Showing papers in "Journal of Postgraduate Medicine in 1989"

Immunotherapeutic modulation of intraperitoneal adhesions by Asparagus racemosus.

Abstract: The hypothesis that macrophages appear to play a pivotal role in the development of intraperitoneal adhesions and that modulation of macrophage activity, therefore, is likely to provide a tool for prevention of adhesions, was tested in the present study. Effect of Asparagus racemosus, an indigenous agent with immunostimulant properties, was evaluated in an animal model of intraperitoneal adhesions induced by caecal rubbing. Animals were sacrificed 15 days following surgery. The peritoneal macrophages were collected to assess their activity. At the same time, peritoneal cavity was examined for the presence of adhesions, which were graded. A significant decrease was observed in the adhesion scores attained by animals receiving Asparagus racemosus. This was associated with significant increase in the activity of macrophages (70.1 +/- 2.52), compared to that in surgical controls (53.77 +/- 10.8). These findings support our hypothesis and provide a novel approach for the prevention and management of post-operative adhesions.

Spectrum of histological lesions in 185 consecutive prostatic specimens.

Abstract: One hundred and eighty five consecutive prostate specimens were studied. The predominant lesion noted was benign prostatic hyperplasia (B.P.H.) (92.97%). The incidence of carcinoma was low, (7.02%). Conditions which can mimic and should be considered in the differential diagnosis of carcinoma, like basal cell hyperplasia, atypical hyperplasia and atrophy associated hyperplasia were noted in 10, 4 and 3 cases of B.P.H. respectively. None of these cases showed evidence of carcinoma. Corpora amylacea were noted in 38.91% of the cases of B.P.H. and were conspicuously absent in cases of carcinoma. Chronic prostatitis was frequently encountered (58%) and metaplastic changes were seen in 11% of the cases.

Pattern of leukemias: a ten-year incidence study of 242 cases.

Abstract: This paper presents an analysis of data collected from 242 cases of acute and chronic leukemia observed during a 10-year period. The incidence of childhood leukemia was 26.45%. In the present series, it was 35.95% for ALL, 21.9% AML, 38.4% CML and 2.89% CLL. The incidences of ALL and CML were found comparable to other series from Bombay. The geographical variations in the pattern of leukemias as observed in India are discussed.

Bombay experience in intensive respiratory care over 6 years.

Abstract: The experience of the intensive respiratory care in 930 cases treated from 1983 for 4 years and in 404 cases over the next 2 years is reported. The background operational problems are stressed. Those between age 10 and 50 years did significantly better (p less than 0.05). The survival over the first 4 years in IPPR cases was 16.3% and in non IPPR group 71.8%; over the next 2 years, the former group, survival was 32.4 and 36.3%. The survival in asthmatic patients was high (76%). In cases with organophosphorus poisoning (without IPPR), survival was 81% while in IPPR group it was 29%. In 1988, the results in this group were better due to more aggressive management. In autopsy data on 85 cases, infection was not a major feature in those dying within 24 hours. The survival in COPD cases showed significant relation to age (p less than 0.05), initial arterial pO2 below 60 mm (p less than 0.01) and arterial pH below 7.3 (p less than 0.01). In cases with pneumonia (also asthma) younger cases did better (p less than 0.05) as also those with pneumonia and initial pO2 above 60 mm (p less than 0.01) and pH above 7.3 (p less than 0.001). When pneumonia was community acquired, survival (64.8%) was better than when it was hospital acquired (24%; p less than 0.01). Only the need for IPPR affected survival in trauma group. The major cause of death was infection with Klebsiella, Pseudomonas, Staphylococci and other gram--ve organisms. It is concluded that with proper planning and training, the IRCU does provide a useful mode of treatment in selected patients with respiratory problems.

Xanthogranulomatous pyelonephritis--(a clinicopathological study of 15 cases)

Abstract: The clinico-pathological features of 15 patients with xanthogranulomatous pyelonephritis (XGP) are described and the probable histogenesis is discussed. Based on our data and the review of literature, we believe that XGP should be regarded as a destructive and at times tumefactive inflammatory process that may complicate chronic pyelonephritis. The initiation of this process remains obscure, but the features commonly associated with XGP are pelvi-calyceal obstruction, ulceration of the pelvic urothelium with collection of necrotic material and bacterial infection.

Chloramphenicol resistant Salmonella species isolated between 1978 and 1987.

Abstract: During the ten year study i.e. 1978 to 1987, out of 53,251 cases of suspected enteric fever, S.typhi was isolated from 4005 cases (7%) and S.para typhi 'A' from 1108 cases (2.5%). A total of 52 strains of S. typhi and 4 strains of S.para typhi 'A' were found to be resistant to chloramphenicol. Minimal inhibitory concentration was greater than 256 micrograms/ml of all the strains of S.typhi and S.para typhi 'A'.

Littre's hernia in a child--an operative surprise (a case report).

Abstract: The incidence of Littre's hernia in children is unknown. The diagnosis is usually made at operation or autopsy. One case in an eight month old infant is described. Heterotropic mucoglandular tissue causing nodularity and adhesions was noted in the diverticulum. Though histological findings in Littre's hernia are not mentioned in previous reports, we believe that Littre's hernia could often be associated heterotropic mucosa.

Post-puerperal Cu-T insertion: a prospective study.

Abstract: One hundred and sixty eight consecutive women accepting copper T (CuT) intrauterine contraceptive device in the post-puerperal period were studied. Out of them, 63 could be followed after 6 weeks of insertion and 65 after 6 months of insertion. The risk of heavy bleeding, pain in abdomen etc. were no greater than those usually found when interval CuT insertion is carried out. There was no case of uterine perforation leading to migration of CuT. But the expulsion rate was found to be high i.e. 16.4%. CuT is a very useful post-puerperal contraceptive method and should be given more importance in MCH programme.

Role of pulsed electromagnetic fields in recalcitrant non-unions.

Abstract: Twenty-nine patients of recalcitrant nonunion of long bones were treated by pulsed electromagnetic fields in an attempt to bring about osteogenesis The pulse used was rectangular, equal mark space wave in the astable, continuous mode operating at a frequency of 40 Hertz The success rate was 825% The result was not dependent on the age, sex, time of nonunion or the presence of infection However, the results were uniformly poor when infection and fracture instability were coexistent in the same patient

Hydatid disease of the thyroid gland--(a case report).

Abstract: Hydatid disease of the thyroid gland, presenting as a solitary thyroid nodule, is being reported below. Pre-operative investigations, including thyroid isotope scanning and aspiration of the nodule, did not help in establishing the diagnosis which was later confirmed by histological examination. Post-operative investigations revealed it to be an isolated involvement of the thyroid gland.

Fatal outcome of group-G streptococcal meningitis (a case report).

Abstract: An adult woman developed meningitis caused by Group-G streptococci. The organism was successfully isolated both from blood and cerebrospinal fluid of the patient. The woman succumbed to infection despite an appropriate antibiotic therapy.

Peritoneal encapsulation of small bowel--(a case report).

Abstract: Peritoneal encapsulation is a rare congenital anomaly. Its occurrence in a female and association with intestinal obstruction are even rarer features which were present in the reported case.

Solitary rectal ulcer of tuberculous origin (a case report).

Abstract: We report our experience in diagnosing a case of anal tuberculosis which presented with an ano-rectal ulcer. The necessity of careful study in differentiating the lesion from carcinoma has been illustrated.

Ossifying lipoma of the thigh (a case report).

Abstract: The term ossifying lipoma is used to describe a rare case of lipoma when its mature adipose tissue shows foci of chondrification and ossification. We are presenting here, a case report of a large sized ossifying lipoma in the anteromedial compartment of the left thigh of a 55 year old farmer.

Anti-convulsant therapy in eclampsia.

Abstract: Seventy four patients presented with eclampsia at N.W.M. Hospital. Bombay. Among the patients with eclampsia, 64.9% were primis, 29.7% were gravida II-IV and 5.4% were grand multis. As many as 40.5% patients were less than 20 years of age, while 2.7% were over 30 years of age. 48.7% had antepartum convulsions, 40.5% had intrapartum convulsions, while 8 patients convulsed in the postpartum period. Besides standard management of eclamptic patients, 3 protocols of anticonvulsant therapy were utilised. 27% were managed with diphenyl hydantoin sodium, 43% with magnesium sulphate, and 30% by combination of diazepam and pentazocine. The maternal and perinatal outcome was evaluated. Control of convulsions was superior with magnesium sulphate while perinatal outcome was best with diphenyl hydantoin.

Lochiauria: a new entity--(a case report).

Abstract: Passage of menstrual blood only in the urine is termed as menouria, which is due to a supraisthmic utero-vesical fistula Passage of lochia in the urine, instead of through the cervix has not been described in the literature A case is described, and has been labelled lochiauria

Cryoglobulin studies in systemic lupus erythematosus.

Abstract: Twenty-two patients with systemic lupus erythematosus (SLE) were investigated to study the incidence and immunochemical nature of circulating immune complexes. In 68.18% of patients, the immune complexes were detected as cryoglobulins. A significantly high value of serum IgG and IgA (1980.64 +/- 1031.53 and 283.81 +/- 131.02 mg% respectively) were observed in these patients compared to those in normal (1097.04 +/- 298.10 and 200.93 +/- 89.96 mg% respectively). The patients also had significantly low levels of serum complement fraction C3 (61.35 +/- 22.64 mg%). Correlation of these parameters could help in understanding of the role of immunochemical factors in the pathogenesis of the disease.

A random plasma glucose method for screening for gestational diabetes.

Abstract: Low renal threshold for glucose during pregnancy renders glycosuria less specific for the diagnosis of gestational diabetes. Screening for gestational diabetes was done by utilising random plasma glucose (RPG). RPG was done at the first antenatal visit. In 12,623 patients who registered for antenatal care at the N.W.M. Hospital, 1371 patients had a RPG more than 100 mg%. An oral glucose tolerance test was advised in these patients. The pick-up rate of gestational diabetes correlated with RPG level. Thirty-six cases of gestational diabetes were picked up. The pick up rate is significantly higher as compared to that which would have been detected utilising conventional screening criteria.

Nosocomial infections due to Acinetobacter calcoaceticus.

Abstract: Fifty four isolates of Acinetobacter calcoaceticus were studied in a period of 6 months. Maximum isolates were from burns cases and environmental sampling from burns ward also grew the same organism, indicating their role as nosocomial pathogen. Acinetobacter may initially be mistaken for Neisseria species. As the organisms show multidrug resistance to commonly used antibiotics their correct identification is important.

Socio-demographic features of cannabis and heroin abuse in Bombay.

Abstract: A study of socio-demographic features of 680 cannabis and heroin addicts showed that the factors like, age, religion, family structure, peer groups and the easy availability of these drugs contribute to the problem of addiction.

An unusual case of hip disability--(a case report).

Abstract: An unusual case of postero-superior periarticular irritation of the hip joint of six months' duration due to an extension of a pre-sacral foreign body granuloma in an 18 year old unmarried girl is presented. Two wooden sticks which probably were inserted pervaginally by a village midwife to induce an abortion for an unwanted pregnancy had found its way to presacral region. The scanning of the vaginal fornix indicated a possible route through which the sticks might have been migrated.

Laparoscopic retrieval of transmigrated IUDS (report of 3 cases).

Abstract: Three cases in whom transmigrated IUDs were removed with operative laparoscope are presented.

Continuous passive motion for prevention and rehabilitation of knee stiffness--(a clinical evaluation).

Abstract: This is a study of 43 knees in 42 patients, in whom a continuous passive motion was used to prevent stiffness of the knee and to assist restoration of a range of motion for a variety of disorders of the knee joint. CPM was given for an average of 6 hours daily in split sessions for a total duration of 3 weeks. Various clinical parameters were maintained and a scoring system was designed. It was observed that CPM caused little or no pain and elicited excellent patient compliance. There was a rapid subsidence of edema and effusion and a shorter hospital stay. 83% of cases had excellent or good results. There were no adverse effects, but there were a few minor complications. The study revealed that CPM is a valuable component of the therapeutic programme for preventing knee stiffness and aiding the speedy restoration of joint function without compromising healing of tissues.

Prevalence of antibodies to aspergilli in bronchial asthmatics.

Abstract: Sputum and bleed samples were analysed from 330 cases of bronchial asthmatics and 50 normal persons without features of bronchial asthma. The prevalence of aspergilli and antibodies to different Aspergillus species were detected using cultural methods and serological technique like agar gel double diffusion (DD), counter-immuno-electrophoresis (CIEP) and enzyme-linked immunosorbent assay (ELISA). Out of total 6.06% yielded Aspergillus species in sputum specimens repeatedly. Precipitins against Aspergillus species were detected in 7.88% of cases by DD and CIEP. ELISA test showed 20% of cases to be having antibodies to A. fumigatus. Allergic broncho-pulmonary aspergillosis can be detected in the early course of the disease in bronchial asthmatics using highly sensitive technique like ELISA.

Immunoprofile of pulmonary tuberculosis-comparison with normal healthy controls.

Abstract: The immunoprofile of 60 adult patients of pulmonary tuberculosis was studied and compared with 22 normal controls. The immunological parameters studied were serum protein electrophoresis, serum immunoglobulins (IgG, IgA and IgM), delayed hypersensitivity by Mantoux test, and T-cell % estimation. The mean total serum proteins and serum albumin were significantly lower, whereas mean beta and gamma globulins were elevated. Mean serum IgG and serum IgA showed a significant rise, whereas the T-cell % was significantly reduced when compared to controls. The significance of these findings is discussed.

Di-George's syndrome with multiple infections (an autopsy report).

Abstract: Di-George's syndrome is a rare condition of congenital immunodeficiency. An infant presented as hypocalcemic tetany with multiple infections. Autopsy confirmed the hypoplasia of thymus and thyroid associated with other anomalies. A brief of the relevant literature is presented.