Sinocranial aspergillosis: a form of central nervous system aspergillosis in south India

Of the 21 patients with aspergillosis of central nervous system seen during the years 1990-1997, 16 (76%) had aspergillosis of sino-cranial origin. The occupation in patients with sino-cranial aspergillosis was either agricultural or manual work and predisposing risk factors were present in only two (12.5%) patients. Skull-base syndromes were the presenting features in 13 patients and three patients presented with features of intracranial space-occupying lesion. Paranasal sinus mass lesions were seen in all the 16 patients. Computerized tomography showed intracranial extradural-enhancing mass lesions in the anterior, middle or posterior cranial fossa in nine (68%) patients, intracranial and orbital lesions in four and orbital lesions in three. Well-formed granuloma with dense fibrosis was the histological feature. Survival rates were not good even after surgical and antifungal chemotherapy. Surgical treatment was subradical in our series. The majority of cases of sinocranial aspergillosis are reported from countries with temperate climates and the high incidence in these regions is probably related to constant exposure to the high spore content of pathogenic Aspergillus species in the 'mouldy' work environment.     

Primary mediastinal hydatid cyst

An unusual case of primary mediastinal echinococcosis in a young female presented with non-specific symptoms. On examination, she had signs of Horner's syndrome and mild superior vena cava compression. She was operated successfully. The final diagnosis could only be made on the operating table and confirmed by histopathology. Hydatid cyst in mediastinum is uncommon but because of surrounding vital structures and potential of its complete cure should be explored without delay.     

Raised serum thiobarbituric acid reactive substance levels in malaria

To study the extent of serum lipid peroxidation in malaria, 62 patients of falciparum malaria (18 uncomplicated and 44 complicated), 15 patients of vivax malaria and 25 healthy controls were enrolled in this study. The extent of serum lipid peroxidation was evaluated by estimating serum thiobarbituric acid reactive substances (TBARS) colorimetrically. The mean serum TBARS levels were 1.5 +/- 0.29, 1.21 +/- 0.2 and 3.58 +/- 1.35 nmol/ml in controls, vivax malaria and falciparum malaria patients respectively. The TBARS level was significantly more in complicated falciparum malaria patients (4.2 +/- 1.03 nmol/ml) than uncomplicated falciparum malaria patients (2.01 +/- 0.61 nmol/ml). The TBARS level was also more in patients who died (4.82 +/- 0.64 nmol/ml) when compared to the survivors (2.92 +/- 1.05 nmol/ml).     

Critical evaluation of Usher's criteria in the assessment of gestational age

Summary 1020 neonates born in the State Zenana Hospital, Jaipur, were studied for evidence of prematurity according to various criteria. The data obtained were recorded and analysed. Special emphasis was laid on the clinical criteria evolved by Usher. The incidence of prematurity, in these 1020 cases, according to the various criteria was determined: Weight up to 2,500 G. 55.6%, crown-heel length less than 47 cm. 52.5%, crown-rump length less than 32 cm. 72.9%, head circumference less than 33 cm. 53.9%, difference between head and chest circumference more than 3 cm. 25.9%, gestational age as evolved by history 16.8%, and clinical criteria of Usheret al. (1966) 13.2%. A comparison of the reliability of the above criteria was made with known gestational age, a definitive criterion. It was found that Usher's criteria were the most reliable for the diagnosis of gestational maturity, next to an accurate history of the gestational age. From the Neonatal Unit, Department of Paediatrics, S.M.S. Medical College, Jaipur.     

Behavioural development of Indian infants from birth to six months

Summary Observations regarding behavioural growth of infants studied longitudinally from birth to six months, are reported. It was seen that the infants in our study were more advanced in behavioural development, than those of more advanced countries. None of the infants with above average birth weight had delayed milestones. The infants with less than average birth weight had delayed milestones during the first quarter, but caught up with the rest, during the second quarter. A positive relation between quarter weight increments and attainment of be haviour manifestations was found in both quarters. Poor socio-economic conditions, and lack of education in the mother adversel affected the behavioural development during the first quarter, but not in the second quarter. The minor and moderate illnesser recorded seemed to have a somewhat adverse effect on the developmental mile stones.     

The pony as an animal model for vascular implants

This study evaluated the pony as a potentially suitable model for vascular implant research. Healthy, conditioned ponies were randomly assigned to one of three groups: group I, carotid artery autografts (n = 6); group II, e-PTFE carotid interpositional grafts (n = 5); and group III, e-PTFE carotid interpositional grafts plus aspirin (10 mg/kg) and dipyridamole (3.5 mg/kg) drug administration. It was found that autografts remained patent longest (mean = 396.2 days; grafts were still patent at time of writing) followed by group III grafts (157.5 days), with group II grafts remaining patent for the shortest duration (61.1 days), (p less than 0.01). Patency was determined using two-dimensional real-time ultrasonography with Doppler velocimetry and/or arteriography. It was demonstrated that the pony's response to antithrombotic drugs was consistent and comparable to that in other animal models, both with respect to platelet function and affect on patency rate. The combination of the ease of surgical manipulation, drug administration, and platelet function testing, the comparable size of the pony and its heart and blood vessels to that of an adult human, the long life span of ponies, and the patency results of this study have demonstrated that the pony is a valuable animal model for vascular research.     

Immunopathological correlation with lymph node metastasis in squamous cell carcinoma of larynx and pharynx

In this study, the commonest malignancy was supraglottic carcinoma (12 of 17 cass). Mostly (94%) our patients were males. Histologically moderate or poorly differentiated squamous cell carcinoma was the commonest tumour. Thirteen of 17 (76%) cases had secondaries in neck and bilateral secondaries were seen only in supraglottic carcinomas. Cases with post cricoid involvement (absent laryngeal crepitus) had metastasis in neck in 90% of cases. DIMCB and PHA skin reactivity did not reveal any difference between the cases with secondary tumours and those without secondaries in neck (P>0.05). Absolute lymphocyte count (A.L.C.) was found to be significantly increased in the former group (P<0.05).     

Anxiety in Mothers of Infants on Apnea Monitors

Mothers of 62 infants on apnea monitors (M) and 72 nonmonitored (NM) infants completed questionnaires describing their anxiety upon leaving the hospital, at 1 to 3 month follow-up, and at postmonitoring (or 3 to 6 month followup) A modified version of the Start-Trait Anxlety lnterval (STAI) assessed general (trait) anxlety as well as anxiety in two situations infant sleepmg with parents and infant sleeping alone Both NM and M mothers reported high anxiety about infant sleeping alone, while M mothers reported higher anxiety than NM mothers about the infant sleeping alone No differences in trait anxiety were observed lnterpretation was qualified due to initial group differences in demographics.     

An eleven-year review of the pharmacy literature: documentation of the value and acceptance of clinical pharmacy

The primary objectives of the article were accomplished by providing both a bibliography of articles dealing with clinical pharmacy services in acute-care facilities and summaries of those constituting original research reports on clinical pharmacy services. However, in the process, we made the following interesting observations. We found that articles reporting impacts on cost, quality, and attitude numbered 48, 58, and 24, respectively. Most articles relating to drug therapy monitoring, with minor exceptions, dealt with either the quality or cost-savings impact or a combination of both. Also, articles concerning drug therapy monitoring comprised almost half of all those summarized (40 articles). Articles detailing drug information and education (category 2) numbered 28 and dealt mainly with attitudes or quality impacts with minor reference to cost-savings. It was also interesting, albeit expected, to observe that the bulk of attitudinal studies fell in category 2. We found category 5, controlling medication administration, had 13 articles, primarily concerned with cost and or quality. Category 4, reporting and detection of adverse drug reactions, contained a total of eight articles mainly studying the impact on quality. The other categories contained very few, if any, articles. From these results, it is evident that the profession has made significant strides in building a strong scientific data base to support the value of its clinical services. However, there is ample room for additional original research reports. Although it can be argued that alone many of the studies could not justify clinical pharmacy as cost-effective, organized as one reference they provide an invaluable resource. Although it might be unreasonable to expect each pharmacy department to be able to cost-justify its existence, this work presents the background data needed to begin or develop such efforts.