Rabies virus infection of a flying fox bat, Pteropus policephalus in Chandigarh, Northern India.

The present communication reports for the first time in South East Asia an active infection of frugivorous flying fox bat (Pteropus poliocephalus) with a virus belonging to the Rhabdo virus group -- a bat virus. Negri body like structures were demonstrated by Seller's stain and direct immunofluorescence in the brain and salivary gland of the dead bat. The virus was isolated after intracerebral inoculation of homogenate of the bat brain, salivary gland or brown fat separately in new born mice.

Alveolar hydatid disease of the liver with Budd-Chiari syndrome.

Alveolar hydatid disease in man is the intermediate stage in the life cycle of the tapeworm Echinococcus multilocularis. This is a rare disease restricted to very few areas of the world. The occurrence of this disease in India is now described for (so far as the authors are aware) the first time. Some unusual features of the disease are highlighted in this patient. The hepatic lesion had infiltrated into the right atrial wall resembling an atrial tumour. The ostium of the inferior vena cava was occluded, causing Budd-Chiari syndrome. The radiological and haemodynamic study of the hepatic outflow tract in this disease are documented.

Pathogenesis of malabsorption in Giardia infection: an experimental study in rats.

It is well established that infection with Giardia lamblia can cause malabsorption although the pathogenesis of this is unknown. Transport studies were made on the intestinal segments of male albino rats infected with Giardia cysts obtained from human stools to investigate this pathogenesis. The results were compared with those seen in a normal group and in a control group that was fed with a Giardia-free stool suspension. There was a significant fall in the transport of glucose and glycine, both of which were actively absorbed. On the other hand, potassium, which diffuses passively in a bidirectional manner across the bowel wall, was not affected. Furthermore, it was observed that the transport mechanism was deranged in the presence of an entirely normal small intestinal mucosa, as judged by light microscopy. It is concluded that Giardia trophozoites interfere with the active transport mechanisms of the small intestinal mucosa. This defect could result either from structural damage to the substrate carriers or from an alteration in cell maturation.

The pathology of noncirrhotic portal fibrosis: a review of 32 autopsy cases.

A wide spectrum of clinical and morphologic changes in 32 autopsy cases of noncirrhotic portal fibrosis have been described. The disease frequently occurs in younger patients with a long history of splenomegaly, usually with a history of hematemesis. Females are affected almost equally as often as males in contrast to cirrhosis. The patients tolerate the bleeding episodes well. Death is usually due to massive hemorrhage. The diagnosis is achieved through a process of exclusion. A critical analysis of hemodynamic data, a splenoportogram, liver function tests (particularly Bromsulphalein retention) and angiographic data is mandatory. Needle biopsy of the liver appears to have limited value in making the diagnosis. The gross anatomic findings vary from a nearly normal liver to gross nodularity, seen particularly on the posteroinferior surface. In some cases these nodules are seen to physically impede the portal blood flow and contribute to portal hypertension. Phlebosclerosis of the smaller radicles of the portal vein and irregular scarring are the outstanding morphologic features of the disease. These changes are usually associated with irregular dilatation of some of the larger intrahepatic branches of the portal vein as well as fibroelastosis with or without occluding or organizing thrombi in both intra- and extrahepatic branches of the portal vein. The changes in hepatic venous radicles are characterized by irregular sclerosis, which seems to contribute significantly toward postsinusoidal block in advanced cases. The probable mode of evolution is discussed.

Chronic oral arsenic intoxication as a possible aetiological factor in idiopathic portal hypertension (non-cirrhotic portal fibrosis) in India.

Estimates were made of the arsenic concentration in liver specimens from nine patients having idiopathic portal hypertension (IP), and in four livers these were found to be significantly higher than those in patients with cirrhosis and in control subjects. The splenovenogram revealed extensive portosystemic collateral circulation. Corrected sinusoidal pressure and blood flow studies showed higher levels in four patients than in normal subjects. Microscopic examination of liver tissues revealed periportal fibrosis. The higher hepatic arsenic levels that were found were due to the inadvertent drinking of water contaminated with arsenic, adulterated opium, and indigenous medicines. A history of opium intake was not forthcoming but two patients had drunk water contaminated with arsenic and two others had taken bhasams (Ayurvedic medicines prepared by repeated oxidation of ores). Though the aetiology of idiopathic portal hypertension is not known, it is possible that arsenic intake may be one of the factors.

The pathology and pathogenesis of fatal hepatic amoebiasis--A study based on 79 autopsy cases.

The present study is based on a retrospective analysis of 79 autopsy cases of hepatic amoebiasis. An attempt has been made to reconstruct the sequence of events starting from intestinal infection to invasion and transport of amoebae along the radicles of the portal veins, the formation of early Zahn's infarct and the proliferation of amoebae in such foci leading to the formation of small abscesses. The coalescence of small abscesses gives rise to the apparently large abscesses. Apart from direct contiguity, more distant extension leading to a satellite abscess is due to involvement of the hepatic and/or portal venous radicles. It seems that obstruction of the hepatic vein contributes substantially towards the enlargement of the liver and its exaggerated nutmeg appearance. Signs and symptoms of hepatic vein obstruction sometimes overshadow the abscess pathology. Thrombosis or pressure of a neighbouring abscess over the portal vein obstruction sometimes overshadow the abscess pathology. Thrombosis or pressure of a neighbouring abscess over the portal vein and bile-duct lead to development of portal hypertension and jaundice. Both cell-mediated and humoral immunity are depressed in fatal cases of hepatic amoebiasis.

Effect of corticosteroid and irradiation on caecal amoebic infection in rats.

Albino rats (Wistar strain) were pretreated with corticosteroid, irradiation or both to study the effect on the outcome of amoebic infection given intracaecally. The number of animals with lesions amongst "treated" groups was not significantly different from that amongst untreated control animals (P greater than 0.05) but amoebic pathology was markedly exacerbated amongst the treated animals. It is thus thought that once the amoebic infection is established, amoebae become better established for penetration in the immuno-depressed host. The study further suggests that corticosteroid therapy could aggravate an otherwise sub-clinical amoebic infection in man.

Orthostatic hypertension.

A 40 year old man was found to have marked hypertension when he was in the upright position with normal pressures when he was supine. Investigations disclosed normal catecholamine and renin levels. The baroreceptor reflex was somewhat depressed. The mechanism of this orthostatic hypertension is not known. The condition has not been reported previously.

Kala-azar in north-western India: a study of 24 patients.

Twenty-four sporadic cases of kala-azar diagnosed over an 11-year period in a referral medical centre in north-western India are reported. Most of the patients were residents of non-endemic areas or where endemicity was low. Certain unusual clinical and laboratory features were seen in some of the cases, namely, lymphadenopathy, nasopharyngeal growth, acute and chronic hepatic involvement and portal hypertension. Awareness of the occurrence of the disease and of its protean modes of presentation was found to be an important factor in early diagnosis.