White phosphorus poisoning--explosive encounter.

Poisoning by white or yellow phosphorus is reported in various forms and also in ages varying from infants to adults, but spontaneous combustion and explosion during its management has never been described. This incidence occurred while attempting to pass a Ryle's tube. Its free end first exhibited a yellow flame and this later on led to an explosive encounter. Role of static electricity generated while handling plastic materials leading to ignition and explosion cannot be overlooked.

A multicentric study with arteether in patients of uncomplicated falciparum malaria.

Two hundred and sixty seven patients of uncomplicated P. falciparum malaria completed study in a multicentric phase III clinical trial of Arteether. Arteether was given intramuscularly in a dose of 150 mg daily for three consecutive days. Each patient was followed upto 28 days of alpha, beta arteether therapy. The cure rate was 97% with fever clearance time between 1-7 days (24-168 hours) and parasite clearance time between 1-3 days (24-72 hours). Parasite reappearance rate was found to be 3% and reported at only three of the centres. Following the treatment no adverse effect was observed on haematological, biochemical and vital clinical parameters.

Radionuclide (MUGA) studies of left ventricular functional abnormalities in asymptomatic patients with sickle cell anemia.

Radionuclide ventriculography was performed on 10 normal subjects and 39 patients with sickle cell anemia (10 homozygous and 29 heterozygous sicklers) at rest and after exercise. Their left ventricular (LV) function was assessed in both these situations. The results were then compared within the subgroups. The reduction in ejection fraction (EF) response (47.5 +/- 7 at rest and 46.4 +/- 8 at exercise in homozygous patients, and 52.4 +/- 8 at rest and 54.3 +/- 8 at exercise in heterozygous patients) was significant in both the homozygous and the heterozygous groups but more so in the former group. The diastolic filling was also significantly impaired in the homozygous group (PER 2.64 +/- 0.74, PFR 2.13 +/- 0.42 and PFR/HR 0.014 +/- 0.001). The study statistically demonstrates, that LV filling patterns are altered in the sickle cell patients, even in the absence of clinical symptoms relating to LV dysfunction. This fact may prove to be a marker of sickle cell heart disease. Frequent and significant sickling is probably the cause of more pronounced LV functional abnormalities in homozygous sicklers.

Primary lingual tuberculosis caused by M. bovis infection.

Although tuberculosis of tongue has been previously reported, its infrequent clinical presentation and increased chance of being overlooked during routine examination of the oral cavity, make it worthy of documentation. Lingual tuberculosis is usually associated with tuberculosis of the oropharynx, lungs, lymph nodes, and miliary tuberculosis. Primary tuberculosis of the tongue is extremely rare and is seldom reported. Early diagnosis of tuberculosis elsewhere in body and its effective treatment by antituberculous drugs may be the reason for its uncommon presentation. The relationship between consumption of raw or unboiled milk and tuberculosis of the tongue is ill-understood and has evidently not been reported. We take this opportunity to present the first case of primary lingual tuberculosis caused by Mycobacterium bovis related to consumption of unboiled cow milk.

Dapsone agranulocytosis in a leprosy patient.

Dapsone-induced agranulocytosis is a rare adverse effect. There are various reports of agranulocytosis in patients treated with dapsone for malaria prophylaxis and other dermatological diseases. However, this adverse reaction in leprosy is not often encountered. We describe agranulocytosis in a young patient who was taking dapsone (100 mg) for borderline-tuberculoid leprosy in a rural environment.

Turpentine poisoning: a case report.

The use of turpentine oil for suicidal and homicidal purposes has become quite infrequent with the increased availability of pesticides and toxic substances. Available literature exhibits few case reports of turpentine poisoning. Such a case is reported here which presented as status epilepticus, unresponsive to the usual line of treatment. Detailed clinical examination and inquiry into the case history revealed turpentine poisoning.