Diagnostic value of Elisa serological tests in childhood tuberculosis.

Two separate studies (study I and study II) were conducted to evaluate the efficacy of ELISA serological test for the detection of IgG antibodies against specific glycolipid antigen (PGLTb1) and ESAT 6 antigen of Mycobacterium tuberculosis, respectively. These results were compared with bacteriological tests [Ziehl Neelson (ZN) staining for acid-fast bacilli and culture on Lowenstein Jensen (LJ) medium] and polymerase chain reaction (PCR) targeting IS6110 sequence. Both studies were carried out on children with pulmonary, central nervous system, lymph node, and gastrointestinal tuberculosis along with matching controls (65 cases and 27 controls for study I and 83 cases and 22 controls for study II). Informed consents of their parents or guardians were taken. They were subjected to clinical examination, relevant laboratory investigations, tuberculin test and chest radiograph. Relevant body fluids were subjected to bacteriological tests and PCR. Sera samples were analyzed for antibodies against PGLTbl and ESAT 6 antigen in study I and study II, respectively. ELISA tests showed a significantly higher sensitivity (49% study I; 53%, study II) as compared with LJ medium culture method (15.4%, study I; 28.9% study II) and ZN staining (27.7%, study I; 20.5%, study II) in all patients (p < 0.05). The results were comparable with PCR (40%, study I; 42.2% study II). Specificity of ELISA test was 100% in all the patients except in those with pulmonary disease (92.8%, study I; 84.8%, study II). In view of the convenience, low cost and comparable sensitivity with PCR, these ELISA tests have a promising future in the diagnosis of childhood tuberculosis.

Helical structure of the human umbilical cord.

The helical structure of the human umbilical cord has been studied on 528 full-term cords from normal deliveries, 18 cords from aborted and developmentally normal fetuses with a CR length of 1.2-19.5 cm, 10 cords from monozygotic twins. In order to resolve the discrepancy in the nomenclature of the twist direction, a method has been suggested which takes into account the direction to which the fetus must have rotated to produce the twist. The incidence of the right helical pattern was 64.58%, of the left helical pattern 15.15%, and of the mixed patterns 17.43%; the twists were indeterminate in 1.89% and absent in 0.95% of the cords. Details of the mixed patterns are listed. The number of the uniform right twists ranged from 1 to 29 (7.5) and that of the left twists from 1 to 19 (6.7). There exists an exponential relation between the number of the twists and the ratio between length and thickness of the cords. The twists begin to appear during the early part of the 8th week, and their final number is possibly attained soon after the 9th week of development. In view of the absence of concordance in monozygotic twins, the helical nature of the cord is possibly controlled by factors which may be partly genetic and partly environmental.

Balantidium peritonitis diagnosed on cytologic material.

Balantidium coli were detached in a routine cytologic smear of ascitic fluid. The morphologic features were clearly discernible in the Papanicolaou stained smears.

Primary liposarcoma of the skull.

Only 14 cases of primary liposarcoma of bones have been reported in the available world literature. This is the first report of its origin from the calvaria. The tumor showed excellent response to deep x-ray therapy.