase being the most severely affected and the last to recover.