Congenital Hepatic Arteriovenous Malformation Presenting as Isolated Massive Hepatomegaly in an Otherwise Healthy Neonate: A Case Report

Congenital hepatic arteriovenous malformations (HAVMs), though rare, carry high morbidity and mortality rates if left undiagnosed. The usual clinical presentation is in infancy with congestive heart failure, anaemia and hepatomegaly. There are reports of presentation as persistent pulmonary hypertension in newborns and reports of their spontaneous regression as well. We describe a healthy full-term neonate with HAVM who was presented with isolated massive hepatomegaly and underwent surgical ligation.

Fine needle diathermy - a choice for managing corneal vascularization

INTRODUCTION

Corneal vascularization develops as a result of various corneal diseases. Fine- needle diathermy (FND) is one of the methods to occlude corneal vessels.

OBJECTIVE

To evaluate the efficacy and safety of this method in a series of patients with corneal vascularization.

MATERIALS AND METHODS

Twenty eight patients with corneal vascularization were treated with FND. The patients were divided into four groups according to etiological factors like pre-keratoplasty (high risk patients), increased keratopathy, recurrent inflammation and postkeratoplasty rejection .The FND was performed under local anaesthesia with the help of a corneal needle of 10-0 monofilament nylon suture. The success of treatment was evaluated in terms of regression and occlusion of corneal vessels.

RESULTS

The main aim of a complete occlusion of blood vessels was achieved in all patients. The most frequent complication seen was a transient whitening of the cornea especially around the needle entry in nine cases, which cleared within 24 hours.

CONCLUSION

FND is a simple safe, inexpensive and effective treatment. It can be repeated and used as an alternative therapy for corneal vascularization.

Effects of psychosocial interventions on motor speed and accuracy of chronic positive, negative, and mixed symptom schizophrenics

Clinical data suggests that schizophrenic patients have an impaired ability to carry our purposeful activities which were previously self-regulative. Schizophrenic psychomotor performance is consequently slow and deliberate, and readily interfered with. This impairment often leads to frustration and despair in the patient as well as in caregivers, and interferes with the rehabilitation process. Psychological interventions in the form of performance contingent verbal feedback and planned interpersonal interaction in small groups were introduced, and were found to ameliorate motor deficits to a significant extent. Implications for patient motivation, well being and rehabilitation are discussed.

Effects of intravenous metoclopramide in 81 patients with tardive dyskinesia

We compared acute effects of single intravenous administrations of metoclopramide (40 mg) and placebo in a double-blind crossover study involving 81 patients with tardive dyskinesia. Metoclopramide produced significantly greater reduction in mean total Abnormal Involuntary Movement Scale score as well as in ratings for six of the seven body areas, when compared with placebo. On adjusting each patient's metoclopramide response for his or her placebo response, we found that 35 of the 81 patients had 50% or greater placebo-corrected improvement. There were no apparent clinical differences between metoclopramide responders and nonresponders. Administration of 60 mg of metoclopramide to 15 patients produced greater improvement in tardive dyskinesia as compared with 40 mg; the incidence of acute dystonia, however, jumped from 10% with 40 mg to 33% with 60 mg.

Tardive dyskinesia in India: a prevalence study

We screened the entire inpatient population (N = 1963) of a state hospital near Bombay, India, for tardive dyskinesia (TD) using specific diagnostic criteria. Prevalence of TD was found to be 9.6%, which was much lower than that reported from the Western countries. Percent prevalence of TD was greatest in the age group 41 to 50, after which it seemed to decline. TD patients had received neuroleptic treatment for significantly longer periods and in significantly greater amounts than non-TD patients. The principal reason for the relatively low prevalence of TD in India is probably the practice of using neuroleptics in comparatively small doses (mean daily dose is about 200 mg of chlorpromazine equivalents). A possible contribution of racial-genetic factors cannot be excluded.

Cross-cultural study of a biochemical abnormality in paranoid schizophrenia

We studied 24-hour urinary excretion of phenylethylamine (PEA) and creatinine in 50 schizophrenic (39 paranoid and 11 nonparanoid) and 19 nonpsychiatric patients from Bombay, India. Methods for diagnosis, clinical assessment, and 24-hour urine collection were identical to those used in an earlier study done in a Washington, D.C. hospital. Clinical evaluations were done in Bombay, while urinary PEA and creatinine estimations were performed at NIMH, Washington, without knowledge of the subjects' identify. Paranoid schizophrenic patients had significantly greater 24-hour urinary excretion of PEA than both nonparanoid schizophrenic patients and nonpsychiatric controls. The mean amount of PEA per g creatinine in urine was also highest of paranoid schizophrenic patients. Our findings provide cross-cultural support to the possibility of abnormal PEA metabolism in at least some patients with paranoid schizophrenia.