Malaria still a threat to life--a postmortem study.

This study is of 25 cases of acute malaria encountered at autopsy. Cause of death was malaria in all the cases. The study covers a period of 6 years i.e. from January 1994 to December 1999. There was an upward trend in deaths due to malaria. P. falciparum malaria with its complications accounted for majority of deaths and cerebral malaria (CM) topped the list. Other complications observed were adult respiratory distress syndrome (ARDS), acute septicemic malaria, acute renal failure (ARF) and disseminated intravascular coagulation (DIC). The commonest presenting symptoms were fever with chills associated with central nervous system (CNS) complaints like altered sensorium and unconsciousness.

Entomopthoromycosis--report of four cases.

Entomopthoromycosis is a rare subcutaneous infection and manifests in two clinically distinct forms. Subcutaneous zygomycosis which manifests as a painless nodule on the trunk or the extremities and rhinofacial zygomycosis which is a locally progressive infection of the nasal cavity, paranasal sinuses and soft tissues of the face. Neither of these two forms occur in patients with underlying disease or defective immunity. Here we report four cases of entomopthoromycosis.

Determination of antidiabetic activity in Allium cepa (onion) tissue cultures.

Seedling, seedling parts and callus cultures of onion were tested for their antidiabetic activity by feeding the tissue-extracts to diabetic rats. The results indicated much higher antidiabetic activity in callus cultures as compared to natural bulbs of onion. These results may be of pharmaceutical significance since the callus can be used as an alternative source for the isolation of antidiabetic compounds.

Amyloid (spheroid) deposits in pituitary adenoma presenting as Cushing disease--a case report.

A rare case of pituitary adenoma with spheroid amyloid deposits encountered in a 40 year old male is presented.

Niemann Pick disease--a case report.

Niemann Pick disease is a rare disorder occuring in paediatric age group. The clinical features, hematological characteristics and autopsy findings in an one year old male diagnosed to have Niemann Pick disease are presented.

Blood transfusion associated fatalities.

16 post transfusion deaths were studied by reviewing clinical and blood bank records and by postmortem examination whenever possible. 13 of these cases belonged to regional blood bank, 2 were transfused in other hospitals and referred for management of transfusion reactions and one case be longed to other blood bank in the city. 3 deaths could not be attributed to transfusion reaction. Post transfusion endotoxaemia (7 cases) was the most frequent mode of transfusion associated fatality followed by cardiac overload (5 cases) and septicaemia (3 cases). In two cases endotoxaemia coexisted with cardiac overload. The pretransfusion compromised clinical course unfavourably thereby contributing significantly in death. The 3 clinically stable patients succumbed to posttransfusion endotoxaemia. The incidence of transfusion associated fatality in the present institute was 0.028% amongst total transfusions.

Acute superior mesenteric artery syndrome due to rapid weight loss following massive small bowel resection.

Acute superior mesenteric artery syndrome is a rare condition and may follow rapid weight loss and immobilization. We present one such case due to rapid weight loss following massive small bowel resection.

Laparoscopic versus mini-lap cholecystectomy for gallstone disease.

AIM: To compare the outcome of laparoscopic cholecystectomy (LC) and mini-lap cholecystectomy (MC) in patients with symptomatic gallstone disease. METHOD: One hundred patients undergoing LC (50) or MC (50) were evaluated for duration of surgery, morbidity, need for analgesia, duration of hospitalization and interval to return to normal work. RESULTS: The mean operative time was significantly longer in the LC group (94 +/- 17 vs 129 +/- 33 min; p < 0.05). The rate of morbidity and conversion to open surgery were similar in the two groups. Patients in the MC group required more oral analgesia (p = ns). The mean post-operative hospital stay in this group was 3.3 +/- 1.5 days as compared to 3.3 +/- 2.7 days in the LC group (p = ns). Patients in the LC group took the same time to return to normal work (19.1 +/- 3.2 days) as those in the MC group 19.5 +/- 5.4 days (p = ns). CONCLUSION: MC and LC are comparable procedures for treatment of gallstone disease in our country.

Anterior seromyotomy with posterior truncal vagotomy in uncomplicated chronic duodenal ulcer.

Thirty cases of uncomplicated duodenal ulcer treated by anterior superficial lesser curvature seromyotomy and posterior truncal vagotomy were studied to evaluate the efficacy of this procedure. There was completeness of vagotomy in all the cases as shown by endoscopic Congo Red test. Twenty-seven cases were asymptomatic at 1-48 months (Mean 22.3) follow up, while 3 patients had controllable side effects such as dumping and diarrhoea. There was no mortality. This procedure is safe, effective and is a favourable alternative to highly selective vagotomy.

Study of systemic fungal infections in autopsy material.

A retrospective study of 2526 autopsy cases was done in order to find out the pattern of systemic fungal infections. The autopsy records were reviewed for case histories, gross and histological findings. The histological sections from cases showing evidence of fungalo infections were reviewed. The fungal infections were found in 28 cases. Of these 11 (93.29 percent) were aspergillosis, 8 (28.27 percent) were mucormyosis, 6 (21.43 percent) were monilial infections and 3 (10.71 percent) were monilial infections and 3 (10.71 percent) were cryptococcosis. The incidence of systemic fungal infection was 1.11 percent. The most common type of fungal infection was aspergillosis. The maximum number of fungal infection was seen in the respiratory system. The fungal infections presented as opportunistic infections in all but one case. The metabolic disturbance was the most frequent predisposing condition for systemic fungal infections.

Effect of centrally administered glucagon on liver glycogen & enzymes in anaesthetised dogs.

Glucagon (0.01 microgram) administered through the intracerebroventricular route in anaesthetised mongrel dogs, caused a significant rise in blood glucose and a fall in liver glycogen (P less than 0.01). Concurrently, it increased the liver phosphorylase, glutamic oxaloacetic transaminase, glutamic pyruvic transminase and lipase activities by 30 min. Identical changes were observed in vagotomised animals. In pancreatectomised animals as well as in spinal cord transectomised animals, glucagon did not cause these changes. The study indicated that the hyperglycaemia produced by the centrally administered glucagon, is possibly a result of liver glycogenolysis and gluconeogenesis induced by endogenous glucagon secreted from the pancreas, the stimulus for which is the hypothalamo-pancreatic fibres responding to glucagon sensitive neurones in the hypothalamus.

Effect of 'Arogyavardhini' against carbon tetrachloride induced hepatic damage in albino rats.

'Arogyavardhini'-an indigenous formulation was evaluated for its hepatoprotective activity in rats, using two models of carbon tetrachloride (CCl4) hepatic damage, one simulating vital hepatitis and the other simulating fatty change. The protective effect was assessed from serum aspartate transaminase (AST) and alkaline phosphatase levels and from histopathological changes in liver. The results revealed that 'Arogyavardhini' (5 mg/100g, PO daily) was effective in minimizing the changes in serum levels of AST and alkaline phosphatase induced by CCI. The protective effect was also evident on histopathological examination.

Effect of centrally administered glucagon on blood lipids in anesthetised dogs.

Previously we have proposed the existence of the central glucagon sensitive receptors in dogs. The present study was undertaken to explore the role of centrally administered glucagon on lipids in view of the proposed theory that the hypothalamic lipomobilizing centres are sensitive to glucose or substances that affect glucose metabolism. Glucagon (0.01 microgram) administered through the intracerebroventricular (ICV) route in anesthetised mongrel dogs, caused hypolipidemia (P greater than 0.001), hypocholesterolemia (P greater than 0.001), decreased blood free fatty acid (P greater than 0.001) and triglycerides (P greater than 0.001) levels; but increased blood high density lipoprotein (P greater than 0.01) level at 30 min. These effects on the central administration of glucagon, were not observed in pancreatectomised animals and spinal cord transectomised animals. Therefore, we conclude that the lipolysis on the central administration of glucagon, is caused by the endogenous glucagon secreted from the pancreas through the sympathetic fibers.