Varicella zoster causing preseptal cellulitis – uncommon but possible

Background: Varicella has been known to be a harmless childhood disease. However, it hasbeen reported that severe complications have taken place following Varicella infection, in bothimmunocompetent, as well as immunocompromised, individuals. Cutaneous complications ofVaricella may manifest as preseptal cellulitis, albeit rarely.Report: We present a case of a 4-year-old boy who presented with symptoms and signs ofpreseptal cellulitis following Varicella infection. He was referred to the otorhinolaryngologyteam for a nasoendoscopy to rule out sinusitis, in view of the fear that a child presentingwith a swollen red eye may be a case of true orbital cellulitis. He was treated successfully withintravenous antibiotics and surgical drainage of the preseptal collection.Conclusion: It is imperative for clinicians to be aware that a simple Varicella infection may leadto cutaneous complications in the pediatric age group, especially in children who are 4 yearsand younger. They may develop preseptal cellulitis, whose presentation might mimic that oforbital cellulitis. Empirical treatment with antibiotics would be advantageous for the patient. Anasoendoscopic examination may also be warranted in these cases to rule out sinusitis as a causeof orbital cellulitis.

Comparative Study of Histo-Pathological Effects of Mercury on Cerebrum, Cerebellum and Hippocampus of Adult Albino Rats.

Background: Previously it was thought that mercury sulphide in low dose shows good therapeutic effect without producing toxic effects in the human beings. Symptoms like ataxia, speech impairment, visual field constriction, deafness, tremors, mental retardation, coma and even death has been reported due to chronic use of this heavy metal. The aim of our present study is to compare histopathological changes in different parts of brain, so that clinical symptoms following mercury intoxication can be explained. Methods: Freshly prepared sterile solution of mercuric chloride in distilled water (0.33 mg/kg body weight) was orally administered daily to total number of 30 adult albino rats (15 males and 15 females) for a month. 3mm thick sections were taken from cerebrum, cerebellum and hippocampus parts. These sections were processed and then stained by haematoxylin & eosin to be observed in light microscope. Results: Histological pictures of all the three areas were suggestive of multiple foci of necrosis with gliosis. Marked congestion of vessels with perivascular necrosis was also noticed. Increased cellularity of granular layer and molecular layer in cerebellum and hippocampus were seen respectively. Conclusion: The histopathological examination revealed that normal cytoarchitecture of all the three areas of brain were distorted resulting in various neurological disorders.

amma Radiation: Physical Elicitor for In vitro Culture Techniques of Cajanus cajan.

Gamma rays are very important in mutation breeding and in in vitro mutagenesis in order to develop required features of plants and increase the genetic variability. Cajanus cajan when subjected to absorbed doses 30 Gy, 50 Gy, 100 Gy, 150 Gy and 200 Gy showed a direct corelation between callus induction, regeneracy frequency and absorbed doses of gamma radiation as compared to control. Gamma irradiation resulted in the induction of autonomous growth in callus, which led to the formation of callus tumors resembling the shape of crown gall tumors. Gamma irradiation in the present study proved to be an important tool in increasing the breeding efficiency, and regeneration frequency, especially that of the recalcitrant varieties.

Significance of anti-HBc screening of blood donors & its association with occult hepatitis B virus infection: Implications for blood transfusion.

Background & objective: Expansions of blood donor screening and improved laboratory detection of viral markers have remarkably reduced the risk for infection with transfusion-transmitted viruses. This study was aimed to evaluate the presence of anti-HBc and to determine the presence or absence of HBV DNA in the serum samples from HBsAg negative, anti-HBc positive blood donors in a tertiary care hospital blood bank from Delhi. Methods: A total of 2175 HBsAg negative, first time volunteer blood donors were included in the study from blood bank, Lok Nayak Hospital, New Delhi. The blood specimens from all these subjects were evaluated for anti-HBV-core antigen (anti-HBc) serology, anti-HBV-surface antigen (anti-HBs) titres and HBeAg. The presence of HBV DNA was evaluated by testing, through polymerase chain reaction (PCR) techniques. Results: Of the 2175 HBsAg negative voluntary blood donors, 413 (19.8%) were tested to be positive for anti-HBc alone. Of these, 153 (group-I) were anti-HBs negative whereas group-II comprises a total of 260 anti-HBs positive cases i.e. 89 out of 413 had anti-HBs titres of 10-99 IU/l and the remaining 171 had anti-HBs titres of 100-500 IU/l. HBV DNA was detected in 7.5 per cent anti-HBc positive samples irrespective of anti-HBs status. Interpretation & conclusions: Our results showed that 18.9 per cent of our donor population was anti-HBc reactive, and hence inclusion of anti-HBc testing will lead to a high discard rate. The presence of HBV DNA in fairly high percentage of anti-HBc positive samples highlighted the need for a stringent and better screening system to prevent occult HBV infection.

Antituberculosis drug-induced hepatitis: risk factors, prevention and management.

Apart from infectious or viral hepatitis, other most common non-infectious causes of hepatitis are alcohol, cholestatic, drugs and toxic materials. The most common mode that leads to liver injuries is antituberculosis drug-induced hepatitis. The severity of drug-induced liver injury varies from minor nonspecific changes in hepatic structure to fulminant hepatic failure, cirrhosis and liver cancer. Patients receiving antitubercular drug frequently develop acute or chronic hepatitis. The time required for the metabolites to reach hepatotoxic levels is much earlier with isoniazid plus rifampicin treatment than isoniazid alone and this has been shown to be synergistic rather than additive. Antituberculosis drug (ATT)-inducible cytochrome P-4502E1 (CYP2E1) is constitutively expressed in the liver. Recent studies show that polymorphism of the N-acetyltransferase 2 (NAT2) genes and glutathione-S-transferase (GST) are the major susceptibility risk factors for ATT-induced hepatitis. The hepatic NAT and GST are involved in the metabolism of several carcinogenic arylamines and drugs. The NAT2 enzyme has a genetic polymorphism in human. N-acetyltransferase 2 genes (NAT2) have been identified to be responsible for genetic polymorphism of slow and rapid acetylation in humans. Slow acetylators of NAT2 prove to develop more severe hepatotoxicity than rapid acetylators making it a significant risk factor. Deficiency of GST activity, because of homozygous null mutations at GSTM1 and GSTT1 loci, may modulate susceptibility to drug and xenobiotic-induced hepatotoxicity. Polymorphisms at GSTM1, GSTT1 and NAT2 loci had been linked to various forms of liver injury, including hepatocellular carcinoma.

Moalejat-e-hindi: a compilation of ăyurvĕdic formulations tested by Nizam--III of Hyderabad.

This Indian Institute of History of Medicine possesses more than 100 medical manuscripts (paper) in Arabic, Persian and Urdu languages. One of the rare manuscripts is known as "Moalejat-e-Hindi", its specialty is that it is on ăyurvĕda in Persian. It contains shlokas in transliterated form. It contains three sections. It has been compiled by the order of Nizam-III of Hyderabad.

Ayurvedic literature in Urdu part-III.

The present article is the continuation of the second part of the previous work published with the same title in the Bulletin of Indian Institute of History of medicine, Vol. XXIX. No. 2 in 1999. This work has ben initiated to introduce the books written in recent past, the period in which Urdu language had a prominent role in preserving the knowledge of old arts and sciences.

Lessor known ayurvedic physicians from an Urdu book Rumoozul Atibba: part II.

Rumoozul Atibba, a rare Urdu book compiled by Hakim Fairozuddin is in two Volumes. It is published by Darul Kutub Rafiqul Atibba, printed in "Rifah-e-Aam press in 1913 at Lahore which contains short biographies of Ayurvedic and Unani physicians. It has been compiled to disclose the tested formulae hidden in the minds of eminent scholars of Ayurveda and Unani with their life sketches.The selection of this work has been aimed to enlight the Ayurvedic History prevailed in different languages. Twenty biographies of Ayurvedic Physicians were in first volume of 'Rumuzul Atibba', which were published prior to this article (Bulletin of Indian Institute of History of Medicine. Vol XXVI (1996).This article contains only three biographies of Ayurvedic physicians.

Cholecystoduodenoplasty for high-output duodenal fistula.

External duodenal fistulae from sutured duodenal ulcer perforation sites are difficult to manage and most patients succumb to septicemia and undernutrition. This is due to failure of closure of the perforation site in the duodenum. Most techniques described in the past to facilitate closure have failed to give satisfactory results. We have devised a new procedure where the duodenal ulcer perforation is closed by mobilizing the gall bladder. A hole is made in the fundus of the gall bladder and it is anastomosed to the freshened edges of the duodenal opening. We have treated six patients by this technique. In five patients the leak was satisfactorily sealed. Three patients died - one due to persistent leak and two due to jejunostomy leak.

Translation of the twelfth chapter of "Uyoonul Anba Fi Tabaqatil Atibba".

This is a translation of an Arabic book "Uyoonul Anba Fi Tabaqatil Atibba" compiled by Ibn-e-Abi Useibia, the famous writer of Abbaside's period of Baghdad in 13th century A.D. This book is in two volumes comprising of 15 chapters dealing with 388 biographies of world known physicians. Looking into the authenticity and importance of this work, the translation of its 12th chapter which is on Indian physicians is being submitted here in this article form. This portion provides information with regard to the Indian physicians, the way of their approach to Baghdad, their miraculous treatments and the literary works etc.

Alauddin Qarshi: a commentator of many classical treatises.

This article deals with the life and work of a commentator of six authentic works. He was a discoverer of pulmonary circulation of blood. He described it more or less accurately, almost three centuries before Harvey (1578-1657). The views of medical historians about this scholar have been given in this article.

Ayurveda during Abbasid's period.

This is a historical paper which deals with a brief account of Abbasid's period. In this article the existence of Ayurveda in Arab countries, arrival of Ayurvedic physicians to Baghdad, their eminence, authenticity and literary additions in medical field has been studied and presented.

Conformations of hydrophobic peptides in trifluoroethanol, water and in solid state: a circular dichroism and Fourier Transform Infrared study.

The conformations of peptides corresponding to KLLIALVLCFLPLAALG have been examined in trifluoroethanol (TFE), aqueous medium by circular dichroism spectroscopy and in the solid state by Fourier Transform Infra Red Spectroscopy (FTIR). The 17-residue parent peptide and peptides corresponding to shorter segments LVLCFLPLAALG and CFLPLAALG showed preference for helical conformation in TFE. Even the shorter hydrophobic peptides corresponding to KLLIA and LVL showed propensity for beta-turn conformations in TFE. However, peptides corresponding to the relatively polar segment FLPLAALG were unordered in TFE. In water, peptides that showed ordered conformation in TFE preferred beta-conformation. In solid-state, FTIR spectra indicated that the hydrophobic peptides adopt beta-structures with extensive hydrogen bonded network in the solid-state. The hydrophobic core segment thus appears to dictate the conformational propensity of the peptide.

Ayurvedic literature in Urdu (Part-II).

This article is a second part of previous work published with the same title in this Bulletin Vol. 28, 1998, P. nos. 151-158. It contains brief notes on six rare Ayurvedic books in Urdu. It provides two types of information, i.e. (i) Introduction to the books studied and (2) Literary history of Ayurveda of that period in which Urdu language had a prominent role in propagation of Arts and Science. It gives an idea for seeking information on these lines regarding the Ayurvedic works in Arabic and Persian also.

Ayurvedic literature in Urdu.

Urdu is a distinct literary language began to develop in India during Mughal empire. Lots of people read, write and speak, this language in Indian subcontinent. This brief article will shed light on the seven rare books in Urdu compiled and published in the period from 19th century to the first half of the current century. Some books may not have high value but the struggle of the scholars, is appreciable.

A rare report of Nizam Ayurvedic Mobile Clinic.

This article is a brief account of a rare Urdu booklet entitled 'Report Nizam Ayurvedic Safari Dawakhana'. It is a report of a mobile clinic sent by Nizam VII of Hyderabad to Kumbh Mela at Allahabad on a religious occasion in the year 1942, which was printed in the same year. This report sheds light on the history of the sacred place Prayag, its importance and the activities of the mobile clinic with the remarks of eminent personalities who visited the clinic on the occasion.

Investigations of anti-inflammatory activity of Jigrine.

Jigrine, a polypharmaceutical herbal formulation containing 14 medicinal plants is used in the Unani system of medicine for the treatment of liver ailments. The antiinflammatory activity of Jigrine (0.5 ml and 1.0 ml/kg, po), was evaluated against acute inflammation caused by carrageenin (injecting 0.1 ml of 1% carrageenin in 0.9% NaCl solution into plantar surface of the hind paw of the rat) and the effect of Jigrine (1 ml/kg/day, po for 7 days) was also studied on the sub-acute inflammation induced by cotton pellet granuloma. The paw volume, biochemical parameters like tissue AST, ALT, gamma-GTP and lipid peroxides and dry wt. of granuloma were measured to assess the anti-inflammatory activity. It showed a significant anti-inflammatory activity as evidenced by lowering the elevated levels of paw volume and biochemical parameters. But it could not reduce the sub-acute inflammation caused by cotton pellet granuloma. The study suggests that Jigrine has significant effect only on acute phase of inflammation caused by carrageenin. Antioxidant and membrane stabilizing action of Jigrine might be responsible for its anti-inflammatory effect.

Protective sensibility--its monofilament nylon threshold equivalents in leprosy patients.

An attempt has been made to definite the levels of "protective sensibility" in terms of perception thresholds to monofilament nylon induced touch/pressure stimuli. Certain problems were observed while interpreting the observations. There appears to be a range of threshold values instead of a clear cut-off point. We suggest that a monofilament nylon stimulus two times the normal threshold value for that patient be taken as cut-off point. This will make the observations of Birke and Sims (1986) and Hammond and Klenerman (1987) reasonable without having any need to exclude the cases who defy the boundaries laid by them. Since the genesis of plantar ulcer is multifactorial, it appears logical to include all patients who have a certain degree of hypoaesthesia, for special ulcer care program. The likely problems while using monofilament nylons in the field and their possible solutions have also been outlined.

Hakeem Ali Gilani: a commentator of canon of Avicenna.

Hakim Ali Gilani was a native of Gilan. He was a distinguished physician and medical writer. He wrote commentary on canon of Avicenna. He came to India during Akbar's time and served two Mughal rulers, Akbar and Jahangir. He was praised very much by the medical historians for his vast knowledge, curiosity and intelligence. A brief account of his achievements has been given in this article.