Traumatic anterior dislocation of the hip joint with posterior acetabular wall fracture

The incidence of traumatic hip dislocation has increased in recent years as a result of high-energy trauma. Anterior hip dislocation forms less than 10-15% of all traumatic hip dislocations. Only a few case reports describe anterior dislocation along with acetabular fractures. The acetabular fracture involved the anterior wall or column in all such cases. We describe a rare case in which anterior superior dislocation of the hip was associated with a large fracture fragment of theposterior acetabular rim and adjacent wall.     

Botryoid rhabdomyosarcoma of common bile duct

Common bile duct is an unusual site for occurrence of botryoid rhabdomyosarcoma. Clinically it is often misdiagnosed as infectious hepatitis. Early diagnosis and treatment has greatly improved the prognosis of this aggressive neoplasm. Here the authors present a case report of Bortroyid Rhabdomyosarcoma of CBD in a two and half year old child masquerading as obstructive jaundice     

Annual risk of tuberculous infection in rural areas of Junagadh district

Paucity of epidemiological data on tuberculosis in India prompted the National Tuberculosis Institute, Bangalore to embark upon a nation-wide survey to estimate the Annual Risk of Tuberculosis Infection in different parts of the country. The survey in Junagadh district, one of the 26 districts drafted under the nation-wide survey is reported here. The prevalence of infection from the analysis of 3164 children not displaying scars of the BCG vaccination was 4.16% (CI: 3.17-5.14) and from this data the ARI was computed as 0.73% (CI: 0.55-0.91). The inclusion of vaccinated children into the study group yielded similar results. The estimate of the ARI in Junagadh district is lesser than that in several other parts of India which is probably in consonance with its better socio-economic development.     

Epidemiological situation of tuberculosis in India

Epidemiological information on tuberculosis (TB) is vital for planning the control strategies in addition assessing the impact of intervention programmes. The survey findings by ICMR revealed the prevalence of sputum positive pulmonary TB is about 4 per 1000 population and an estimated 1.5 million infectious cases spreading infection in the community. Studies conducted by the National Tuberculosis Institute, Bangalore revealed similar diseases prevalence of sputum positive pulmonary TB. The annual risk of tuberculous infections defined as the probability of acquiring new infection with tubercle bacilli over a period of one year is the key parameter for the epidemiological study in developing countries. It is estimated that there are about 4.6 lakhs death in the country every year with one person dying every minute. The average annual risk of tuberculous infection is about 1.7%. The prospects of decreasing TB case now look good provided that all TB cases have access to the DOTS strategy by bringing the remaining uncovered half of the population under RNTCP.     

Tuberculin test

Although tuberculin test is widely used for detection ot tuberculous infection among children, there is no clear understanding about its performance and interpretation. This article has been written with the purpose of elucidating the performance and interpretation of standard tuberculin test, based on the experiences gained at the National Tuberculosis Institute, Bangalore and other centres. The standard tuberculin test involves intradermal injection of "ITU PPD RT23 with Tween 80’ on the mid-volar aspect of forearm and measurement of the maximum transverse diameter of induration after 3 days. Larger the size of induration, higher is the probability of it being due to tuberculous infection. The majority of reactions with induration size of 15 mm and above are attributable to infection with tubercle bacilli, irrespective of BCG-vaccination status. While indurations of less than 5 mm indicate absence of any kind of tuberculin sensitivity, the majority of indurations in 5–9 mm range are usually of non-tuberculous nature. An induration of 10–14 mm requires more careful interpretation. It is more likely to be attributable to infection with tubercle bacilli in case of history of contact with smear positive case or among children with clinical findings of tuberculosis. However, the size of induration in an infected child may be diminished in the presence of immuno-suppressive conditions. One should also consider the purpose of the test while interpreting the test results.     

The group II metabotropic glutamate receptor agonist, DCG-IV, alleviates akinesia following intranigral or intraventricular administration in the reserpine-treated rat

1. This study examined whether activation of group II metabotropic glutamate (mGlu) receptors in the substantia nigra pars reticulata (SNr) could reverse akinesia in a rodent model of Parkinson's disease (PD). 2. Male Sprague Dawley rats, stereotaxically cannulated above either the SNr or third ventricle, were rendered akinetic by injection of reserpine (5 mg kg-1 s.c.). Eighteen hours later, the rotational behaviour induced by unilateral injection of the group II mGlu receptor agonist, (2S,2'R,3'R)-2-(2',3'-dicarboxycyclopropyl)glycine (DCG-IV), was examined. 3. Following intranigral injection, DCG-IV (0.125-0.75 nmol in 0.1 microliter) produced a dose-dependent increase in net contraversive rotations (n = 6-8 animals per dose), reaching a maximum of 395 +/- 51 rotations 60 min-1 after 0.75 nmol. The effects of DCG-IV (0.5 nmol) were inhibited by 63.0 +/- 9.0% following 30 min pre-treatment with the group II mGlu receptor antagonist, (2S)-alpha-ethylglutamic acid (EGLU; 100 nmol in 0.2 microliter; n = 6). 4. Following intraventricular injection, DCG-IV (0.125-1.5 nmol in 2 microliters) produced a dose-dependent increase in bilateral locomotor activity (n = 6-7 animals per dose), reaching a maximum of 180 +/- 21 locomotor units 30 min-1 after 0.5 nmol. Pre-treatment with EGLU (200 nmol in 2 microliters) inhibited the effects of DCG-IV (0.5 nmol) by 68.2 +/- 12.3% (n = 5). 5. These data show that activation of group II mGlu receptors in the SNr provides relief of akinesia in the reserpinized rat model of PD. The reversal seen following intraventricular administration supports the likely therapeutic benefit of systemically-active group II mGlu receptor agonists in PD.