Marchiafava-Bignami disease.

Marchiafava- Bignami disease is the symmetrical demyelination of the middle portion of the corpus callosum observed in people with chronic alcoholism. We report two male patients who had history of chronic alcoholism, different clinical presentation and MRI findings consistent with the diagnosis of Marchiafava-Bignami disease.

Alkaptonuria and intramedullary calcification.

Alkaptonuria is a rare disorder of metabolism caused by deficiency of homogentisic acid oxidase enzyme and characterized by triad of homogentisic aciduria (dark urine), relentlessly progressive arthritis and ochronosis. We have documented a case with typical features of alkaptonuria along with intramedullary calcification which has not been reported in the literature before.

Progressive multifocal leukoencephalopathy--as a presenting manifestation of AIDS.

Progressive multifocal leukoencephalopathy (PML) is an opportunistic demyelinating disease caused by the ubiquitous, usually non pathogenic JC Polyomavirus. We report a case of PML as a presenting manifestation of AIDS in a forty five year old man on the basis of clinical features and neuroradiology.

Importance of age in outcome of oesophagogastroduodenoscopy in open access endoscopy: a profile of patients in Sub-Himalayan region of North India.

The Oesophago-Gastro-Duodenoscopy (OGD) is done in patients received by either open access system or the conventional system. The presenting complaints and OGD findings may differ among patients with age < 45 yrs and those who are more than 45 yrs old. The referral diagnosis, age, sex, and environmental factors have important implications on the chances of finding and objective abnormality on endoscopy in a patient. This study was aimed to evaluate to evaluate the profile of 1186 patients divided into younger (<45 yrs) and older age (45 or > 45 yrs) groups presenting for oesophago gastroduodenoscopy through open access referral system in sub-Himalayan region of North India. This is a retrospective study carried out on patients who underwent the OGD from Jan, 2004-Dec, 2004. The study was conducted in Indira Gandhi Medical College situated at a moderate altitude in North India. All patients presenting in Medical College during the study period for OGD were taken into study. The patients were divided into two groups based on age; less than 45 yrs and 45 yrs or more than 45 yrs. Their presenting complaint, age, sex, and OGD findings were recorded. The profile was compared between the two groups. A total of 1186 patients underwent OGD; the females were 451(38%) and males were 735(62%); 616(52%) were < 45 yrs old and 570(48%) of the patients were 45 yrs or older. In the group I 431(70%) had a normal endoscopy and 185(30%) showed abnormal endoscopic findings. In group II 302(53%) had a normal endoscopy, and 268(47%) had abnormal findings on endoscopy. Gastric ulcers, mass lesion/new growth were more common in elderly group, Gastro-esophageal reflux disease (GERD) was more common in younger group. The presenting complaints were similar in both groups. It is concluded that for the same presenting diagnosis the yield of OGD was more in patients > 45 yrs old. The positivity rate increased from 30% in < 45 yrs to 47% in the elderly cohort. So, all people >45 yrs should go for endoscopy at the first hint of upper GI pathology, or appearance of alarm symptoms.

Symmetrical peripheral gangrene due to viral gastroenteritis.

A case of multifactorial symmetrical peripheral gangrene due to viral gastroenteritis, shock, dopamine infusion, exposure to low temperature and nonlactose fermenters septicaemia is presented for its rarity and devastating consequences.

Mesangial proliferative glomerulonephritis in chronic obstructive pulmonary disease.

Ten patients of chronic obstructive pulmonary disease were studied for changes in ultrastructure of the glomeruli, serum immunoglobulin and complement levels. The glomeruli showed proliferation in the mesangium in 90% patients and electron dense deposits in the mesangium in 30% patients. IgA and IgG were usually elevated whereas complements were usually depressed in most of these patients. It is suggested that repeated respiratory infections in these subjects may be responsible for mesangioproliferative type of glomerulonephritis, high IgA and IgG levels. The complements are activated and they take part in immune complex formation getting deposited in mesangium.

Prevalence of NIDDM in the general population (> 40 years) in Shimla.

A random survey for determining the prevalence of NIDDM was conducted in the population aged 40 years and above of Shimla town. 1195 subjects were screened for estimation of NIDDM prevalence from seven randomly selected wards. The prevalence of NIDDM in age group 40 years and above was 4.86% (5.17% in males and 4.38% in females). NIDDM was found to be positively associated with increasing age, BMI, WHR, family history of diabetes and negatively with physical activity. Stress should be on early detection of diabetes to reduce the heavy burden of morbidity and mortality caused by diabetes.

Electrocardiographic manifestations of healthy residents of a tribal Himalayan village.

Electrocardiograms of 984 healthy subjects residing in village Kalpa at the height of 9000 feet above sea level were studied. Right ventricular hypertrophy (RVH) was observed in 9 (0.914%) subjects. Electrocardiographic evidence of ischaemic heart disease was found in 6 (0.609%) subjects.

Effective reduction of LDL cholesterol by indigenous plant product.

A herbal powder containing guar gum, methi, tundika and meshasringi was administered to 30 control and 30 type 2 (non-insulin dependent) diabetes mellitus patients for a month. Total serum cholesterol and its fractions eg, high density lipoprotein, low density lipoproteins, very low density lipoproteins and serum triglyceride were determined before and after the trial period. Total and low density lipoprotein (LDL) cholesterols were reduced significantly after the therapy. There were no significant changes in high density lipoproteins (HDL), very low density lipoproteins (VLDL) or triglyceride levels. Side-effects eg, mild flatulence and looseness of bowel were noticed in less than 40% cases.