Primary Low-Grade Fibromyxoid Sarcoma of Kidney-an Extremely Rare Entity.

Renal LGFMS is an extremely rare tumor. So far, only four cases have been reported in literature. LGFMS are indolent tumor with distinctive histopathological features with potential for late recurrences and metastasis. The diagnosis is made on histopathological examination and supported by immunohistochemical analysis. A 35-year-old young male was presented with flank pain and lump and diagnosed as low-grade fibromyxoid sarcoma after surgery on immunohistochemical analysis. This is the fifth case of renal LGFMS and we presented the review of literature. Radical surgery remains the primary treatment modality. Long follow-up is mandatory.

Ocular manifestations of head injury: a clinical study.

AIM: This prospective study aimed to clinically correlate the various ocular findings with the neurological status in cases of closed head injury. METHODS: A total of 200 consecutive cases of closed head injury admitted to a major teaching hospital underwent a thorough ophthalmic assessment. The Glasgow coma scale (GCS) and the Revised trauma score (RTS) were applied to grade the severity of injury and assess the prognosis. Kendall's tau-b and Fisher's exact test were used in the analysis. RESULTS: The main causes of head injury were road traffic accidents 52.5% followed by assaults in 34%. Ocular involvement was found in 167(83.5%) cases. These included corneal and scleral tears in 2%, subconjunctival haemorrhage or ecchymosis in 46%, orbital fractures 12%, pupillary involvement 6.5%, papilloedema 5.5%, intraocular trauma 5.5%, proptosis 3%, lateral rectus palsy 2%, lacrimal gland prolapse 1%, and optic nerve trauma 0.5%. All 21 patients (10.5%) who died had eye involvement. In all, 150 cases (75%) with a RTS of 12 had a good prognosis. Of these 124 (82.6%) had ocular involvement of no neurological significance. CONCLUSIONS: Although sophisticated imaging techniques are available to localize lesions, early ophthalmic assessment in correlation with the GCS aids in prognosticating outcomes. Pupillary involvement, papilloedema, and ocular motor paresis pointed to a more severe head injury. To our knowledge, this is the only prospective study recording ocular findings in the first few hours and attempting a correlation with the final outcome.

Plasma homocysteine and insulin in diabetic nephropathy: relationship to body mass index.

The data on plasma homocysteine and endogenous insulin in type 2 diabetes mellitus with nephropathy and relationship to body mass index (BMI) is particularly from the Indian subcontinent. A prospective study was carried out in 50 patients of type 2 diabetes mellitus with overt nephropathy (Group A). The results were compared with 25 diabetics without nephropathy (Group B), and 25 age and sex matched healthy controls (Group C). Microenzyme immunoassay and ELISA estimated the plasma homocysteine and insulin, respectively. The mean values of plasma homocysteine were significantly elevated in diabetic nephropathy (21.3+/-7.2 micromol/L) and diabetics without nephropathy (19.4+/-7.1) when compared to healthy control (11.5+/-2.3). The insulin levels and BMI were significantly higher in diabetics as compared to controls. There was no correlation between homocysteine and insulin, homocysteine and BMI, and homocysteine with the degree of renal failure.

Intrapulmonary vascular dilatation in portal hypertension due to cirrhosis of liver.

BACKGROUND: Intrapulmonary vascular dilatation in patients with portal hypertension due to chronic liver disease has been reported mainly from Western countries. METHODS: Fifty in-patients with portal hypertension due to cirrhosis of the liver were subjected to contrast-enhanced two-dimensional echocardiography in order to detect the presence of intrapulmonary vascular dilatation. Their arterial blood oxygen saturation was measured. The patients, including 37 men, were aged mean 43.5 years; 30 had alcoholic cirrhosis and 20 postnecrotic cirrhosis. Twelve patients were in Child-Pugh, class B and 38 in class C. RESULTS: None of the 50 patients was cyanosed or had clubbing. Their mean pO2 was 83.2 mmHg. None had evidence of intrapulmonary vascular dilatations. CONCLUSION: Intrapulmonary vascular dilatation was not observed in our patients with liver cirrhosis. However, the sensitivity of contrast-enhanced echocardiography for this purpose needs to be reviewed.

Hepatitis A associated with myoglobinuria.

We report a patient with hepatitis A who had myoglobinuria. Creatine phosphokinase levels and electromyography and muscle biopsy findings were consistent with polymyositis.

Evaluation of serum lipid profile and cardiac enzyme changes in cerebrovascular accidents.

Serum lipid profile is, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL) and triglycerides and serum cardiac enzymes ie, creatinine phosphokinase (CPK), creatinine phosphokinase isoenzyme MB (CPK-MB), lactate dehydrogenase (LDH) and serum aspartate aminotransferase (AST/SGOT) levels were estimated in 50 cases of cerebrovascular accidents (CVA) consisting of 26 cases of cerebral haemorrhage and 24 cases of cerebral thrombosis. All analyses were made on day 1 and day 7. Serum cholesterol, LDL and triglycerides levels were significantly higher in CVA patients on day 1. Lipid level fell significantly on day 7 in respect to day 1. On comparing the lipid levels between cerebral haemorrhage and cerebral thrombosis, no significant difference was observed. Cardiac enzymes like CPK and CPK-MB were significantly raised whereas, AST/SGOT and LDH were marginally raised on day 1 in CVA patients. However, there was no change in cardiac enzyme levels between cerebral haemorrhage and cerebral thrombosis patients.

Study of oestrogen and progesterone receptors in meningiomas by a technique utilizing the binding hormones in a polymerized state.

Forty six cases of meningiomas were studied by utilizing oestrogen and progesterone hormone bound to fluroscent-iso-thiocynate (FITC) for the presence of oestrogen and progesterone receptors. Oestrogen receptors were present in 33% cases and only one fourth of these showed strong positivity. Progesterone receptors were positive in 41% cases, and more than half of these showed strong positivity. Thus this study revealed higher positivity rate for progesterone receptors than oestrogen receptors.

Effect of posture in immediate post-exercise period on ischaemic ST-changes during stress electrocardiographic testing.

In this study of stress testing, the posture in which patients were put had effect on heart rate, blood pressure, rate pressure product and ST-segment depression integral in the recovery phase. The systolic blood pressure in recovery phase of stress testing fell more rapidly towards normal pre-exercise value in sitting (Group I) than in lying down (Group II) posture (p < 0.05) from 2nd to 5th minute. The changes in heart rate were less and slower in lying posture than with sitting up. The decrease in rate pressure product (RPP), a determinant of myocardial oxygen requirement was lower in lying down than in sitting up posture (p < 0.05) from 2nd to 5th minute of recovery. Consequently, ST-depression, a marker of ischaemia was more marked in lying down than sitting up. The ST-depression integral was 4.15 +/- 1.2 and 7.10 +/- 1.65 in 2nd minute in group I and group II respectively, and the difference was statistically significant in 2nd, 7th (p < 0.05) and 8th minute (p < 0.01) of recovery. These changes are important in interpretation of results of exercise testing.

Serum pepsinogen levels in patients with gastro-duodenal lesions.

Serum pepsinogen (SP) levels were studied in 100 patients with gastroduodenal lesions, and 100 healthy volunteers. SP levels were significantly elevated in patients with duodenal ulcer (DU) and duodenitis compared to the controls. SP values above 150 ug Tyr/ml/24 hr were highly suggestive of duodenal ulcer disease. Age and sex of patients and controls did not influence SP levels. The mean values of SP in North India were found to be lower in both normal and DU subjects compared to the west.

Copper, zinc, calcium and magnesium in chronic renal failure.

Estimation of copper, zinc, calcium and magnesium was done in plasma, erythrocytes and urine of twenty patients with chronic renal failure of diverse aetiologies. Twenty normal individuals formed the control group. Significant plasma hypozincaemia and hypozincuria was observed in uraemic patients, though the concentration of zinc in erythrocytes was significantly higher than in controls. The copper content of the erythrocytes was significantly higher in patients when compared to controls, while the reverse was true for its excretion in the urine. The increased level of copper in the erythrocytes showed a correlation with increasing severity of renal failure. Significant hypocalcaemia was seen in the erythrocytes and plasma of uraemic patients, though magnesium level was elevated. Urinary excretion, however, of both calcium and magnesium were markedly reduced in these patients. The magnesium levels in plasma and urine showed a significant correlation with the severity of renal failure.

Risk of sudden visual loss following trabeculectomy in advanced primary open-angle glaucoma.

We studied the postoperative course of two groups of patients with primary open-angle glaucoma and small residual visual fields undergoing trabeculectomy. We found that there is a considerable risk of sudden loss of visual field after operation on these patients.

Orthodontic status of school children in Ile-Ife, Nigeria

Se hizo un estudio en niños escolares de un área rural de Ile-Ife, Nigeria para determinar su condición ortodóncica. El 51% de los niños examinados estaban libres de problemas ortodóncicos. 45% presentó maloclusión Clase I de Angle. Cuando se comparan estos resultados con los obtenidos en otros estudios en niños nigerianos de zonas urbanas, el presente estudio sugiere que: 1) la prevalencia de problemas ortodóncicos en niños escolares nigerianos de la zona rural es menor que la de niños de la zona urbana; 2) cuando ocurren los problemas ortodóncicos, son ligeramente más severos en los niños escolares de la zona urbana que en los niños de la zona rural