Wheat containing snowdrop lectin (GNA) does not affect infection of the cereal aphid Metopolophium dirhodum by the fungal natural enemy Pandora neoaphidis.

Studies were carried out to determine if susceptibility of the cereal aphid Metopolophium dirhodum to the fungus Pandora neoaphidis was affected by wheat expressing snowdrop lectin (GNA). Aphid infection did not differ significantly between the transgenic GNA and non-transformed lines (91 and 82%, respectively). Fecundity also did not differ between aphids on the two lines, and was ca. 18 nymphs adult(-1). Time to infection was ca. 5 days for M. dirhodum on both lines in two of three assays. Our results indicate that wheat expressing GNA would not compromise the efficacy of P. neoaphidis as a biocontrol agent.

Clinical profile of polymyositis in Kashmir valley.

OBJECTIVES: The present study is a retrospective and prospective study of 24 cases of idiopathic inflammatory myopathies from Kashmir valley. The study was conducted to depict the clinical profile of polymyositis from this part of the world. METHODS: The diagnosis of polymyositis/dermatomyositis was established by following the criteria of Bohan and Peter (1975). Besides relevant clinical examination, investigations like complete blood count, ESR, muscle enzymes, LE cell phenomenon, antinuclear antibodies and rheumatoid factor were also done. Electrophysiological study and open muscle biopsy was performed in 21 and 24 cases respectively. RESULTS: The mean age at presentation was 34 years with 62.5% cases presenting in fourth decade. Pelvic girdle weakness was observed in all the 24 cases. Male:Female ratio was 1:1.4. Four (16.8%) cases had associated collagen vascular disease. No case was associated with malignancy or childhood vasculitis. Raynauds' phenomenon was seen in seven (29.1%) cases. Creatine phosphokinase and lactic dehydrogenase was elevated in 22 (91.6%) and 12 (50%) cases respectively. Electromyography revealed myopathic features in 74.3% cases. Muscle biopsy revealed features of inflammatory myopathy in 22 (91%) cases. CONCLUSIONS: The conclusions drawn from this study are as follows: a. Younger age at presentation b. Shorter duration of illness at presentation c. Increased frequency of Raynaud's phenomenon as compared to other Indian series. d. No case of polymyositis/dermatomyositis associated with malignancy or childhood vasculitis was seen. e. Biochemical, electrophysiological and histopathological features suggestive of shorter duration of illness were observed.

Clinical profile of headache and cranial neuralgias.

OBJECTIVES: The present study, first of its kind from Kashmir Valley, was conducted on 2982 patients to depict the pattern of various headache types and cranial neuralgias. Besides demographic parameters, various factors influencing the frequency of headaches and cranial neuralgias were also analysed. METHODS: Patients presenting with the chief complaint of headache and facial pain were included in this study. The diagnosis of different headache types and cranial neuralgias were established after following the criteria as devised by the International Headache Society (1988). RESULTS: Mean age at presentation for all headache types/cranial neuralgias was 24.5 years (range 7-74 years) with a male:female ratio of 2:1. Tension headache and migraine was found in 1988 (66.6%) and 407 (13.6%) cases respectively. Cranial neuralgias were observed in 20 (1%) cases. CONCLUSIONS: Tension headache and migraine were the commonest forms of headache disorders. Militancy related stress and handicrafts profession were the main predisposing factors for tension and cervicogenic headaches respectively. Ramadan fasting was the prime precipitating factor for migraine.

Spectrum of neuropsychiatric complications in 791 cases of typhoid fever.

Over a 6-year period, we studied 791 patients with multidrug-resistant typhoid fever, of whom 665 individuals (84%) developed neuropsychiatric manifestations. These were: acute confusional state (73%); myelitis (6%); cerebellitis (1%); parkinsonism (1%); acute psychosis (0.6%); meningo-encephalitis (0.5%); encephalitis (0.25%); sensory motor polyneuropathy, polymyositis, acute schizophrenia and bizarre neurological syndromes (0.12% each). Severe parkinsonian rigidity and meningo-encephalitis are associated with significant morbidity but very low mortality (0.5%).

Hepatic trauma: experience of 110 cases.

A total of 110 patients with hepatic injuries was treated at a major urban trauma centre between June 1988 and December 1991. The mechanism of injury was blunt trauma in 86 patients (78 per cent). Non-operative treatment was given in six patients (5 per cent). Simple hepatorrhaphy, use of topical haemostatic agents or peritoneal drainage alone were performed in 79 (72 per cent) cases. Extensive hepatorrhaphy, hepatotomy with selective vascular ligation, resection and débridement or resection, perihepatic packing and major vascular ligation were undertaken, often in combination, in 25 (23 per cent) cases. Percutaneous arterial embolization was carried out in one case. The mortality rate was 18 per cent. The most frequent postoperative complications related to hepatic injury were intra-abdominal abscess (7 per cent) and coagulopathy (5 per cent); prolonged biliary leak (3 per cent), late haemorrhage (2 per cent) and hepatic necrosis (1 per cent) were also observed.

Ambulatory hydrocele surgery: a review of 50 cases.

In a prospective study, 50 cases of hydrocele were treated by ambulatory surgery. Lord's technique was performed under local anaesthesia. A modified simple scrotal dressing was used to facilitate ambulation. In one case (2%), haematoma was reported. There were no wound infections. Patients tolerated the procedure well and ambulation was excellent in all cases. On the grounds of safety and cost effectiveness, most hydrocele repair procedures should be performed on ambulant patients.

Medical admissions: a confusing disease.

It is strictly for admission to undergraduate medical courses. (i) 50% of seats should be reserved for local candidate on merit of HSC, with academic year starting after the HSC results. (ii) 20% of seats should be reserved for candidates coming from rural areas, on the basis of merit at HSC, with academic year starting after HSC results. (iii) 30% of seats to be filled by an all-India competitive examination. The academic year to start 6 months after the HSC results. A ceiling of minimum number of marks and a minimum number of attempts for eligibility to the all-India PMT would make the conduct of such an examination more practical.

Intra peritoneal rectal tear: delayed presentation in a battered baby.

We report a two and a half year old child who presented with an acute abdomen two days after a spoon was forcefully inserted per rectum. The child recovered after repair of the rectal tear and a temporary sigmoid colostomy.

Delusions of parasitosis.

I have presented a case of delusion of parasitosis, a relatively uncommon psychiatric condition, which was successfully treated with haloperidol.

Fine needle aspiration cytologic diagnosis of metastatic Merkel cell carcinoma in the parotid gland.

A case of Merkel cell (trabecular) carcinoma metastatic to the parotid gland and diagnosed clinically by fine needle aspiration cytology is described. The primary tumor was on the left upper eyelid and had been resected four months earlier. This unusual presentation and the incidence of secondary tumors involving the parotid gland are discussed.

Treatment of acute bacterial infections of the upper respiratory tract.

An open comparative study was carried out to assess the effectiveness of 4 antibiotic regimens in eradicating acute bacterial infections of the upper respiratory tract. Patients in each treatment group had similar physical parameters, severity of disease and bacterial pathogens, and were treated for 10 days with either erythromycin estolate, erythromycin stearate, ampicillin or oxytetracycline in the recommended dosage. Each patient was reviewed daily by physical examination and the bacteriological findings from throat swab and salivary washings. The results showed that erythromycin stearate produced more rapid bacterial eradication and clinical resolution of symptoms and fever than with the other antibiotic preparations, and was well tolerated by most patients.