Hemostatic abnormalities in patients with closed head injuries and their role in predicting early mortality.

Abnormalities of blood coagulation are frequently found in patients following traumatic brain injury. Exposure to thromboplastin, which is abundant in brain, plays an important role in initiating coagulopathy. Eighty patients of moderate-to-severe head injury were screened for platelet count, prothombin time (PT), activated partial thromboplastin time (a-PPTK), fibrinogen degradation product levels (FDP), D-dimer levels, and disseminated intravascular coagulation scores (DIC), calculated within the first 24 hours of injury. Increased consumptive coagulopathy at admission, as reflected by high DIC scores, predicted mortality in both moderate and severe head injury patients with a high degree of accuracy (p < 0.001). Similarly, increased PT, FDP, and D-dimer values correlated with higher mortality in both groups, but platelet counts and a-PPTK values correlated with mortality only in the severe head injury group. From this study we conclude that hemostatic abnormalities are independent predictors of early mortality in moderate-to-severe head injury patients.

Histoid, a clinical variant of multibacillary leprosy: report from so-called nonendemic areas

This is a hospital-based study of 25 biopsy-proven cases of histoid leprosy in the arid, northwest Rajasthan region of India. Over an 11-year span, a total of 893 new cases of leprosy were diagnosed at our institution. These 25 histoid cases thus make up 2.8% of our new patients. Various clinical and laboratory observations are summarized and compared to other published series.

Histoid, a clinical variant of multibacillary leprosy: report from so-called nonendemic areas.

This is a hospital-based study of 25 biopsy-proven cases of histoid leprosy in the arid, northwest Rajasthan region of India. Over an 11-year span, a total of 893 new cases of leprosy were diagnosed at our institution. These 25 histoid cases thus make up 2.8% of our new patients. Various clinical and laboratory observations are summarized and compared to other published series.

Cerebral chromoblastomicosis--a rare case report of cerebral abscess and brief review of literature--a case report.

A rare case of Cerebral Chromomycosis caused by chromogenic fungus Cladosporium trichoides in a 35 year old male with classical presentation of cerebral abscess is being presented. The case report lays emphasis on the histological diagnosis of chromogenic fungus in the wall of the abscess cavity, surgically removed from a well delineated circumscribed lesion in the frontal lobe of the cerebrum. The causative fungus could be detected even in unstained paraffin sections. The diagnosis could be made only after surgical removal and histopathological examination. The mycological culture could not be made as the material was received in formaldehyde fixative. The unique features of the case is its recurrence free uneventful survival five years after surgical excision. This is probably the fifth reported case of cerebral chromomycosis from India and first of its type from arid zone of Rajasthan.

Granular cell ameloblastoma of jaw. A report of rare case and brief review of literature.

Ameloblastoma is an epithelial odontogenic tumour of the jaw and exhibits diverse microscopic patterns which occurs either singly or in combination with other patterns. The rare granular cell variant is seen in combination usually with follicular or plexiform subtypes. The reported case reveals the microscopic patterns characteristic of granular cell variant only, which is uncommon. The tumour was excised and no recurrence has been observed after nineteen months of surgery.

Immunoglobulin profile in mycetoma.

Serum samples obtained from 25 patients of mycetoma caused by Madurella mycetomi in 18, Streptomyces somaliensis in 5, Streptomyces madurae and streptomyces palletierii from 1 each and also from 25 healthy controls were evaluated for immunoglobulins IgG, IgM and IgA by radial immunodiffusion method using tripartigen plates. All the three classes of immunoglobulins showed increased concentration in cases of mycetoma by M. mycetomi and S. pelletierii. The raised levels of IgG and IgM in cases of mycetoma caused by S. madurae and S. somaliensis where bones were involved, were not statistically significant. IgA was consistently high in all cases of mycetoma irrespective of causative agent and tissue involved. These alterations may possibly reflect relatively poor IgG and IgM response in individuals with extension of mycetoma lesion to bones.

Cutaneous loxoscelism.

A case of spider bitea presenting as cutaneous loxoscelism is reported. The clinical features and management of spider bite are highlighted and the relevant literature has been reviewed.

Omento-mesentral myxoid hamartoma--a case report.

Omento-mesentral myxoid hamartoma, a very rare lesion seen in children, is reported in a three year old child. Its rarity, problem in its clinical pre-operative diagnosis, its characteristic gross and microscopic features, its benign, non recurrent clinical course is stressed.

A 18 years study of testicular tumours in Jodhpur, western Rajasthan.

The present study based on WHO histologic typing of testicular tumours deals with 100 cases recorded in the files of the Department of Pathology from 1969 to 1987. These tumours accounted for 2.57% malignancies of male genital system. Maximum number of tumours were recorded in the third and fourth decades. Right testis was affected in 60% cases. Scrotal swelling was the predominant presenting feature, followed by pain. Five cases of testicular tumours were observed in undescended testis. Germ cell tumour of one histologic type constituted 76% of testicular tumors. Germ cell tumors of more than one histologic type were 23%. One case (1%) belonged to lymphoid and haemopoietic system and was of large cell lymphocytic lymphoma. Amongst the germ cell tumors with one histologic type, seminoma (34%) and embryonal carcinoma (28%) were predominant while teratocarcinoma was a predominant tumour in combination group.

Renal angiomyolipoma (report of 2 cases).

Renal angiomyolipoma, a rare benign renal neoplasm constitutes less than 3 percent of all renal neoplasm. Two rare cases of renal angiomyolipoma were reported from the Department of Pathology, Dr. S.N. Medical College, Jodhpur in last fifteen years. Both were not associated with tuberous sclerosis. The relevant literature on the subject is reviewed.

Role of phenytoin in healing of large abscess cavities.

The promotion of healing of large abscess cavities attained with topical phenytoin was evaluated in controlled studies of clinical and experimental wounds. In the clinical abscess cavities, phenytoin application in 20 patients compared with conventional treatment in 20 patients resulted in earlier separation of slough, decrease in oedema, control of pain and overall enhanced healing. The mean(s.d.) rate of reduction of wound area was 2.02(0.48) cm2/day in the phenytoin group versus 1.58(0.51) cm2/day in controls (P less than 0.05) on day 10, and 1.8(0.32) cm2/day versus 1.19(0.21) cm2/day (P less than 0.01) on day 20. The mean volume reduction rates at both the 10th and 20th day were 0.48(0.01) cm3/day for phenytoin versus 0.32(0.04) cm3/day for controls; (P less than 0.005). By day 20, 17 of the patients treated with phenytoin were rated as having healed completely, compared with only one of the controls. In a standardized guinea-pig model of the clinical abscess cavity, which included inoculation of the wound with Bacillus proteus and Klebsiella pneumoniae, an enhanced healing rate was also observed (at 7 days 0.40(0.05) cm2/day with phenytoin versus 0.21(0.08) cm2/day in controls; P less than 0.005). All eight of the animals treated with phenytoin healed by day 21, compared with one of the eight controls. Biopsies of wounds treated with phenytoin showed less inflammation, no necrosis, and enhanced neovascularization, collagen deposition and fibroblast proliferation compared to controls. Bacterial colonies also decreased more rapidly with the use of phenytoin.