Superficial angiomyxoma of the external ear not associated with Carney's complex: a case report.

Superficial angiomyxomas are rare tumours and multiple tumours occurring in the external ear are invariably associated with Carney's complex. In the present study, a solitary superficial angiomyxoma was found in a 20 year old lady; and there was no evidence of any of the components of Carney's complex at the time of presentation or at the end of 2 years of follow-up, after the surgical excision of the tumour.

Host-mediated juvenoids affect development and metamorphosis of endoparasitic wasp, Chelonus blackburni (Hymenoptera: Braconidae) and consequent morphogenetic derangements in its reproductive system.

Juvenoids, applied topically on larvae of Corcyra cephalonica harbouring the larvae of the parasitoid, produce various types of developmental derangements in parasitoid C. blackburni. The deformed morphs, e.g., apparently normal adults, adultoids and prolonged larvae were developed at different rates by different doses of juvenoids. Larval and pupal mortality rates of the parasite were 6-13 and 4-8% respectively in different treatments. Deformities in reproductive system of the parasitoid were increased or decreased ovariole number, development of compound egg chamber and ill-developed ovariole.

Fatal atypical mycobacterial infection in a cardiac transplant recipient.

A 37-year-old female underwent heart transplantation for giant cell myocarditis. The patient died within three-and-a-half months of cardiac transplantation. Postmortem specimens from the heart and lung showed multiple necrotizing granulomas with numerous acid-fast bacilli. Polymerase chain reaction done on both the postmortem samples confirmed the presence of atypical mycobacterial infection. This fatal case of atypical mycobacteriosis in a cardiac transplant patient is reported for its rarity.

Morphogenetic derangements in the reproductive system of Bracon hebetor, a beneficial parasitoid, bred on juvenoid treated host (Corcyra cephalonica) larvae.

Effect of juvenoids (hydroprene and methoprene) on the ecto-parasite B. hebetor was investigated by rearing them upon the juvenoid treated ultimate instar host larvae of C. cephalonica. Emerged adultoid wasps of either sexes obtained from treated series showed anatomical deformities in the reproductive systems. Ill-developed ovaries with reduced length, terminally free ovarioles and abnormal testicular growth showing non-fusion of lobes were the important abnormal features. Data on measurements of male reproductive system, e.g., width (transverse axis) of testis, length of common vas deferens plus ejaculatory duct and length of accessory gland showed significant difference (P < 0.05) from control.

Bone marrow necrosis in paediatric patients.

Necrosis of bone marrow is a very rare condition with a prevalence ranging from 0.15 to 7 percent. It is mostly not compatible with life. We diagnosed four cases of necrotic marrow out of 830 bone marrow aspirations done in last five years of time. All were paediatric patients having peripheral pancytopenia. Three out of four patients expired within one month of diagnosis.

Delay in specialist consultation in cancer patients.

A psychiatric evaluation of 75 cases of different types of cancer revealed significant psychological morbidity in 81% of cases. The time lag, if any, between primary diagnosis and presentation to oncologists was noted and the reasons for the delay were ascertained. 62% of patients (N = 47) delayed three months or more and this group also showed significantly greater (p < 0.05) psychological morbidity compared to those who delayed less than three months (N = 28). 89% of patients used denial as a mental defence mechanism and there was no significant difference in the degree of denial displayed by both groups. Psychological reasons such as denial of the illness, fear of cancer, fear of its treatment, and domestic difficulty were commonly cited as causes of delay. It is hoped that addressing these issues will reduce delay and help early detection in cancer programmes.

A psychiatric evaluation of referred cancer and medical patients: a comparative study.

We evaluated the psychiatric status of referred cancer patients (N = 39) and referred medical patients at two other institutions (N = 64, N = 62). Depression, anxiety, psychosis, delirium occurred with comparable frequency in both groups. Cancer patients presented with somatic complaints more frequently. However the average number of referrals of cancer patients to the psychiatric service was very low (3/months) compared to referral of medically ill patients (32/month, 10/month). The data suggests that a comparable level of psychological distress exists in cancer patients, and psychiatric referral may help in its early recognition and alleviation.

Value of a single Widal test in the diagnosis of typhoid fever.

Results of a single Widal test in patients with bacteriologically confirmed typhoid fever (116), clinically suggestive but culture negative fever (170) and non-typhoidal febrile illness (98) and in normal control children (54) were analysed. Positive Widal test (antibody titre against S. typhi O antigen of 1:160) was recorded in 61.2 per cent of patients with bacteriologically confirmed typhoid fever and in 58.8 per cent with culture negative but clinically suggestive typhoid fever. In contrast, the same titre was observed in 10.2 per cent patients with other febrile illnesses of known etiology and in 1.8 per cent of normal children. Differences in the positivity of Widal test in patients with bacteriologically confirmed typhoid fever and clinically suggestive but culture negative fever were highly significant (P < 0.000001) when compared to that of patients with non-typhoidal febrile illnesses and normal controls. High specificity and positive predictive value in 1:160 dilution makes the Widal test acceptable as a diagnostic tool.

Malignant mesothelioma in the young (with prosthetic aortic valve an unusual association).

A case of malignant mesothelioma (MM) in a 15 year old boy is reported. He had a prosthetic aortic valve implanted in 1980 at our centre for rheumatic aortic regurgitation. Fever, weight loss and chest pain as initial symptoms suggested possibility of prosthetic valve endocarditis. Dysphagia as another initial symptom was interesting and caused further diagnostic dilemma. Role of Computerised Tomography (CT) scan in diagnosis of MM is highlighted.