Puerperal tetanus

Fifty cases of puerperal tetanus were studied. It constituted 6.66% of total cases of tetanus with overall mortality of 52% which was higher in cases with incubation period of 14 days or less, period of onset 48 hours or less, higher grades, cases with temperature more than 37.7 degrees C and patients with respiratory complications. Significantly higher mortality rate after 48 hours signifies the need of effective local control of infection to improve prognosis. Prevention, early detection and prompt treatment of respiratory complications which is the main cause of death may further reduce mortality rate in these patients.

Lens epithelial cell density and histomorphological study in cataractous lenses

Human epithelial cell density was determined from flat preparation of 195 cataractous lenses from 108 males and 87 females between 30 and 80 years of age. The mature cataracts had significantly lower cell counts than the other cataracts. Cell density was significantly higher in the females than in the males. Morphohistological study of the epithelia was focused on the following cataract types: (1) nuclear, (2) posterior subcapsular, (3) mature, (4) mixed, (5) hypermature, and (6) black. The major cataractous changes in all types involved vacuolization of the cytoplasm. The mature types of cataractous epithelia showed 56% superimposed cells; the epithelia in nuclear, posterior subcapsular, and black cataracts showed between 6% and 16%. In the hypermature cataracts, four of five tissues analyzed showed superimposed cells. The superimposed areas are probably the source of increased and altered cell activity. We propose that the metaplastic processes leading to posterior capsular opacification originate from these areas. The majority of nuclear and black cataracts were almost similar to the normal human lens epithelium with more or less uniform distribution of cells. Nucleus shrinkage (5 microns) was more evident in nuclear cataracts; in subcapsular cataracts most of the nuclei were large (average 9 microns diameter). Variation in morphological changes like vacuolization of cytoplasm and nuclei, pyknotic nuclei, and superimposed cells was more evident in the mixed type of cataracts.

Selenium and diabetes in the tropics

We have examined the possibility that selenium deficiency may underlie one or more of the following peculiarities of chronic pancreatitis in tropical as compared to temperate zones: much higher prevalence, propensity for pancreatic calculi, and high frequency of diabetes. Selenium was measured by graphite furnace atomic absorption spectrometry in sera from 20 healthy volunteers, 36 patients with chronic pancreatitis (calcific 35, diabetic 32), and 23 patients with primary forms of diabetes, from Madras, South India; results were compared with data from 41 controls and 37 patients with chronic pancreatitis (calcific 13, diabetes 8) from Manchester, North West, England. We conclude that (a) bioavailability of selenium is equally high in each geographic area; (b) decrement in serum selenium (p less than 0.001) is of a similar order in Manchester and Madras patients, which denies a connection with calculi formation or pancreatic exocrine failure (since the incidence of these two problems was substantially higher in the Madras series); and (c) selenium levels do not account for accelerated course to diabetes in tropical chronic pancreatitis.

Role of proteins and cholesterol in human senile cataractogenesis

Cataracts are a major cause of blindness in man with far reaching personal, social and economic consequences. The clarity of the lens is dependent upon the maintenance of the integrity of the fiber cell plasma membrane whose important component is cholesterol. In the present study, we have demonstrated that cataract formation influences the cholesterol and protein distribution within the lens.

A stress wave propagation technique for bone repair study

The diagnosis of bone fracture and its rate of healing still remains a problem among orthopedic surgeons. An acoustic technique based on stress-wave propagation is developed. The technique is used on laboratory experimental in vitro bones, as well as on in vivo (human) bones, to diagnose a fracture. The rate of healing of the fracture is also studied. The technique developed is quick, economical, reliable, portable, and safe for both the patient and the operator.

Identification of a region of UDP-galactose:N-acetylglucosamine beta 4-galactosyltransferase involved in UDP-galactose binding by differential labeling

The location of regions in the primary structure of UDP-galactose:N-acetylglucosamine beta 4-galactosyl-transferase (GT) that are involved in binding UDP-galactose has been investigated by differential chemical modification with two different reagents in the presence and absence of UDP-galactose. Treatment with periodate-cleaved UDP and NaCNBH3 resulted in a loss of 80% of GT activity, which was largely prevented by UDP-galactose. Stoichiometry of labeling and peptide maps of the modified enzyme samples indicated partial labeling at many sites. A major site of reaction in the absence of UDP-galactose that was essentially unmodified in its presence was found to correspond to Lys341 in the cDNA sequence of GT. As a second approach, the reactivities of the amino groups of GT were compared in the presence and absence of saturating levels of UDP-galactose by trace acetylation with [3H]acetic anhydride. UDP-galactose binding was found to perturb the reactivities of a number of lysines in the C-terminal region of GT, the most pronounced effect being a reduction in the reactivity of Lys351. The two procedures thus identified a region between residues 341 and 351 as being associated with UDP-galactose binding. This region overlaps a small section in the sequence of GT that was previously noted to be similar to part of bovine alpha-1,3-galactosyltransferase (Joziasse, D. H., Shaper, J. H., Van den Eijnden, D. H., Van Tunen, A. J., and Shaper, N. L. (1989) J. Biol. Chem. 264, 14290-14297). Sequence comparisons indicate that extended regions at the C terminus of each enzyme encompassing this area may represent homologous UDP-galactose-binding domains.

Circulating iso and auto antibodies to human spermatozoa in infertility

Blood samples from 50 couples of unexplained primary infertility and 25 healthy fertile couples were tested for antispermatozoa antibodies (ASA) by gelatin agglutination test and sperm immobilising complement dependent cytotoxicity test. The incidence of sperm agglutinating and sperm immobilising antibodies was found to be 14 per cent and 10 per cent respectively in infertile couples. Agglutinating antibodies were detected in 18 per cent males and 16 per cent of females while cytotoxic antibodies were found in 14 per cent males and 10 per cent of females. Only 4 per cent of the normal fertile couples taken as a control group showed positive ASA, hence the difference in incidence of positive ASA between the infertile and fertile couples was found to be statistically significant. Also, the agglutination test was observed to be more sensitive than the cytotoxicity test.

Respiratory complication in tetanus

Six hundred cases of tetanus were studied to find out incidence of respiratory complications and to evaluate factors predisposing such complications in tetanus. The incidence of complications was 41 per cent. Infants, patients of more than 40 years of age, smokers, cases with grossly contaminated injuries, short incubation period and short period of onset were more vulnerable. Patients with dysphagia, spasm, associated respiratory diseases and the patients in higher grades were also found to be more susceptible to respiratory complications.

Role of natural frequency of bone as a guide for detection of bone fracture healing

The natural frequency of bone is studied in normal and fractured bones, in vitro as well as in vivo, by recording the outputs of microphone pick-ups, attached at proximal and distal ends to the bone defect. Natural frequency of bone is determined for an optimum output displayed on a cathode ray oscilloscope with respect to different stress wave frequencies. A comparative study of normal and fractured bone in vivo in 25 patients was made to diagnose the size of the fracture and its rate of healing. The natural frequency and intensity of sound in the injured bone was reduced while the output voltage increased with respect to the normal bone. The investigation reports a simple, reliable and rapid technique for the assessment of bone fracture.

Single-eyed infantile esotropia-abductional nystagmus syndrome (unilateral convergent squint following enucleation)

Three infants underwent enucleation of one eye for different indications. This was followed by the development of esotropia of varying degree within one to four months in all the three cases, and was associated with a coarse nystagmus present in abduction, but absent in the primary and adducted positions of gaze. There was a face turn to the side of remaining eye. This appears to be a separate clinical entity and not early onset esotropia. Possible mechanisms and medicolegal implications are discussed.

Oral manifestations associated with human immunodeficiency virus infection in 200 Indian patients

Objective: To determine the pattern and prevalence of oral lesions in HIV infected 200 costal Andhra Pradesh patients. Patients and methods: the study population comprised 200 consecutive HIV seropositive patients presented to regional ART center at Andhra Pradesh, India. The oral lesions were diagnosed based on clinical appearance and were entered in to the database for analysis. Results: 30-39 yrs age group was most commonly affected and 87% of the patients had acquired infection via heterosexual contact. Oral lesions were seen in 66% of the patients. Gingivitis (36.7% males & 33.9% females) was the most common lesion followed by candidiasis (21% males & 26.4% females), periodontitis (6.8% males & 7.5% females), pigmentation (36.7% males & 33.9% females), ulcers (2.7% males & 0% females) and leukoplakia (1.3% males & 0% females). Conclusion: The pattern of oral lesions associated with HIV infection was not markedly different form those reported in the literature, the prevalence of each type of lesion differ slightly. Key words: CD4 lymphocyte count; Female; HIV infections; Male; Humans.DOI: 10.3329/bjms.v9i3.6470Bangladesh Journal of Medical Science Vol.09 No.3 July 2010, pp.150-153

Study of acute encephalitis syndrome in children

Objective: To determine the profile and outcome of children admitted with Acute Encephalitis Syndrome (AES) and to find out the prevalence of Japanese Encephalitis (JE) IgM antibodies positive cases among these patients with their case fatality rate (CFR). Materials and methods: Study consist of retrospective analysis of hospital records of children up to 15 years of age admitted with diagnosis of AES in pediatric wards of College of Medical Sciences-Teaching Hospital, Bharatpur from January 2007 to December 2008. Results: During two years, 61 patients of AES were admitted. Male and female patients were 33 and 28 respectively. Meningitis accounted for 29 and encephalitis for 32 patients. JE IgM seropositive cases contributed for 18% of all AES cases. Case fatality for JE was 16.6%. Conclusions: Japanese Encephalitis is endemic in catchment area of the hospital. JE has significant morbidity and mortality which can be prevented by immunization and mortality can be reduced if supportive interventions are provided in time. Key words: AES; JE; CFR. DOI: 10.3126/jcmsn.v6i1.3596 Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 1, 7-13