Interaction between Bean and Colletotrichum gloeosporioides: Understanding Through a Biochemical Approach.

In addition to its role in animals, nowadays nitric oxide (NO) is considered as an emerging signaling molecule in plant systems. It is now believed that NO exerts its pivotal role in various plant physiological processes, such as in seed germination, plant developmental stages, and plant defense mechanisms. In this study, we have taken an initiative to show the biochemical basis of defense response activation in bean leaves during the progression of Colletotrichum gloeosporioides (Penz.) Penz. and Sacc. in detached bean leaves. Stages of pathogen penetration and colonization were successfully established in the detached bean leaves. Results showed up-regulation of different defense-related enzymes and other defense molecules, such as phenols, flavonoids, callose, and lignin molecules, along with NO at early stages of pathogen invasion. Although in the later stages of the disease, development of NO and other defense components (excluding lignin) were down-regulated, the production of reactive oxygen species in the form of H2O2 became elevated. Consequently, other stress markers, such as lipid peroxidation, proline content, and chlorophyll content, were changed accordingly. Correlation between the disease index and other defense molecules, along with NO, indicate that production of NO and reactive oxygen species (ROS) might influence the development of anthracnose in common bean.

Portal hypertension related to light chain deposition disease of liver: an enlightening experience.

A 55-year-old alcoholic man presented with firm hepatomegaly, ascites and markedly elevated alkaline phosphatase. He had a history of pulmonary tuberculosis. Work-up for malignancy was negative. Histological examination of liver showed extracellular deposition of pink amorphous material which is Congo red stain negative. Deteriorating renal function and nephrotic-range proteinuria were noted. Renal histology showed thickening of the glomerular and tubular basement membranes by non-congophilic deposits along with mesangial expansion. Bone marrow examination revealed patchy areas of pink amorphous deposits which are Congo red stain negative. Immunohistochemical staining of amorphous depositions in liver, kidney and bone marrow were positive for κ light chains. Serum-free light chain assay confirmed markedly elevated free κ-light chain. κ-light chain deposition disease is a systemic disease with universal renal involvement but rarely it presents as chronic cholestatic liver disease with portal hypertension and frequently associated with fatal outcome due to diagnostic delay.

Autoimmune hepatitis in a teenage boy: 'overlap' or 'outlier' syndrome--dilemma for internists.

An 18-year-old boy presented with upper gastrointestinal bleeding and jaundice. Investigations revealed coarse hepatomegaly, splenomegaly and advanced oesophageal varices. Blood reports showed marked rise of alkaline phosphatase and more than twofold rise of transaminases and IgG. Liver histology was suggestive of piecemeal necrosis, interphase hepatitis and bile duct proliferation. Antinuclear antibody was positive in high titre along with positive antismooth muscle antibody and antimitochondrial antibody. The patient was positive for human leukocyte antigen DR3 type. Although an 'overlap' syndrome exists between autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC), a cholestatic variant of AIH, a rare 'outlier' syndrome could not be excluded in our case. Moreover, 'the chicken or the egg', AIH or PBC, the dilemma for the internists continued. The patient was put on steroid and ursodeoxycholic acid with unsatisfactory response. The existing international criteria for diagnosis of AIH are not generous enough to accommodate its variant forms.

Treatment of hypertrophic osteoarthropathy in the case of pulmonary metastasis secondary-to-nasopharyngeal carcinoma with zoledronic acid: an enlightening experience.

We describe a case of 23-year-old man, who presented with painful hypertrophic pulmonary osteoarthropathy involving bilateral upper and lower extremities, resulting from intrathoracic metastasis. The patient had a history of undifferentiated nasopharyngeal carcinoma which was treated successfully 2 years ago. The painful osteoarthropathy had made the patient incapacitated. A single dose of 4 mg of intravenous zoledronic acid (ZA) was given which resulted in complete resolution of pain along with reduction of swelling. There was no recurrence on follow-up. Bisphosphonates by their action on bone metabolism might alleviate the symptoms and its use should be encouraged in cancer patients with debilitating arthropathies. This article aims at highlighting the role of bisphosphonates, particularly ZA in managing patients with hypertrophic osteoarthropathy (HOA) and sharing our experience with this drug because of the rarity of the condition and lack of sufficient data in the medical literature.

An unusual cause of haemoptysis: a diagnostic challenge for clinicians.

A 32-year-old male patient presented with haemoptysis in the background of high-grade fever for 3 weeks. Chest examination and x-ray were suggestive of right-sided moderate pleural effusion. On finding tender hepatomegaly in abdominal examination, an ultrasonography of abdomen was performed which was suggestive of ruptured hepatic abscess. Cytological examination of both sputum and aspirate from hepatic abscess showed neutrophilic debris mixed with red blood cells. The serological test for antibody to Entamoeba histolytica was positive. Computerised tomography-guided trans-tracheal fistulogram demonstrated presence of hepato-bronchial fistula. Our case responded to conservative management. Follow-up ultrasonography after 6 months showed total abolition of abscess cavity and sealing of bronchial connection. Amoebic liver abscess complicating into hepato-bronchial fistula is thought to be an obsolete entity in contemporary world. But possibility of amoebic liver abscess should be kept in mind while managing a patient of haemoptysis in appropriate clinical setting in endemic areas.

Seckel syndrome with asymptomatic tonsillar herniation and congenital mirror movements.

Seckel syndrome is a rare genetic disorder of recessive inheritance characterized by prenatal-onset growth retardation, abnormally small head, varying degrees of mental retardation and an unusual ''beak-like'' protrusion of the nose. Additionally, it is associated with multiple organ system anomalies, including that of the central nervous system. An 8-year-old male child with typical features of Seckel syndrome and asymptomatic cerebellar tonsillar herniation diagnosed by magnetic resonance imaging associated with congenital mirror movements of the upper extremities is described. The child, additionally, had agenesis of the corpus callosum. Previously reported central nervous system anomalies associated with congenital mirror movements include corpus callosal agenesis and cranio-vertebral anomalies, both of which were present in this child. To the best of our knowledge, this is the first report of congenital mirror movements occurring in association with Seckel syndrome.

Acute Wilson disease associated with E beta-thalassemia.

We report on an 11-year-old girl with concomitant Ebeta thalassemia (EbetaT) and Wilson disease (WD). She was diagnosed with EbetaT at 2 years of age, but the coexistence of WD could only be established at 11 years. The diagnosis of the later was based on the clinical presentation of hepatitis and severe Coomb's negative hemolytic anemia, coupled with laboratory evidence of WD. To our knowledge, this is the first report on the cooccurrence of EbetaT and WD. As both the conditions are associated with variable degrees of hemolysis, WD in the setting of EbetaT may remain masked and consequently remain undiagnosed for a long time. Sudden, severe hemolysis in a patient of thalassemia may be explained by the coexistence of additional pathology, in this case WD.

Splenic abscess as a complication of enteric fever.

A rare and unrecognized complication of enteric fever is splenic abscess. We report two cases of childhood enteric fever complicated by splenic abscess (one solitary and the other multiple).