Hyperdense posterior cerebral artery sign in a setting of spontaneous vertebral artery dissection: a blessing in disguise?

To report a case of a hyperdense posterior cerebral artery [PCA] sign in the setting of spontaneous vertebral artery dissection. A 28-year-old, previously healthy female presented with rapidly progressive coma. A noncontrast computerized tomographic [CT] scan showed a hyperdense PCA sign, which prompted an urgent arteriogram. She was found to have spontaneous vertebral artery dissection with an occluding thrombus. She underwent intra-arterial thrombolysis with tissue plasminogen activator. Follow-up magnetic resonance imaging showed an area of acute infarction in the medial temporal and occipital regions corresponding to the area supplied by the left PCA. The patient was started on systemic anticoagulation therapy with intravenous heparin. She showed slow and continued recovery but was left with significant neurological deficits that required posthospital discharge to a long-term rehabilitation facility. This case showed that the hyperdense PCA sign on a noncontrast CT scan necessitated an emergent CT angiogram that showed vertebral artery dissection and a devastating vascular occlusion. Hence, we suggest an early intervention that may allow for potential revascularization therapy

Mycobacterial culture of fine needle aspirate - a useful tool in diagnosing tuberculous lymphadenitis.

A prospective study was undertaken on suspected lymph node TB (LNTB) patients, to evaluate the diagnostic utility of mycobacterial culture of fine needle aspirate (FNA), in comparison with the cytological examination and acid fast staining. Eighty percent of 157 aspirates studied were positive by cytological examination; 18% by ZN smear and 45% were positive by culture. Twelve aspirates which were negative by cytological features yielded positive mycobacterial cultures; four out of these were from HIV positive patients. Our observations suggest that supplementing FNA cytology with mycobacterial culture would increase the sensitivity of diagnosing LNTB; in addition to giving a highly specific diagnosis.

A study of mycobacterial species causing lymphadenitis.

This prospective study evaluated the non-tuberculous mycobacteria (NTM) cases of lymphadenitis. A total of 76 isolates of mycobacteria were obtained from 200 lymph node aspirates suspected of tuberculosis, 74 of which were Mycobacterium tuberculosis, one was Mycobacterium fortuitum and one Mycobacterium kansasii. These results highlight the importance of NTM in HIV-negative patients as a case of lymphadenitis, and indicates the re-emergence of NTM as potential lymph node pathogens in this part of the country. Further studies on a larger scale are needed to delineate the association between NTM infections in HIV positive and negative subjects.

Bacteriological techniques compliment the clinical and cytological diagnosis of tuberculosis in human immuno deficiency virus infected persons.

Human immunodeficiency virus (HIV) and M. tuberculosis are two intracellular pathogens that interact with each other at both clinical and cellular levels. A known HIV positive case, presentingwith vague pulmonary symptoms followed by bilateral cervical lymphadenopathy, is reported here. The condition was treated as asthma, based on lung symptoms. Cytology revealed acute purulent lymphadenitis. Only Z. N. staining and culture of sputum and lymphnode aspirate could diagnose tuberculosis. Patient responded well to the standard anti tuberculosis treatment.

Giant rheumatoid synovial cyst of the hip joint: diagnosed by MRI.

Synovial cysts are commonly found in the knee joint. Hip Joint is an infrequent site for formation of synovial cysts. The features of a large, synovial cyst on magnetic resonance imaging, occurring in the hip joint, are described.

Subcutaneous and osteolytic rhinosporidiosis.

A young man presented with multiple Subcutaneous nodules over scalp, hand, feet and osteolytic lesions of small bones of hand. Clinically and radiologically he was diagnosed as a case of Giant Cell Tumour. Aspiration cytology and biopsy proved it to be rhinosporidiosis. Epidemiological study revealed that he perhaps contracted this infection as an occupational hazard. This is the third reported case of osteolytic lesions due to rhinosporidiosis. Diagnostic dilemmas of subcutaneous and osteolytic rhinosporidiosis are discussed.

Effects of cimetidine combination with cyclophosphamide in transplanted murine tumors.

Studies were carried out on the combination of Cimetidine (CMTD) with Cytoxan (CTX) in three murine tumors. While the combination significantly potentiated the anticancer effect of CTX in L1210 leukemia, the results with P388 leukemia were not significantly different. The results with Lewis Lung Carcinoma showed a consistent reduction in the number of metastases. However, there was no consistent concomitant prolongation in survival. The host strain, biology of the tumour and the drug used in combination with CMTD might be some of the factors responsible for the varied response.

Combined effect of cyclophosphamide and extracts of Crotalaria and Senecio plants on experimental tumours.

The combined effect of cyclophosphamide (CTX) and extracts of six patients belonging to Crotalaria and Senecio genera was assessed on experimental transplantable S180 (both ascitic and solid forms) tumour. Successive petroleum ether and methanolic extracts from these plants were obtained. The combined administration of CTX and petroleum ether extract of C. albida and the methanolic extracts of C. albida, S. chrysanthemoides, S. densiflorus and S. jacquemontianus led to prolonging the life span of S180 (ascitic) tumour bearing mice. The data indicate that the most effective extract in combination with CTX was the methanolic extract of S. chrysanthemoides. The extracts alone had no effect on survival of tumour-bearing mice. The same extracts and the same combinations had no effect on S180 solid tumour.

Inability of amphotericin B(Fungizone) or of sodium deoxycholate to alter natural drug resistance or sensitivity of transplanted murine leukemias.

The ability of Amphotericin B ('Fungizone') to alter the natural resistance of leukemia L1210 to vincristine was studied in BDF1 mice Neither Fungizone nor the "solubilizing agent" sodium deoxycholate, when used in combination with vincristine potentiated the activity of the drug against L1210. There was no change in the activity pattern of 5-fluorouracil against L1210 or vincristine against P388 lymphocytic leukemia respectively, which are sensitive to these drugs. Thus, both Fungizone and sodium deoxycholate failed to improve the activity of the drugs in either a naturally resistant or sensitive murine leukemia in vivo.

Anti tumour and pharmacological effects of the oil from Semecarpus anacardium Linn. f.

Semecarpus anacardium Linn.f. nuts were extracted by using non-polar and polar organic solvents. Hot methanol extract and a resinous fraction, isolated from it, showed antitumour activity against P388 lymphocytic leukaemia in BDF1 mice as judged by their median survival time. Petroleum ether extract and its chromatographically isolated fraction were obtained. The latter fraction was distilled under reduced pressure to get an orange-coloured oil, (b.p. 200-20 degrees/2-3 mm). Both had antitumour activity. The orange-coloured oil, on further distillation under reduced pressure, yielded Bhilawanol. An acetyl derivative of the oil was also obtained. The latter two also had antitumour activity.