Neurological complications of brucella spondylitis.

Twenty-two patients with brucella spondylitis and neurobrucellosis were studied during a 2-year period. The diagnosis was based on history of exposure, compatible signs and symptoms, high antibody titre and/or positive culture of a clinical specimen(s). Spondylitis was confirmed by plain radiographs, bone scan, CT and in some cases by histology. Neurobrucellosis was confirmed by CSF examination and culture, myelography, NCV, EMG and CT head. The spondylitis was early in 4 cases, chronic active in 12, smouldering "partially healed" in 3 and healed in 3 cases. Of these, 15 patients (68%) had neurological complications of various types. Plain radiographs were not a good index of activity of spondylitis. Tc99 bone scan was not specific and it remained positive long after the completion of therapy. CT was superior in revealing details of bone destruction, soft tissue swelling and entrapment of nerve roots and cord. The 3 modalities were complementary. Spondylitis is commonly associated with neurobrucellosis and symptoms of one may over shadow those of the other and in some cases neurobrucellosis may be subclinical. In all cases of spondylitis, a thorough search for neurobrucellosis should be made and vice versa. Prolonged treatment with a combination of 3 anti-brucella drugs is recommended and prolonged follow-up is necessary.

Brucella meningitis: presentation, diagnosis and treatment--a prospective study of ten cases.

Diagnosis of brucella meningitis was made in 10 patients by serological tests on blood and cerebrospinal fluid using Rose Bengal, standard agglutination, indirect immunofluorescent and enzyme-linked immunosorbent assay (ELISA) tests and by blood and CSF culture. All patients had significantly elevated antibody titres. In three Br. melitensis was isolated both from blood and CSF and in a further three from blood only. Eight patients were 30 years old or less and seven were female. Seven patients had a history of contact with livestock and had consumed raw milk. Meningitis occurred in five, meningoencephalitis with hemiplegia in one, paraplegia and cranial nerve palsies in one and psychosis and/or nightmares in three. Transient Parkinsonism was seen in one patient and generalized rigidity and non-Parkinsonian tremors in another. Computerized tomography revealed ventricular dilation in one patient and punctate hyperdense, non-enhancing shadows in the lentiform nuclei in two others. Treatment with a combination of tetracycline, rifampicin and streptomycin was successful.

Hormone profile in lepromatous leprosy. A preliminary study.

In a preliminary study, 11 male patients with lepromatous leprosy were evaluated with regard to endocrinopathy and hormonal status. Basal circulating hormone levels were estimated with a view to correlating the biochemical findings and clinical features. Thyroid hormones T3 and T4, Free Thyroxine Index (FTI), TSH, and cortisol were within normal limits, indicating that further study of these hormones would not be worthwhile. The finding of elevated levels of prolactin as well as the gonadotrophins LH and FSH, however, promises to yield more valuable information if studied in greater detail in a larger group of patients.

Ventricular tachycardia in a patient on dehydroemetine and chloroquine for amoebic liver abscess.

A case of ventricular tachycardia in patient who was being treated with dehydroemetine and chloroquine for amoebic liver abscess is reported. The patient had 15 episodes of this arrhythmia. The hazard of using dehydroemetine and chloroquine in conventional doses, even sequentially, is emphasized.

Coexistence of diabetes and hypothyroidism in South India.

Diabetes mellitus coexisting with primary hypothyroidism is believed to be rare. Seventy-nine such cases were seen between 1960 and 1973. Statistically this association appears to be more frequent than the separate frequencies of the two disease warrant. The patients were mostly females, and invariably obese. Diabetes preceded hypothyroidism in the majority of cases. This frequent association is presumed to be of autoimmune origin.

The influence of protein restriction imposed at various stages of pregnancy on fetal and placental development.

The effect of protein restriction on fetal and placental growth was investigated. Pregnant rats were maintained on an isocaloric diet containing either 23% or 5% protein. The diet was imposed either from days 1-21 of gestation or from days 7-21 of gestation. Fetal body development was assessed. Fetal brain and placental growth were determined by both analysis of organ DNA, RNA and protein and differential radiochemical labelling procedures. Maternal protein restriction inhibited fetal growth. Brain weight was reduced due to a significant decrease in cellular content. Brain cell size was significantly increased and may have accounted for the reduction in cell concentration. Placental growth was similarly impaired. These data demonstrate impaired fetal and placental growth following decreased maternal dietary protein intake. Severity of growth retardation increased with the duration of malnutrition. The results also suggest that malnutrition may affect the rate of development, causing premature cessation of cell division and early cell differentiation.