A Prospective Study of Cutaneous Calcifications and Clinicopathologic Correlations.

Background: Cutaneous calcifications or calcinosis cutis is an interesting lesion, wherein the skin, soft tissues and in the walls of small/medium sized veins, arteries. The aim of the present study is to evaluate the calcinosis cutis or cutaneous calcification prevalence and also its correlation with age, sex, site of the lesion, clinical features and histopathological findings. Methods: A 5 years prospective study was on 40 patients suspected to have calcinosis cutis. Surgical excision of skin lesions was also performed to do the histopathological study. Results: Women presented with lesions around the waist commonly. Males presented with lesions at different sites like over dorsum of legs and fore arm most commonly. Out of 40 cutaneous calcifications, 14 (35%) were Asymptomatic, 12 (30%) were painless papules/nodules, 8 (20%) were ulceration with or without discharge, 6 (15%) were painful papules/nodules. Conclusion: As the Cutaneous calcifications were mostly asymptomatic or painless, need to evaluate the carefully and treat if there is any underlying pathologies. Calcinosis cutis individuals should be educate and counsel regarding underlying pathologies and treatment.

Risk profile in asymptomatic first degree relatives of Coronary Artery Disease (CAD) patients.

Aim: Cardiovascular disease is on the rise and is expected to be a leading cause of death and disability worldwide. Identification of risk in asymptomatic individual in higher risk group could help to plan individual patient’s management. Positive family history is one of the risk factors and screening at this level may help in determining individual therapy. Studies have shown relation of positive family history but are lacking in this part of world, so we considered it worthwhile to assess FRS in asymptomatic sibling of CAD Patients Materials and methods: 75 volunteers were enrolled in the study and they underwent Bruce treadmill exercise protocol after their initial evaluation, these volunteers than also underwent biochemical test – Fasting blood sugar and lipid profile. These volunteers were divided into two groups based upon their Treadmill test results. Results: 31 out of 75 volunteers were TMT positive and they were kept in one group. These volunteers differed significantly (p<0.05) in higher age, fasting blood sugar and Low density lipoprotein level (LDL). This group also had a significantly lower metabolic equivalents and higher Framingham Risk Score. Conclusion: Our study showed that positive family history is associated with a higher Framingham risk score in asymptomatic volunteers.

Taste dysfunction in vestibular schwannomas.

Background: Gustatory dysfunction associated with vestibular schwannomas (VS) is a poorly represented clinical presentation. Materials and Methods: One hundred and forty-nine cases operated from 1997 to 2005 where at least six-month follow-up was available were included. All patients were tested for taste sensations using four modalities of standard taste solutions. Apart from the taste sensations, any altered or abnormal taste perceptions were recorded both in the preoperative and postoperative period. Results: After applying the exclusion criteria, the taste dysfunction was studied in 142 patients. The evidence of decreased taste sensation was found in 58 (40.8%) patients prior to surgery. Preoperatively, taste disturbance was found in 29 (37.2%) giant, 28 (45.9%) large and one (33.3%) medium-sized tumors, respectively. There were no significant age or sex-related differences. The postoperative taste disturbances were found in 65 (45.8%) patients. Among patients with anatomically preserved facial nerve, postoperative taste disturbances were found in 55 (42.3%) patients whereas nine (6.9%) patients reported improvement in taste sensations. Conclusions: Taste dysfunction is common following vestibular schwannoma surgery. Patient counseling prior to surgery is necessary to avoid any distress caused by taste dysfunction. Taste dysfunction should be included in the facial nerve functional grading system while assessing outcome.

Electrocardiographic changes following exercise in the congenitally deaf school children: relationship with Jervell Lange Neilsen syndrome (the Long QT syndrome).

The present study was conducted to test the effects of exercise stress on the ECG of the congenitally deaf children from school for deaf, in view of the occurrence of the Jervell-Lange Neilsen (Surdo Cardiac) variant of the Long QT Syndrome (LQTS) in them. An ECG Lead II was recorded at rest and after two minutes of static jogging. For comparison, the same protocol was repeated in normal healthy children from another school. ECG were analysed for the calculation of corrected QT interval (QTc) by Bazett's equation QTc = QT/square root of R-R and also for the evidence for other abnormalities. Both in the normal and deaf children, exercise did not produce significant (P > 0.05) change in QTc from their resting values. However, when pre and post exercise QTc values of deaf children were compared with normal children, the female deaf had significantly longer QTc (P < 0.01) both at rest and after exercise than normal female children. Normal children did not show significant ECG abnormality either at rest or on exercise. On the contrary many of their counter part (deaf) exhibited occasional ECG abnormality at rest but plethora of abnormalities after exercise viz., sinus arrhythmias, sinus pauses, ST depression, T-inversion, biphasic-T, notched-T, T-alternans, nodal ectopics and junctional rhythm. These results lend credence to the hypothesis of sympathetic imbalance and repolarisation defects in deaf children's heart, which in more severe form could pass into frank Jervell-Lange Neilsen variant of the Long: QT Syndrome.

Effect of vitamin C deficiency and excess on the liver: a histopathological and biochemical study in guinea pigs fed normal or high cholesterol diet.

When guinea pigs were kept on a restricted vitamin C intake of only 0.5 mg daily, their serum ascorbic acid fell to 0.16 +/- 0.06 mg/d1 in 16 weeks as compared to 0.73 +/- 0.11 in control. This was associated with significant increase in liver cholesterol and triglycerides. When they were simultaneously challenged with a high cholesterol load, this fat accumulation was markedly exaggerated. The weight of the liver now increased by almost two-and-half times. Liver cholesterol rose to 12.90 +/- 2.63 mg/gm as compared to 3.23 +/- 0.56 mg/gm with low vitamin C alone. Histopathology showed marked distension and vacuolation of hepatocytes, focal necrosis and fibroplasia. Administration of excess vitamin C (100 mg daily) significantly countered these changes. The vitamin C-lipid relationship has important clinical bearings and liver could be an important site of vitamin C action.

Leucocyte and serum ascorbic acid levels in mothers and their newborn in semi-arid western India.

Leucocyte ascorbic acid (LAA) and serum ascorbic acid (SAA) have been estimated in 50 pregnant women, their newborn infants, and 14 non-pregnant women living in the semi-arid region of western India. LAA was significantly higher in the newborn as compared to their mothers, the mean values being 35.52 +/- 6.85 and 23.94 +/- 5.84 micrograms/10(8) cells, respectively (P less than 0.01). The sex and birth weight of the infant, however, did not influence its ascorbic acid status. Pregnant women had relatively lower SAA (0.81 +/- 0.22 mg/dl) and LAA (23.94 +/- 5.84 micrograms/10(8) cells) as compared to the matched non-pregnant group (1.01 +/- 0.26 mg/dl and 29.98 +/- 8.45 micrograms/10(8) cells). But despite the semi-arid, draught prone geographical region and the hemodilution which accompanies pregnancy, none of the mothers had a clearly subnormal vitamin C status.