Ameliorating Effects of Thyroxine and Atropine in Phosphamidon Intoxicated Chick Embryos

lNTRODUCTIONPhosphamidon(l-chloro-l-N,N-diethylcarban1oyl-lpropen-2-yl-dimethylphosphate)-isanorganophosphateinsecticideusedinagricultureagainstplantpests(Worthing,.l987).Ithasbeenreportedthat,i11additiontoitsinsecticidalpropeI-ty,itcausesalterationindini-trogenfixationandmetabolismincyanobacteriumPCC7ll9(Peronaetal.,l99l);residu-altoxicitytotheadultsofLiPaPhiserysimi(JagadishandDhinpo,l99l);changesinvita-ndnCcontentofhepatopancrea,gillandfootoftomellidenscondanus(KulkarniandKe-shava…     

Keratitis, ichthyosis, deafness (KID) syndrome-the first report from India

A patient with the keratitis, ichthyosis and deafness (KID) syndrome is described. The patient had recurrent skin infections which led to complete scalp hair loss. The nails were dystrophic. Physical development was normal; however, his intelligence was subnormal. The erythro-keratodermatous plaques over the face, trunk and extremities were characteristic and the skin in general was dry and hyperkeratotic. Palms and soles showed marked thickening with a stippled appearance.     

Trans-ethmoidal optic nerve decompression

Blunt head injury frequently results in visual impairment, the optimal treatment of which is still debated. Over a 5-year-period (1987–1991) 111 patients with indirect optic nerve injury resulting from closed head trauma have been treated. In each case loss of vision was the only neurological deficit. In group A, 66 patients were initially treated with large doses of prednisolone (80 mg/day) for 3 weeks. Twenty-seven patients improved on steroids alone. In the remaining 39 patients in whom either unsatisfactory or no improvement occurred a transethmoidal optic nerve decompression was performed. Twenty-two patients in the latter group improved, thus yielding an overall improvement rate of 74.2% in group A. Group B (control), in which 45 patients were treated with prednisolone only (80 mg/day for 3 weeks), had an overall improvement rate of 51% (23 patients). The study reveals that while nearly half of such patients can improve on steroids alone, optic nerve decompression significantly improves recovery rates in patients where conservative treatment is unsatisfactory (P < 0.05). Total loss of vision not responding to steroids, absence of waveform on visual evoked response, and presence of an optic canal fracture indicate a poor prognosis.     

Human Botulism Caused by Clostridium Botulinum Type E: The Birmingham Outbreak

Four elderly patients developed botulism following ingestionof tinned Alaskan salmon contaminated with Clostridium botulinumtype E. Severe skeletal muscle paralysis, occurring within 18hours in peripheral, respiratory and facial, extrinsic ocularand pharyngeal muscles, resulted in progressive respiratoryfailure, ptosis, loss of eye movements, dysphonia and dysphagia.In addition, the development of intestinal ileus, loss of vagalcardiac control, hypotension and lack of vasomotor responseto either postural change, stimulation by cold or the Valsalvamanoeuvre indicated dysfunction of both parasympathetic andsympathetic nervous systems. Sensation was unimpaired and noalteration of consciousness occurred despite the presence ofextensive abnormal delta activity in the EEGs of all patients. The diagnosis of botulism was confirmed by demonstration ofCl. botulinum type E toxin in the serum of all four patientsand in salmon remnants from the suspect tin, in which Cl. botuilnumtype E spores were also identified. Standard supportive intensive care and antitoxin therapy werecomplemented by the use of a novel neuromuscular blockade antagonist,4-aminopyridine. This agent was shown by electromyography tobe effective in restoring neuromuscular transmission and, clinically,to produce almost complete reversal of peripheral paralysis.However, this effect was transient and there was no detectableeffect on respiratory muscle. Administration of 4-aminopyridineby constant infusion produced sustained improvement in peripheralmuscle power, but there was no additional effect on respiratorymuscle, and convulsive phenomena occurred following treatment.Despite these latter problems, 4-aminopyridine produced a greaterresponse in peripheral muscle than might have been expectedwith guanidine and further studies, possibly with less neurotoxicanalogues, are indicated.