Retrospective and prospective study of head and neck cancer

A prospective clinico pathological study of Head and Neck Cancer cases presenting in E.N.T. OPD was done and its observations were compared with retrospective studies done earlier by Gupta et al (1986), It was seen that carcinoma laryngopharynx was the commonest (38.18%) malignancy seen in the present study followed by carcinoma of Larynx (16.36%) and Oesophagus (14.54%). Carcinoma of the nasopharynx was seen in 12.72% cases followed by carcinoma oropharynx (10.91%), Histopathologically; 98.18% cases were of squamous cell carcinomas and out of these only 31.48% were well differentiated carcinoma. There was only 1 case (1.81%) of occult primary. In the retrospective study, the incidence of cancer of Laryngopharynx was 33.33% followed by oropharynx 16.66% and Larynx and Lymphoma (11.11%) each. Occult primary was observed in 3 cases (5.33%) and carcinoma naspoharynx in 4 cases (4.44%). Poor socioeconomic status, bad orodental hygiene, Plummer-vinson syndrome in females were the commonest predisposing factors in addition to smoking, Pan Masala, Zarda and Gutka chewing in the causation of Head and Neck cancer both in prospective and retrospective studies.

Prevalence of human immunodeficiency virus infection in and around Varanasi, Uttar Pradesh, India

Human Immunodeficiency Virus (HIV) infection is rising rapidly in the eastern Uttar Pradesh; however no data is available regarding its positivity rate. We have screened 1239 cases of various groups. HIV seropositivity rate of 0.28% was noted. These results suggest that HIV infection is spreading rapidly in this part of the country. M. tuberculosis was the commonest co-infection amongst them (29.5%). We recommend routine HIV screening of all patients of tuberculosis, especially if the persons frequent the cities, visit foreign countries where sex tourism is encouraged or stay away from their spouses for long periods as true history of sexual contact with commercial sex workers was difficult to obtain from them.

Spontaneous intraperitoneal expulsion of an unruptured hydatid cyst

We report a 43-year-old man with a 20 x 20 cm hydatid cyst, spontaneously extruded out from the left lobe of the liver. This complication of hydatid cyst has not been recorded earlier, and makes the case unique in itself and worth reporting. The patient presented with a rare complication of biliary peritonitis of hydatid disease.

Status of Ca(2+)-channels in hearts perfused with Ca(2+)-free medium as well as upon reperfusion (Ca(2+)-paradox)

Although a wide variety of biochemical changes have been observed during the occurrence of Ca(2+)-paradox, very little is known about membrane alterations during Ca(2+)-free perfusion which may predispose the heart to the development of intracellular Ca(2+)-overload in the Ca(2+)-paradox phenomenon. In view of the marked influx of Ca2+ into the myocardial cell during Ca(2+)-paradox and the involvement of Ca(2+)-channels in the entry of Ca2+, we determined the status of Ca(2+)-channels by measuring the binding of a Ca(2+)-antagonist, [3H] PN200-110, with membranes obtained from rat hearts perfused with Ca(2+)-free medium. The density of Ca(2+)-channels in the membranes was increased upon perfusing the heart with Ca(2+)-free medium for > 2 min or when the perfusion medium contained less than 25 microM concentration of Ca2+. The increase in Ca(2+)-channel density was attenuated when the hearts were perfused with Ca(2+)-free medium in the presence of a low concentration (35 mM) of Na+ or at low temperature (21 degrees C); two conditions which are known to prevent the occurrence of Ca(2+)-paradox. These results indicate that increased density of Ca(2+)-channels due to Ca(2+)-free perfusion may contribute towards the massive Ca(2+)-influx into the myocardial cell for the induction of intracellular Ca(2+)-overload associated with Ca(2+)-paradox during reperfusion with Ca(2+)-containing medium.

Cyclic vertical squint

A rare case of cyclic vertical squint which developed after surgery on medial rectus muscle and its subsequent management by the Faden operation is described.

Subretinal fluid in the diagnosis of posterior scleritis

The etiology of subretinal mass lesions is very difficult to establish. A 28-year-old man presented to us with an area of choroiditis, which progressed, despite corticosteroid and antibiotic therapy, to an exudative retinal detachment, secondary glaucoma and a painful blind eye. To develop a means of identifying the cause of such lesions, we did a subretinal fluid tap prior to enucleation. Cytopathology showed only inflammatory cells and the final histopathological diagnosis was that of a granulomatous scleritis.

Role of metal ions in goat carboxypeptidase A-catalysed hydrolysis of acyl peptides

The carboxypeptidase A purified from goat pancreas has been found to have a molecular weight of 34,600 +/- 300. The enzyme is a zinc-protein and the molar ratio of zinc to enzyme protein is 1:1. Removal of zinc yields an inactive apocarboxypeptidase A. The loss of activity of the native enzyme and restoration of the activity of the apoenzyme run parallel with the zinc content of the protein, thus showing the essentiality of zinc for the enzymatic activity. The exact role of zinc in the enzyme catalysed hydrolysis of the acylpeptides has been investigated after preparing metallo proteins by substituting the zinc of carboxypeptidase A with Co2+, Mn2+, Ni2+, Fe2+, Cd2+, Hg2+, and Cu2+ and determining the kinetic parameters of such metalloproteins. These studies indicate that the metal ion is involved in both binding the substrate and polarising the peptide bond.

Traumatic posterior dislocation of the hip in children

Eighteen cases of traumatic dislocation of the hip in children between two and a half and twelve years of age were treated by closed reduction. The patients presented at our hospital 26 hours to 75 days after injury. All the cases had posterior dislocation of the hip. Closed reduction, either by manipulations or by heavy traction and gradual reduction, was satisfactorily achieved in all the cases. Avascular necrosis was seen in one case only. The interval between dislocation and its reduction, the nature of the injury, the age of the patient, the type of treatment and the period of time in which the patient bears no weight do not seem to exert a significant influence on final results. All the patients were followed up from two to seven years.