A presumptive case of lead poisoning in a brass-worker's child.

A one-year-old male child was admitted with the complaints of vomiting and irritability for 4 days, haematemesis and melaena for one day and had generalised tonic convulsions on the day of admission. Examination revealed exaggerated reflexes with group II coma. Blood film showed basophilic shippling. Straight x-ray showed lead lines in the metaphyses of ribs, humerii, scapulae, iliac crests and upper ends of femurs. The boy's father was an employee of brass industry where brass alloys used cotained lead in substantial amount. A presumptive case of lead poisoning (as diagnosed) was treated symptomatically. Chelating agent was called for but the patient left. In the present case the hands of the child were contaminated with lead dust brought home by his father either in person or in clothings. The child used his hands constantly in his mouth to get poisoned by lead.

CSF/blood glucose ratio and other prognostic indices in pyogenic meningitis.

Fifty cases of pyogenic meningitis were examined for various prognostic indices, especially cerebrospinal fluid (CSF)/blood glucose ratio. Overall mortality was 40%. Age below one year and depressed level of consciousness were associated with high mortality. Illness of more than 7 days, presence of associated illness and absence of neck rigidity were not found to be statistically significant factors associated with higher mortality. CSF leucocyte count of more than 1000 cells/cmm and CSF protein more than 500 mg/dl were statistically significant factors associated with higher mortality. In cases of CSF glucose level below 20 mg/dl and CSF/blood glucose ratio below 0.2, the increase in mortality was highly significant. CSF/blood glucose ratio in cases who recovered was much higher than those who died. CSF/blood glucose ratio increased to normal in cases who recovered but remained low in cases who expired.