External clues to inner malformations.

A malformation is a morphological defect of an organ, or a larger region of the body resulting from an intrinsically abnormal developmental process. In this analysis of 1421 neonatal autopsies performed between 1984 and 1993, 243 (17.1%) cases showed malformations. The data was analysed to find external cues to internal malformations. Twenty three (85%) of the 27 neonates with various facial abnormalities had associated internal malformations in the form of cardiac (n = 11; 40%), renal (n = 7; 25%), or gastrointestinal (n = 3; 11%) abnormalities and diaphragmatic hernia (n = 2). Sixty seven neonates had neural abnormalities. These were associated with cardiac (n = 7; 10%), renal (n = 12; 18%) or gastrointestinal (n = 7; 10%) abnormalities; 43 cases, however, did not have any associated malformations. Renal malformations (n = 66) had highest association with skeletal abnormalities (n = 9; 22%). As many as 45(76%) of the 59 cases with cardiac abnormalities had no external anomalies. Five cases of hypoplastic lungs were seen, all associated with external malformations.

Paraproteins and plasma cell dyscrasias.

Serum protein electrophoresis done on 1100 patients with various diseases in one year demonstrated M-band in 31 patients. Most (87%) had the classical features of plasma cell dyscrasia (PCD), however a few had unusual presentations which are highlighted. A 22-year-old male operated for a massive tumour of the scapula clinically diagnosed as chondrosarcoma revealed plasmacytoma with amyloid on histology. Another case of kala-azar presented with features akin to that of PCD and one case had dual malignancies. Such a high incidence of PCDs with varied picture in a short time is not usually seen in other parts of this country; a fact which may be due to lack of awareness.

Antral diaphragm with achalasia cardia.

A 50-year-old woman presented with gastric inlet and outlet obstruction due to achalasia cardia and antral mucosal diaphragm, respectively. The diagnosis was based on typical radiological features, endoscopy and full-thickness histology of biopsy at postmortem.

Malignant rhabdoid tumour of kidney. A case report.

A case of malignant rhabdoid tumour of kidney is reported. Interesting features are bony metastasis at presentation and FNAB diagnosis of metastasis.

Malpighian corpuscles of spleen in infancy and childhood.

In early infancy splenic white pulp is seen arranged around the central arterioles. They do not show any reactive changes even in the presence of systemic infections. Lymphoid follicles are seen at 6 weeks of life. Germinal centres appear from the 8th week of life onwards. Periarteriolar lymphocytic sheaths persist in the older children along with the reactive changes.

Outbreak of Salmonella worthington meningitis & septicaemia in a hospital at Chandigarh (north India).

During August 1988 an outbreak of hospital acquired infection due to S. worthington has been reported at the Nehru Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh. A total of seven neonates presented with the clinical features of meningitis and septicaemia during this outbreak and six babies died. S. worthington was isolated from blood and cerebrospinal fluid respectively. The same strains were isolated from the baby warmer mattress, baby cot, suction machine bottle and wall of the fridge. Samples from doctors, nurses and apparently healthy babies born during this period did not grow the above organism. This appears to be the first report on S. worthington in human beings from India. The outbreak was controlled by thorough cleaning and fumigation. The organisms were also mostly sensitive to antibiotics used, in contrast to the multiple drug resistant pattern reported from elsewhere.