Partial HELLP syndrome with unilateral exudative retinal detachment treated conservatively

Peripartum vision loss, an uncommon, often reversible complication of pregnancy usually occurs in the setting of pre-eclampsia or eclampsia. The HELLP syndrome is characterized by hypertension, elevated liver enzymes and low platelets. This is a rare case of unilateral exudative retinal detachment associated with the Partial HELLP syndrome that occurred after delivery in a 23-year-old Indian woman. The retinal detachment subsequently reattached with good visual improvement under conservative treatment. This case highlights the importance of early intervention by the ophthalmologist when pregnant women complain about visual symptoms.     

Spontaneous symmetry breaking and the onset of chaos in a muscle model

Abstract

The Hill length-tension curve of a muscle fibre is not linear. This had led us to investigate the behaviour of a model muscle sarcomere. The muscle is modelled as an oscillator of mass m subject to a nonlinear restoring force, a periodic external driving force and friction. We have found that this simple, idealized model exhibits spontaneous symmetry breaking and transition to chaos via a period doubling sequence. This result suggests that the nonlinearity in the length-tension curve of a muscle fibre could be responsible for irregular temporal behaviour and muscle tremor.     

Necrotising Fasciitis of the Neck and Anterior Chest Wall

Maxillary antral mucocoeles have an incidence of only 3–10%. Mucocoeles are more commonly seen in the frontoethmoidal region. We present one such rare case of a 52-year-old lady who came to us with complaints of pain and swelling of the left cheek of 4 months duration. Clinical examination and investigation revealed a giant maxillary sinus mucocoele which was duly treated surgically. We discuss its classical presentation and management since such large mucocoeles are not often seen in the maxillary sinus.     

Alternatives to animal testing: A review

The number of animals used in research has increased with the advancement of research and development in medical technology. Every year, millions of experimental animals are used all over the world. The pain, distress and death experienced by the animals during scientific experiments have been a debating issue for a long time. Besides the major concern of ethics, there are few more disadvantages of animal experimentation like requirement of skilled manpower, time consuming protocols and high cost. Various alternatives to animal testing were proposed to overcome the drawbacks associated with animal experiments and avoid the unethical procedures. A strategy of 3 Rs (i.e. reduction, refinement and replacement) is being applied for laboratory use of animals. Different methods and alternative organisms are applied to implement this strategy. These methods provide an alternative means for the drug and chemical testing, up to some levels. A brief account of these alternatives and advantages associated is discussed in this review with examples. An integrated application of these approaches would give an insight into minimum use of animals in scientific experiments.     

Clinical presentation and diagnostic sensitivity of laboratory tests for Strongyloides stercoralis in travellers compared with immigrants in a non-endemic country

OBJECTIVES: To assess whether the clinical and laboratory methods for diagnosing Strongyloides stercoralis infection in non-endemic countries is different between those who are chronically exposed and those who travel. METHODS: Analysis of laboratory and clinical data from 204 patients having S. stercoralis infection at the Hospital for Tropical Diseases, London. RESULTS: Sixty-four travellers and 128 immigrants from endemic countries had laboratory-proven strongyloides. In those with microscopically proven disease, serology was 73% sensitive in travellers and 98% sensitive in immigrants (P < 0.001). There was no difference in the eosinophil count between the two groups with 19% having a normal count. Patterns of symptoms varied between the groups, and around one-third were asymptomatic in both groups. Serology was of limited use in follow-up. CONCLUSIONS: Eosinophil count and stool microscopy are insufficiently sensitive to be used alone for screening strongyloides. The sensitivity of serology is good in immigrants with chronic infection, but lower in travellers.