Congenital generalized lipodystrophy (a case report).
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Biomedical subjects
Publications and source records attributed to A Pandit.
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The study covers 78 children with typhoid fever who were hospitalized in April & May 1990. Serious complications were present in 32% (toxemia 22%, ileus 25% and myocarditis 8%). Blood cultures were positive in 30 of 49 tested. Others were diagnosed by positive Widal test. In vitro cultures of S. typhi were resistant to chloramphenicol (90%), ampicillin (93%) and co-trimoxazole (97%). However all were highly sensitive to ciprofloxacin and moderately sensitive to cephalexin and gentamycin. Ciprofloxacin alone or in combination was given in 73 of the 78 children and found to be remarkably effective in controlling the disease and preventing relapse. No serious side effects were noted. The cohort is being followed up for possible long term adverse effects.
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Seventeen children aged 3 weeks to 19 months with severe Protracted Diarrhea (PD), and who were deteriorating on our standard management protocol (including special diets) were given Parenteral Nutrition (PN) for 4 to 19 days with crystalline aminoacid solution (Vamin N) in 10% dextrose and lipid emulsion (Intralipid 10%). Peripheral lines were used in majority (84%). Enteral feeds were started early and rebuilt as per tolerance. The mean daily protein and caloric intake achieved by hyperalimentation was 2.2 +/- 0.7 g/kg and 106 +/- 41 K cal/kg respectively. Diarrheal control and improvement in nutritional status was achieved in all but 4 who died (2 of refractory diarrhea and 2 of sepsis, 1 of which was probably PN related). Other PN related, treatable complications included thrombophlebitis (11.8%), sepsis (17.6%), and metabolic imbalance (17.6%). PN solutions and accessories alone cost an approximate average of Rs. 280/day, with extras for biochemical monitoring (Rs. 70/day) and special nursing (Rs. 200/day). Only 5 of the 13 survivors had a significant relapse of PD, within 5 to 80 days of discharge, necessitating further PN in 2. There were no further deaths. PN was therefore, found to be of life saving value in 13 of 17 children with severe protracted diarrhea and therefore, must be available in specialised units caring for such children.
In this preliminary study, the wound healing response of full-thickness skin defects to transforming growth factor beta (TGF-beta) incorporated in a collagen scaffold was evaluated. The objectives of this study were (1) to compare the effects of TGF-beta on the cellular and tissue response and mechanical properties and (2) to determine the effects of a collagen scaffold on wound healing when compared to control. Three 3 x 3 cm, full-thickness defects were created on the dorsi of 15 New Zealand White rabbits. Each rabbit had a control (no treatment), collagen scaffold, and collagen scaffold with TGF-beta (2 microg/cm2). All the wounds were covered with a transparent polyurethane dressing. There were three periods of study (1, 2, and 3 weeks) with five rabbits in each period. The volume fraction of the tissue and cells was histomorphometrically determined for each wound. A greater inflammatory response was found in the collagen scaffold-treated group, but the fastest epithelialization and contraction rates were associated with TGF-beta and collagen. No significant differences in the mechanical strength between the different treatment groups were seen. Overall, TGF-beta delivered through a collagen scaffold enhanced the healing process and showed promise for future clinical applications.
Primary pancreatic lymphoma is rare. We report a young man with primary lymphoma in the pancreatic head who presented with obstructive jaundice.
A middle aged male patient presented with gradual distension of the abdomen. Imaging modalities showed classical features of pseudomyxoma peritoneii which was confirmed by aspiration cytology. Details of the case are described and relevant literature is reviewed.
BACKGROUND AND AIM: Oxidative stress could play a role in the pathogenesis of antitubercular drug (ATD)-induced hepatotoxicity. We therefore studied the plasma level of reduced glutathione (GSH) and malondialdehyde (MDA) in patients with ATD-induced hepatotoxicity (cases), ATD-treated controls (disease controls) and in healthy volunteers. METHODS: This study was carried out in a case-control design. Twenty-one cases, 21 age- and sex-matched disease controls, and 10 healthy volunteers were enrolled. Plasma levels of GSH and MDA were measured. RESULTS: Plasma levels of GSH (median [range] 11.5 [6.2-21.2] mmol/dL) and MDA (1390 [560-2310] nmol/dL) of cases were significantly different (p<0.01) from GSH (18.4 [10.5-24.4]) and MDA (290 [240-550]) of disease controls. Further, plasma GSH and MDA levels of both the ATD-treated groups were different from those in healthy controls. CONCLUSION: Lower levels of plasma GSH and higher levels of MDA may be due to oxidative stress resulting from ATD therapy.
BACKGROUND AND AIM: Bacteriological studies are necessary to confirm the diagnosis of tuberculous lymphadenitis, as cytological appearances mimic other granulomatous lesions. The objective was to assess the diagnostic role of culture of fine needle aspiration done on clinically suspected cases of tuberculous lymphadenitis and to determine the prevalence of drug resistance in M. tuberculosis isolates. SETTING AND DESIGN: A prospective, double-blind study over a period of one year in a tertiary care hospital. MATERIAL AND METHODS: Fine needle aspiration cytology and culture were done on 250 patients with clinical suspicion of tuberculous lymphadenitis. STATISTICAL ANALYSIS: Data was statistically analysed using chi square test. Sensitivity, specificity, positive predictive and negative predictive values and likelihood ratio were also calculated. RESULT: Of the 161 cytologically or microbiologically proven cases of tuberculous lymphadenitis, cytological changes consistent with tuberculosis were observed in 133 patients, out of which mycobacteria were isolated in 102 aspirates. Mycobacteria were also isolated from 28 aspirates cytologically missed as tuberculous lymphadenitis. Of the 130-mycobacterial isolates, 5 were non-tuberculous mycobacteria. Culture positivity was significantly higher (P<0.001) than smear positivity. Drug susceptibility studies showed resistance to one or more drugs in 61% of isolated strains with maximum resistance to isoniazid (16% primary and 48% secondary) and minimum to ethambutol (4% primary and 12% secondary). CONCLUSION: Culture for mycobacteria should be carried out on all aspirates from patients suspected with tuberculous lymphadenitis.
Data on 105 solitary thyroid nodules, confirmed at surgery to be solitary, is presented. Six (5.7%) were malignant, 4 papillary and 2 follicular. The sensitivity and the specificity of 131I radionuclide thyroid scan (n = 90) were 100% and 24% respectively. Similarly, the sensitivity and specificity of fine needle aspiration cytology (n = 65) was 75% and 100% respectively. In both instances, the "gold standard" was the histopathology of the surgically removed nodule. In order to avoid unnecessary surgery, without missing malignancy, we would recommend the combination of radionuclide thyroid scan and FNAC for investigation of solitary thyroid nodules.
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