Pedunculated oropharyngeal schwannoma arising from posterior tonsillar pillar.

Schwannoma are benign tumours which arise from Schwann cells. Most commonly occur in the paraharyngeal space in the neck. Peduncalted oropharyngeal schwannoma are very rare and to the best of our knowledge only 5 cases of peduncaleted oropharyngeal tumours have reported in literature. We present 52 year old male with peduncaleted oropharyngeal schwannoma which was arising from superior part of posterior tonsillar pillar. This site of origin for a pedunculated schwannoma has never been reported before.

Clinical utility of screening for antinuclear antibodies by enzyme immunoassay--a preliminary study.

AIMS OF THE STUDY: To evaluate the advantages and reliability of screening for antinuclear antibodies (ANA) by enzyme immunoassay (ELISA). METHODOLOGY: Sera from 96 patients comprising 51 with systemic lupus erythematosus (SLE), 11 with other systemic rheumatological diseases (SRD) and 34 with various other diseases (non-SRD) were tested using a commercial ELISA kit (ANA-Ease, Genesis Biotechnology, U.K.). These sera consisted of 53 immunofluorescence assay (IF) ANA-positive and 43 IF ANA-negative samples RESULTS: We observed that when compared to the IF for ANA the sensitivity, specificity, predictive values for positives (PPV) and negatives (NPV) of ELISA were 90.7%, 85.7%, 89.1% and 87.8% respectively. Exclusion of borderline ELISA positive by slightly raising the cut-off optical density (OD) increased the specificity and PPV to 93.1%, and 94.1% respectively. Importantly, none of the non-SRD sera were positive when this higher cut-off was used. ELISA was noted to be strongly positive in three IF ANA-negative SLE patients. However there was no correlation between the ELISA ANA semi-quantitative index and the IF ANA titers. CONCLUSIONS: ELISA appears to be suitable as a preliminary screening test for ANA. An appropriate cut-off should be identified to segregate low positive samples that could be false-positives. Nevertheless, IF will need to be performed to estimate the titers, identify patterns of ANA positive samples and confirm results of low positive "gray-zone" samples and ELISA negative sera from patients with a high index of clinical suspicion of SLE.

Transient low levels of antibodies at initial presentation of primary anti-phospholipid syndrome.

We present, herein, a case of venous thrombosis who was lupus anticoagulant negative and had low levels of anticardiolipin antibodies at the time of initial presentation. A definite diagnosis of antiphospholipid syndrome (APS) could be made only when repeat testing, six months later, revealed a dramatic rise of these antibodies.

Air pollution related respiratory morbidity in central and north-eastern Bombay.

A study of 4 comparable communities in central & northeastern Bombay (2 each) among randomly matched 349 subjects in 1988-9, along with ambient sulfur dioxide (SO2), Nitrogen dioxide (NO2) & suspended particulate matter (SPM) air monitoring was carried out. The levels in winter were higher particularly for SO2 in Parel (upto 584 micrograms) in Maravali; Deonar showed lower pollution. There were inter-area differences for housing, income, residential history but age-sex differences were small; these were reduced by matching. Clinical respiratory symptoms were higher in Parel & Maravali (cough 12% and 11.2%, dyspnoea 17% & 13.3% respectively). Cardiac problems are commoner in Parel (11.0%). Smoker had cough more often but not dyspnoea. Maravali had a high prevalence for headache and eye irritation (9.5%). Those using kerosene suffered more than those using gas (22.2% as compared to 9.2%) Lung functions (FVC, FEVI) were lowest in Parel for males and in Maravali for females. Expiratory flow rates were lower at Dadar and then at Maravali. Despite lower SO2 pollution, Maravali residents suffered equally as in Parel. This may be due to added effect of diesel exhausts (NO2, SPM) or other unmeasured chemicals.