Intravitam Diagnosis of Rabies in Patients with Acute Encephalitis: A Study of Two Cases.

Rabies is one of the oldest known zoonotic diseases. Rhabdovirus, an RNA virus belonging to the genus Lyssavirus and family Rhabdoviridae, causes rabies. Rabies diagnosis is challenging as the rabies virus remains confined to neurons after the initial animal bite. It largely remains immune-evasive until the infection reaches the central nervous system. The bottleneck in rabies diagnosis remains the non-availability of technical expertise and failure to collect an appropriate sample. The laboratory confirmation of rabies in both antemortem and postmortem samples is important. The samples were tested for anti-rabies antibodies using quantitative ELISA. In this report, two case studies are presented to demonstrate the suitability of ELISA for the intra vitam diagnosis of rabies using cerebrospinal fluid (CSF) as a diagnostic sample. The interpretation of serology results for both vaccinated and unvaccinated individuals has been discussed in detail, which has helped to confirm the antemortem diagnosis of rabies. In this report, we observed that ELISA can be a viable alternative for anti-rabies antibody detection in CSF and can be used as a viable alternative to more technically challenging tests, such as Rapid Fluorescent Focus Inhibition Test (RFFFIT) and Immunofluorescence Assays (IFA).

First-line management of metastatic non-small cell lung cancer: An Indian perspective.

Lung cancer has been the most common cancer in the world for several decades. The non-small cell lung cancer (NSCLC) constitutes approximately about 80% of the total cases of lung cancer. Therapeutic interventions in NSCLC have shifted to the target-based approach from histology-based approach, and this has completely changed the face of the management of NSCLC. Developing countries, such as India, have very limited data compiled about the prevalence and treatment practices of lung cancer, despite a large burden of the disease. However, in recent times, there has been a lot of data generated in this regard. This article is an attempt to collate and shine light on the available data for the first-line treatment of NSCLC in India keeping in mind the current standards of care in this area.

Malignant Catatonia and Neuroleptic Malignant Syndrome in Relation to Disulfiram Overdose.

Disulfiram is a widely used drug in the management of alcohol dependence syndrome as an aversive agent. Although a drug of high efficacy, it has a large number of side effects. Disulfiram-induced catatonia is a known rare side effect of the drug and herein we report a case of what appeared to be the sequential development of malignant catatonia and neuroleptic malignant syndrome in a patient with a diagnosis of alcohol dependence syndrome and co-morbid paranoid schizophrenia following disulfiram overdose. Clinicians need to be vigilant on the emergence of such rare side effects.

Age estimation in Indians from extracted unsectioned teeth.

Teeth are useful indicators of age-at-death and non-destructive methods ensure preservation of dental evidentiary material which could be used for court presentation. No previous data exists on estimating age from extracted teeth per se in Indians. This paper examined four parameters-dental attrition, periodontal ligament (PDL) attachment level, root dentin translucency and root color-on a heterogeneous sample of 106 teeth extracted from as many subjects (age range = 20-78 years). A number of well-established methods that used both visual grading and measurements were utilized in assessing these changes. Linear and stepwise regression analyses revealed low correlation (r/R = 0.05-0.46) and high standard errors of estimate (± 13.1-4.6 years). PDL attachment level graded using the visual criteria showed the strongest correlation (r = 0.45), possibly owing to dietary habits in Indians contributing to consistent gingival recession with aging; dentinal translucency-irrespective of whether they were visually graded or measured-exhibited the lowest correlation (r = 0.05-0.09; p > 0.05), probably due to its diffused appearance on extracted unsectioned teeth, undermining proper delineation. PDL attachment level and attrition entered the stepwise regression analysis (R = 0.46; p < 0.01), implying that age may be estimated 'clinically' without the necessity for tooth extraction; however, low correlation and high error rates preclude its routine usage in forensic cases.