MRI findings in methanol intoxication: a report of two cases.

Methanol is a highly toxic substance and acute methanol poisoning produces severe metabolic acidosis and serious neurological symptoms, including severe visual impairment, extrapyramidal signs and coma. Its similarity to ethanol in appearance and odour leads to accidental use. We present two cases of accidental methanol intoxication and discuss the MRI findings.

Tuberculous parotitis: a series of five cases diagnosed on fine needle aspiration cytology.

Parotid gland tuberculosis is still a rare entity and has mostly been diagnosed after parotidectomy. We present five cases which were diagnosed on fine needle aspiration cytology (FNAC) and managed medically avoiding surgical intervention.

Prevalence and etiology of vertigo in adult rural population.

A survey on 10.000 adults between the age of 20 and 79 years out of a total population of 66.186 persons in rural settlements under the inrisduction of Union Territory of Chandigarh between June 1993 to June 1995 was conducted to find out the prevalence and various causes of vertigo. In general community, in rural population, we found that more people suffer from non-otologic vertigo rather than otologic vertigo. We found overall prevalence of vertigo in rural adult community to be 0.71%. Vertigo secondary to cardiovascular disease was most common and prevalent in 0.32% of population. Neurologic disease accounted for vertigo in 0.14%, metabolic disease in 0.09% and otologic disease 0.08%. Miscellaneous disorders were present in remaining 0.08% of population studied. To the best of our knowledge this study represents the first population based survey of prevalence of various causes of vertigo in general community in adult rural population.

Azimilide dihydrochloride: a new class III anti-arrhythmic agent.

Azimilide dihydrochloride (Stedicor) is a new class III anti-arrhythmic agent that is being developed by Proctor & Gamble to treat supraventricular and ventricular arrhythmias. Development of this agent is being undertaken due to the high prevalence of atrial fibrillation and the lack of satisfactory therapy for this arrhythmia, along with the desire to develop therapy to reduce the risk of life-threatening ventricular arrhythmias in patients following myocardial infarction. The mechanism of action of azimilide is to block both the slowly conducting (I(Ks)) and rapidly conducting (I(Kr)) rectifier potassium currents in cardiac cells. This differs from other class III agents that block I(Kr) exclusively or in combination with sodium, calcium, or transient outward (I(to)) potassium current channels. Azimilide is distinguished by a relative lack of reverse use-dependence, excellent oral absorption, no need for dose titration, an option for out-patient initiation, no need for adjustment associated with renal or liver failure and a lack of interaction with warfarin or digoxin. It carries some risk of torsade de pointes and rarely, neutropoenia. Azimilide has shown dose-related efficacy in prolonging the time to recurrence of atrial fibrillation. A large trial examining the impact of azimilide on mortality in high-risk patients following myocardial infarction has completed enrolment and should yield data in the next couple of years and further studies are planned. Even if this trial fails to show a survival benefit, a neutral effect on mortality will make the agent attractive for atrial arrhythmias.

Kimura's Disease - report of a case masquerading as a parotid tumor.

Kimura's Disease is a part of an ill- defined spectrum of vascular lesions of the subcutis. It is a benign chronic inflammatory condition producing subcutaneous tumour like nodules chiefly in the head and neck region with predilection for periauricular areas. It is characterised histologically by dense fibrosis, lymphoid infiltration, vascular proliferation and eosinophilia. The condition has a preponderance in the for eastern countries. It is extremely uncommon in Indian subcontinent. There has been no reported case from the Indian subcontinent in the English Literature. We report such a rare case in which the condition presents as parotid masses. We also present its CT, MRI & histopathology features and a brief review of literature.

Pseudoaneurysm of subclavian artery--atypical presentation.

We present a rare case of pseudoaneurysm of right subclavian artery who presented with supraclavicular mass. Injury of the subclavian artery causing pseudoaneurysm is a serious surgical emergency and a surgical intervention is indicated.

P amylase is always greater than S in spot urine of normal subjects. Diagnostic implications.

Single random samples of urine were collected from 50 control subjects; 27 patients with chronic pancreatitis; 19 with acute pancreatitis; 6 with acute on chronic pancreatitis; five in the recovery phase of acute attack; four patients with pseudocysts. Salivary (S) and pancreatic (P) amylase values were measured by cellulose acetate electrophoresis. The P amylase values always exceeded those of S amylase in the control specimens. In acute pancreatitis, both the lower and upper levels of total and P amylase were considerably higher than in the controls, and these high values tended to return to normal during the recovery phase of acute pancreatitis. The S amylase values were often very low or undetectable during the acute phase. Values for P amylase exceeded control values in patients with pseudocysts even in the presence of chronic pancreatitis. In chronic calcific pancreatitis, S amylase was higher than P amylase. We conclude that P amylase is always greater than S amylase in normal urine specimens, and a change in this pattern may be helpful in diagnosing various forms of pancreatitis.

Self-induced hematuria.

Two patients, an adult and a child, are reported who presented with factitious hematuria secondary to self-induced finger sticks with contamination of unwitnessed urine samples. Feigned illness of this kind may be more common than generally appreciated.

Detection of endothelium in cerebral blood vessels.

An increasing body of evidence implies that the results of pharmacological studies of blood vessels may depend on the presence of an intact layer of endothelial cells inside the blood vessels. This is often inadvertently removed during the early part of the experiment and it is thus necessary to have some means of determining whether the endothelium is intact or has suffered extensive damage. Previous reports describe a stain that will enable the endothelial cells to be visualized, however we find that in the cerebral vasculature this approach is unsatisfactory in that it provides a gross underestimate of the amount of intact endothelium. A modification of the original procedure is described that provides results that correspond well with those of scanning or transmission electron microscopy.