Clinical profile and multimodality approach in the management of juvenile nasopharyngeal angiofibroma.

Our experience with 19 cases of juvenile nasopharyngeal angiofibroma (JNA) over a period of 10 years is discussed. All cases are managed with combined modalities which include pre-operative hormonal therapy, radiotherapy and/or surgical resection via transpalatal approach. All patients became asymptomatic with these treatment modalities. The use of combined modalities of treatment is advocated so as to achieve decreased intraoperative blood loss and cure, a reality.

Evaluation of risk factors in CA CX at Government Medical College and Hospital, Aurangabad (Marathwada).

The Department of Radiotherapy & Oncology at Government Medical College, Aurangabad is a major cancer treatment centre of Marathwada region. The case records of 737 patients of carcinoma cervix registered from January 1996 to December 1997, have been reviewed and the various contributing etiological factors for the causation of cervical cancer relevant to this part of Maharashtra state, are analysed and an attempt has been made to identify high risk group.

In vitro antibiotic sensitivity pattern of common bacterial isolates from cases of acute bacterial meningitis with special reference to ceftriaxone.

Ceftriaxone (RO 13-9904) has only recently been introduced in Benghazi and many parts of the word. We determined its in-vitro antibacterial activity against the primary aetiological agents of childhood meningitis in Benghazi, that included eighteen (23.3%) strains of H. influenzae, 17 (22.1%) of Str. pneumoniae and 1 (1.3%) of N. meningitidis isolated from 77 cases of acute purulent meningitis above the age of neonatal period. All strains of H. influenzae. Str. pneumoniae and N. meningitidis were sensitive to ceftriaxone and showed wide zones of inhibition by the disc diffusion technique of Kirby-Bauer. Ampicillin and chloramphenicol resistance was observed for H. influenzae (23% and 11% respectively), and Str. pneumoniae (12% and 0% respectively), in addition, 18% of strains of Str. pneumoniae showed resistance to penicillin. The broad spectrum activity of ceftriaxone has been confirmed for our locality and this finding, together with its exceptionally long half-life, excellent penetration into the C.S.F. and ease of administration (single daily dose) warrants it as the drug of choice in empherical treatment of cases of acute bacterial meningitis in children in Benghazi and in cases where resistance to ampicillin and chloramphenicol are found on subsequent testing.

Dexamethasone as an adjunctive treatment of bacterial meningitis.

This study was conducted on 77 Libyan infants and children aged month to 10 years with acute bacterial meningitis. Upon admission, the patients were divided randomly in two groups. Group I (38 patients) received ceftriaxone plus dexamethasone i.v. Group II (39 patients) received ceftriaxone alone. Both groups were compared for mean changes in CSF sugar, CSF protein and CSF polymorph count at 4th day of treatment. There was a significant difference between the two groups in CSF sugar and protein changes (P < 0.05) but not in CSF polymorph (P > 0.05). Both groups showed prompt clinical response and similar occurrence of acute complications, fatality rate and permanent neurological sequelae. However, group I manifested shorter duration of fever (P < 0.05). Dexamethasone improved the inflammatory reaction in acute bacterial meningitis and shortened the duration of fever but it did not have any significant effect on the fatality and the occurrence of neurological sequelae of this disease.

An evaluation of modified Widal test in the diagnosis of enteric fever.

Serum samples obtained from 50 bacteriologically positive cases of Salmonella Typhi infection as well as 50 healthy individuals were subjected to conventional and modified Widal tests simultaneously. A 4-fold difference in the titres was noticed in 50 sera of the test group and no change in the titres of the control group. The early rising 'O' antibodies which are of IgM in nature and formed due to recent infection are inactivated by 2-mercaptoethanol while it has no effect on IgG antibodies which are formed due to flagellar 'H' antigens or due to anamnestic response or by nonspecific reasons. The use of modified Widal test along with conventional one can therefore help in the diagnosis of enteric fever with certainty.

Metal binding to pyridoxal derivatives. An NMR study of the interaction of Eu(III) with pyridoxal phosphate and pyridoxamine phosphate.

The solution conformations of pyridoxal-5'-phosphate and pyridoxamine- 5'-phosphate have been investigated using Eu(III) as a nuclear magnetic resonance shift probe. Binding of Eu(III) to pyridoxal phosphate results in the formation of two complexes, at the phosphate group and the o-hydroxy-aldehyde moiety, which are in slow exchange on the nuclear magnetic resonance time-scale. The lanthanide-induced pseudo contact shifts calculated using the McConnell-Robertson equation (J. Chem. Soc. (1950), 22, 1561) are in good agreement with the experimentally observed values for both pyridoxal phosphate and pyridoxamine phosphate and lead to a family of closely related conformations.