Leptomeninges as a site of relapse in locally controlled,diffuse pontine glioma with review of literature

Case report Leptomeningeal involvement in diffuse intrinsic brain stem gliomas is rarely diagnosed clinically and in majority of the instances diagnosed only on postmortem examination. We report two cases of diffuse pontine glioma diagnosed clinicoradiologically and treated with conventional radiotherapy.Observations On follow-up, both patients showed clinical features suggestive of meningeal spread although imaging for pontine tumor showed stable disease. Leptomeningeal disease in the spine was confirmed on imaging and in one case by cerebrospinal fluid examination also. During the follow-up of patients with pontine glioma, the possibility of leptomeningeal involvement must be borne in mind.     

Efficacy of various methods in evaluation of eustachian tube function

In the present study 35 patients with preforated and 15 cases with intact ear drums, were studied and eustachian tube function was assessed by Saccharine test. Bortnick-Miller test, and manual impedance audiometry. The merits and demerits of one over the other were evaluated. It was observed thal more than one test when employed provides better information as every test has its own advantages and limitations     

Role of Bengal gram (Cicer arietinum) seed coat as an antiatherogenic agent in rabbits.

Bengal gram seed coat appeared to be a potent hypocholesterolemic/hypolipidemic agent in rabbits. When fed to hypercholesterolemic rabbits, it lowered hepatic cholesterol/lipid much more than in the control group. Aortic lipid levels were rather marginally increased but the increase was less in Bengal gram seed coat fed rabbits. Though seed coat of Bengal gram failed to prevent the development of atherosclerosis in hypercholesterolemic rabbits, but certainly it slowed down the process of its development. The hypocholesterolemic action of Bengal gram seed coat appeared to be due to the increased catabolism and excretion of cholesterol.     

Cases of buprenorphine abuse in India.

Buprenorphine was introduced as a potent analgesic with low abuse potential. Reports of buprenorphine abuse by opiate abusers have accumulated over the years, highlighting its use as a cheap alternative to heroin. The lower potency compared with heroin is being compensated by using a cocktail of buprenorphine with benzodiazepines or cyclizine. This study of 18 cases seen over 3 years broadly confirms these findings. Four cases reported haematemesis during acute withdrawal, a symptom not reported in earlier studies.     

Postoperative Intravenous Drip Infusion is not Required after Minilaparotomy Cholecystectomy

Objective: To determine if drip infusion should be discontinued after full recovery of the patient from anaesthesia after minilaparotomy cholecystectomy in uncomplicated cases.Design: A randomised controlled clinical trial on 60 patients, from the waiting list, of cholelithiasis/cholecystitis operated by minilaparotomy cholecystectomy between November 1995 to March 1996. 30 patients did not receive postoperative IV drip infusion and in 30 patients 12–24 hours of standard drip transfusion was continued according to the current practice.Setting: Single Surgical Unit, SS Hospital, Banaras Hindu University, Varanasi, India.Main outcome measure: Recognition of clinical indication for continuation of. IV drip infusion after full recovery from anaesthesia.Results: In the cohorts of 30 patients each who were or were not given IV drip infusion after full recovery from anaesthesia following minilaparotomy cholecystectomy the observations on pulse rate, blood pressure, time to first voiding of urine and time to start first oral intake of fluids were identical. However postoperative urinary retention occured in 6 (20%) patients in whom the IV drip infusion was given.Conclusion: There is no clinical indication to continue IV drip infusion after full recovery from anaesthesia in patients operated for minilaparotomy cholecystectomy.     

Serum ceruloplasmin in acute myocardial infarction.

Serum ceruloplasmin levels were estimated in 81 patients within one week after an attack of acute myocardial infarction. A total of 126 healthy subjects were taken as controls and investigated for this copper containing protein. Results showed that there is an elevation in the levels of serum ceruloplasmin in patients as compared to the controls. Ceruloplasmin levels showed a return to almost normal values in 54 follow-up cases of acute myocardial infarction during the fourth week after infarction.     

An experimental study on development of gallstone disease after curative gastrectomy for cancer--postoperative alteration of the composition of canine gallbladder bile after subtotal gastrectomy with truncal vagotomy]

In connection with gallstone (GS) formation after gastrectomy for cancer, we examined alteration of the composition of gallbladder bile after subtotal gastrectomy with truncal vagotomy. Of 11 mongrel dogs with cholecystostomy, 3 underwent B-I and 4 B-II gastrectomy. Four dogs without gastrectomy were served as controls. Bile was collected for 12 months. Bile acids were quantified by GLC. The bile was cultured for bacteriology. TBA did not significantly differ among the three groups of the dogs. In the two gastrectomized groups, CDA (a secondary bile acid) kept a higher level and CA (a primary bile acid) maintained a lower concentration compared with those in the controls. A remarkable increase of non-conjugated bile acids was recognized in both gastrectomized groups. Lithogenicity was low for all of the 3 groups. All but 1 control dog incurred bile infection that persisted long. Black pigment stones containing calcium bilirubinate developed in 1 of the 3 B-I and 2 of the 4 B-II dogs but none in the controls. The bile infection seemed to be involved in the development of GS. As the alteration of bile composition and GS occurred solely in the gastrectomized dogs, subtotal gastrectomy with truncal vagotomy might precipitate the GS formation.