Salivary fistulae

Three cases of unusual cervical fistulae are presented with a review of the literature to caution against labelling all lateral cervical fistulae as simple branchial fistulae or midline ones as dermoid cysts.

Isolated common bile duct tuberculosis

We report a patient with isolated involvement of common bile duct by tuberculosis. The diagnosis was established by histological examination of the resected specimen. Surgery and antitubercular chemotherapy resulted in complete recovery.

Five-year longitudinal study of efficacy and safety of purified Vero cell rabies vaccine for post-exposure prophylaxis of rabies in Indian population

Three hundred and nine (309) persons, vaccinated against rabies with Purified Vero-cell Rabies (PVR) vaccine from 1991-1995, were included in this five-year longitudinal study. This study was conducted to observe the consistency, immunogenicity, inocuity, safety and efficacy of this vaccine under field conditions. All the 309 persons attended our centre after taking post-exposure vaccination following bites by suspected rabid animals or contact with hydrophobia patients for antirabies antibody titre estimation. The vaccine was very well tolerated by vaccinees with only 7 per cent, complaining of mild to moderate side reactions. On an average, every year 70-100 vaccinees reported at this centre after PVR vaccination. The epidemiological characteristics of rabies based on above data are also discussed in this paper. Serological response, i.e., antirabies antibody titre following vaccination in all these persons were found to be satisfactory with mean antibody titre of 4.25 I.U./ml.

Isolated collagenoma: a case report with a review of connective tissue nevi of the collagen type

A 22-year-old male had had five skin colored tumorous growths on the mid-palm, ring and little fingers of the right hand for the last 15 years. Histopathological examination with hematoxylin and eosin and special stains confirmed the diagnosis of connective tissue nevi of collagen type. There were no associated cutaneous or systemic findings; thus the case was designated as isolated collagenoma. A review of connective tissue nevi of the collagen type is presented.

The quality of life in successful live-related renal allograft recipients in India

BACKGROUND

The high cost of maintenance of haemodialysis makes most patients in India and elsewhere opt for a renal transplant. The degree of rehabilitation can best be assessed by evaluating the quality of life in successful recipients.

METHODS

We studied vocational rehabilitation, social relations, sexual and married life, psychological status and life satisfaction in 51 successful live-related renal allograft recipients using Schwab's depressive scale, Bigot's life satisfaction index and the Kamofsky physical scale.

RESULTS

Eight-four per cent of our patients had returned to their original jobs. Ninety-eight per cent of patients had a Kamofsky scale of 90-100 and 81% were leading a normal married life. Ninety-four per cent of them led an active social life.

CONCLUSION

Successful live-related renal transplantation is associated with a good quality of life and should be the treatment of choice for patients with end-stage renal disease.

Papuloerythroderma of ofuji

A 62-year old female had intensely pruritic eruption consisting of widespread coalescing sheets of uniform erythematous papules with characterstic sparing of body folds (deck-chair sign). Papuloerhthroderma of Ofuji is a rare disease of unknown aetiology.

Odontotrichodysplasia: a case report with a review of conditions combining ectodermal dysplasia (subgroup 1-2) with skin manifestations

We report a 5-year-old girl with partial anodontia, hypotrichosis, hyperpigmentation of the skin, absence of pilosebaceous structures, and long thin fingers. There has as yet been, to the best of our knowledge, no report of such a combination of features. A review of conditions combining ectodermal dysplasia (subgroup 1-2) with skin manifestations is presented.

Ten year longitudinal study of efficacy and safety of purified chick embryo cell vaccine for pre- and post-exposure prophylaxis of rabies in Indian population

One thousand three hundred and seventy-five (1375) persons, who were vaccinated against Rabies with Purified Chick Embryo Cell (PCEC) vaccine from 1984 to 1993, were included in this ten-year longitudinal study, conducted to observe the consistency, immunogenicity, inocuity, safety and efficacy of PCEC vaccine under controlled trial and field conditions. The study period was divided into three phases. Phases I and II covered the premarketing controlled trial and Phase III the post-marketing serosurveillance study of the vaccine. During Phase I, fifteen healthy volunteers were given a pre-exposure regime of vaccine on Day 0, 7 and 21, and the rest 15, simulated post-exposure regime on Day 0, 3, 7, 14, 30 and 90. All the subjects had satisfactory antirabies antibody response with mean titres, of 7.08 and 5.72 I.U./ml respectively, and minimal side reactions. In the Phase II, from 1984-85, 56 persons with proven rabid animal bites were given post-exposure vaccination and all had satisfactory antibody titres with mean titre of 4.45 I.U./ml after 6th dose of vaccine and with minimal side reactions. 19 to 36 months follow up after vaccination revealed no vaccine failures. In the Phase III post-marketing field study conducted from 1985 to 1993, 1289 persons reported to our Centre for consulation and antirabies antibody titre estimation following PCEC vaccination. One thousand two hundred and fifty-two (1252) persons took post-exposure vaccination following bites by rabid animals, contact with an hydrophobia patient and 37 high risk personnel took pre-exposure vaccination.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical evaluation of purified vero-cell rabies vaccine in patients bitten by rabid animals in India

Fifty-five individuals bitten by rabid animals were administered purified vero-cell rabies vaccine (PVRV) at WHO Collaborative Centre for Rabies Epidemiology for South-East Asia at National Institute of Communicable Diseases, Delhi to test its immunogenicity, inocuity, safety and clinical efficacy. Fifty-two (94.5 per cent) of these individuals underwent complete course of treatment. Sera samples collected prior to the commencement of treatment showed all these persons to be sero-negative for antibody against Rabies virus. However mean titre of 2.44 I.U./ml, 7.76 I.U./ml and 10.77 I.U./ml were detected after third, fourth and sixth injections, respectively of PVRV. Persistance of protective titres of this antibody could be demonstrated even after 15 months of treatment. Of 327 inoculations, local and general reactions were observed after 10.6 per cent inoculations. All these cases were followed up for periods between 7 and 25 months and were, alive and healthy till the end of observation period, thereby proving the efficacy of the vaccine in preventing rabies.

Immunogenicity and feasibility of purified chick embryo cell vaccine

Two hundred seventy-one children reported at the WHO Collaborative Centre for Rabies Epidemiology for South-East Asia at National Institute of Communicable Diseases, Delhi, for advice and antirabies antibody assessment after post-exposure prophylaxis with purified chick embryo cell (PCEC) antirabies vaccine from January 1986 to October 1992. Vaccine was very well tolerated by these children and only 7% complained about mild to moderate side reactions like pain, induration, fever or rash. On an average, every year 50-55 children had reported at this Centre after post-exposure vaccination with PCEC vaccine excepting years 1986 and 1987. One hundred and forty-four children underwent complete course of post-exposure prophylaxis, i.e., 5 or 6 doses on day 0, 3, 7, 14, 30 and 90 (optional) of PCEC vaccine were administered, forty-three (43) children received 4 doses on day 0, 7, 14 and 30 (day 3 dose was omitted) and eighty-four (84) children received 2 to 3 doses as the biting animals were alive for 10 days in these cases. Two hundred and twenty-nine children (84.5%) were bitten by dogs and in 10%, the dog was proven rabid by laboratory examination of dog brain. One hundred and forty-nine (55%) had Class III bite. Serological response, i.e., antirabies antibody titre in all these children were satisfactory (> 0.5 IU/ml) with mean titre of 1.98 IU/ml irrespective of doses of PCEC vaccine administered. No vaccine failure was observed in this study.

Studies on victims of bite by a dog in Delhi

Ninety persons were bitten by a single rabid dog on 23rd January, 1992 in Central Delhi area. All patients were given immediate first-aid, prophylactic tetanus toxoid injection and post-exposure antirabies treatment i.e., hyperimmune antirabies serum (ARS) and antirabies vaccination in different Hospitals of Delhi. Fifteen (15) patients received tissue culture antirabies vaccine (Rabipur or Verorab) and rest 75 patients were given nervous tissue vaccine. ARS was given to all patients as all had severe (Class-III) bite. Altogether there were 76 male and 14 female and 80 adult and 10 children bitten by the dog. All patients well tolerated the vaccines excepting a few, who developed very minor side-effects. Investigation regarding post-exposure antirabies antibody assessment were carried out in twenty-four patients at WHO Collaborative Centre for Rabies. Epidemiology for South-east Asia at National Institute of Communicable Diseases, Delhi. Paired blood samples were obtained from these patients and all of them had protective antibody titre (0.5 IU/ml) with mean titre of 1.81 IU/ml and 2.11 IU/ml in first and second samples, respectively. All patients were followed after six months and there were no death or vaccine failure reported.