Acute renal failure following poisonous snakebite.

This study describes acute renal failure (ARF) following snakebite in humans and the effects of viperide venoms on the renal structure and function in subhuman primates. ARF developed in 45 of 157 patients with a history of snakebite admitted to the hospitals of the Postgraduate Medical Institute, Chandigarh, India. They were studied clinically, hematologically, and in 35 cases, for renal histopathology. All 45 were treated with antibiotics, and 8 received anti-snake venom. Ten cases had bilateral renal cortical necrosis (BRCN), eight of whom died; less severe acute tubular lesions (ATL) occurred in 23 patients, four of whom died (P less than .001). Sepsis was significantly more common with BRCN than ATL (P less than .05). No statistical difference was found between these groups in bleeding incidence, disseminated intravascular coagulation (DIC), hemolysis, or hypotension. Monkeys given lethal doses of viperide venom developed hypotensive shock, DIC, and hemolysis, with significantly reduced serum complement, and died within 24 hours. However, no renal functional changes or lesions were found. Monkeys given sublethal doses of viperide venom showed a significant increase in serum creatinine levels after 48 hours, and renal lesions were observed in a majority of animals. In conclusion, ARF in snakebite victims appears to be multifactorial in origin. Although hypotension, hemolysis, and DIC are likely to be important pathogenetic factors, a direct cytotoxic effect of the venom on the kidney in producing ARF cannot be excluded.

Hemostatic abnormalities following Echis carinatus (saw-scaled viper) envenomation in the rhesus monkey.

Hemostatic abnormalities following lethal and sublethal doses of Echis carinatus venom were studied in a subhuman primate model. The observations suggest the occurrence of disseminated intravascular coagulation of varying magnitude within a few hours of envenomation. A procoagulant effect of the venom of Echis carinatus is likely to be the major cause of the disturbance in the hemostatic mechanism.

Serum lipids in leprosy.

Sera of 58 patients of various types of leprosy were tested for total fat, phospholipids, cholesterol and alpha and beta lipoproteins. Total fat and both fractions of lipoproteins were found to have values comparable to normals in all types of leprosy. Serum phospholipid levels were significantly reduced in LL type of leprosy as compared to normals and TT group of patients. Similarly cholesterol levels were found to have significantly no value in LL group compared to that of the controls.

T and B lymphocytes and blastogenesis in leprosy.

T and B cell percentages and their blastogenic response to PPD and lepromin have been studied in 107 patients of various types of leprosy. T cell counts and their blastogenic response were found to be considerably lower in all types of leprosy as compared to the normal. The counts and stimulation were the lowest for lepromatous leprosy. B cell counts were unaltered in all types of leprosy.

Peritoneal dialysis in obstructive jaundice: an experimental study.

Rats were subjected to common bile duct ligation, after which intermittent peritoneal dialysis with a buffered solution containing rat plasma proteins was carried out in an attempt to reduce plasma bilirubin levels. Plasma bilirubin increased significantly (P less than 0.01) on the seventh day and was still rising 12 days after ligation of the common bile duct. Dialysis was performed during the second postoperative week. Provided that rat plasma protein was present in the dialysing fluid, dialysis significantly reduced (P less than 0.01) the levels of total plasma bilirubin, conjugated bilirubin and serum GPT in the experimental animals.

Amebic granuloma--an experimental study.

The etiopathogenesis of granuloma formation in amebiasis is not known. An experimental study was carried out in 48 guinea pigs arranged into four groups, to assess the role of hypersensitivity in formation of amebic granuloma. Repeated intracecal inoculations of saline in Group I and mixed amebic and bacterial suspension in other groups were made. Animals in Group III were sensitized by amebic antigen and in Group IV by bacterial antigen before inoculations. Lesions produced in the amebic hypersensitive group of animals were notably different from those in other groups. A higher frequency of cecal ulceration and a significantly severe grade of cecal damage was seen in these animals. Extensive pericecal adhesions and marked thickening of the wall produced nodular lesions. Granulomas were formed with dense chronic inflammatory cell infiltration including fibroblasts.