Neuromuscular junctional disorders.

Neuromuscular junctional disorders (NMJ) in children are distinct entity. They may be acquired or hereditary. They pose problem in diagnosis because of the higher occurrence of sero negative Myasthenia Gravis (MG) cases in children. The identity of MusK antibody positivity in a good percentage of sero negative cases further adds to problems in diagnosis. The Congenital Myasthenic Syndrome (CMS) which are rare disorders of hereditary neuromuscular transmission (NMT) has to be differentiated because immunotherapy has no benefit in this group. Molecular genetic studies of these diseases helps to identify specific type of CMS which is important as other drugs like Fluoxetine, Quinidine are found to be effective in some. In infancy, all can manifest as floppy infant syndrome. The important key to diagnosis is by detailed electrophysiological studies including repetitive nerve stimulation at slow and high rates and its response to anticholinesterases and estimation of Acetyl choline receptor antibodies. Other causes of neuromuscular transmission defects viz. snake venom poisoning and that due to drugs are discussed.

Unilateral ocular myasthenia gravis--a case report.

Unilateral ocular myasthenia gravis is being reported. He had significant involvement of one eye with no involvement of the fellow eye.

A study of pancreatic enzymes by duodenal intubation in normal subjects after prostigmine administration.

Twenty healthy subjects have been selected for the present study. There was significant parallelism between trypsin and lipase secretion but frequent dissociation between trypsin and amylase. Lower values of pancreatic volume, bicarbonate and enzymes secretion as compared to the Western reports are explained by the lower weight of Indians in comparison to Western people. Prostigmine an inexpensive and reliable alternative to pancreozmin is recommended for routine clinical studies of pancreatic enzymes.