A clinico-radiological study of secondary mycoses in pulmonary tuberculosis

Clinical and radiological differences were compared in Fungus positive (74) and negative (66) cases of pulmonary tuberculosis. Cough, expectoration, dyspnoea, and fever were marked in former group than that of latter. Anaemia, leucocytosis, raised ESR, abnormal radiological shadows and mycetoma in healed cavity were also noted in significant number in fungus positive cases.

Frequency of hyponatremia and nonosmolar vasopressin release in the acquired immunodeficiency syndrome

The frequency and pathophysiology of hyponatremia were studied in the acquired immunodeficiency syndrome. Of 71 hospitalized patients surveyed retrospectively, hyponatremia was observed in 37 (52%). Of 48 patients studied prospectively, 27 (56%) were hyponatremic. In 16 hyponatremic patients, volume status; serum and urine osmolalities; renal, adrenal, and thyroid function; and plasma vasopressin levels were assessed. Urine osmolalities were inappropriately elevated (mean, 377 mmol/kg of water) relative to serum osmolalities (mean, 268 mmol/kg of water). Four patients had moderate renal insufficiency. Plasma vasopressin levels were elevated in 15 patients, with the highest levels seen in patients who died (median, 7.08 pmol/L). Hyponatremia of multiple etiologies occurred in a majority of inpatients with the acquired immunodeficiency syndrome, often following the administration of hypotonic fluids, and was associated with a 30% (8/27) short-term mortality.

Physiological responses of Vicia faba plants to sulfur dioxide

Exposure of broad bean (Victa faba L.) plants to 270 +/- 32 and 670 +/- 45 micrograms m 3SO2 for 1.5 hr daily between 40 and 85 days of their ages resulted in an increase in their transpiration rate, water saturation deficit, phenol content, and peroxidase activity and a decrease in protein content. With the increase in number of exposures of plants to SO2, chlorotic and brown, necrotic visible injury signs were also developed in leaves. It was further noted that the magnitude of undesirable biochemical changes, which possibly helped in the formation of new pigment characteristic of necrotic tissue of SO2-exposed plants, was not totally dependent on the pollutant concentration.

Coagulase negative staphylococcal septicemia in newborns

A retrospective analysis of 254 newborns having blood cultures positive for coagulase negative staphylococci (CONS), and admitted in the neonatal unit of a Rural Medical College Hospital over a period of five years, was done for various clinical and perinatal characteristics as well as antimicrobial sensitivity profile of isolates. Of them, 118 (46.5%) neonates had clinical evidence of sepsis with CONS as the only growth in blood culture, and were designated as having CONS septicemia. Majority of them were delivered in this hospital itself and by normal vaginal delivery. Preterms and LBW babies constituted 23.7 and 59.4% of total cases, respectively. Other high risk perinatal factors for infection were present in 66.1% cases. Approximately two third of these cases developed sepsis within first three days of life. Early onset sepsis was more frequently seen in neonates with history of assisted delivery or perinatal asphyxia. Overall mortality in these cases was 15.6%, being significantly higher in offspring of outside deliveries and normal vaginal deliveries, in preterm and LBW babies and slightly higher in presence of birth asphyxia. Only 15.3% CONS isolates were resistant to all routinely used antibiotics and sensitivity was maximum with gentamicin followed by ampicillin. A difference in sensitivity pattern of CONS causing EOS and LOS was also recorded.

Neonatal gastrointestinal perforation

During the 7-year period from 1980 to 1986, 56 neonates with gastrointestinal (GI) perforation were treated in the Hospital for Sick Children, London. The overall mortality rate was 30%. The highest mortality rate (60%) was associated with gastric perforation, which in this series occurred only in premature neonates. Colorectal perforation carried the lowest risk of mortality (17%). The mortality rate from small bowel perforation was 35%. Prematurity and low birth weight were significant factors increasing the mortality rate from neonatal intestinal perforation. The predominant cause of perforation in the small and large intestine was necrotizing enterocolitis and the most common site of perforation was the terminal ileum. Mechanical ventilation was thought to be the cause of the perforation in four of the five neonates with gastric perforation. Primary anastomosis is a definite option in neonates who are stable intraoperatively. The mortality rate and in-patient stay for neonates who had primary anastomosis were less than for those who had stomas.

Analysis of blood-culture isolates from neonates of a rural hospital

All blood culture reports obtained from newborns admitted in a neonatal care unit during 1983-87 were reviewed to determine the current bacteriological profile of neonatal septicemia. A total of 1160 neonates of high risk category or having clinical features suggestive of septicemia were subjected to blood culture study during this period. The culture positivity rate was 73%. Of these, 24.9% cultures were polymicrobial. Among the 1059, growths obtained, 60.1% were Gram negative, with Klebsiella, E. coli and Pseudomonas as the commonest pathogens. In Gram positive group, coagulase negative Staphylococci were most frequent, constituting 24% of the total isolates. An increasing incidence of coagulase positive Staphylococci and Pseudomonas infections was observed in recent years. Another significant finding was a comparatively high prevalence of Group D beta hemolytic isolates among streptococcal growths, with S. fecalis as the single commonest streptococci isolate.

Quantitative study of radioiodinated metaiodobenzylguanidine uptake in children with neuroblastoma: correlation with tumor histopathology

Six children with neuroblastoma and one with ganglioneuroma received [125I] metaiodobenzylguanidine (MIBG) before major surgery. Uptake of [125I]MIBG in the excised tissues was measured by scintillation counting, and the material was submitted for histopathology. The ranges of uptake of [125I]MIBG, expressed as percent of the injected dose per gram of tissue, were as follows: for neuroblastoma 0.0013-0.071, for ganglioneuroma 0.0017-0.0028, and for non-neoplastic control tissues 0.0002-0.011. The quantitative uptake of [125I]MIBG by neuroblastoma varied between different patients and between different parts of individual tumors. The more undifferentiated tumors took up more [125I]MIBG and may be more likely to respond to targeted radiotherapy with MIBG.

Hysteria in children and adolescents

Thirty eight cases of childhood hysteria admitted to a rural medical college hospital, were studied for epidemiological characteristics, clinical presentation, precipitating factors and psychosocial environment and behaviour. Hysteria was commonly seen during adolescence (73.2%) and in males (63.2%). It was more common in the lower socio-economic status (60.5%) and in children for nuclear (94.7%) and large size families (81.6%). Eldest or youngest siblings of the families were found to be more prone to develop hysteria. Motor symptoms were most frequently observed (71.1%) and 55.3% cases had more than one symptom at the time of presentation. In a majority of cases hysteria was acute in onset. Precipitating psychological event was identified in 81.6% cases; scolding (26.3%) being the commonest followed by school avoidance (13.2%), examination fear (10.5%) and quarrel with peers (10.5%). Past history of 52.6% of patients of hysteria and 18.4% of their parents revealed subtle behavioural abnormalities. All patients improved with psychotherapy and modification of the psychosocial environment.

Malignant rhabdoid tumour of the bladder with immunohistochemical and ultrastructural evidence suggesting histiocytic origin

A malignant rhabdoid tumour of the bladder is reported from a girl aged 6. Detailed immunohistochemical and ultrastructural investigations provide evidence which suggests a histiocytic origin for this controversial neoplasm.

Biliary atresia and meconium ileus associated with Niemann-Pick disease

A boy, and 10 months later his sister, presented in the neonatal period with meconium ileus. Both became jaundiced and were found to have biliary atresia and Niemann-Pick disease, type C. The causes of the meconium ileus were not established. Both died before the age of 6 weeks.

Noma neonatorum

Noma neonatorum is a gangrenous process involving oral, nasal and anal area and occasionally, the eyelids and scrotum. It is seen during the first few weeks of neonatal life. The disease is caused by P. aeruginosa and is usually fatal. Noma neonatorum should be distinguished from the regular noma as it comprises a distinct age group, clinical course, microbiology and prognosis.

Increased levels of plasma renin, aldosterone, catecholamines and vasopressin in chronic ambulatory peritoneal dialysis (CAPD) patients

Fluid excess can cause hyporeninemia and hypoaldosteronemia in hemodialysis patients. In six patients on CAPD, plasma renin activity (PRA) and plasma aldosterone (PA) were elevated to levels of : PRA 10.2 +/- 2.9 nl (1-5 ng/ml/h), and PA: 47.4 +/- 16.2 (normal 5-20 ng/dl). In 4 patients, data posthemodialysis and later during CAPD revealed that PRA increased from 0.9 +/- 0.3 to 14.1 +/- 4.6 and PA increased from 3.4 +/- 0.3 to 67.4 +/- 24.9 on CAPD (p less than 0.05). Mean arterial pressure was lower on CAPD and serum glucose was higher. No significant difference was seen in weight, hematocrit, BUN, or potassium, however. Plasma volume was not decreased in five CAPD patients: 3619 +/- 358 ml (predicted 3083 +/- 201 ml). Elevated catecholamine levels were seen in CAPD patients: norepinephrine 868.0 +/- 104.1 (normal 358.4 +/- 41.5 pg/ml), epinephrine 386.3 +/- 49.2 (normal 58.3 +/- 10.6 pg/ml). Plasma vasopressin levels were elevated to the range usually seen with hyperosmolality. In eight patients who lost or gained weight on CAPD, levels of PRA and PA changed as expected, but catecholamine levels did not correlate with weight changes. The data suggest that in CAPD patients, PRA and PA may be elevated in association with augmented sympathetic stimulation and elevated vasopressin levels. Serial observations demonstrated that PRA and PA can respond appropriately to changes in body weight, while catecholamine and vasopressin levels seem to be influenced by other factors.

The renin-angiotensin system is not responsible for hypertension following coronary artery bypass grafting

Systemic hypertension following coronary artery bypass graft (CABG) procedures has been reported to occur in 15% to 80% of cases. Previous reports have implicated the renin-angiotensin system as being responsible, at least in part, for this phenomenon. In this prospective study, 18 previously normotensive subjects were studied before, during, and after CABG. In 4 patients (22%), paroxysmal postoperative hypertension developed (systolic blood pressure greater than 150 mm Hg). There were no differences between the normotensive and hypertensive groups in plasma renin activity, angiotensin II level, or aldosterone level. Despite the trend toward elevation of these variables during cardiopulmonary bypass (CPB), all had returned to control levels within two hours after CPB, whether or not hypertension developed. Serum norepinephrine levels were elevated (.10 greater than p greater than .05) in the hypertensive group at the time hypertension developed. No other relationship or pattern could be defined to distinguish the hypertensive from the normotensive group. The renin-angiotensin system does not appear to be responsible for paroxysmal hypertension following CABG.

Congenital hypertrophic pyloric stenosis--a 20-year review of 282 surgically treated infants

A series of 282 children subjected to pyloromyotomy for congenital hypertrophic pyloric stenosis seen in the years 1961--1980 is presented. The various features relating to presentation, diagnosis and treatment are compared and contrasted in those treated in the first decade, 1961--1970 (series A) with those treated in the second decade, 1971--1980 (series B). It is noteworthy that there was an increased demand for radiological investigation in the second decade, and the fact that the number of patients diagnosed by radiological means only has doubled (from 9% to 19%) in the two series is probably a reflection of medical training and attitude. There was a marked decrease in the amount of post-operative vomiting during the second decade of this study and there was a slight tendency to earlier discharge from hospital in the latter years. The series confirms that congenital hypertrophic pyloric stenosis treated by pyloromyotomy has no mortality and only a minimal morbidity.

Pelviureteric obstruction in infancy and childhood. A review of 117 patients

A series of 135 kidneys with pelviureteric obstruction in 117 children is reviewed (a 16% incidence of bilateral obstruction). The majority (89%) of pyeloplasties or other reconstructive procedures were performed via an anterior transperitoneal approach which afforded excellent surgical exposure with a low (4%) incidence of related post-operative complications. Extra-renal drainage alone was preferred to nephrostomy in the majority of patients. Children presenting with bilateral hydronephrosis were managed by a single, simultaneous bilateral procedure rather than by 2 operations. The total nephrectomy rate of 5% compares favourably with the results reported by authors who favour an extraperitoneal approach and routine nephrostomy drainage.

Male contraception properties of a new synthetic steroid derivative (danazol) in Rattus rattus rufescens

Chronic administration of Danazol (25 mg/kg body wt) caused lesions in the testes of Rattus rattus Rufescens. Depletion of spermatocytes, spermatids and spermatozoa was conspicuous. Impairment of Leydig cell function was correlated with reduced cell size and depressed accessory sex organ weights. Epididymal cell height was greatly reduced. The lumen was devoid of spermatozoa. Danazol administration inhibited the synthesis of RNA, protein, sialic acid in the testes and accessory sex organs. Total cholesterol of the testes was increased, whereas the acid phosphatase enzyme activity was reduced. Testosterone propionate did not enhance the growth of accessory sex organs in castrated rats receiving Danazol. In conclusion, Danazol inhibits the system of steroidogenesis and spermatogenesis in Rattus rattus, when treated chronically for a period of 40 days. These effects are reversible after 60 days of cessation of drug administration.

Inhibition of spermatogenesis in house rat (Rattus rattus Rufescens) following the administration of alpha- chlorohydrin

Chronic administration of alpha-chlorohydrin (25 mg/kg body wt.) caused lesions in the testis of house rat. The changes in the germ cells were degenerative. The seminiferous tubules and Leydig cell nuclear diameter were reduced. Epididymal cell height was greatly reduced. The lumen was devoid of spermatozoa. alpha-Chlorohydrin administration inhibited the synthesis of RNA, protein, sialic acid in the testis and accessory sex organs. Total cholesterol of the testis was increased. Adrenal ascorbic acid depletion was conspicuous. alpha-Chlorohydrin anatagonizes the stimulatory action of testosterone in castrated house rats. alpha-Chlorohydrin can be considered as a biologically effective compound for the control of house rat population in human dwellings. It's dose dependent reaction is discussed.

The effects of light deprivation/blindness on testicular function of gerbil (Meriones hurrianae Jerdon)

1. Light deprivation either by enucleation or darkness resulted in a wide-spread testicular damage. The changes consisted of loss of type A spermatogonia, spermatocytes, spermatids and spermatozoa. 2. The atrophic testes of eyeless gerbils regenerated after 20 weeks and were indistinguishable from those of untreated, continuous light exposed animals. The reversible effects were not seen in continuous dark exposure. 3. Light deprivation (enucleation/continuous darkness) inhibits the synthesis of RNA, protein and sialic acid in the testes, epididymides and seminal vesicles. The testicular cholesterol and alkaline phosphatase activity was increased. 4. Haemoglobulin, haematrocrit and serum-transaminase levels were all the time within normal limits. Histological preparations of the liver showed normal architecture. 5. Reduced androgen production following a long term light deprivation was reflected in low levels of RNA and sialic acid in the testes and epididymides and shrunken Leydig cell nuclei. 6. In conclusion, light deprivation caused damage to the male genital tract of gerbils.

Liver dysfunction following whole-body Co-60 irradiation in gerbil (Meriones Hurrianae Jerdon) and house rat (Rattus rattus Rufescens)

Liver dysfunction following whole-body Co-60 irradiation has been studied in domestic and desert rat species. A significant elevation in the serum transaminases activity was noticed both in gerbil and house rat. Alkaline phosphatase and plasma cholesterol levels were also increased indicating an early radiation impairment of the liver tissue, which was later confirmed by histological studies. A steady fall in liver glycogen in irradiated gerbils was strikingly in contrast to an increase in irradiated house rat. Drastic depletion in liver glycogen, changes in the serum enzyme levels and the severity of the hepatic necrosis in gerbils point out that desert mammalian species are much more sensitive to radiation hazard as compared with domestic ones.

The effects of chemical occlusion of vas deferens on the testicular function of dog: a preliminary study

A new approach to rapid male sterilization was studies by giving a single injection of sclerosing chemical agents (10% silvernitrate, 3.6% Formaldehyde in ehanol, 5% potassium permagnate, 100% ethanol, and 3.6% Formaldehyde) directly into the vas deferens to determine whether blocking the vas has any adverse effects on the testicular function. 2 - Chemical occlusion of vas is quite effective in producing a block in the vas deferens of dogs. 3 - Ethanol injection in the vas deferens caused an atrophy of the testis. Extensive necrossis and exfoliation of the seminiferous elements were conspicuous. These changes increased in severity in 3.6% Formaldehyde in ethanol, 5% potassium permagnate, and 10% silver nitrate solution injected dogs. 4 - Decrease in the testicular contents of RNA, Protein and sialic acid, four weeks after vas occlusion were associated with degenerative changes of the spermatogenic elements. 5 - Testicular cholesterol and total lipids were increased following vas occlusion. 6 - Reduced sialic acid levels in the testis of vas occluded dogs indicates an inhibition of androgen production, which is further reflected in reduced leydig cell function. 7 - The role of vas deferens in determining the fate of a given testis is being discussed.