Myocarditis and hemiplegia from scorpion bite--a case report.

A 16 year old boy presenting with features of myocarditis and pulmonary oedema following scorpion sting developed hemiplegia with patchy vasculitic lesions on CT scan. The possible pathogenic mechanism is discussed.

Diagnostic significance of T I < T III and TV1 > TV6 signs in ischaemic heart disease.

One hundred seventy patients with ischaemic heart disease (IHD) and 141 healthy controls were evaluated to assess the diagnostic significance of T I < T III and TV1 > TV6 as compared to widening of QRS-T angle. Number of cases with abnormal widening of QRS-T angle was significantly higher (P < .001) in frontal and horizontal planes in the IHD group. T I < T III sign has 61.2% sensitivity, 74.5% specificity and 25.5% false positivity in diagnosis of IHD. Along with abnormal QRS-T angle widening it gave a specificity of 95.5% but a false positivity of 35% and a low sensitivity index (35.3%). TV1 > TV6 sign has sensitivity, specificity and false positivity of 72.9% 84.4% and 15.6% respectively. Combining it with abnormally wide QRS-T angle did not materially improve these indices. Combining T I < T III and TV1 > TV6 signs gives a sensitivity of 49.4%, specificity of 95% and false positivity of 5% in IHD. This is a good diagnostic index and can be assessed at a quick glance without cumbersome estimation of QRS-T angle.

Contrast computed tomography in epilepsy with special reference to intracranial ring or disc enhancing lesions.

We report the results of computed tomography (CT) in 170 patients who developed seizures. Localized signs could be demonstrated by neurologic examination in 23.5%. CT findings were normal in 64 patients (37.6%). The commonest abnormality was a focal ring or disc enhancing lesion in 66 patients (62.3%) followed by calcification (18 patients; 16.9%), cerebral atrophy (9; 8.5%), vascular lesions (7; 6.6%), tumours (4; 3.8%) and congenital hydrocephalus (2; 1.9%). The occurrence of abnormal CT was higher (74.3%) in patients with partial seizures.

Complete intraventricular dissociation. Electrocardiographic manifestation of a rare intracardiac complete dissociation.

Complete Intraventricular Dissociation manifesting as dual ventricular rhythm was observed on surface electrocardiography in two middle-aged males with acute myocardial infarction. The first patient had a dominant accelerated (AV) junctional rhythm, and there was a sudden emergence of an additional independent slow and regular idioventricular escape rhythm. These ventricular complexes were bizarre and markedly widened, waveform with prolonged undulating electric potentials. In the second case, the emergence of a dominant idioventricular rhythm was coexistent with an additional independent escape rhythm with monophasic wider agonal ventricular complexes. Terminal tracings recorded later were essentially the same, except that an ill sustained ventricular fibrillation had replaced the ectopic agonal beats, and there was an enhanced automaticity in the dominant ventricular part. The sites of ectopic ventricular rhythms were thought to be in the ischaemic damaged ventricular myocardium, with a surrounding zone of conduction block.

A study of urinary creatinine and creatinine coefficient in healthy young adults.

Daily urinary creatinine excretion and creatinine coefficient of eighty-four healthy medical students have been studied for three consecutive days. Daily creatinine excretion has been observed to be higher in the male subjects compared to the female counterparts. Creatinine excretion has been observed to be dependent on body weight of the subjects. The variability from subject to subject was higher than observed by most other workers. Day to day consistency within the same subject was rather low. Creatinine coefficient was computed per kg of body weight as well as per kg of lean body weight. In both the cases, it has been found to be higher in the males than in the females. Though an important factor, yet body weight of a subject alone could not explain satisfactorily wide variability of creatinine excretion in the present study. The possible influencing factors have been discussed along with clinical implications.