Seasonal variation in the incidence of hyponatremia

AIM

To study the seasonal variation in the incidence of hyponatremia and to correlate it with the rainfall pattern.

METHOD

Retrospective analysis of patients having serum sodium of less than 120 meq/L was done during the 24 months from March, 1995. Patients with fever, renal failure, cardiac failure, cirrhosis, hyperlipidemia, hyperproteinemia, patients taking diuretics and postoperative patients were also excluded. Average inpatient number and rainfall for each month was noted. Daily incidence of hyponatremia was expressed as percentage of total inpatients for each day and was compared with the rainfall.

RESULTS

A total of 353 patients had hyponatremia during the two years from March, 1995; 174 cases during the first year and 179 during the second year. Average inpatient strength was 302.17 +/- 21.41 during the first year and 313.67 +/- 12.94 during the next year. The incidence of hyponatremia was 0.24 +/- 0.096% between June and August and 0.1 +/- 0.04% between December and February (95% confidence interval 0.045-0.235, p < 0.01). Statistically significant correlation was observed between rainfall pattern and hyponatremia, r = 0.711, 95% confidence interval 0.478-0.913, p = 0.01 during 95-96 and r = 0.825, 95% confidence interval 0.478-0.949, p < 0.001, during 96-97.

CONCLUSION

Incidence of hyponatremia is higher during the peak southwest monsoon season with similar pattern for the study period of two years. Humidity and temperature may have important role in the manifestation of hyponatremia.

A case of Haemophilus parainfluenzae pneumonia

A 41 year old woman presented with community acquired pneumonia (CAP) which failed to resolve following treatment with amoxycillin and cefaclor prior to referral. Quantitative culture of sputum revealed a pure growth of Haemophilus parainfluenzae and, following antibiotic susceptibility testing of the isolate, ciprofloxacin was prescribed resulting in resolution of the infection. Immunological investigations showed that the patient had a high titre of H parainfluenzae specific IgM. The combination of a pure growth of H parainfluenzae, a response to appropriate antimicrobial therapy, and the presence of a specific antibody response indicated that this organism had a pathogenic role in the patient's pneumonia and should be considered in the differential diagnosis of CAP.

Influence of smoking and hypertension on left ventricular mass

OBJECTIVE

The present study was designed to observe the influence of smoking and hypertension on left ventricular mass (LVM), both individual and the combined effect.

METHODS

This study was conducted in the Department of Medicine, SMS Medical College Hospital, Jaipur. Hundred patients were included in the study. They were divided into four groups--non smoker normotensives, non-smoker hypertensives, smoker normotensives and smoker hypertensives. They were also divided into smokers and nonsmokers and hypertensives and normotensive. Patients of age group 31-65 years of both sexes were chosen. Patients with secondary hypertension, diabetes mellitus, dyslipidemia, cardiomyopathies, valvular heart disease women on oral contraceptives were excluded from the study on the basis of history and relevant laboratory tests. An M-mode echocardiography was done and the LV mass was calculated by the formula proposed by Devereux et al. LV mass = 0.8 [1.04 (IVSd + LVIDd + LVPWd)3 - (LVIDd)3] + 0.6 gms

RESULTS

The mean LV mass (in gms) in the four groups of nonsmoker normotensives, nonsmoker hypertensives, smoker normotensives and smoker hypertensives are 106.77 +/- 25.78, 165.3 +/- 42.55, 154.53 +/- 24.6 and 228.78 +/- 56.88 respectively. The comparison of mean LV mass (in gms) of smokers and nonsmokers were 191.66 +/- 40.74 and 136.04 +/- 36.16 (P < 0.001) respectively. The comparison of the mean LV mass (in gms) of hypertensives and nonhypertensives were 197.25 +/- 49.72 and 126.29 +/- 25.19 (P < 0.001) respectively. Comparison of the mean LV mass (in gms) of patient with two risk factors i.e., smokers hypertensives with patients without any risk factor i.e., nonsmoker normotensive were 228.78 +/- 56.88 and 106.77 +/- 25.78 (P < 0.001) respectively. While comparison of the mean LV mass (in gms) of patients with one risk factor each i.e., smoker normotensives and nonsmoker hypertensives were 165.3 +/- 42.55 and 154.53 +/- 24.6 (P < 0.05) respectively.

CONCLUSION

Both smoking and hypertension cause an increase in LV mass, hypertension causing a more increase, than smoking, individually. Both smoking and hypertension combine together to increase the LV mass, more than either of them individually. Smoking by itself can cause an increase in LV mass independent of hypertension.

Psychogenic elaboration of simple partial seizures

Seizures that cause loss of consciousness (LOC) can be classified as epileptic or nonepileptic based on evaluation of ictal semiology and analysis of changes in EEG events, recorded with continuous scalp EEG and video monitoring. We report 3 patients who had hippocampal electrographic seizures documented with intracranial EEG recording with no accompanying scalp EEG change immediately preceding psychogenic unresponsiveness. Each patient also had complex partial seizures (CPS) originating in the hippocampus. Some individuals can have complex interactions of epileptic and nonepileptic seizures.

Automation of the Maxam-Gilbert chemical sequencing reactions

A practical automated method of Maxam-Gilbert chemical sequencing reactions that uses solid-phase chromatography methods to purify DNA following chemical modification and cleavage is described in this report. The automation has primarily been made possible by using specially designed BioPak mini-columns, compatible with the Biomek 1000 automated workstation, which can be utilized in a manner similar to that of standard pipet tips. This automated chromatographic sequencing method produces rapid and reliable data as verified by sequencing a known human factor IX exon VIII gene fragment. The procedure presented in this report is a prototype for a single-fragment reaction and can easily be expanded to perform reactions on as many as 8 fragments at a time. The automation eliminates the tedious and time-consuming steps in the original method and increases the rate of sequence acquisition. This technology makes the Maxam-Gilbert chemical sequencing protocol more accessible, especially in large-scale, automated sequencing projects.

Interleukin 3 is a growth factor for human follicular B cell lymphoma

More than one-half of adults with non-Hodgkin's B cell lymphomas present with low-grade follicular lymphomas. These tumor cells are found in close association with follicular T lymphocytes and dendritic cells, suggesting that the surrounding cells may play a role in the support of follicular tumors. Supernatants from activated human peripheral blood lymphocytes were found to promote the in vitro proliferation of follicular tumor cells. This effect was entirely due to interleukin 3 (IL-3), a factor generally thought to cause the growth and differentiation of immature hematopoietic cells. IL-3 receptors were detected on fresh isolates of all primary follicular cell tumors examined. These findings suggest that follicular cell tumors may be dependent in vivo on IL-3 and that therapies directed against IL-3, its receptor, or the T cells that produce it may be effective treatment for follicular lymphoma.

Microbiological study of urethritis in men attending a STD clinic

A microbiological study of 275 male patients suffering from urethritis and 100 healthy male controls showed that Neisseria gonorrhoeae (130), Ureaplasma urealyticum (81), Staphylococcus aureus (38), and alpha and beta streptococci (34) were the common isolates. Specificity and sensitivity of the direct fluorescent antibody technique in the detection of N. gonorrhoeae in 130 urethral samples, were found to be 100 per cent. Penicillin (10 units/disc) resistance was found in 36.93 per cent of N. gonorrhoeae. Minimum inhibitory concentration of penicillin for 75 isolates of N. gonorrhoeae (including 5 beta lactamase producers) varied from 0.01-5 micrograms/ml with a 95 per cent confidence limit range of 0.26-0.61 microgram/ml. Most of the N. gonorrhoeae isolates tested were sensitive to norfloxacin and spectinomycin. Inclusion bodies of Chlamydia trachomatis were observed in 25 patients.

HLA linked resistance factors and survival in acute myelogenous leukemia

The concept that HLA-linked immune response genes may influence survival of patients with malignant disease has been investigated by performing HLA typing on a series of 150 patients with acute myelogenous leukemia. Patients with A1 and B8 and/or A2 and B12 survival longer than patients without either of these pairs of antigens in association. However, after correction of the statistical probability for the number of A and B locus combinations theoretically possible, these differences are not statistically significant. Clarification of this must await independent analysis of other series and more direct approaches to the study of immune response genes in man.

Root apical organization in gymnosperms : Root apex of Ephedra foliata, with a suggestion on the possible evolutionary trend of root apical structures in gymnosperms

The roots of Ephedra foliata have a long cap. The root apical meristem can be distinguished into (1) a discrete layer of stelar initials, (2) the columella and its initials, and (3) a common initiating region for the cortex and the peripheral region of the cap. The study of the cell lineages brings out that the first zone and its derivatives show a "Körper" complex of cells, the second and its derivatives divide in a transverse plane, and the third zone exhibits the "Kappe" complex.This organization resembles the "gymnospermous" type mentioned in the older literature in the discreteness of the "plerome".A possible line of evolution of the root apical structures of gymnosperms is suggested.

Convection and fate of mitochondria in nerve fibers: axonal flow as vehicle

Images