Delayed extensive surgical emphysema after Valsalva manoeuvre post Eustachian tuboplasty.

OBJECTIVE: This paper reports a case of balloon Eustachian tuboplasty with delayed presentation of extensive surgical emphysema. METHODS: This is a clinical case report with a review of literature. RESULTS: Eustachian tube dysfunction is a functional disorder that results in inadequate middle-ear ventilation, causing aural fullness and tinnitus. A 36-year-old male presented with the sudden onset of an isolated, painful, left-sided neck swelling. The patient underwent balloon Eustachian tuboplasty, which was uneventful, but subsequently developed a sudden onset of isolated left-sided neck swelling on the 5th post-operative day during Valsalva manoeuvre. Neck examination revealed extensive crepitus on the left side of the neck. Examination findings were confirmed by imaging. The patient was conservatively managed and subsequently discharged home. CONCLUSION: Balloon Eustachian tuboplasty is a safe procedure; however, extra care must be taken to avoid possible complications. Patients should be counselled against Valsalva manoeuvre and heavy weightlifting. They also should be instructed to sneeze with an open mouth and consider the use of stool softeners.

Design and development of technology for walnut cracking.

The aim of the present study was to design, develop and evaluate hand operated and power driven crackers for walnuts. Kaghazi (thin shelled) and medium shelled walnuts after subjecting to pre-optimized soaking conditions were cracked by developed crackers. Different parameters were evaluated to check the performance of the power operated cracker and hand operated cracker in comparison to manual cracking. 100% shelling coefficient and cracking coefficient value of 1 were recorded in manual and hand operated cracking methods in both Kaghazi and medium shelled walnuts. The coefficient of wholeness was recorded highest in hand operated cracking method in both Kaghazi and medium shelled walnuts. The throughput capacity and effective throughput capacity was highest and labour requirement was least in power operated walnut cracking method followed by manual cracking and hand operated cracking methods in both Kaghazi and medium shelled walnuts. In both Kaghazi and medium shelled walnuts, the butter ball + kernel halve recovery and cracking efficiency was recorded maximum in hand operated cracking method. The economic analysis reveals that both hand operated and power operated crackers can be useful for small to medium scale walnut growers and processing industries.

Cerebral demyelination in children with collagenous colitis.

Collagenous colitis (CC) is a form of microscopic colitis characterized by the presence of inflammatory infiltrate and subepithelial deposition of collagen in the colon and it is a rare condition with a predominant prevalence in the adult population. Only few cases have been reported in children. We report two children with the CC with concomitant neurological manifestations. Both cases demonstrated variable neurological symptoms clinically and significant cerebral demyelination. In both patients, the gastrointestinal manifestations drastically improved with a short course of prednisolone. However, the neurological symptoms were persistent and progressive. To the best of our knowledge, similar association has not been reported in children.

Trend of selected risk factors for hepatitis B infection among the drug addicts in Bangladesh: a five year statistics.

The present retrospective study was conducted by review of records of last five years from 1996 to 2000, among 1497 drug addicts, admitted in a selected drug addicts treatment centre in Dhaka, with an aim to find out the trend of occurrence of hepatitis B infection among the drug addicts, as well as the trend of the risk factors. It was found from the study that during the period of five years, among the total drug addicts, sixty-nine addicts were found to be hepatitis B positive as determined by HBsAg status. The main contributing risk factors were found to be history of exposure to the commercial sex workers (CWS), injecting drug use (IDUs) and needle sharing. It was also found that the trend of hepatitis B infection was gradually falling down among the drug addicts probably due to reduction of the risk factors, especially the injection of drugs. It can be recommended that as a considerable portion of (NUDS) have shown evidence of hepatitis B infection, especially those who were using and sharing needles with others. Therefore, for protecting them from this dreadful infection, drug addicts should be counseled to avoid the above high risk behavior.

Non-syndromic mental retardation segregating with an apparently balanced t(1;17) reciprocal translocation through three generations.

We describe a family in which non-syndromic mental retardation (MR) and an apparently balanced reciprocal translocation, t(1;17)(p36. 3;p11.2) segregates in eight individuals over three generations. Four children showed psychomotor developmental delay, reduced muscle tone, poor coordination, and learning difficulties. The affected adults had a varying range of behavioral problems and difficulties in social adjustment but no abnormal neurological signs. Most of them were functioning at the borderline learning difficulty level in intellectual abilities with additional specific difficulties in reading in two individuals. The Smith-Magenis and 1p36.3 deletion syndromes were excluded. We propose that this reciprocal translocation has disrupted an autosomal gene with an important function in cognitive development, and this family represents a unique resource for the molecular genetic study on non-syndromic MR.

Caroli's disease diagnosed in a child by MRCP.

We describe a case of Caroli's disease associated with a choledochal cyst and autosomal recessive polycystic kidney disease in a child whose diagnosis was confirmed with magnetic resonance cholangiopancreatography (MRCP), after initial abnormalities were seen by ultrasonography. Invasive procedures such as liver biopsy or endoscopic retrograde cholangiopancreatography (ERCP) were, therefore, not necessary. Recent radiological advances in the diagnosis of Caroli's disease with particular emphasis on MRCP are discussed.

Parturient haemoglobinuria in buffaloes--a review.

Parturient haemoglobinuria is a disease of economic importance in buffalo rearing countries in general and in India, Pakistan and Egypt in particular. This study reviews the information on aetiology, epidemiology, clinical aspects and treatment of parturient haemoglobinuria in buffaloes. The body of literature reviewed suggests that phosphorus deficiency in the diet of affected animals plays a major role in causing this disease, although the precise mechanism involved is complex. The possible factors involved and their interplay, plus the clinical picture of affected animals and the results of different preventive and therapeutic regimes are discussed. The study also identifies areas for further research.

Antiatherosclerotic effect of Lipotab Forte in cholesterol-fed rabbits.

The effect of Lipotab Forte, a new polypharmaceutical herbal formulation developed on the principles of the Unani system of medicine, was investigated on the progression of atherosclerosis in cholesterol fed rabbits. Retardation of the progression of atherosclerosis was observed in animals treated with Lipotah Forte. The results were related to changes in the cholesterol content of aorta from the same animal. Blood cholesterol and triglyceride levels were greatly elevated in all rabbits on cholesterol feeding, but were significantly decreased by Lipotab Forte treatment. Lipotab Forte treatment also lowered aorta Thiobarbituric acid reactive substance (TBARS) levels from 79.72 (+/-5.70) to 24.9 (+/-2.04) nmol/g of wet tissue and reduced hepatic cholesterol significantly in hypercholesterolemic rabbits.

Gastric evacuation for acute ethanol intoxication in a three year old.

A three year old girl presented in a deeply comatose state. She had drunk ethanol four hours previously and her blood ethanol concentration on arrival was 79.8 mmol/litre (3.69 g/litre). Because of her young age, high blood ethanol concentration, time since ingestion, and severe neurological depression on presentation, nasogastric aspiration of the stomach contents was performed and 4.2 g of ethanol were removed. She made an uneventful recovery.

A comparison of the skeletal neuromuscular and autonomic ganglion-blocking potencies of five non-depolarizing relaxants.

1 Results from in vitro experiments on the phrenic nerve-diaphragm and the hypogastric nerve-vas deferens preparations of the guinea-pig have been used to plot log concentration-effect curves for skeletal neuromuscular and ganglion blockade, respectively, for (+)-tubocurarine, pancuronium, alcuronium, gallamine and fazadinium (AH 8165). 2 From the log concentration-effect curves, EC50S and equipotent ratios were calculated. The order of neuromuscular blocking potency was pancuronium = alcuronium > (+)-tubocurarine > fazadinium = gallamine. The ratio EC50 for ganglion blockade/EC50 for neuromuscular blockade was 2.3 for fazadinium, 6.7 for (+)-tubocurarine, 22.9 for alcuronium, 24.3 for gallamine and 200.0 for pancuronium. 3 For pancuronium and gallamine there was a range of concentrations below those producing ganglion blockade at which the response of the vas deferens to hypogastric nerve stimulation was augmented. 4 The results are compared with some of those available in the literature, measured on other species by other methods.

Effect of ketamine on transmission in sympathetic ganglia.

The effect of ketamine on sympathetic ganglion transmission has been studied using the guineapig isolated hypogastric nerve-vas deferens preparation. Ketamine produced a dose-dependent depression in the response to preganglionic stimulation (IC50 2.05 X 10--4 mol litre--1). No change in the response to postganglionic stimulation was recorded. The anti-cholinergic activity of ketamine was confirmed using the frog isolated rectus abdominis.

Comparative potency and speed of onset of fazadinium and d-tubocurarine.

The potency and speed of onset of fazadinium and d-tubocurarine have been compared at three cumulative doses. Wtih thiopentone as the induction agent, the dose ratio fazadinium/d-tubocurarine ranged from 1.2 to 1.3 for single twitch reduction and from 1.1 to 1.2 for reduction of tetanus. The times taken for the development of 50% and 100% effect after each dose increment were not significantly different for the three doses of fazadinium and the 2nd and 3nd doses of d-tubocurarine. However, the 1st dose of d-tubocurarine was markedly slower than fazadinium to achieve a 50% and 100% effect.